UNITED STATES COURT OF APPEALS
FOR THE FIFTH CIRCUIT
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No. 95-30979
SUMMARY CALENDAR
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DENISE A. BREAUX,
Plaintiff-Appellant,
VERSUS
METROPOLITAN LIFE INSURANCE COMPANY,
Defendant-Appellee.
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APPEAL FROM THE UNITED STATES DISTRICT COURT
FOR THE EASTERN DISTRICT OF LOUISIANA
U.S.D.C. No. CA-95-3487-G
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March 4, 1996
Before REAVLEY, SMITH, and PARKER, Circuit Judges.
PER CURIAM:*
Denise Breaux appeals the district court’s grant of summary
judgment in favor of Metropolitan Life Insurance Company
(“Metropolitan”). Breaux had originally filed this suit in
Louisiana state court seeking to enforce her rights under a prior
settlement in which she asserts Metropolitan had agreed to
payment of disability benefits under an employee benefit plan
provided to her by her former employer. After Metropolitan
successfully removed the suit to federal court, the district
*
Pursuant to Local Rule 47.5, the court has determined that
this opinion should not be published and is not precedent except
under the limited circumstances set forth in Local Rule 47.5.4.
court held, and Breaux now agrees, that her state court cause of
action was preempted by the Employee Retirement Security Act
(“ERISA”), 29 U.S.C. § 1001, et seq. Breaux asserts her
complaint alleged facts sufficient to state a cause of action
under ERISA.
Breaux’s pleading, styled “Petition to Enforce Settlement,”
asserts in relevant part that: Metropolitan was the disability
insurer for Ebasco Services, Inc., Breaux's former employer;
Breaux was injured on the job while so employed and was rendered
totally and permanently disabled; Breaux filed suit against
Metropolitan in connection with that accident; under terms of a
settlement she gave up valuable consideration in the form of her
right to pursue claims for penalties and attorney’s fees in
return for Metropolitan’s agreement to pay her long term
disability payments; Metropolitan paid said benefits until
September 1, 1992, when they were discontinued; there has been no
change in Breaux’s condition which would warrant discontinuance
of benefits; and discontinuance of disability benefits was
arbitrary and capricious in violation of a state statute and the
settlement previously entered into by the parties has been
ignored. She prayed for enforcement of the settlement,
reinstatement of her benefits, and assessment of costs and
attorney's fees.
The district court, relying on Boren v. N.L. Industries,
Inc., 889 F.2d 1463 (5th Cir. 1992), cert. denied, 497 U.S. 1029
(1990), held that Breaux’s complaint failed to state a cause of
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action under ERISA, but only alleged a breach of a settlement
agreement and requested statutory remedies. However, it is not
clear to us that Boren is applicable. Both sides treat this
claim as one not limited to a state court claim on contract, but
as an insurer's refusal to continue its obligations under the
terms of an employee benefit plan. If the suit were simply one
to enforce a contract apart from the insured's rights under the
plan, then it would not be an ERISA cause of action, but only a
state law claim.
Boren clearly presented a case in which an employee sought
to enforce a settlement for payment of benefits under an employee
benefit plan, but alleged only a state law claim. If the
settlement in the instant case is different, that is if
Metropolitan had terminated the plan and on its own had refused
to continue payments under the terms of a settlement agreement,
then the suit is not one based on ERISA. It is our understanding
from the arguments and briefs presented in this case that,
although the settlement may have been similar to that in Boren,
if Breaux was still participating in the Ebasco plan at the time
her benefits were terminated and she complains because those
benefits were wrongfully denied her, then the suit does
sufficiently raise ERISA.1
1
No written settlement agreement appears in the record, and
Metropolitan does not acknowledge that any settlement resulted
from Breaux's lawsuit filed in 1982 after her benefits were
terminated. However, deposition testimony of Metropolitan staff
consultant James Hartz, submitted in support of Breaux's
(continued...)
3
Because Breaux's complaint is unclear, we remand to the
district court to determine this issue and proceed accordingly.
VACATED AND REMANDED.
(...continued)
Memorandum in Opposition to Motion for Summary Judgment, reveals
that her benefits under the plan were reinstated in 1984 as a
result of an administrative appeal.
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