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Danko v. AMTRAK

Danko v. AMTRAK

United States District Court for the Eastern District of Pennsylvania

February 10, 2017, Decided; February 13, 2017, Filed

CIVIL ACTION NO. 16-1235

Opinion

 [*656]  MEMORANDUM OPINION

Rufe, J.

In this case brought under the Employee Retirement Income Security Act ("ERISA"),1 Defendant National Railroad Passenger Corporation ("Amtrak") has filed a motion to dismiss the Complaint, which Plaintiffs oppose. For the following reasons, the motion will be granted in part and denied in part.

I. FACTUAL ALLEGATIONS

Plaintiffs, husband and wife, filed this action on their own behalf and on behalf of a proposed class of similarly-situated individuals. The Complaint alleges that Mark Danko, an Amtrak employee, and his wife Pauline receive health insurance coverage through Amtrak's Group Health Plan. Ms. Danko was injured in a motor vehicle accident in 2011, and received benefits under the Plan. Ms. Danko filed a lawsuit against the driver responsible for the accident and settled for the limits available under the driver's policy, [**2]  and asserted an uninsured or underinsured motorist claim under her own automobile policy, which also settled. Pursuant to the terms of the Plan, Amtrak had a subrogation lien of $7,893.95 against the settlements so that it could be reimbursed for the medical benefits it had paid.

Amtrak sought the entire amount of the lien, while Ms. Danko's attorney took the position that the amount should be reduced by the proportionate amount of attorneys' fees expended to obtain the settlements, for a total of $5,262.63 in satisfaction of the lien. Ms. Danko's attorney sent a check for that amount, which was eventually cashed. From March until June of 2015, Ms. Danko's attorney and a representative from Optum, Amtrak's subrogation administrator, exchanged emails with regard to whether or not Amtrak was entitled to the remaining $2,631.32, without a clear resolution. The funds remained in the attorney's client security fund. On November 15, 2015, Ms. Danko's attorney wrote to the administrator  [*657]  and to Amtrak, stating his understanding that any administrative prerequisites to suit had been exhausted, and did not receive a response.

Several months later, Plaintiff filed this suit, alleging that Defendant [**3]  violated the subrogation terms of the Plan and seeking recovery of benefits due, declaratory and injunctive relief, interest, and attorneys' fees. Upon receipt of the Complaint, Defendant's counsel sent a letter "to confirm that the Plan absolutely and irrevocably waives any and all right to further reimbursement relating to any benefit claims paid to Pauline Danko" in connection with the accident.2 Defendant requested that Plaintiffs dismiss the lawsuit, which Plaintiffs declined to do without payment of attorneys' fees and costs.3 Defendant then moved to dismiss, arguing that there is no justiciable case or controversy between the parties.

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234 F. Supp. 3d 655 *; 2017 U.S. Dist. LEXIS 19715 **; 62 Employee Benefits Cas. (BNA) 2313

PAULINE DANKO and MARK DANKO, Individually and on behalf of all others similarly situated, Plaintiffs, v. NATIONAL RAILROAD PASSENGER CORPORATION, Defendant.

CORE TERMS

funds, motion to dismiss, allegations, subrogation, benefits, argues, attorney's fees, settlement, moot, terms of the plan, exhausted, rights