UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF FLORIDA

RICHARD DYE,

Plaintiff, Case No.:

v.

ANTHEM LIFE INSURANCE

COMPANY,

Defendant.

_____________________________/

COMPLAINT

COMES NOW the Plaintiff, RICHARD DYE (hereinafter, “Plaintiff”), by and

through the undersigned attorney, and files this Complaint stating a cause of action

against Defendant, ANTHEM LIFE INSURANCE COMPANY (hereinafter,

“Defendant”/“ANTHEM”), and alleges as follows:

1. This is an action for recovery of benefits under an employee welfare

benefit plan brought pursuant to 29 U.S.C. Section 1001, Et Seq. (“ERISA”). Plaintiff

seeks to recover benefits he claims are due to him under the ERISA governed plan

pursuant to 29 U.S.C. §1132(a)(1)(b) (“ERISA”). More specifically, Plaintiff seeks

long-term disability benefits under his former employer’s group policy issued by

Defendant which he claims has been wrongfully denied.

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PARTIES

2. Plaintiff, RICHARD DYE, is and at all times material hereto was, an

adult resident citizen of Santa Rosa County, Florida.

3. Defendant is, and at all times material hereto was, a foreign for-profit

corporation incorporated under the laws of the State of Indiana and authorized to

engage and engaging in business within the State of Florida, including the Northern

District of Florida. 

4. At all times relevant to this action, Defendant provided insurance longterm disability (“LTD”) benefits to Plaintiff pursuant to Anthem Life Insurance

Company Group Number C00415 (“the Plan”).

5. At all times relevant to this action, the Plan was in full force and effect

and Plaintiff was a Plan participant. 

6. Defendant is in possession of all master Plan Documents.

7. Defendant is a third party plan administrator or claims fiduciary given

discretion to interpret Plan provisions and is a Plan fiduciary, or alternatively, is a

Plan fiduciary without discretion to interpret Plan provisions.

BASIS FOR JURISDICTION

8. This Court maintains subject matter jurisdiction over this action pursuant

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to 29 U.S.C. Section 1132(e) and 28 U.S.C. Section 1331.

FACTS APPLICABLE TO ALL COUNTS

9. Plaintiff purchased through his employer, Anthem Companies, Inc., a

contract of salary continuance insurance including LTD benefits. 

10. On or before October 16, 2018, Plaintiff became totally disabled from

his past employment as defined by the Plan, due to Major Depressive Disorder,

Degenerative Joint Disease, and other exertional and non-exertional impairments. 

11. Plaintiff made application for LTD benefits to the Defendant, and 

Defendant denied such application.

12. On or about June 5, 2018, Defendant or its agents denied benefits by

letter dated August 5, 2019.

13. Plaintiff timely appealed the termination of LTD benefits by the

Defendant, by letter dated January 15, 2020 seeking immediate payment of LTD

benefits.

14. By letter dated January 24, 2020, Defendant confirmed the receipt of

Plaintiff’s LTD appeal.

15. By letter dated May 15, 2020, Defendant denied Plaintiff’s LTD appeal

and upheld its previous refusal to approve payment of LTD benefits payable to

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Plaintiff under the Plan.

16. Plaintiff continues to suffer from Major Depressive Disorder,

Degenerative Disc Disease, and other exertional and non-exertional impairments

which render him disabled from his “Own Occupation” as well as “Any Occupation”

as defined by the Plan language.

17. Plaintiff has exhausted all available administrative remedies afforded by

the Plan and has otherwise complied with all conditions precedent to this action.

18. Each of Defendant’s denials of Plaintiff’s claim for LTD benefits was

arbitrary and capricious, constituted abuse of Defendant’s discretion under the Plan,

and derogated Plaintiff’s right to disability benefits under the terms of the Plan.

WHEREFORE, Plaintiff prays for a judgment against the Defendant for all

Plan benefits owing at the time of said judgment, pre-judgment interest, attorney’s

fees, costs of this action, and all other relief deemed just and proper by the Court.

Dated this 28th Day of May, 2020.

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Respectfully submitted,

/s/ Daniel M. Soloway

Daniel M. Soloway, Esq.

Florida Bar No.: 508942

d.soloway@solowaylawfirm.com

/s/ R. Ian MacLaren

R. Ian MacLaren, Esq.

Florida Bar No.: 47743

i.maclaren@solowaylawfirm.com

Soloway Law Firm 

1013 Airport Blvd

Pensacola, FL 32504

(850) 471-3300 (T)

(850) 471-3392 (P) 

Counsel for Plaintiff

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