In a significant decision, the U.S. Supreme Court has opted not to review the Fourth Circuit Court’s partial revival of a lawsuit involving the death of an airline employee whose employer delayed covering his heart transplant surgery until after his death.
SCOTUS Won’t Hear ERISA Suit Over Heart Transplant : Background of the Case
On Monday, the justices declined the petition from Jody Rose, mother of the late Kyree Devon Holman. Rose had argued that the Supreme Court’s 2011 ruling in Cigna Corp. v. Amara held that health plans cannot retain funds earmarked for medical treatments, asserting her son’s estate was entitled to the money under the “surcharge” provision of the Employee Retirement Income Security Act (ERISA).
The Fourth Circuit had previously revived Rose’s unjust enrichment claim but kept her denial of benefits claim dismissed.
Troubling Denial of Medical Coverage
Rose’s initial suit, filed in December 2019 on behalf of her son’s estate, claimed PSA Airlines and other administrators of Holman’s health plan violated ERISA by repeatedly denying necessary heart transplant surgery, leading to a deterioration of his condition. By the time the procedure was finally approved after an expedited review, Holman had already passed away in February 2019.
