US AIRWAYS, INC., IN ITS CAPACITY AS FIDUCIARY AND PLAN ADMINISTRATOR OF THE US AIRWAYS, INC. EMPLOYEE BENEFITS PLAN v. MCCUTCHEN ET AL.
No. 11-1285
SUPREME COURT OF THE UNITED STATES
April 16, 2013
569 U. S. ____ (2013)
CERTIORARI TO THE UNITED STATES COURT OF APPEALS FOR THE THIRD CIRCUIT
NOTE: Where it is feasible, a syllabus (headnote) will be released, as is being done in connection with this case, at the time the opinion is issued. The syllabus constitutes no part of the opinion of the Court but has been prepared by the Reporter of Decisions for the convenience of the reader. See United States v. Detroit Timber & Lumber Co., 200 U. S. 321, 337.
SUPREME COURT OF THE UNITED STATES
Syllabus
US AIRWAYS, INC., IN ITS CAPACITY AS FIDUCIARY AND PLAN ADMINISTRATOR OF THE US AIRWAYS, INC. EMPLOYEE BENEFITS PLAN v. MCCUTCHEN ET AL.
CERTIORARI TO THE UNITED STATES COURT OF APPEALS FOR THE THIRD CIRCUIT
No. 11-1285. Argued November 27, 2012—Decided April 16, 2013
The health benefits plan established by petitioner US Airways paid $66,866 in medical expenses for injuries suffered by respondent McCutchen, a US Airways employee, in a car accident caused by a third party. The plan entitled US Airways to reimbursement if McCutchen later recovered money from the third party. McCutchen‘s attorneys secured $110,000 in payments, and McCutchen received $66,000 after deducting the lawyers’ 40% contingency fee. US Airways demanded reimbursement of the full $66,866 it had paid. When McCutchen did not comply, US Airways filed suit under
1. In a
(a)
(b) Sereboff‘s logic dooms McCutchen‘s argument that two equitable doctrines meant to prevent unjust enrichment—the double-recovery rule and common-fund doctrine—can override the terms of an ERISA plan in such a suit. As in Sereboff, US Airways is seeking to enforce the modern-day equivalent of an equitable lien by agreement. Such a lien both arises from and serves to carry out a contract‘s provisions. See 547 U. S., at 363-364. Thus, enforcing the lien means holding the parties to their mutual promises and declining to apply rules—even if they would be “equitable” absent a contract—at odds with the parties’ expressed commitments. The Court has found nothing to the contrary in the historic practice of equity courts. McCutchen identifies a slew of cases in which courts applied the equitable doctrines invoked here, but none in which they did so to override a clear contract that provided otherwise. This result comports with ERISA‘s focus on what a plan provides:
2. While McCutchen‘s equitable rules cannot trump a reimbursement provision, they may aid in properly construing it. US Airways’ plan is silent on the allocation of attorney‘s fees, and the common-fund doctrine provides the appropriate default rule to fill that gap. Pp. 12-16.
(a) Ordinary contract interpretation principles support this conclusion. Courts construe ERISA plans, as they do other contracts, by “looking to the terms of the plan” as well as to “other manifestations of the parties’ intent.” Firestone Tire & Rubber Co. v. Bruch, 489
(b) US Airways’ reimbursement provision precludes looking to the double-recovery rule in this manner because it provides an allocation formula that expressly contradicts the equitable rule. By contrast, the plan says nothing specific about how to pay for the costs of recovery. Given that contractual gap, the common-fund doctrine provides the best indication of the parties’ intent. This Court‘s cases make clear that the doctrine would govern here in the absence of a contrary agreement. See, e.g., Boeing Co. v. Van Gemert, 444 U. S. 472, 478. Because a party would not typically expect or intend a plan saying nothing about attorney‘s fees to abrogate so strong and uniform a background rule, a court should be loath to read the plan in that way. The common-fund rule‘s rationale reinforces this conclusion: Without the rule, the insurer can free ride on the beneficiary‘s efforts, and the beneficiary, as in this case, may be made worse off for having pursued a third party. A contract should not be read to produce these strange results unless it specifically provides as much. Pp. 13-16.
663 F. 3d 671, vacated and remanded.
KAGAN, J., delivered the opinion of the Court, in which KENNEDY, GINSBURG, BREYER, and SOTOMAYOR, JJ., joined. SCALIA, J., filed a dissenting opinion, in which ROBERTS, C. J., and THOMAS and ALITO, JJ., joined.
NOTICE: This opinion is subject to formal revision before publication in the preliminary print of the United States Reports. Readers are requested to notify the Reporter of Decisions, Supreme Court of the United States, Washington, D. C. 20543, of any typographical or other formal errors, in order that corrections may be made before the preliminary print goes to press.
