UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF FLORIDA

PENSACOLA DIVISION

 

FELICIA LYONS,

Plaintiff, Case No.:

v.

HARTFORD LI FE AND

ACCIDENT INSURANCE CO.,

Defendant.

_____________________________/

COMPLAINT 

COMES NOW the Plaintiff, FELICIA LYONS (hereinafter, “Plaintiff”), by

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

action against Defendant, HARTFORD LIFE AND ACCIDENT INSURANCE CO..

(hereinafter, “Defendant”/“Hartford”), 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 she claims are due to her 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 her former employer’s group policy issued by

Defendant which she claims has been wrongfully denied.

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PARTIES

2. Plaintiff, Felicia Lyons, is and at all times material hereto was, an adult

resident citizen of Florida, and resident of Escambia 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 Connecticut and authorized

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

Northern District of Florida. 

4. At all timesrelevant to this action, Defendant provided insurance LongTerm Disability (“LTD”) Benefits, along with other benefits , to Plaintiff pursuant to

policy number GLT 395110.

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.

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BASIS FOR JURISDICTION

8. ThisCourtmaintainssubjectmatterjurisdiction overthis action pursuant

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

FACTS APPLICABLE TO ALL COUNTS

9. Plaintiff purchased through her employer, Grifols Shared Services North

America, Inc., a contract of salary continuance insurance including LTD benefits and

other benefits. 

10. On or before January 16, 2019, Plaintiff became totally disabled from

her past employment as defined by the Plan, due to her limitations resulting from

anxiety, chronic neck, back, and shoulder pain and other exertional and nonexertional impairments.

11. Plaintiff made application for LTD benefits and all other available

benefits to the Defendant on July 11, 2019.

12. By way of a letter dated November 5, 2019, Hartford communicated to

Defendant that all LTD benefits and all other benefits were denied.

13. Plaintiff timely appealed the termination of these benefits by letter dated

January 24, 2020.

14. By letter dated January 29, 2020, Defendant confirmed the receipt of

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Plaintiff’s LTD appeal.

15. By letter dated August 7, 2020, Hartford denied the appeal of these

benefits.

16. Plaintiff continues to suffer from limitations due to anxiety, chronic

back, neck, and shoulder pain, as well as other exertional and non-exertional

limitations, that prevent her from performing her “Own occupation” as defined under

the Plan nor “Any occupation” as defined by the plan.

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 claimfor LTD benefits and all

other available benefits was arbitrary and capricious, constituted abuse of

Defendant’s discretion under the Plan, and derogated Plaintiff’s right to disability

benefits and any other benefits under the terms of the Plan.

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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 August 20, 2020.

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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