American Journal of Law & Medicine

ERISA: plan reimbursement from personal injury settlement not subject to attorney fees off-set or "make whole" doctrine - Harris v. Harvard Pilgrim Health Care, Inc.

ERISA: Plan Reimbursement from Personal Injury Settlement Not Subject to Attorney Fees Off-Set or "Make Whole" Doctrine--Harris v. Harvard Pilgrim Health Care, Inc.(1)--The United States Court of Appeals for the First Circuit held that Harvard Pilgrim Health Care (HPHC) was entitled to reimbursement from the personal injury settlement obtained by its plan members, Michael Harris and Wendy Harris, but HPHC would not be obligated to pay a pro rata share of the Harrises' attorney fees that accrued as a result of the personal injury settlement.(2)

After Michael Harris was injured in a motorcycle accident, HPHC paid $102,874 in medical costs pursuant to the ERISA plan. Subsequently, the Harrises sued the party responsible for the accident. Thereafter, HPHC, according to the subrogation provision in the Harrises' ERISA plan, filed a state-law lien against any award that the Harrises might obtain from the suit. …

Log in to your account to read this article – and millions more.