SUPREME COURT OF THE UNITED STATES
No. 11-1285
US AIRWAYS, INC., IN ITS CAPACITY AS FIDUCIARY AND PLAN ADMINISTRATOR OF THE US AIRWAYS, INC. EMPLOYEE BENEFITS PLAN, PETITIONER v. JAMES E. MCCUTCHEN ET AL.
ON WRIT OF CERTIORARI TO THE UNITED STATES COURT OF APPEALS FOR THE THIRD CIRCUIT
[April 16, 2013]
JUSTICE KAGAN delivered the opinion of the Court.
Respondent James McCutchen participated in a health benefits plan that his employer, petitioner US Airways, established under the
This Court has held that a health-plan administrator like US Airways may enforce such a reimbursement provision by filing suit under
I
In January 2007, McCutchen suffered serious injuries when another driver lost control of her car and collided with McCutchen‘s. At the time, McCutchen was an employee of US Airways and a participant in its self-funded health plan. The plan paid $66,866 in medical expenses arising from the accident on McCutchen‘s behalf.
McCutchen retained attorneys, in exchange for a 40% contingency fee, to seek recovery of all his accident-related damages, estimated to exceed $1 million. The attorneys sued the driver responsible for the crash, but settled for only $10,000 because she had limited insurance coverage and the accident had killed or seriously injured three other people. Counsel also secured a payment from McCutchen‘s own automobile insurer of $100,000, the maximum amount available under his policy. McCutchen thus received $110,000—and after deducting $44,000 for the lawyer‘s fee, $66,000.
On learning of McCutchen‘s recovery, US Airways demanded reimbursement of the $66,866 it had paid in medical expenses. In support of that claim, US Airways relied on the following statement in its summary plan description:
“If [US Airways] pays benefits for any claim you incur
as the result of negligence, willful misconduct, or other actions of a third party, . . . [y]ou will be required to reimburse [US Airways] for amounts paid for claims out of any monies recovered from [the] third party, including, but not limited to, your own insurance company as the result of judgment, settlement, or otherwise.” App. 20.1
McCutchen denied that US Airways was entitled to any reimbursement, but his attorneys placed $41,500 in an escrow account pending resolution of the dispute. That amount represented US Airways’ full claim minus a proportionate share of the promised attorney‘s fees.
US Airways then filed this action under
The Court of Appeals for the Third Circuit vacated the District Court‘s order. The Third Circuit reasoned that in a suit for “appropriate equitable relief” under
We granted certiorari, 567 U. S. ____ (2012), to resolve a circuit split on whether equitable defenses can so override an ERISA plan‘s reimbursement provision.2 We now
II
A health-plan administrator like US Airways may bring suit under
In Sereboff v. Mid Atlantic Medical Services, Inc., we allowed a health-plan administrator to bring a suit just like this one under
The question in this case concerns the role that equitable defenses alleging unjust enrichment can play in such a suit. As earlier noted, the Third Circuit held that “the principle of unjust enrichment” overrides US Airways’ reimbursement clause if and when they come into conflict. 663 F. 3d, at 677. McCutchen offers a more refined version of that view, alleging that two specific equitable doctrines meant to “prevent unjust enrichment” defeat the reimbursement provision. Brief for Respondents i. First, he contends that in equity, an insurer in US Airways’ position could recoup no more than an insured‘s “double recovery“—the amount the insured has received from a third party to compensate for the same loss the insurance covered. That rule would limit US Airways’ reimbursement to the share of McCutchen‘s settlements paying for medical expenses; McCutchen would keep the rest (e.g., damages for loss of future earnings or pain and suffering), even though the plan gives US Airways first claim on the whole third-party recovery. Second, McCutchen claims that in equity the common-fund doctrine would have operated to reduce any award to US Airways. Under that rule, “a litigant or a lawyer who recovers a common fund for the benefit of persons other than himself or his client is entitled to a reasonable attorney‘s fee from the fund as a whole.” Boeing Co. v. Van Gemert, 444 U. S. 472, 478 (1980). McCutchen urges that this doctrine, which is designed to prevent freeloading, enables him to pass on a
