Thomas Amschwand knew he was dying and did everything in his power to make sure his wife would be able to collect his $426,000 life insurance policy. Yet when the 30-year-old succumbed to heart cancer, his employer, Spherion, a temporary staffing company, told his widow Melissa that she would receive nothing.
Spherion had switched life insurance providers without informing Thomas. Under the new policy, employees had to work for one full day to activate their coverage. Spherion never mentioned this to Thomas, and repeatedly assured him that he didn’t need to do anything to retain his coverage.
His widow said he easily could have worked a day if that was what it took to activate the new policy. Spherion could have waived the one-day-of-work provision, as it did for other employees but not for Amschwand.
When Thomas died, because the policy had never been formally activated, Spherion refunded his insurance premiums and told his widow she would receive nothing else.
The story has played out often under the federal Employee Retirement Income Security Act. Designed to protect employee benefits, the law has been used by employers as a shield against suits.
Federal appeals courts, interpreting Supreme Court decisions dating to 1993, consistently have said companies that offer health, life and retirement benefits under ERISA cannot be sued for large amounts of money, or damages. Instead, they can be sued only for typically smaller sums such as Amschwand’s insurance premiums.
Several federal judges have bemoaned the unfairness even as they have felt constrained to rule in favor of employers.
“The facts … scream out for a remedy beyond the simple return of premiums,” Judge Fortunato Benavides of the New Orleans-based 5th U.S. Circuit Court of Appeals said in the Amschwand case. “Regrettably, under existing law it is not available.”
The Supreme Court recently refused to hear Melissa’s case. Congress has refused to act. Insurers continue scrape up lucre, and consumers are left to suffer.