ERISA-Eleventh Circuit Rules That Action By The Defendant To Stop Benefit Payments Causes The Statute Of Limitations On Filing Suit To Start Running

In Witt v. Metropolitan Life Insurance Co., No. 14-11349 (11th Cir. 2014), the Eleventh Circuit Court of Appeals (the “Court”) was asked to determine whether the plaintiff Don Witt’s lawsuit, seeking to recover disability benefits allegedly due from May 1997 to the present, is barred by the applicable statute of limitations and, if so, whether the defendants waived that statute-of-limitations defense.

In this case, from May 18, 1972, until December 29, 1994, Witt worked as a senior operations specialist with Shell Oil Company. In connection with his employment, Witt gained access to short-term and long-term disability insurance through the Shell Oil Long Term Disability Plan (the “Plan”), whose long-term disability claims are administered by Metropolitan Life (“MetLife”). In January, 1997, Witt filed a claim for disability benefits based on a number of medical problems. MetLife approved this claim. However, on May 22, 1997, MetLife terminated Witt’s claim, effective May 1, 1997, for failure to provide adequate supporting medical records. After filing an unsuccessful appeal with MetLife in 2011, which MetLife entertained as a “courtesy review” but denied, Witt brought this suit for reinstatement of the benefits in 2012.

In analyzing the case, the Court said that, because Congress did not specify a limitations period for a claim-of-benefits ERISA action, district courts must apply the forum state’s statute of limitations for the most closely analogous action. The applicable statute here is Alabama’s six-year statute of limitations. Federal law determines when the statute begins to run. Witt contends the limitations period did not begin to run until May 4, 2012, when MetLife issued a final, conclusive, and written decision denying him benefits following the courtesy review. In response, MetLife contends that the limitations period began to run when MetLife stopped making monthly payments to Witt because, at that point, Witt knew or should have known that his claim had been denied.

The Court said that, as in this case, in the absence of a final or formal denial, an ERISA cause of action accrues–and the limitations period begins to run–when the claimant has reason to know that the claim administrator has clearly repudiated the claim or amount sought. MetLife’s conduct-failing to provide benefits on or after May 1, 1997- demonstrated a clear and continuing repudiation of Witt’s rights, and therefore caused the six year statute of limitations to start running (and expire well before 2012). Witt’s claim is thus time-barred. Further, MetLife’s subsequent courtesy review in 2011 did not restart the statutory clock. Additionally, MetLife did not waive any defense based on the statute of limitations by failing to specify untimeliness as a basis for denying the claim after its courtesy review.

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