Oral Argument Preview: Ghee v. USAble Mutual Insurance Co.

Alex Sidwell

Billy Fleming went to the emergency room on June 11, 2013, complaining of severe abdominal pain.  Following nonsurgical treatment, his physicians scheduled a colectomy, the removal of all or part of the colon.  Blue Advantage, the company in charge of Fleming’s employee health-insurance coverage, determined that nonsurgical treatment was appropriate, denied coverage of the surgery, and told Fleming to go to the emergency room if his pain worsened.  Fleming returned to the emergency room on July 15, 2013, where he appeared in distress.  Fleming died on July 16, 2013, and an autopsy showed his cause of death was “septic shock” resulting from a ruptured intestine.

Douglas Ghee, on behalf of Fleming’s estate, sued Blue Advantage for the wrongful death of Fleming caused by medical malpractice. Blue Advantage moved to dismiss the claim on the ground that the Employee Retirement Income Security Act (“ERISA”) preempted the wrongful death claim. ERISA is a federal law that regulates the operation of a health insurance benefit plan if an employer provides one for its employees. The trial court agreed with Blue Advantage and dismissed the wrongful death claim, ruling that the claim was preempted by ERISA. Ghee appealed to the Alabama Supreme Court on October 26, 2016.

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