No. 19-980

Ariana M. v. Humana Health Plan of Texas, Inc.

Lower Court: Fifth Circuit
Docketed: 2020-02-05
Status: Denied
Type: Paid
Response RequestedResponse WaivedRelisted (2) Experienced Counsel
Tags: attorney-fees beneficiary-rights civil-rights employee-benefits erisa fee-award health-plan judicial-review legal-success legal-victory standard-of-review
Key Terms:
AdministrativeLaw Arbitration ERISA SocialSecurity Privacy JusticiabilityDoctri
Latest Conference: 2020-06-18 (distributed 2 times)
Question Presented (AI Summary)

Whether a beneficiary achieves 'some success on the merits' for purposes of a fee award under ERISA Section 502(g)(1) when she obtains a significant legal victory that increases the likelihood of a favorable benefits determination and that benefits other plan participants and beneficiaries, regardless of whether benefits are ultimately awarded

Question Presented (from Petition)

QUESTION PRESENTED Section 502(g)(1) of the Employee Retirement Income Security Act of 1974 (“ERISA”) provides that “[i]Jn any action under this subchapter * * * by a participant, beneficiary or fiduciary, the Court in its discretion may allow a reasonable attorney’s fee and costs of the action to either party.” 29 U.S.C. 1132(g)(1). This Court, in Hardt v. Reliance Standard Life Ins. Co., 560 U.S. 242 (2010), held that to be eligible for an award of attorney’s fees under this statutory provision, an applicant need not be a “prevailing party,” id. at 252, but rather need only achieve “some success on the merits.” Id. at 256. Petitioner Ariana M. was a beneficiary under an ERISA-covered healthcare plan insured and administered by Respondent Humana Health Plan of Texas, Inc. “Humana”). She sought, to no avail, benefits under the plan covering mental health treatment that she underwent in 2013. In 2018, after a district court in Texas and a panel of the Fifth Circuit upheld Humana’s denial of her claim under a deferential standard of review, Petitioner obtained a favorable decision from the en banc Fifth Circuit reversing its decades-old precedent and remanding her claim to the district court for de novo consideration of Respondent’s denial. On remand, the district court again concluded that Respondent correctly denied Petitioner’s claim for benefits, and denied Petitioner’s request for attorney’s fees for the work leading up to the en banc decision. The Fifth Circuit affirmed. The question presented is whether a beneficiary achieves “some success on the merits” for purposes of a fee award under ERISA Section 502(g)(1) when she obtains a significant legal victory that increases the likelihood of a favorable benefits determination and that benefits other plan participants and beneficiaries, regardless of whether benefits are ultimately awarded. (i)

Docket Entries

2020-06-22
Petition DENIED.
2020-06-02
DISTRIBUTED for Conference of 6/18/2020.
2020-05-29
Reply of petitioner Ariana M. filed. (Distributed)
2020-05-15
Brief of respondent Humana Health Plan of Texas, Inc. in opposition filed.
2020-03-24
Motion to extend the time to file a response is granted and the time is extended to and including May 15, 2020.
2020-03-23
Motion to extend the time to file a response from April 15, 2020 to May 15, 2020, submitted to The Clerk.
2020-03-16
Response Requested. (Due April 15, 2020)
2020-03-04
DISTRIBUTED for Conference of 3/20/2020.
2020-03-01
Waiver of right of respondent Humana Health Plan of Texas, Inc. to respond filed.
2020-02-05
Petition for a writ of certiorari filed. (Response due March 6, 2020)

Attorneys

Ariana M.
Elizabeth HopkinsKantor & Kantor, LLP, Petitioner
Elizabeth HopkinsKantor & Kantor, LLP, Petitioner
Humana Health Plan of Texas, Inc.
Carlos R. SolteroSoltero Sapire Murrell PLLC, Respondent
Carlos R. SolteroSoltero Sapire Murrell PLLC, Respondent