Nathan Vercellino v. Optum Insight, Inc., et al.

The Eighth Circuit affirmed the district court’s grant of Summary Judgment in favor of Optum Insight, Inc., United Healthcare Services, Inc., and Ameritas Holding Company Health Plan (“the Plan”) holding the plan’s language allowed reimbursement for medical expenses paid while the petitioner, Nathan Vercellino, was a minor child, and for which his parents were responsible under Nebraska law. Neither the parents nor the Plan filed a timely lawsuit against the tortfeasor. Because the statute of limitations has run on the parents’ claim, the medical expenses are no longer recoverable. Nathan, now an adult, filed a lawsuit against the tortfeasor for his general damages. The plan sought reimbursement from any recovery made by Nathan in his current suit, for the $600,000.00 in medical expenses paid, although recovery for those medical expenses is time barred and, accordingly, not part of Nathan’s current claim for damages. This case expands the question examined by this Court in Montanile: Can an ERISA fiduciary claim an equitable lien for medical expenses paid for the benefit of the parents against a judgment or settlement of their child, who was a minor at the time those benefits accrued, and, as a matter of law, can never recover those medical expenses as damages.