We rejected a similar claim in Sereboff, though without altogether foreclosing McCutchen‘s position. The Sereboffs argued, among other things, that the lower courts erred in enforcing Mid Atlantic‘s reimbursement clause “without imposing various limitations” that would “apply to truly equitable relief grounded in principles of subrogation.”5 547 U. S., at 368 (internal quotation marks omitted). In particular, the Sereboffs contended that a variant of the double-recovery rule, called the make-whole doctrine, trumped the plan‘s terms. We rebuffed that argument, explaining that the Sereboffs were improperly mixing and matching rules from different equitable boxes. The Sereboffs asserted a “parcel of equitable defenses” available when an out-of-pocket insurer brought a “freestanding action for equitable subrogation,” not founded on a contract, to succeed to an insured‘s judgment against a third party. Ibid. But Mid Atlantic‘s reimbursement
In the end, however, Sereboff‘s logic dooms McCutchen‘s effort. US Airways, like Mid Atlantic, is seeking to enforce the modern-day equivalent of an “equitable lien by agreement.” And that kind of lien—as its name announces—both arises from and serves to carry out a contract‘s provisions. See id., at 363-364; 4 S. Symons, Pomeroy‘s Equity Jurisprudence §1234, p. 695 (5th ed. 1941). So enforcing the lien means holding the parties to their mutual promises. See, e.g., Barnes, 232 U. S., at 121; Walker v. Brown, 165 U. S. 654, 664 (1897). Conversely, it means declining to apply rules—even if they would be “equitable” in a contract‘s absence—at odds with the parties’ expressed commitments. McCutchen therefore cannot rely on theo-
We have found nothing to the contrary in the historic practice of equity courts. McCutchen offers us a slew of cases in which those courts applied the double-recovery or common-fund rule to limit insurers’ efforts to recoup funds from their beneficiaries’ tort judgments. See Brief for Respondents 21-25. But his citations are not on point. In some of McCutchen‘s cases, courts apparently applied equitable doctrines in the absence of any relevant contract provision. See, e.g., Washtenaw Mut. Fire Ins. Co. v. Budd, 208 Mich. 483, 486-487, 175 N. W. 231, 232 (1919); Fire Assn. of Philadelphia v. Wells, 84 N. J. Eq. 484, 487, 94 A. 619, 621 (1915). In others, courts found those rules to comport with the applicable contract term. For example, in Svea Assurance Co. v. Packham, 92 Md. 464, 48 A. 359 (1901)—the case McCutchen calls his best, see Tr. of Oral Arg. 47-48—the court viewed the double-recovery rule as according with “the intention” of the contracting parties; “[b]road as [the] language is,” the court explained, the agreement “cannot be construed to” give the insurer any greater recovery. 92 Md., at 478, 48 A., at 362; see also Knaffl v. Knoxville Banking & Trust Co., 133 Tenn. 655, 661, 182 S. W. 232, 233 (1916); Camden Fire Ins. Assn. v. Prezioso, 93 N. J. Eq. 318, 319-320, 116 A. 694, 694 (Ch. Div. 1922). But in none of these cases—nor in any other we can find—did an equity court apply the double-recovery or common-fund rule to override a plain
Nevertheless, the United States, appearing as amicus curiae, claims that the common-fund rule has a special capacity to trump a conflicting contract. The Government begins its brief foursquare with our (and Sereboff‘s) analysis: In a suit like this one, to enforce an equitable lien by agreement, “the agreement, not general restitutionary principles of unjust enrichment, provides the measure of relief due.” Brief for United States 6. Because that is so, the Government (naturally enough) concludes, McCutchen cannot invoke the double-recovery rule to defeat the plan. But then the Government takes an unexpected turn. “When it comes to the costs incurred” by a beneficiary to obtain money from a third party, “the terms of the plan do not control.” Id., at 21. An equity court, the Government contends, has “inherent authority” to apportion litigation costs in accord with the “longstanding equitable common-fund doctrine,” even if that conflicts with the parties’ contract. Id., at 22.
