COBRA Notice Does Not Cover Insurance Conversion Rights

>Chief District Judge Samuel Wilson of the US District Court for the Western District of Virginia determined in Weeks v. Western Auto Supply Co. that no violation of ERISA occurred because of adequate description of the life plan in the employee handbook.   This comes in addition to the rulings for Western Auto that the estate of the deceased former employee cannot recover medical expenses due to the employer’s diligence in sending COBRA notification, according to Washington-based legal publisher BNA.

>Wilson found that Western Auto sent the proper COBRA notice to the former employee, even though the employee never received it during his hospitalization.   Wilson ruled that even if the employee never opened the COBRA notice sent by his employer, the employer satisfied its requirements under COBRA and thus could not be ordered to provide insurance for the employee.

>Additionally, the court rejected the estate’s contention that the employer was responsible for payment of the employee’s medical expenses after a representative in the employer’s human resources department incorrectly told the employee’s mother that he was not entitled to health insurance after he quit his job.   The court found no responsibility on Western Auto’s part because the representative was not a plan fiduciary.

Employee Departure

>Perry Weeks worked for a subsidiary of Western Auto until he resigned on March 23, 2000. One week after he left his job, Weeks was diagnosed with acute leukemia relapse and was admitted to the hospital for treatment.   Weeks died on June 9, 2000.

>During his hospitalization, Weeks’s mother contacted his former employers to determine whether Weeks was still insured by Western’s group health plan.   A representative in Western’s human resource department incorrectly told Weeks’s mother that Weeks was not covered by the plan because he was no longer an employee.

However, while Weeks was hospitalized, Western sent to his home in Virginia a letter detailing his COBRA rights. The letter was not opened until after Week’s death.  

Upon opening the letter, Weeks’s mother contacted Western to obtain insurance for her son. When Western refused to cover Weeks’s medical expenses, Weeks’s estate sued Western alleging it violated COBRA by not extending benefits to Weeks. Weeks’s estate also alleged that Western violated ERISA by failing to send Weeks notice of his right to convert his group life insurance plan to an individual policy.

The case is   Weeks v. Western Auto Supply Co.,W.D. Va., No. 7:02cv 00724, unpublished 6/25/03.