NOT RECOMMENDED F OR FUL L -TEXT PUB L I CATI ON File Na me: 10a0112n.06 No. 09-3303 UN ITED STA TES C OU RT OF AP P EA LS F OR THE SI XT H C IR CU IT
J OHN E. WERNER, J R., Pla int if f- Ap pe lla nt,
v. PRI MAX RECOVERI ES, I NC.; AC S RE CO VE RY SER

VI CES , I NC , De fe nd ants -A

pp e lle e s. ) ) ) ) ) ) ) ) ) ) ) ) ON APPEAL FROM THE U NI TED ST ATES DI STRI CT COURT FOR THE NORTHE RN DI STRI CT OF O H IO

B e fo re : D AU GH TRE Y, GI L MA N, and KE TH L ED GE , Ci rc uit

Judg e s. KETHL EDGE, Circuit Ju dg e. Plaintiff J ohn E. Werner , J r. cha lleng es the district cour t’s g rant of summar

y judgme nt in fav o r o f d efe ndants Primax Recove ries, Inc. and A CS R ecove ry Se rv ic e s, Inc . ( c oll e c tiv e ly , “ Pr imax”) , o n h is c la ims un de r t he Em plo y e e Reti rem ent Inc ome Se c ur ity Ac t ( “ ERI SA” ) a

nd Oh io c omm on

law. We r e

je c t hi s a rgume nts and

a ff ir m. I. Werner w as involved in a traffic acc ident on J une 28, 2002, and r equire d medical tre atment for his injuries. He was e ntitled to healthcar e bene fits throug h two differ ent i nsurer s. First, he had an employ er- sponsored he alth-insuranc e policy thr o u gh M edica l Mutual of Ohio (“Me dical Mutual”). Werne r also had a motor-vehicle -insuranc e policy throug h Prog ressive Pr ef err edNo. 09-3303

W erner v . Primax Re cove ries, Inc.

-2- I nsuranc e C o mp an y

(“ P ro gre s s i v e” ) t h atco v er edu p t o $ 5 0 0 0 i nm ed i ca l -e x p en s e b en ef i t s (t h e “ M ed Pay ” cove rag e). Werner sub mi tt e d

mo s t o f h is me dical-tre atment bills to Medical Mutual. He submitted other bills t o Prog ressive. B oth insurers paid the bills direc tly , rathe r than re imbursing W er n er . The Medica l Mutual policy

inclu d ed a subrog ation clause . Under that clause , Medica l Mutual was entitled to rec oup from third par ties, including othe r insurer s, benef its that it had paid on Werne r’s behalf . Medica l Mutual entere d into a contra ct wi t h P ri max R ecove ries—which ha s since bee n
a c qu ir e d b y

AC S Re c ov e ry

Se rv ic e s—

to c on du c t it s r e c ou

pme nt e ff or ts. On Novembe r 27, 2002, Prog ressive ma iled Werner a letter inquiring whether

he would be
su bmi tti nga dd iti on a l bi lls . We rn e r re sp on de d that he ha d jus t un de rg on e surg e ry and that he wo uld be submitting o t h er b i l ls. He did send one suc h bill, which Progr essive paid. Ar ound this ti me, Werner a lso eng ag ed an attorney , C. Michael Piace ntino, to manag e his persona l-injury claim. On J anuar y 28, 2 003, Prog ressive se nt another le tter—this time to P iace ntino—inquiring about additional bills. P iace ntino r esponded that he would submit additional bills. There is no indication in the rec ord, howe ver, that either Piace ntino or Werner e ver did so. On Ap ri l 28 , 2 00 3, Pr imax noti fi e d Pr og re ssi ve tha t it wa s a sse rt ing a lie n a g a ins t the un pa id balanc e of Werne r’s Med Pay benef its. P rog ressive attempted to telephone Pi ace ntino reg ardingthe l i e n , b uta l l e g e d l y r e c e i v e d ano u t
- o f

- s e r v i c e m e s s a g e . P r o g r e s s i v e th e nc o n t a c t e d W e r n e r d i r e c t l y, who stated that he had bee n rec eiving collection notices a nd that he did not know why Piacentino had failed to submit the bills. P rog ressive a lso sent Piacentino letters re questing that he for war d any bills t hat he ha d and informinghim of Primax ’s purporte d lien. Piacentino neve r re plied.No. 09-3303

W erner v . Primax Re cove ries, Inc.

