Court: Benefits Claim Filed Too Late

May 30, 2003 ( - An employee can't challenge a benefits decision by his employer's health and welfare plan because of the plan's three-year limit on when lawsuits can be filed, an appeals court ruled.

>The US 3 rd Circuit Court of Appeals said the statute of limitations clock started ticking as soon as plaintiff Thomas Fontana’s benefits claim was deemed denied when the health plan didn’t respond to his appeal. Because Fontana didn’t file suit against Diversified Group Administrators until May 2001 – more than three years after his benefits claim was deemed denied in April 1998 – the court case could not be pursued, according to Washington-based legal publisher BNA.

>The court rejected the argument that the statute of limitations period should have been postponed because Fontana was actively pursuing his claim with the health plan.

The case is Fontana v. Diversified Group Administrators Inc., 3d Cir., 022337, unpublished 5/28/03.