ERISA-District Court Rules That One Year Limit Contained In The Plan For Bringing Suit Is Extended By State Insurance Law

In Halpern v. Blue Cross/Blue Shield of Western New York, No. 12-CV-407S (W.D. New York 2014), the plaintiff, Burce J. Halpern (“Halpern”), brought this suit, under ERISA section 502 against defendant, Blue Cross/Blue Shield of Western New York (“Blue Cross”), following the denial by Blue Cross of reimbursement claims under an insured group health benefits plan (the “Plan”).

One issue which the district court faced was whether Halpern’s suit is timely. Blue Cross argues that Halpern ‘s suit is time-barred under the Plan’s contractual limitations period because this period is one year, and Halpern filed his ERISA suit over one year from the last date for which he claimed benefits. The district court said that, since ERISA contains no statute of limitations for actions brought under section 502, such claims are subject to the most analogous state statute of limitations. In New York, courts typically apply the six-year limitations period for contract actions set forth in N.Y. Civil Practice Law and Rules. This limitations period may be shortened, where the parties memorialize such agreement in writing.

However, New York Insurance Law states that the limitations period in an insured arrangement cannot be less than two years following the time proof of loss is required by the arrangement. Since the Plan is insured, it is subject to this requirement, and ERISA preemption does not apply. Here, Halpern brought this suit on April 23, 2012, so that medical services from August 2010 to April 2011 for which he now seeks reimbursement fall within the applicable limitations period.