-3- Meanwhile, Pri m ax s ent P rog ressive two more inquiries, including a demand f

or reimburse ment. Prog ressive a cce ded to that demand on August 15, 2003, and sent Primax a che ck for $3895, whic h exhausted Werner’ s benef its under the Med P ay p o licy . Prog ressive the n sent Pia c e nti no a

le tte r t o n oti fy

him of its a c tio ns . So o n af t er ward, one of Werne r’s medic al provider s sued him for non-pa y ment. Werner demande d that Prog ressive se ek a r efund f rom Primax . When Progr essive re fused to d o s o , he tur ne d to the c ourt s. As pa

rt of a pe rs on a l- inj ur

y a c tio n a g a ins t th e tor

tf e a so r i n h is tra ff

ic a c c ide nt, Wer ne r as se rt e d c la ims a g a ins t Pr og re ssi ve se e kin g Me d Pa y c ov e ra g e of

his tr e a tme nt b ill s. Werner’ s an d

Pr o g r e s s iv e ’ s a tt o r

n e y s c o r r e s p o n d e d

in late 2 0 0 4 , an d

o nJanu ar

y 2 8 , 2 0 0 5, Prog ressive se nt Werner a chec k for $3895 in an attempt to settle the l awsuit. Werner r eturne d the
c h e c k b e c a

u s e P r o g r e s s i v e r e f

u s e d t o p ay i n t e r e s t o n th a t s u m an d a t t o r n e y ’ s f e e s i n c urre d in de fe nd ingthe su it b ro ug ht b y his pr ov ide r. L a te r tha

t y e ar, Wer

ne r v olu nta ri ly dis mis se d h is c la ims aga i n s t Progr essive. B ut Werner sue d Prog ressive a g ain in Fe bruar y 2007, this ti me in a putative class ac tion. That ca s e en d ed in summary judgme nt for Prog ressive. W erner v . Progressive Preferred I

ns. Co. , 533 F. Supp. 2d 776 (N.D . Ohio 2008), aff’d , 310 F. App’ x 766 (6th Cir. 2009). Werner the n sued Primax, even though it ha d alre ady returne d the $3895 to Progr essive 20 months earlier
. He i nitially asser ted only Ohio common-law c onversion and br eac h-of- contra ct cl ai m s , invoking the district c ourt’s jurisdiction over c lass actions, see 28 U.S.C. § 1332(d). He
so ug ht d ama g e s, pr e

jud g me nt i nte re st, de c larator y and inj un c tiv e re lie f, and a tto rn e y ’s fe e s, a s w e ll
a s c la ss c e rt if

ic ati on . Af

te r P ri ma x fil e d a

summa ry -j ud g me nt m oti on , a sse rt ingthat E RI SA pree mpted those state-la

w cl aims, Werner a

mended his complaint to include c laims under two ofNo. 09-3303

W erner v . Primax Re cove ries, Inc.

-4- ERI SA’ s c iv il

- e n f

o r c e me n t p r o v is io n s . H e a s s e rte d th a t t h o s e c la im s e n ti tl e d

h im to mo s t o f

the
ear lier-soug ht relief, a

nd added a

new c laim for re stitut ion t h ro u g h a construc tive trust or an equitable lien. The district cour

t gr anted Primax’s summary -judg ment motion on mootness and pre emption g ro un ds . We rn e r t

he n f ile d a mot ion , w hic h the dis tr ic t c ourt c on str ue d a s a mot ion un de r F e d. R. Civ . P. 5 9 ( e ) t o am e n d

o r a l t e r a j u d g m e n t , a s s e rt i n g th a tth e c o urth a d n e g l e c t e d

t o r u l e o nhis ERI SA c la ims . T he c ourt de nie d th a t mo tio n o n s tand ing , mo otn e ss, and fo rf e iture g ro un ds
. This appea l followed. II. Werner c halleng es the district cour t’s summary -judg ment g rant to Primax
. We reviewthat g rant de novo, draw ing a ll reasona ble infer ence s in W erne r’s fa vor. See Allen v. Highlands Hosp. Corp. , 5 45 F .3 d 3 87 , 3 93 (6 th C ir . 2 00 8) . Summa ry jud g me nt i s a

pp ro pr iate wh e n “ the ple a din g s, the discover

y and dis closure materials on file, and any aff idavits show that there is no g enuine issue as to any materia l fac t and that the movant is entitled to judgme nt as a matter of la w.” F ed. R. Civ. P. 5 6( c ). Hi s nume ro us a ssi g nme nts of e rr or fa ll i nto thr e e g e ne ra l c a te g or ie s. A. Wer ne r a sse rt s se ve ra l st a te -l a w c l a i m s a g a i n s t Pr imax. Hi s le g a l th e or ie s are no t pa rt ic ula rl y clea r, but we attempt to sum marize them here . First, he claims that Primax conver ted benef its that he wa s entitled to under his Med Pay policy when it asser

ted a lien ag ainst them under the Medica l Mutual policy ’s subrog ation clause
. Second, he claims that Primax brea ched his insura nce c ontrac t wi t h M ed i cal Mutual whe n, actingas Medica l Mutual’s ag ent, Primax asser ted nonexist entNo. 09-3303

W erner v . Primax Re cove ries, Inc.

