Fourth Circuit Tweaks Statute of Limitations Rules for ERISA Benefit Claims.

ERISA itself does not contain a statute of limitations for filing a lawsuit for benefits, nor does it specify when such a claim begins to accrue. Nevertheless, in the Fourth Circuit, it is well-settled that a Court should borrow from the forum state’s statute of limitations applicable to an analogous claim (such as breach of contract) to arrive at the limitations period. The accrual date, on the other hand, is governed by federal common law: In general, a benefit claim accrues after administrative remedies have been exhausted and the claim has been formally denied. White v. SunLife Assurance Co., 488 F. 3d 240 (4^th Cir. 2007). In White, the plan language provided that any lawsuit must be filed within three years after proof of claim is required. Under this language, the Court held, the plan’s time limit conceivably could run before the claim was formally denied. Because a claimant is required to exhaust administrative remedies before he can file suit, (Makar v. Carefirst, 872 F 2d 80 (4^th Cir. 1989)), the Court found that the plan language impermissibly “starts the clock [running] before the participants can even file suit.” Id., at 247. The Court therefore held that plan language could not trump federal common law with respect to the accrual starting date.

The Fourth Circuit recently fine-tuned the rule in White. In Belrose v. Hartford, 2012 U.S. App. Lexis 7506 (4^th Cir. (April 13) 2012),the Fourth Circuit affirmed the District Court, (2010 U.S. Dist. Lexis 121254 (E.D. Va. 2010)) which allowed the plan’s language to trump the forum state’s limitations statute, even if the plan’s time limit was shorter, and even if the accrual date under the plan language was invalid. In Belrose, plan language similar to the plan language in White was at issue: The plan required a lawsuit to be filed within three years after proof of loss was required. The Fourth Circuit, in affirming the District Court, followed White ’s holding that the claimant’s cause of action would not begin to accrue until after his administrative remedies were exhausted and the claim had been finally denied, but the Court held that the three-year limitations period specified in the plan applied, rather than the forum state’s five-year statute of limitations.

Another recent tweaking of the statute of limitations was made by the District Court in Maryland, in Wallace v. Freight Drivers Pension Fund, 2012 U.S. Dist. Lexis 53724 (D. Md. (April 17), 2012). In Wallace, the plaintiff retired in 2003 and began receiving pension benefits. In September of 2006, he notified the plan that his benefits were miscalculated, and requested the additional amount. He proceeded through the administrative process, which culminated in the plan’s final denial on July 30, 2008. On July 27, 2011, just shy of the three year limitation period, the plaintiff filed a lawsuit. The plan argued that the statute of limitations accrued when the plaintiff first received benefits in 2003, and therefore his benefit claim was time-barred. The plaintiff argued that his claim did not begin to accrue until after the final formal denial. The Court rejected both arguments under the circumstances, finding that the accrual of plaintiff’s claim began under the “discovery rule”: When the claimant knew or reasonably should have known that the calculation was incorrect.