Third Circuit: Remand Order to Administrator of AD&D Policy Not Immediately Appealable | Practical Law

Third Circuit: Remand Order to Administrator of AD&D Policy Not Immediately Appealable | Practical Law

In a case of first impression, in Papotto v. Hartford Life & Accident Insurance Company, the US Court of Appeals for the Third Circuit held that the district court's remand of an action under the Employee Retirement Income Security Act of 1974 (ERISA) to the administrator of an AD&D policy was not a final decision and therefore not immediately appealable.

Third Circuit: Remand Order to Administrator of AD&D Policy Not Immediately Appealable

by Practical Law Litigation
Published on 01 Oct 2013USA (National/Federal)
In a case of first impression, in Papotto v. Hartford Life & Accident Insurance Company, the US Court of Appeals for the Third Circuit held that the district court's remand of an action under the Employee Retirement Income Security Act of 1974 (ERISA) to the administrator of an AD&D policy was not a final decision and therefore not immediately appealable.
On September 26, 2013, in a case of first impression, the US Court of Appeals for the Third Circuit issued an opinion in Papotto v. Hartford Life & Accident Insurance Company, holding that the district court's remand of an action under the Employee Retirement Income Security Act of 1974 (ERISA) to the administrator of an insured policy was not a final decision and therefore not immediately appealable.
The plaintiff in this case was the beneficiary under her husband's accidental death and dismemberment (AD&D) policy, which was:
  • Provided as part of an employer-sponsored welfare benefit plan.
  • Insured by Hartford, which served as the policy's administrator and paid claims under the policy.
The plaintiff sought payment of benefits from Hartford under the AD&D policy following her husband's death. However, the AD&D policy explicitly excluded losses sustained while an insured was intoxicated, and a posthumous toxicology report indicated that the husband's blood-alcohol level at death exceeded the legal limit. As a result, Hartford denied the plaintiff's claim for AD&D benefits. The insurer's decision was upheld on administrative appeal, after which the plaintiff sued the insurer in federal district court under the Employee Retirement Income Security Act of 1974 (ERISA). The district court determined that the policy implicitly required a causal connection between the intoxication and the loss. It remanded the case to the administrator to consider additional evidence and to determine whether intoxication caused or contributed to the husband's death. Both parties appealed.
The Third Circuit dismissed the appeal for lack of appellate jurisdiction. Under 28 U.S.C. § 1291, appellate courts have jurisdiction to review only district court orders that are final. A final order ends the litigation on the merits. The Third Circuit, in analyzing whether a remand order to a plan's administrator in an ERISA action is a final order, joined its sister courts in concluding that remands to administrators under ERISA plans are analogous to remands to administrative agencies.
The Third Circuit noted the general principle that district court orders remanding cases to administrative agencies are not final and not appealable. However, the court acknowledged that, under Kreider Dairy Farms, Inc. v. Glickman, a case may be excepted from the final judgment rule. The Third Circuit determined that it may exercise appellate jurisdiction over remands to administrative agencies when all of the following factors are present:
  • The remand finally resolves the issue.
  • The issue is important.
  • Denial of the review forecloses future appellate review.
In applying these factors, the Third Circuit concluded that the district court's remand order was not final because:
  • The issue of the plaintiff's eligibility for benefits under the AD&D policy was not finally resolved on the merits.
  • The administrator was ordered to consider additional evidence and engage in further fact-finding on the issue of causation.
  • The case was administratively closed and the district court retained jurisdiction over the matter.
The Third Circuit also denied appellate jurisdiction under the collateral order doctrine.
Counsel should be aware that a district court's remand of a case to an administrator of an ERISA plan generally is not immediately appealable unless the remand order finally resolves an important issue and the district court does not retain jurisdiction.
Court documents: