UNITED STATES DISTRICT COURT

 SOUTHERN DISTRICT OF FLORIDA

CASE NO.:

FRANCIS O. BOYER,

Plaintiff,

v.

HARTFORD LIFE AND ACCIDENT

INSURANCE COMPANY,

Defendant.

____________________________________)

COMPLAINT

The Plaintiff, FRANCIS O. BOYER (“BOYER”), by and through his undersigned 

counsel, hereby sues HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY 

(“HARTFORD”), and alleges as follows:

JURISDICTION, VENUE AND PARTIES

1. This action arises under ERISA or the Employee Retirement Income Security Act of 

1974, 29 USC §§ 1001 et seq., and more particularly 29 USC §1132 (a) (1) (B) thereof. 

This Court has jurisdiction under 29 USC § 1132 (f), which grants to the federal court 

original jurisdiction to determine claims under 29 USC §§ 1001 et seq. BOYER brings 

this action to recover long-term disability (“LTD”) benefits due to him under the terms of 

an employee welfare benefit plan, to enforce his rights under the plan and to clarify his

rights to benefits under the terms of the plan.

2. BOYER was at all times relevant a citizen of the United States of America and in all 

respects sui juris.

3. HARTFORD is a corporation with its principal place of business in the State of 

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Connecticut that is authorized to transact and is transacting business in the Southern 

District of Florida.

4. Venue is proper in this District under 29 USC 1132 (e)(2), in that the defendant, 

HARTFORD, is authorized to and is doing business within the Southern District of 

Florida and “may be found” in the Southern District of Florida

FACTUAL ALLEGATIONS

5. This case arises out of the purposeful, unwarranted and unlawful denial of disability 

benefits to BOYER by HARTFORD.

6. BOYER was at all times material a plan participant under Long Term Disability 

Insurance Policy GLT-677230 (the “LTD Policy”), which is a group Long Term 

Disability Insurance Policy/Plan issued by HARTFORD to VALMONT INDUSTRIES, 

INC., which is the Policyholder, Employer, Plan Sponsor and Plan Administrator. It is 

pursuant to Policy GLT-677230 to which BOYER is entitled to benefits. 

7. The LTD Policy is an employee welfare benefit plan within the meaning of Title 29, USC 

§ 1002 and regulated by ERISA.

8. HARTFORD is the insurer of benefits under the LTD Policy and was appointed by the 

Plan Administrator as the named fiduciary for deciding claims for benefits under the LTD 

Policy and for deciding any appeals of denied claims.

9. As the decision maker and payer of plan benefits, HARTFORD administered the claim 

with a conflict of interest and the bias this created affected the claims determination. As 

such, HARTFORD is not entitled to a deferential standard of review.

10. HARTFORD is the fiduciary charged with making benefit determinations under the LTD 

Policy, including the determinations made on BOYER’s claim at issue.

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11. Pursuant to the terms and conditions of the LTD Policy, BOYER is entitled to LTD 

benefits for the duration of his disability, or until age 67, so long as he remains disabled 

as required under the terms of the LTD Policy. 

12. According to the LTD Policy, 

13. At all relevant times, BOYER complied with all conditions precedent and exhausted all 

required administrative remedies under the LTD Policy.

14. Since September 29, 2021, BOYER has been disabled under the terms of the LTD Policy.

15. Since September 29, 2021, as a result of accidental bodily injury, sickness, mental illness, 

or substance abuse, BOYER has been prevented from performing one or more of the 

Essential Duties of Any Occupation, as such is defined by the policy. 

16. At all relevant times, BOYER has been under the appropriate and regular care and 

treatment of a physician.

17. At all relevant times, BOYER was a Covered Person under the LTD Policy.

18. Shortly after becoming disabled, BOYER made a claim under the LTD Policy for 

disability benefits but no benefits under the LTD policy have ever been paid. 

19. By letter dated June 1, 2022, BOYER was informed by HARTFORD that it had 

determined that he did not meet the policy definition of disability and that benefits were 

not payable. 

20. BOYER properly and timely submitted an appeal of HARTFORD’s June 1, 2022 denial 

letter. 

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21. By letter dated August 24, 2022, HARTFORD notified BOYER of its decision to uphold 

its previous decision which denied his claim for LTD benefits and this correspondence 

also informed BOYER that no further appeals would be considered as his administrative 

remedies had been exhausted. 

22. At all relevant times, BOYER complied with all conditions precedent and exhausted all 

required administrative remedies under the LTD Policy. 

23. BOYER has never received benefits owed to him under the LTD Policy, despite 

BOYER’s right to these benefits.

24. HARTFORD has refused to pay any and all LTD benefits.

25. At all relevant times, HARTFORD was the payer of benefits.

26. At all relevant times, HARTFORD was the “Insurance Company” responsible for the 

LTD Policy.

27. At all relevant times, HARTFORD was appointed by the Plan Administrator as the 

named fiduciary for deciding claims for benefits under the LTD Policy and for deciding 

any appeals of denied claims.

28. At all relevant times, BOYER has been and remains Disabled and entitled to LTD 

benefits from HARTFORD under the terms of the LTD Policy.

29. BOYER has been forced to retain the services of the undersigned counsel in order to 

prosecute this action and is obligated to pay a reasonable attorney’s fee.

CLAIM FOR BENEFITS, ENFORCEMENT AND CLARIFICATION OF RIGHTS, 

PREJUDGMENT AND POSTJUDGMENT INTEREST AND ATTORNEYS’ FEES AND 

COSTS PURSUANT TO 29U.S.C. § 1132(a)(1)(B)

30. BOYER incorporates Paragraphs 1 through 29 as if fully set forth herein.

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31. This is a claim to recover benefits, enforce rights, and clarify rights to future benefits 

under 29 U.S.C. §1132(a)(1)(B)

32. Pursuant to 29 U.S.C. §1132(a)(1)(B), BOYER, as a participant under the LTD Policy, is 

entitled to sue for judicial determination and enforcement of benefits. 

33. BOYER has no other adequate remedy at law to address the injuries he has suffered and 

will continue to suffer as a result of HARTFORD’s failure to pay his disability benefits. 

34. BOYER has exhausted all administrative remedies under the LTD Policy.

35. Defendant breached the LTD Policy and violated ERISA in the following respects: 

(a) Failing to pay LTD benefit payments to BOYER at a time 

when HARTFORD knew, or should have known, that BOYER was entitled to 

those benefits under the terms of the LTD Policy, as BOYER was disabled and 

unable to work and therefore entitled to benefits. 

(b) Failing to provide a prompt and reasonable explanation of 

the basis relied upon under the terms of the LTD Policy documents, in relation to 

the applicable facts and LTD Policy provisions, for the termination of BOYER’s

claim for LTD benefits; 

(c) After BOYER’s claim was terminated in whole or in part, 

HARTFORD failed to adequately describe to BOYER any additional material or 

information necessary for BOYER to perfect his claim along with an explanation 

of why such material is or was necessary.

(d) HARTFORD failed to properly and adequately investigate 

the merits of BOYER’s disability claim and failed to provide a full and fair 

review of BOYER’s claim. 

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36. BOYER believes and thereon alleges that HARTFORD wrongfully terminated his claim 

for disability benefits under the LTD Policy by other acts or omissions of which BOYER

is presently unaware, but which may be discovered in this future litigation and which 

BOYER will immediately make HARTFORD aware of once said acts or omissions are 

discovered by BOYER. 

37. Following the termination of benefits under the LTD Policy, BOYER exhausted all 

administrative remedies required under ERISA, and BOYER has performed all duties and 

obligations on his part to be performed under the LTD Policy.

38. As a proximate result of the aforementioned wrongful conduct of HARTFORD, BOYER

has damages for loss of disability benefits in a total sum to be shown at the time of trial.

39. As a further direct and proximate result of this improper determination regarding 

BOYER’s claim for benefits, BOYER, in pursuing this action, has been required to incur 

attorneys’ costs and fees. Pursuant to 29 U.S.C. § 1132(g)(1), BOYER is entitled to have 

such fees and costs paid by HARTFORD. 

40. The wrongful conduct of HARTFORD has created uncertainty where none should exist. 

As such, BOYER is entitled to enforce his rights under the terms of the LTD Policy and 

to clarify his right to future benefits under the terms of the LTD Policy. 

REQUEST FOR RELIEF

WHEREFORE, FRANCIS O. BOYER prays for relief against HARTFORD LIFE AND 

ACCIDENT INSURANCE COMPANY as follows:

1. Payment of disability benefits due Plaintiff; 

2. An order declaring that Plaintiff is entitled to immediate reinstatement to the LTD Policy, 

with all ancillary benefits to which he is entitled by virtue of his disability, and that 

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benefits are to continue to be paid under the LTD Policy for so long as Plaintiff remains 

disabled under the terms of the LTD Policy; 

3. In the alternative to the relief sought in paragraphs 1 and 2, an order remanding Plaintiff’s 

claim to the claim’s administrator to the extent any new facts or submissions are to be 

considered; 

4. Pursuant to 29 U.S.C. § 1132(g), payment of all costs and attorneys’ fees incurred in 

pursuing this action; 

5. Payment of pre-judgment and post-judgment interest as allowed for under ERISA; and 

6. Such other and further relief as this Court deems just and proper. 

DATED: November 3, 2022

ATTORNEYS DELL AND SCHAEFER, 

CHARTERED

Attorneys for Plaintiff

2625 Weston Road

Weston, FL 33331

Phone: (954) 620-8300

Fax: (954) 922-6864

S/ Alexander A. Palamara

ALEXANDER A. PALAMARA, ESQUIRE

Florida Bar No: 0037170

Email: alex@diattorney.com

GREGORY MICHAEL DELL, ESQUIRE

Florida Bar No: 299560

Email: gdell@diattorney.com

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