-5- subrog ation rig hts ag ainst Progr essive. Third, he claims that he is entitled—under e ither a tort theor y
or a c o n t ra ct t h eo ry

—to prejudg ment interest on the Me d Pay funds Primax there by

obtained and held for 27 months. Four th, he claims that he is entitled to attorney ’s fe es as a result of that a lleg ed
wr on g do ing
. An d fi na lly , he a sse rt s that Pr imax routin e ly a sse rt s th e su

br og a tio n c la

us e a g a ins t hi s and other insureds’ Me d Pay

benef its, and that class ce rtification is there fore appropr iate. These state-lawclaims are vulnera ble on seve ral fr onts, but the district court g rante d summary jud gm en t on the g round that they are all pree mpted by

ERI SA. Werner c halleng es that de te rm inatio n. He re c og nizes th at we hav e lon g int e rp re te d E RI SA a s b ro a dly pr e e mpt ing“ mos t state law c la ims ” that re late to an e mpl oy e e -b e ne fi t pla n, pa rt ic ula rl y wh e re —a s he re —th os e c la ims “explicitly

ref er to such a

plan.” See Zuniga v. BlueCross & Blue Shield of Mich. , 52 F.3d 1395, 1401 (6th Cir
. 1 995) (inter nal citations and quotation marks omitted). Ne verthe less, he conte nds that a pair of re cent c ases ha

ve “some what modi fi ed ” o u r interpr etation. See R odriguez v. Tenn. Laborers Health & W

elfare Fund , 463 F.3d 473 (6th Cir. 2006); Primax Re cove ries, Inc. v . Gunter , 433 F.3d 515 ( 6th Cir. 2006). But Werne r con fu s es pree mption with s ubject-matter jurisdiction. Rodriguez

and Gunter

mere ly hold that a fe dera l court may have subje ct-matter

jurisdiction over an action brought under ERI SA, e ven though the action seeks relief that itself is not available unde r the statute. See Rodriguez , 4 63 F .3 d at 47 6; Gunter , 433 F.3d at 516. He re , w e ne e d lo ok

on ly a t th e fa c e of

Wer ne r’ s c omp la int to de te rm ine that it “ re late [s] to an employ ee be nefit plan” and is there fore pree mpted. See29 U. S.C. § 1 14 4( a ); Zuniga , 52 F.3d at 1401
. U n d e r

E RI SA , th e p h r a s e “ e mp lo y e e b e n e f it p la n ” in c lu d e s e mp lo y e r - s p o n s o r e d me dical insurance policies. 29 U.S.C. § 1002(1) and (3). Werner expressly alleg es t hat “the health insuranc eNo. 09-3303

W erner v . Primax Re cove ries, Inc.

-6- po lic y pe rt ine nt t o th is a c tio n w a s p ro vid e d to the re pr e se ntativ e pla int if f b y his e mpl oy e r. ” (A m. Compl. ¶ 1.) He a lso alleg es t h at hi s health insurer paid medica l bills on his behalf, ( id. ¶ 6), a nd that Primax acte d as his insurer’ s ag ent in making subrog ation claims under the terms of the insurance policy , ( id. ¶¶ 7- 10 , 1 6- 17 ). Ea c h o f We rn e r’ s st a te -l aw claims de pe nd s o n th os e alleg ations, beca

use eac h claim require s consideration of Primax ’s actions undert h e s u brog ation
c la us e . T hat de pe nd e nc y

mor e tha n me e ts the “ re late s to” st and ard in § 1 14 4( a ), and thu s th e se claims are all pree mpted. The district cour t did not err in conc luding a s much. B. Wer n e r c h a ll e n g e s th e d is tr ic t c o urt’ s le g a l f in d in g s o n e a c h o f h is E RI SA c la ims. He initially broug ht those claims under §§ 502(a) (1)( B) and 502(a) (3) of ERI SA, but now conce des that only § 502(a) (3) is applicable here
. (Werner ’s R eply Br
. 6.) That sec tion allows a plan par ticipant to s e e k e qu ita

