[DOWNLOAD] "International Association of Machinists and Aerospace Workers v. Waukesha Engine Division" by United States Court of Appeals for the Seventh Circuit " Book PDF Kindle ePub Free

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• Title: International Association of Machinists and Aerospace Workers v. Waukesha Engine Division
• Author : United States Court of Appeals for the Seventh Circuit
• Release Date : January 17, 1994
• Genre: Law,Books,Professional & Technical,
• Pages : * pages
• Size : 74 KB

Description

ESCHBACH, Circuit Judge. On behalf of one its members, the International Association of Machinists (""IAM"") filed a complaint with the Wisconsin Employment Relations Board (""WERB"") against Waukesha Engine Division, Dresser Industries (""Waukesha"") to compel arbitration over a grievance arising under their Collective Bargaining Agreement (""CBA""). After removal to federal court pursuant to Section 301 of the Labor Management Relations Act of 1947, 29 U.S.C. § 185, and 28 U.S.C. § 1441, the district court dismissed IAM's complaint on the ground that the dispute between IAM and Waukesha was not subject to arbitration as provided in the CBA. We agree and affirm the district court's dismissal of IAM's complaint. We have jurisdiction pursuant to 28 U.S.C. § 1291. James Schmoller is an employee of Waukesha and a member of IAM. At all relevant times, both he and his wife Judy were participants in Waukesha's Group Benefits Plan (the ""Plan""), which includes medical benefits. The CBA expressly incorporates the Plan, which is self-funded by Waukesha. Aetna Life Insurance Company (""Aetna""), not a party to this lawsuit or to the CBA, is the Plan's Benefits Administrator. As the Benefits Administrator, among other things, Aetna evaluates the medical necessity of participants' requests for certain medical treatment, including hospital stays. During the period in which she was covered under the Plan, Judy Schmoller became ill and requested precertification under the Plan for a 14-day hospital stay. Aetna granted this request as well as Ms. Schmoller's later request for seven more days. Mrs. Schmoller then requested precertification for 14 additional days. Aetna denied this last request, concluding that hospitalization was not ""medically necessary"" because the care she required could be provided on an out-patient basis. Notwithstanding Aetna's denial of her request, Mrs. Schmoller stayed in the hospital approximately two-and-a-half more weeks, incurring additional charges for which the Plan refused reimbursement.

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