UNITED STATES DISTRICT COURT

SOUTHERN DISTRICT OF OHIO

WESTERN DIVISION

Martha Bethel

7930 Woodview Ct.

Maineville, Ohio 45039

and

Richard D. Bethel, Jr.

7930 Woodview Ct.

Maineville, Ohio 45039

Plaintiffs,

vs.

Golden Rule Insurance Company

c/o statutory agent CT Corporation 

System

150 West Market Street, Suite 800

Indianapolis, Indiana 46204

and

West Chester Hospital, LLC

c/o statutory agent GH&R Business 

Services, Inc. 

312 Walnut St., Suite 1800

Cincinnati, Ohio 45202

Defendants.

Case No. 1:18-cv-00354TSB

Judge Timothy S. Black

AMENDED COMPLAINT FOR 

DECLARATORY JUDGMENT, 

BREACH OF CONTRACT AND 

DAMAGES

Plaintiffs, Martha and Richard Bethel, (“Plaintiffs”), by and through counsel, for its 

complaint against Defendants Golden Rule Insurance Company and West Chester Hospital, state 

the following, upon information and belief. 

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VENUE AND JURISDICTION

1. Plaintiffs Martha Bethel and Richard Bethel, Jr. are married and at all times relevant herein 

were and are residents of Warren County, State of Ohio residing at 7930 Woodview Ct.,

Maineville, Ohio 45039.

2. Defendant, Golden Rule Insurance Company (“Golden Rule”), is an Indiana corporation, 

doing insurance business in the State of Ohio. 

3. Defendant. West Chester Hospital, LLC (“West Chester Hospital”) is an Ohio Limited 

Liability Company. 

4. The events that form the basis of this Complaint occurred in Ohio. 

5. Venue and jurisdiction are proper in United States Southern District of Ohio Court, 

Western Division.

FACTUAL ALLEGATIONS

6. Plaintiffs restate as if fully rewritten herein, each and every allegation contained within 

paragraphs 1 through 6 so as to sustain the foregoing paragraphs of this Complaint as set 

forth herein. 

7. In September, 2016, Plaintiff Richard D. Bethel, Jr., applied for health insurance coverage 

with the Defendant, Golden Rule Insurance Company. Plaintiff, Richard D. Bethel, Jr., 

applied for the insurance through Defendant’s agent, Regina Marie Brumley-Rebholz, to 

purchase the health insurance coverage. She assisted Mr. Bethel in answering all of the 

pertinent questions on the application form for health insurance, including preexisting 

conditions. Upon completing the application, Mr. Bethel was under the impression that he 

obtained insurance coverage for his wife and himself. 

8. On September 28, 2016, Plaintiff, Richard D. Bethel, Jr., learned, through, Regina Marie 

Brumley-Rebholz, the application had not been processed. He was directed by the agent, 

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Regina Marie Brumley-Rebholz, to go online and to fill out the online application. At the 

direction of Regina Marie Brumley-Rebholz, Mr. Bethel applied for health insurance 

coverage for he and his wife, through the Defendant, Golden Rule Insurance Company. 

Mr. Bethel paid for the health insurance coverage during the online application process.

9. After filling out the application, the Defendant, Golden Rule Insurance Company, issued a 

policy of insurance to Plaintiffs Martha Bethel and Richard D. Bethel, Jr. which provided 

insurance coverage for short term medical coverage and supplemental accident benefit. A 

true and accurate copy of the policy of insurance is attached hereto as Exhibit 1. 

10. Plaintiffs purchased the Policy from Defendants with the understanding and expectation 

that Defendants would act in good faith and deal fairly pursuant to the Policy and the 

obligations created thereunder. 

11. The Policy issued by Defendant Golden Rule Insurance Company to Plaintiffs contained 

an implied covenant that neither party would do anything to deprive the other party of the 

benefits of the Policy. 

12. Plaintiffs’ initial payment was delivered on or about September 29, 2016. 

13. Under the Policy, the insurance became effective at 12:01 AM on September 29, 2016.

14. Under the Policy, the insurance termination date was 12:01 AM on September 24, 2017. 

15. After initial payment, Plaintiffs continued to submit a monthly payment of $73.89 for 

dental and $543.70 for medical on the first of every month.

16. On or about September 25, 2016, Plaintiff, Martha Bethel was admitted into the Bethesda 

North Hospital complaining of back pain. She was diagnosed with degenerative changes 

and was told to follow up with her primary care physician. 

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17. On or about October 1, 2016, Plaintiff, Martha Bethel was admitted to the hospital for low 

back pain. An MRI was done which indicated that she had a spinal abscess and infection 

in her lower back. She was admitted to the hospital for this condition. She was in and out 

of the hospital and in and out of treatment throughout the remainder of 2016. As a result 

of this infection, Plaintiff Martha Bethel has incurred in excess of $124,000.00 in medical 

bills. Many of these medical bills have been sent to collection.

18. On or about February 8, 2017, Plaintiffs received a letter from Defendant Golden Rule 

Insurance denying insurance benefits, alleging that Plaintiffs had not cooperated with 

Defendant’s inquiries. Exhibit 2. 

19. On or about February 17, 2017, Plaintiffs’ counsel responded to Defendant Golden Rule 

Insurance’s denial letter, asserting that Plaintiffs had fully cooperated and requesting all 

relevant documents regarding the denial.

20. On or about February 20, 2017, Defendant Golden Rule Insurance sent a letter to Plaintiffs 

informing them their claim was denied as a result of misrepresentation of material fact and 

preexisting condition. Exhibit 3. 

21. On numerous occasions, Plaintiffs requested a complete copy of the claim file, in addition 

to a complete and certified copy of the policy of insurance in effect, to which no response 

was given. 

22. On or about April 26, 2017, Plaintiffs received a letter from Defendant Golden Rule 

Insurance indicating a panel reviewed the voidance of Plaintiffs’ coverage, and the decision 

to void coverage was upheld. 

23. On July 24, 2017, Defendant sent a letter to Plaintiffs that informed them their claims were 

being denied as a result of an alleged misstatement in the application in response to 

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question eight. Exhibit 4. Specifically, question eight of the application asked the 

following:

i. Have you or has any person named in question 1 had testing performed and 

has not received results or been advised by a medical professional to have 

treatment, testing or surgery that has not been performed (Excluding HIV 

and AIDS testing)?

ii. RESPONSE: Plaintiff, Richard D. Bethel, Jr. filled out the application 

process initially with the assistance of insurance agent, Regina Marie 

Brumley-Rebholz and later, online, the answer was NO. 

24. As a result of the answer in the application, the Defendant Golden Rule Insurance

has refused to pay any of the medical bills that were incurred by Plaintiffs as the 

result of the infection she sustained in her lower back which resulted in 

hospitalizations beginning on October 1, 2016. 

25. To date, Plaintiffs have exhausted all administrative avenues that they were 

required to exhaust under the policy of insurance. 

26. Pursuant to the policy, on or about January 15, 2018, Plaintiffs sent a letter to 

Defendant Golden Rule to inform them of Plaintiffs’ intent to file suit. 

COUNT ONE

27. Plaintiffs restate as if fully rewritten herein, each and every allegation contained within 

paragraphs 1 through 27 so as to sustain the cause of action in Count One. 

28. There is a valid and existing insurance agreement between Plaintiffs and Defendant,

Golden Rule Insurance.

29. Plaintiffs did everything that they were required under the contact, including paying the 

Policy premiums each month, 

30. Defendant’s, Golden Rule’s, denial of coverage was unreasonable and/or without proper 

justification and/or without proper investigation.

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31. Defendant’s, Golden Rule’s, denial demonstrated a failure or refusal to discharge a known 

and obvious contractual responsibility and it was prompted by a conscious and deliberate 

act, which frustrated an agreed upon purpose of the Policy, thereby depriving Plaintiffs of 

the bargained-for-benefits. 

32. The actions of the Defendant, Golden Rule, as described herein constitutes a Breach of 

Contract.

33. As a direct and proximate result of the Defendant’s, Golden Rule’s, Breach of Contract, 

Plaintiffs sustained damages in excess of $124,000.00, in an amount to be proved at trial.

COUNT TWO

34. Plaintiffs restate as if fully rewritten herein, each and every allegation contained within 

paragraphs 1 through 34 so as to sustain the cause of action in Count Two.

35. Regina Marie Brumley-Rebholz assisted and instructed the Plaintiff, Richard D. Bethel as 

to how to fill out the application for the insurance coverage. The recommendations and 

instructions provided by Regina Marie Brumley-Rebholz were negligent in that she 

improperly instructed Mr. Bethel how to fill out the insurance application. Regina Marie 

Brumley-Rebholz, is the agent of Defendant, Golden Rule. Golden Rule is vicariously 

liable for the actions of its agent Rebholz pursuant to the doctrine of respondeat superior. 

As a result of the actions as described herein, Plaintiffs have been damaged in the amount 

of $124,000.00 in an amount to be proven at trial. 

COUNT THREE

36. Plaintiffs restate as if fully rewritten herein, each and every allegation contained within 

paragraphs 1 through 36 so as to sustain the cause of action in Count Three. 

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37. Defendant, Golden Rule breached its statutory duties under Ohio law in the handling of the 

Plaintiffs’ health insurance claim, including, but not limited to, the requirements under 

OAC §3901-8-11 Unfair Health Claim Practices.

COUNT FOUR

38. Plaintiffs restate as if fully rewritten herein, each and every allegation contained within 

paragraphs 1 through 38 so as to sustain the cause of action in Count Four.

39. Based upon the terms and conditions of the Golden Rule insurance policy, Golden Rule 

insurance company is required to pay for the medical treatment that Plaintiff, Martha 

Bethel, received as more fully described herein.

40. Pursuant to ORC §2721.01 et seq., Plaintiffs state that there is a controversy that exists 

between them and Golden Rule Insurance Company and the Plaintiffs are entitled to a 

declaration of the rights, duties and obligations of Golden Rule Insurance Company arising 

under the terms and conditions of the policy and under Ohio law. 

41. Plaintiffs are entitled to a declaration that the Golden Rule Insurance Policy provides 

coverage for the medical treatment that Plaintiff, Martha Bethel received as described 

herein.

COUNT FIVE

42. Plaintiffs restate as if fully rewritten herein, each and every allegation contained within 

paragraphs 1 through 42 so as to sustain the cause of action in Count Five. 

43. The actions of the Defendants as described herein were done without reasonable 

justification in denying Plaintiffs claims for medical insurance payments under the policy 

of insurance and was done without reasonable justification and in violation of Ohio law. 

The Defendants’ actions constitute bad faith. 

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44. As a direct and proximate cause of Defendants’ bad faith, Plaintiffs have incurred medical 

expenses of $124,000.00. Many of these bills have been sent to collection and as a result 

of the Defendant’s bad faith, Plaintiffs have sustained severe emotional distress in an 

amount to be proven at trial but in excess of $25,000.00.

45. The actions of the Defendants as described herein constitute a reckless and conscious 

disregard for the Plaintiffs rights and the actions of the Defendants demonstrate malice 

and/or aggravated or egregious fraud, entitling Plaintiffs to punitive damages.

46. As such, the Plaintiffs are entitled to an award of damages for bad faith and an award of 

punitive damages and attorney fees against the Defendants in accordance with Ohio law in 

an amount to be determined at trial, but in excess of $25,000.00. 

COUNT SIX

47. Plaintiffs restate as if fully rewritten herein, each and every allegation contained within 

paragraphs 1 through 46 so as to sustain the cause of action in Count Six.

48. Defendant West Chester Hospital provided Plaintiff Martha Bethel with medical treatment. 

As a result, Plaintiffs incurred approximately $75,845.65 in medical bills. These medical 

bills should have been covered by Plaintiffs’ insurance. To date, however, they have not 

been paid in full. 

49. Defendant West Chester Hospital claims a right in this case and should be required to set 

forth its interest or be forever barred. 

WHEREFORE, Plaintiffs, Martha Bethel and Richard D. Bethel, Jr. hereby demand 

judgment against the Defendants, Golden Rule Insurance Company for an amount in excess of 

$124,000,00, in compensatory damages, damages for bad faith, for punitive damages, for special 

damages, for attorneys’ fees, prejudgment interest, post judgment interest any other relief this 

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Court finds just and appropriate, all in an amount to be proven at trial and for West Chester 

Hospital to set forth its interests, or be forever barred.

Respectfully submitted,

DRODER & MILLER CO., L.P.A.

/s/ Melanie M. Lennon ___

Jeffrey T. Kenney (0051807)

Melanie M. Lennon (0095576)

125 West Central Parkway

Cincinnati, Ohio 45202-1006

(513) 721-1504 ext. 202

Fax: (513) 721-0310

jkenney@drodermiller.com

mlennon@drodermiller.com

Attorneys for Plaintiffs

CERTIFICATE OF SERVICE

I hereby certify that a true and correct copy of the foregoing was uploaded to the Court’s 

electronic filing system this 17th day of October, 2018, which will cause service upon: 

Katheryn M. Lloyd, Esq. 

Shana Ortiz See, Esq. 

280 Plaza, Suite 1300

Columbus, Ohio 43215

lloyd@carpenterlipps.com

see@carpenterlipps.com

Attorney for Defendant, Golden Rule 

Insurance Company

/s/ Melanie M. Lennon ___

Jeffrey T. Kenney (0051807)

Melanie M. Lennon (0095576)

Attorneys for Plaintiffs

18th

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