ble re lie f f

or vio latio ns of

ERI SA o r t

he pl an. § 50 2(a) (3 ) ( c od if ie d at 29 U. S.C. § 1132(a) (3))
. Werner sought severa l differ ent t y pes of equitable relief under § 502(a) (3). But the ri g ht o f a c tio n p ro vid e d b y tha t se c tio n, a lon e , is ins uf

fi c ie nt to ma int a in thi s su it. Wer ne r m us t f ir st satisfy the re quirements for fede ral jurisdi ction under Article I I Iof the United States Constitution. And as the district c ourt rec og nized, he fails in that reg ard. Werner f irst sought injunctive a

nd decla ratory relief . He a sked the dis t ri ct court to orde r Primax to enforc e the subrog ation clause “ac cording to its terms” and to bar Primax from eng ag ing in futur e e f

f o rts to c o ll e c t M e d

Pa y f un d s un d e r

th e c la u s e . H e a ls o a s k e d

f o r a d e c la r a ti o nth at Pr imax’s c oll e c tio n ef

fo rt s we re “ ill e g a l.” To have sta nd ing to s e e k a

n in jun c tio n in

fe de ra l c ourt , ho we ve r, Wer

ne r m us t sh owa no n-s pec ulativ e thr e a t th a t “ he wi ll a g a in e xpe ri e nc e inj ur y a s aNo. 09-3303

W erner v . Primax Re cove ries, Inc.

-7- result” of the alleg ed wr ong doing. See City of Los Angeles v. Lyons , 461 U.S. 95, 109 (1983). And to have standingto seek fe dera l declar atory relief , Werner must “demonstrate ac tual prese nt harm
or the sig nificant possibility of future harm.” Se e Fi e

ge r v . F e rry , 471 F.3d 637, 643 (6th Cir. 2006) (citation omitted). Werner vir

tually admits t h at h e cannot meet those requir ements per sonally , g iven that he “would n o t s e r io u s ly

c o n te s t t h e lo w e r c o urt’ s r u li n g . . . if

th e s e r e qu e s ts f

o r ju d ic ia l r e lie f
c on c e rn e d o nly Mr
. Wer

ne r. ” (We rn e r’ s B r. 35 ). Wer ne r be lie ve s that he ha s st and ing , n on e the le ss, beca use it is Primax’s “ standard prac tice” to c ollect Med Pay funds in this manner and Wer ner se eks to repre sent not only

himself but an entire class. That belief is mist aken: “ The Ar

ticle I I Istanding
re qu ir e me nts a

pp ly e qu a lly to c la ss a c tio ns . T he c la ss r e pr e se ntative mu st a lle g e an in div idu a l, persona l injury

in order to se ek re lief on beha lf of himself or a ny other membe r of the c lass.” Sutton v. St. Jude M

ed. S.C., Inc. , 419 F.3d 568, 570 ( 6th Cir. 2005). The district cour t did not err, then, by c on c lud ingthat We rn e r l a c ke d s tand ingto a sse rt the se c la ims
. Werner a lso sought re stitut ion, asking the district court to i mpose a c onstructive trust or a n
e qu ita ble lie n o n th e $3 89 5 th a t Pr imax o bta ine d f ro m Pr og re ssi ve . T he c ourt fo un d th a t r e qu e st t o be moot, howeve r, bec ause Primax ha d returne d those funds to Progressive near ly 20 months prior to We rn e r’ s f

ili ng of th is ac tio n. Wer ne r a rgue s th a t th e dis tr ic t c ourt e rr e d b y a ssumin g that a specific res had to be identifia ble bef ore i t co u ld impose an equitable lien. H e re lies solely on a passag e in Sereboff v. Mid Atlantic Medic al Service s, Inc. , 547 U.S. 356 ( 2006), in which the Court explained that “strict tra cing ” of f unds is not necessar

y when a n equitable lien is established by an ag ree ment. See id. at 364-65. But that relianc e is misplaced: Werner has no ag ree ment with PrimaxNo. 09-3303

W erner v . Primax Re cove ries, Inc.

