This agreement states that the injured party will reimburse the plan for the funds advanced upon recovery of a judgment or settlement from the third party. Benefits, however, may be advanced only if the injured party executes an "Acts of Third Party" Agreement. Fruit of the Loom indicated that it would advance the medical benefits to Jeffrey McInnis, but only if he executed an "Acts of the Third Party" agreement as specified in the plan.įruit of the Loom Group Medical Plan does not provide coverage for injuries caused by a third party. Lori McInnis concededly was covered by the plan as an employee of a subsidiary. The welfare benefit plan, which provided group life insurance and medical benefits for employees of Fruit of the Loom and its subsidiaries, was sponsored by Fruit of the Loom and issued by Provident Life and Accident Insurance Company ("Provident Life"). 4 Following the settlement, Jeffrey McInnis submitted a claim in the amount of $58,121 to the welfare benefit plan provided by Lori McInnis' employer, Martin Mills, Inc., a subsidiary of Fruit of the Loom, Inc., for reimbursement of hospital expenses incurred by Lori McInnis before her death. 28A-13-3(a)(23), finding the settlement total of $200,000 to be "in the best interest of the Estate of Lori Smith McInnis, and the beneficiaries of said Estate, to wit: Jeffrey Charles McInnis and the minor, Joshua H. On the petition of Jeffrey McInnis as the administrator, the Superior Court in Richmond County, North Carolina, approved the settlement, as required by the North Carolina's wrongful death statute, N.C.Gen.Stat. 3 The insurance company covering Hinson offered to settle any claims against Hinson for the policy limit of $25,000, and the insurance company covering the McInnis vehicle offered to settle a claim under that company's underinsurance coverage for $175,000. She was survived by her husband, who was appointed the administrator of her estate, and by a three- year-old child. Two weeks later, she died from her injuries. Jeffrey McInnis' wife, Lori McInnis, who was riding in the passenger's seat, was seriously injured and hospitalized. ![]() McInnis was struck head-on by an automobile operated by Leon Hinson, who was intoxicated at the time. 2 * On February 26, 1990, in Moore County, North Carolina, an automobile driven by Jeffrey C. ![]() For the reasons that follow, we hold that in the circumstances of this case ERISA preempts the operation of the North Carolina statute. The questio n presented here is whether the employee benefit plan must pay medical benefits to the estate of a deceased plan participant and be denied reimbursement under the North Carolina statute or, in the alternative, whether the North Carolina statute is preempted by ERISA. 28A-18-2, however, places a limit on such reimbursement from the estate of a deceased. North Carolina's wrongful death statute, N.C.Gen.Stat. 1 The employee benefit plan sponsored by Fruit of the Loom, Inc., provides medical benefits to employees for injuries caused by third parties, provided that any employee making a claim agrees to reimburse the plan if the employee recovers payment from the third party.
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