ARBOR HEALTH CARE CO. v. SUTPHEN CORP., 1999 U.S. App. LEXIS 8565 (6th Cir. April 30, 1999)(Unpublished)-The Sutphen health care plan covered Mr. Speakman and his wife. Mrs. Speakman suffered from dementia (memory impairment), Parkinson's disease (a progressive neurological disorder that affects certain areas of the brain responsible for movement), and Charcot-Marie-Tooth syndrome (a hereditary neurological disorder resulting in progressive muscle weakness). Mrs. Speakman required 24 hour custodial care. Arbor Health care provided this case.
The Sutphen plan, a union plan, paid for 120 days of the care. In late 1994, Sutphen negotiated with the union to get a new labor contract. As part of the contract, Sutphen ceased having a self-funded insurance plan and switched to a plan sponsored by United Healthcare. The United Healthcare plan provided that it would not pay custodial care for someone confined on the effective date of the coverage.
Plaintiff sued in State Court for severance claiming breach of implied contract. Defendant removed the case claiming ERISA preempts Defendant's clams. Defendant moved for dismissal under Rule 12(b)(6) claiming ERISA preemption. The Court converted the motion to a motion for summary judgment. Judge granted Plaintiff's Motion for time to respond to Defendant's Motion for Summary Judgment. Since the Plaintiff never responded the Court granted the motion for summary judgment. Plaintiff never appealed the Court's ruling.
Instead the Plaintiff sued again in federal court claiming Defendant violated Plaintiff's ERISA rights. District Court dismissed second suit claiming res judicata. Sixth Circuit affirmed. "Where two successive suits seek recovery for the same injury, a judgment on the merits operates as a bar to the later suit, even though a different legal theory of recovery is advanced in the second suit. Baltimore S.S. Co. v. Phillips, 274 U.S. 316, 319-21, 71 L. Ed. 1069, 47 S. Ct. 600 (1927).