-8- that cre ates a

n equitable lien. Rathe r, he se eks an e quitable lien in restitution, i. e., the return of something that he alleg es Primax wrongf ully took. Se re bo

ff e xpre ssl y dis tin g uis he s su c h c la ims
. Moreove r, Se re bo

ff still require s that a re quest for r est itution under § 502(a) (3) tar g et

“ ‘ p art i c u l ar

f un d s o r p r o p e rty in the defendant’s possession .’” Id. at3 6 2 (q u o t i n g Gr e at- W est Li fe &Annuity Ins. Co. v. Knuds on , 534 U.S. 204, 213 (2002) (e mphasis added) ). Werner does not dispute that Primax returne d the $3895 t o Prog ressive. We fail t o see why that would not alrea dy
amou nt t o r e sti tut ion h ere, thu s mo oti ngthe re qu e st— un le ss what We rn e r a c tua lly se e ks is po sse ssi on

of the $3 89 5 fo r him se lf

. B ut fo r t hat, p re suma

bly he may no w f ile re imb ur se me nt c la ims with P ro gre s s i v e. Restitution certainly does not requir e that Primax pay twice. Our

revie w of Se re bo ff also leads us to conc lude that Werner ’s re stit u t ion claim is for re lief that a c ourt ca nnot g rant unde r § 502(a )(3) , beca use he se eks l eg al rather than equitable re stitut ion. See id. at 361-62 (distinguishingthe two ty pes and e x plaining that only equitable r estitution i s available under § 502(a) (3)) ; Fed. R. Civ. Pro. 12(b)(6)
. The district c ourt proper ly g rante d summary judgme nt on thi s c la im. Wer ne r ne xt argue s that the dis tr ic t cou rt e rr on e ou sly

fo un d mo ot h is p re

jud g me nt- int e re st claim under

ERI SA. What the court actua lly did, however , was e x pressly reje ct his ERI SA-based argument for pr ejudg ment interes t b eca use that ar g ument first appe are d in the reply brief Werner filed in support of his Rule 59(e) motion. W erner v . Primax Re cove ries, Inc. , 2009 WL302311, at *3 n. 1 (N. D. Oh io F e b. 9, 20 09 ). Th e c ourt wa s w e ll w ith in it s aut ho ri ty to d o s o. “ [U]nd e r R

ule 59(e) , parties c annot use a motion for rec onsideration to ra ise new leg al arguments that could have been raised before a judgment was issued.” Roge r M ill e r M us ic, I nc . v . S on y /A TV P ub l’

g, LLC , 477No. 09-3303

W erner v . Primax Re cove ries, Inc.

-9- F.3d 383, 395 (6th Cir. 2007). Simi larly , we will not consider the a rgument on appea l when it was not pr operly prese nted to the district c ourt in the first instance. Ar ms tro ng v . Ci ty

of M e lv ind ale , 432 F .3 d 6 95 , 6 99 -7 00 (6 th C ir . 2 00 6) . T hu s, Wer ne r’ s p re jud g me nt- int e re st c la im f a ils
. Finally , Werner argues that the district c ourt abused its discr etion in denying his re quest for attorney ’s fe es. See § 113 2(g ). In light of his fa ilure to adva nce a n argument upon which we can so much as reac h the m erits of his claim, we think it obvi ous that no rea sonable c ourt would have g ra nte d th a t r e qu e st. C. Werner a rgues that the c ourt err ed in re solving his reque st f or class ce rtification. He rathe r
c and idl y a dmi ts that th e “ pr ima

ry thr us t of this c a se . . . is fo r c la ss c e rt if ic a tio n” and

tha t th e tim e and expense of this litigation—not to mention the “e conomical use of the Court’s time”—w ould not be justified by

an aw ard of

interest and a

ttorney ’s fe es in Werner’ s case alone. ( Werner’ s Br . 40-41.) Given that this case repr esents Werne r’s sec ond appea ranc e bef ore us attempting to stitch toge ther
a c la ss a c tio n o ut o f t

he same se t of

e ve nts, we think

it i s w or th p ointin g out th a t, d e sp ite his numerous theor ies about how Primax and Progr essive wrong ed him , it is rea dily appar ent that the fault, if any , lies somewher e else. Had Piacentino coordinated Werner’ s benef its be tween the two insurers, timely

submitt ed all of Werne r’s c laims , o r ev en responded to Prog ressive’ s numerous attempts to reac h him, most of the e nsuing “ time and expense” w ould likely have be en avoide d. In a ny e ve nt, a s e xpla ine d a

bo ve , We rn e r’ s st a te -l aw c la ims are pr e e mpt e d. Hi s E RI SA claims variously

fail for lack of standing , mootness, a nd forf eiture. And beca

use Werner is thus leftNo. 09-3303

W erner v . Primax Re cove ries, Inc.

-10- without a viable individual c laim, the issue of cla ss cer tification is moot. See Johnson v. Turner , 125 F.3d 324, 339 ( 6th Cir. 1997). The district cour

t’s judgme nt is affirmed.