Why Didn the Plaintiffs Sue Under Federal Law – ERISA – In the First Place?
Before I discuss the Supreme Court’s decision, it might be helpful to ask why Davila and Calad did not sue under ERISA in the first place. Under ERISA, a federal suit against a health insurer or plan administrator has been understood to permit the plaintiff limited remedies–she might be able to get a court to “enjoin” or force the insurer to agree to pay for a benefit in advance or, afterwards, get back the benefits promised under the plan. But in Davila and Calad’s cases, they claimed that they had no time to sue their HMOs to get a court to force them to pay for the Vioxx or the extra day in the hospital in advance. And the benefit in dispute–the price of the Vioxx or the extra day in the hospital–was somewhat of a moot point after they had suffered their injuries afterwards. What they wanted afterwards was full damages–their pain and suffering, lost wages, additional medical expenses, and, if warranted, punitive damages. Only the THCLA could give them that. The Supreme Court, ho