But if the agreement governs, the agreement governs: The reasons we have given (and the Government mostly accepts) for looking to the contract‘s terms do not permit an attorney‘s-fees exception. We have no doubt that the common-fund doctrine has deep roots in equity. See Sprague v. Ticonic Nat. Bank, 307 U. S. 161, 164 (1939) (tracing equity courts’ authority over fees to the First Judiciary Act). Those roots, however, are set in the soil of unjust enrichment: To allow “others to obtain full benefit from the plaintiff‘s efforts without contributing . . . to the litigation expenses,” we have often noted, “would be to enrich the others unjustly at the plaintiff‘s expense.” Mills v. Electric Auto-Lite Co., 396 U. S. 375, 392 (1970); see Boeing, 444 U. S., at 478; Trustees v. Greenough, 105 U. S. 527, 532 (1882); supra, at 6-7 and n. 4. And as we have just explained, principles of unjust enrichment give way
The result we reach, based on the historical analysis our prior cases prescribe, fits lock and key with ERISA‘s focus on what a plan provides. The section under which this suit is brought “does not, after all, authorize ‘appropriate equitable relief’ at large,” Mertens, 508 U. S., at 253 (quoting
III
Yet McCutchen‘s arguments are not all for naught. If the equitable rules he describes cannot trump a reimbursement provision, they still might aid in properly construing it. And for US Airways’ plan, the common-fund doctrine (though not the double-recovery rule) serves that function. The plan is silent on the allocation of attorney‘s fees, and in those circumstances, the common-fund doctrine provides the appropriate default. In other words, if US Airways wished to depart from the well-established common-fund rule, it had to draft its contract to say so—and here it did not.7
Ordinary principles of contract interpretation point toward this conclusion. Courts construe ERISA plans, as they do other contracts, by “looking to the terms of the plan” as well as to “other manifestations of the parties’
The reimbursement provision at issue here precludes looking to the double-recovery rule in this manner. Both the contract term and the equitable principle address the same problem: how to apportion, as between an insurer and a beneficiary, a third party‘s payment to recompense an injury. But the allocation formulas they prescribe differ markedly. According to the plan, US Airways has first claim on the entire recovery—as the plan description states, on “any monies recovered from [the] third party“; McCutchen receives only whatever is left over (if anything). See supra, at 3. By contrast, the double-recovery rule would give McCutchen first dibs on the portion of the recovery compensating for losses that the plan did not cover (e.g., future earnings or pain and suffering); US Airways’ claim would attach only to the share of the recov-
By contrast, the plan provision here leaves space for the common-fund rule to operate. That equitable doctrine, as earlier noted, addresses not how to allocate a third-party recovery, but instead how to pay for the costs of obtaining it. See supra, at 7. And the contract, for its part, says nothing specific about that issue. The District Court below thus erred when it found that the plan clearly repudiated the common-fund rule. See supra, at 4. To be sure, the plan‘s allocation formula—first claim on the recovery goes to US Airways—might operate on every dollar received from a third party, even those covering the beneficiary‘s litigation costs. But alternatively, that formula could apply to only the true recovery, after the costs of obtaining it are deducted. (Consider, for comparative purposes, how an income tax is levied on net, not gross, receipts.) See Dawson, Lawyers and Involuntary Clients: Attorney Fees From Funds, 87 Harv. L. Rev. 1597, 1606-1607 (1974) (“[T]he claim for legal services is a first charge on the fund and must be satisfied before any distribution occurs“). The plan‘s terms fail to select between these two alternatives: whether the recovery to which US Airways has first claim is every cent the third party paid or, instead, the money the beneficiary took away.
Given that contractual gap, the common-fund doctrine provides the best indication of the parties’ intent. No one can doubt that the common-fund rule would govern here in the absence of a contrary agreement. This Court has “recognized consistently” that someone “who recovers a common fund for the benefit of persons other than himself” is due “a reasonable attorney‘s fee from the fund as whole.” Boeing Co., 444 U. S., at 478. We have understood that rule as “reflect[ing] the traditional practice in
IV
Our holding today has two parts, one favoring US Airways, the other McCutchen. First, in an action brought under
It is so ordered.
SUPREME COURT OF THE UNITED STATES
No. 11-1285
US AIRWAYS, INC., IN ITS CAPACITY AS FIDUCIARY AND PLAN ADMINISTRATOR OF THE US AIRWAYS, INC. EMPLOYEE BENEFITS PLAN, PETITIONER v. JAMES E. MCCUTCHEN ET AL.
ON WRIT OF CERTIORARI TO THE UNITED STATES COURT OF APPEALS FOR THE THIRD CIRCUIT
[April 16, 2013]
JUSTICE SCALIA, with whom THE CHIEF JUSTICE, JUSTICE THOMAS, and JUSTICE ALITO join, dissenting.
I agree with Parts I and II of the Court‘s opinion, which conclude that equity cannot override the plain terms of the contract.
The Court goes on in Parts III and IV, however, to hold that the terms are not plain and to apply the “common-fund” doctrine to fill that “contractual gap,” ante, at 14. The problem with this is that we granted certiorari on a question that presumed the contract‘s terms were unambiguous—namely, “where the plan‘s terms give it an absolute right to full reimbursement.” Pet. for Cert. i. Respondents interpreted “full reimbursement” to mean what it plainly says—reimbursement of all the funds the Plan had expended. In their brief in opposition to the petition they conceded that, under the contract, “a beneficiary is required to reimburse the Plan for any amounts it has paid out of any monies the beneficiary recovers from a third-party, without any contribution to attorney‘s fees and expenses.” Brief in Opposition 5 (emphasis added). All the parties, as well as the Solicitor General, have treated that concession as valid. See Brief for Petitioner 18, and n. 6; Brief for Respondents 29; Brief for United States as Ami-
I would reverse the judgment of the Third Circuit.
