Second Circuit Holds Power of Attorney Does Not Give Medical Provider Standing to Sue under ERISA

In Karkare v. Int’l Ass’n of Bridge, No. 22-2874, —F.4th—-, 2025 WL 1618132 (2d Cir. June 9, 2025) (Before: Sullivan, Robinson, and Kahn, Circuit Judges), the Second Circuit Court of Appeals considered whether a medical provider has standing to sue for benefits under the Employee Retirement Income Security Act of 1974 (“ERISA”) using a power of attorney. The district court dismissed the complaint sua sponte after concluding that a power of attorney, distinct from an assignment of claim, did not permit the provider to maintain his ERISA cause of action on behalf of his patient. The court remanded the case to the district court to consider whether the patient should be permitted to substitute into the action pursuant to Federal Rule of Civil Procedure 17.

Dr. Nakul Karkare, a surgeon affiliated with AA Medical, took legal action against the International Association of Bridge, Structural, Ornamental & Reinforcing Iron Workers Local 580. The dispute arose over unpaid benefits for surgical services he provided to Patient JN, with Dr. Karkare acting under a power of attorney from the patient. The union, which had a self-funded insurance plan, reimbursed only a fraction of the claimed amount for the surgery, leading to this litigation.

The central question was whether Dr. Karkare had the standing to sue under ERISA using a power of attorney. The court determined that Dr. Karkare lacked Article III standing. Despite holding a power of attorney, he was suing in his own name rather than on behalf of Patient JN. The court emphasized that a power of attorney does not equate to an ownership interest in the claim, which is crucial for establishing standing. ERISA typically restricts the right to sue to plan participants and beneficiaries. While there is a limited allowance for claims based on valid assignments, the court highlighted that a power of attorney is not a substitute for such assignments.

The court vacated part of the district court’s decision and remanded the case, allowing for the possibility of substituting Patient JN into the action or amending the complaint to properly assert the ERISA claim.