ERISA-Eleventh Circuit Holds That Plaintiff Did Not Timely File Her Claim For Long Term Disability Benefits And Is Not Entitled To Toll The Applicable Limitations Period
In Wilson v. The Standard Insurance Company, No. 14-10825 (11th Cir. 2015) (Unpublished Opinion), Harriet Wilson appeals the district court's grant of summary judgment in favor of Standard Insurance Company on her ERISA claim for long term disability benefits.
In this case, the grant of judgment against Wilson was based on her failure to file her lawsuit within the three-year period prescribed in the governing disability policy. She filed thirty-four months after that period expired. She contends that the running of the three-year contractual limitations period should be equitably tolled for the thirty-four months that her lawsuit was late, because Standard's letter denying her claim did not give her notice that the policy imposed a three-year limitations period instead of the six-year period for contract actions that would otherwise have been borrowed from state law. She argues that the contractual limitations period should be equitably tolled until the date she filed her lawsuit because Standard violated an ERISA regulation that required it to provide in the claim denial letter notice of the time limit for filing a lawsuit.
In analyzing this case, the Eleventh Circuit Court of Appeals (the "Court") noted that ERISA does not provide a statute of limitations for suits, such as this one, brought under § 502(a)(1)(B) of ERISA to recover benefits. Thus, a court borrows the most closely analogous state limitations period, unless the parties have contractually agreed to a different one in the ERISA plan. In case of such agreement, the court will follow the plan's limitations provision, unless it determines either that the period is unreasonably short, or that a controlling statute prevents he limitations provision from taking effect. The Court ruled that neither of the two exceptions apply here.
As to Wilson's equitable tolling argument, the Court said that, in this case, the policy's contractual limitations period is enforceable, unless Wilson can establish that she is entitled to equitable tolling, by showing both extraordinary circumstances and diligence in pursuing her rights. In this case, Wilson did not show the required diligence, since she failed to either investigate basic issues that are relevant to her claim or proceed with the claim in a reasonably prompt fashion. Wilson could have requested a copy of the policy, which was central to her claim, and one of whose terms was the contractual limitations period. Her lawsuit easily could have been timely filed if she had exercised even minimal diligence in discovering the terms of the policy. As such, the Court affirmed the district court's summary judgment.