Unpublished Disposition, 869 F.2d 1498 (9th Cir. 1984)

Annotate this Case
US Court of Appeals for the Ninth Circuit - 869 F.2d 1498 (9th Cir. 1984)

Donald R. ROBERSON, Jr., Plaintiff-Appellant,v.EQUITABLE LIFE INS., Defendant-Appellee,andVicki Johnson, Alpha Microsystems, Nina Doles, Defendants.

No. 87-6253.

United States Court of Appeals, Ninth Circuit.

Argued and Submitted Feb. 7, 1989.Decided Feb. 21, 1989.

Before CANBY, WIGGINS, and O'SCANNLAIN, Circuit Judges.


MEMORANDUM* 

Appellant Donald Roberson was diagnosed in August 1983 as suffering from ulcerative colitis. He filed a claim with Appellee, the Equitable Life Assurance Society of the United States ("Equitable"), which offered health insurance benefits through Roberson's employer's employee benefits plan. Equitable paid Roberson all benefits due for his medical bills encountered prior to December 15, 1984, but refused to pay any further benefits after that date. Roberson then brought suit in California state court alleging various common-law causes of action and, in addition, a cause of action for violating section 790.03(h) of the California Insurance Code. See Cal.Ins.Code Sec. 790.03(h) (West 1986). Equitable removed the action to federal district court and sought summary judgment on the ground that all causes of action were preempted by the Employee Retirement Income Security Act of 1974 ("ERISA"), Pub. L. No. 93-406, 88 Stat. 829 (codified as amended at 29 U.S.C. §§ 1001-1461 (1982)).

Roberson conceded that ERISA preempted his state commonlaw causes of action. See Pilot Life Ins. Co. v. Dedaux, 107 S. Ct. 1549 (1987). He maintained, nevertheless, that ERISA did not preempt his cause of action under section 790.03(h), which, he argued, was an "insurance regulation" that fell within the savings clause of ERISA's preemptive provisions. See 29 U.S.C. § 1144(b) (2) (A) (1982). The district court ruled that section 790.03(h) was not an insurance regulation and therefore was expressly preempted by ERISA. Roberson v. Equitable Life Assurance Soc'y of the United States, 661 F. Supp. 416, 422 (C.D. Cal. 1987). The district court further ruled that even if section 790.03(h) was not expressly preempted, it nevertheless conflicted with ERISA's exclusive civil remedies provisions, and therefore was impliedly preempted. Id. at 423-24. The district court then granted Equitable's motion for summary judgment and this timely appeal followed. We exercise our jurisdiction pursuant to 28 U.S.C. § 1291 (1982) by reviewing de novo the district court's legal conclusion that ERISA preempts section 790.03(h). United States v. McConney, 728 F.2d 1195, 1201 (9th Cir.) (en banc), cert. denied, 469 U.S. 824 (1984).

Under 29 U.S.C. § 1144(a) (1982), Congress provided that ERISA expressly preempts every state law that "relates" to employee benefit plans. Congress excepted from this provision state laws that "regulate [ ] insurance," id. Sec. 1144(b) (2) (A) ("savings clause"), but qualified the exception by disallowing states from treating employee benefit plans as though they were offered by insurance companies, id. Sec. 1144(b) (2) (B) ("deemer clause"). Under the terms of this statute, therefore, section 790.03(h) would be expressly preempted unless it is characterized as an "insurance regulation." Even though the district court decided this issue against Roberson, " [w]e can assume, without deciding, that Sec. 790.03(h) is a law regulating insurance under the savings clause." Kanne v. Connecticut Gen. Life Ins. Co., 859 F.2d 96, 100 (9th Cir. 1988). For even if section 790.03(h) is not expressly preempted, the inquiry remains whether it is impliedly preempted.

In Kanne this court ruled that ERISA's civil enforcement remedies provide the exclusive remedy for recovering for injuries caused by an insurer's improper processing of claims. Id. In reaching this conclusion the court looked to language in Pilot Life Insurance Co. v. Dedaux, 107 S. Ct. 1549 (1987), in which the Supreme Court stated:

In sum, the detailed provisions of Sec. 502(a) set forth a comprehensive civil enforcement scheme that represents a careful balancing of the need for prompt and fair claims settlement procedures against the public interest in encouraging the formation of employee benefit plans. The policy choices reflected in the inclusion of certain remedies and the exclusion of others under the federal scheme would be completely undermined if ERISA-plan participants and beneficiaries were free to obtain remedies under state law that Congress had rejected in ERISA.

Id. at 1556. From this language the Kanne court found "the conclusion inescapable that Sec. 790.03(h) is preempted by ERISA." 859 F.2d at 100 (footnote omitted). Indeed, in reaching this result the court cited the district court's decision here, one of a handful of district courts that had decided the issue by that time, as the one with which the panel agreed with most. Id. at 100 n. 6 (citing Roberson, 661 F. Supp. at 423-24).

Roberson argues nonetheless that Kanne is wrong for the same reason that the district court is wrong. Even if we were to disagree with the result in Kanne, however, we are bound by its authority until either an en banc panel of this court or the Supreme Court directs otherwise. See, e.g., Royal Dev. Co. v. NLRB, 703 F.2d 363, 368-69 (9th Cir. 1983). Accordingly, we affirm the district court's granting of summary judgment in favor of Equitable.

AFFIRMED.

 *

This disposition is not appropriate for publication and may not be cited to or by the courts of this circuit except as provided by 9th Cir.R. 36-3

Some case metadata and case summaries were written with the help of AI, which can produce inaccuracies. You should read the full case before relying on it for legal research purposes.

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.