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Michael W. BRUZAS, Constance K. Bruzas and Christopher A. Bruzas, Plaintiffs, v. Cipriano QUEZADA-GARCIA and Elida Torres, Defendants, American Family Mutual Insurance Company, Defendant-Appellant, Employers Insurance of Wausau, Subrogated Party, Underwriters Laboratories, Inc., Subrogated Party-Respondent.
This case is before the court on certification from the court of appeals pursuant to Wis. Stat. § (Rule) 809.61 on the question of “whether an ERISA health benefit plan must expressly confer discretion to the plan administrator before a reviewing court owes deference to the administrator's interpretations of the plan and actions taken under the plan.”
¶ 2 The underlying issue is whether the subrogation clause in Underwriters Laboratories' ERISA plan allows subrogation where the plan beneficiary has not been made whole. We accepted the court of appeals' certification on the standard of review question noted above.
¶ 3 At oral argument, counsel acknowledged that the record contains no explicit subrogation determination by the plan administrator, nor any explicit interpretation of the plan's subrogation language by the plan administrator. While a determination or interpretation might be implicit in Underwriters Laboratories' subrogation claim, counsel conceded that the plan administrator has not in fact issued a determination or interpretation of the plan's subrogation clause. As such, a decision about the applicable standard of review upon judicial review is premature. We therefore dismiss the certification as improvidently granted and remand the case to the court of appeals for proceedings consistent with this opinion.
The certification from the court of appeals is dismissed as improvidently granted and the cause remanded to the court of appeals.
¶ 1 PER CURIAM.
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Docket No: No. 00-0043.
Decided: December 04, 2001
Court: Supreme Court of Wisconsin.
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Get help with your legal needs
FindLaw’s Learn About the Law features thousands of informational articles to help you understand your options. And if you’re ready to hire an attorney, find one in your area who can help.
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