Opinion ID: 3029993
Heading Depth: 3
Heading Rank: 1

Heading: Claim for Benefits Due

Text: Koert claims that she is entitled to recover her unpaid benefits pursuant to ERISA § 502(a)(1)(B), 29 U.S.C. § 1132(a)(1)(B). ERISA does not contain a specific statute of limitations for benefits claims brought under this provision. “As a general rule, when Congress omits a statute of limitations for a federal cause of action, courts ‘borrow’ the local time limitation most analogous to the case at hand. In the absence of an applicable ERISA limitation, the courts thus apply the statute of limitations for the state claim most analogous to the ERISA claim pursued.” Gluck v. Unisys Corp., 960 F.2d 1168, 1179 (3d Cir. 1992) (citations and internal quotation marks omitted). The statutory limitation period most applicable to a claim for benefits due under a plan is that for a breach of contract claim. See id. at 1181-82. The statute of limitations for a breach of contract claim in Pennsylvania is four years. 42 PA. CONS. STAT. § 5525(8). Parties may, however, contract for a shorter limitation period, so long as the contractual period is not manifestly unreasonable. See 3 Lardas v. Underwriters Ins. Co., 231 A.2d 740, 741-42 (Pa. 1967); Hosp. Support Servs., Ltd. v. Kemper Group, Inc., 889 F.2d 1311 (3d Cir. 1989). As the District Court properly recognized, the insurance policy specified that a shorter, three-year limitation period would apply. According to the policy: For 60 days after the written Proof of claim as required by us has been filed, no legal or equitable action may be brought against us for that claim. No action at all may be brought against us after 3 years from the date on which written Proof of claim is required. Thus, the contractual limitation period is three years, not four. Koert insists that despite this language, the applicable limitation period is the statutory one. She directs us to language in the policy which specifies that “[t]he time limits for . . . filing legal action will be changed to comply with the minimum requirements of any applicable law.” Were Pennsylvania’s statutory limitation period a “minimum requirement” beneath which parties could not contract, then Koert would be correct that the applicable limitation period would be four years. It is not. Pennsylvania law allows parties to contract for limitation periods shorter than those specified by statute, and a three year period is certainly reasonable. Therefore, the statutory period is not a minimum requirement, and the policy’s shorter limitation period is applicable. In applying the policy’s limitation period, it is necessary to determine the date on which the clock began to run. Koert argues that the policy is materially ambiguous as to this point, and that the ambiguous language should be construed in her favor. We agree with the 4 District Court’s determination that the policy’s language is unambiguous and the limitation period began running more than three years before Koert filed her complaint. Consequently, her complaint was untimely. Koert argues that even if her complaint was untimely, she may proceed with her suit because GE waived the contractual limitation period. She contends that GE has acted in a manner that was procedurally irregular, biased, and unfair, and that under ERISA regulations and Epright v. Envnl. Res. Mgmt., Inc. Health & Welfare Plan, 81 F.3d 335 (3d Cir. 1996), these defects preclude GE from relying upon the contractual limitation period. In Epright, we held that “[w]hen a letter terminating or denying Plan benefits does not explain the proper steps for pursuing review of the termination or denial, the Plan's time bar for such a review is not triggered.” 81 F.3d at 342. Epright involved the failure by an ERISA-regulated plan to notify a beneficiary whose claim had been denied of the Plan’s own review procedures. That defect is not present in this case because GE provided Koert with the information necessary to appeal the determination. Neither did GE fail to provide other required information in its correspondence with Koert. It is true that under 29 C.F.R. § 2560.503-1(g)(iv), a notification of an adverse benefit determination must state that a claimant has a right to bring civil suit under § 502(a), and that GE did not so notify Koert. But this regulation applies only to claims filed on or after January 1, 2002. 29 C.F.R. § 2560.503-1(o)(1). Koert filed her claim—and GE made its adverse determination—well before this date. The regulation does not apply. Finally, the other procedural irregularities of which Koert complains do not invalidate 5 the contractual limitation period. Koert alleges, in essence, that GE’s review of her claim was not duly thorough; she does not allege that GE failed to comply with the requirements of her policy. As such, we find no procedural irregularity which would excuse Koert’s delay.