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COMPLAINT

KANTOR & KANTOR LLP

19839 Nordhoff Street

Northridge, California 91324

(818) 886 2525

Glenn R. Kantor – SBN 122643

Email: gkantor@kantorlaw.net

Corinne Chandler – SBN 111423

Email: cchandler@kantorlaw.net

Andrew M. Kantor – SBN 303093

Email: akantor@kantorlaw.net

KANTOR & KANTOR, LLP

19839 Nordhoff Street

Northridge, California, 91324

Telephone: (818) 886-2525

Facsimile: (818) 350-6272

Attorneys for Plaintiff,

Nicholas Zakas

UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF CALIFORNIA

SAN JOSE

NICHOLAS ZAKAS,

Plaintiffs,

v. 

THE GUARDIAN LIFE INSURANCE 

COMPANY OF AMERICA, AND 

BOX, INC. HEALTH & WELFARE 

PLANS, 

Defendants.

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Case No.: 

COMPLAINT FOR BREACH OF 

THE EMPLOYEE RETIREMENT 

INCOME SECURITY ACT OF 1974;

ENFORCEMENT AND 

CLARIFICATION OF RIGHTS; 

PREJUDGMENT AND POST 

JUDGMENT INTEREST AND 

ATTORNEYS’ FEES AND COSTS 

Plaintiff Nicholas Zakas herein sets forth the allegations of his Complaint 

against The Guardian Life Insurance Company of America and Box, Inc. Health &

Welfare Plans (hereinafter sometimes referred to as “defendants”).

JURISDICTIONAL AND VENUE ALLEGATIONS

1. Plaintiff brings this action for declaratory and monetary relief pursuant to 

§§502(a)(1)(B) and 502(a)(3) of the Employee Retirement Income Security Act of 

1974 (“ERISA”) and 29 U.S.C. §§1132(a), (e), (f) and (g), as it involves a claim by 

plaintiff for employee benefits under an employee benefit plan regulated and governed 

Case 5:17-cv-00384-NC Document 1 Filed 01/25/17 Page 1 of 7
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COMPLAINT

KANTOR & KANTOR LLP

19839 Nordhoff Street

Northridge, California 91324

(818) 886 2525

by ERISA. Jurisdiction is predicated under these code sections as well as 28 U.S.C. § 

1331 as this action involves a federal question.

2. This action is brought for the purpose of recovering short and long term 

disability benefits under the terms of an employee short term and long term health and 

welfare plan, enforcing plaintiff’s rights under the terms of a short term and long term 

health and welfare plan, and to clarify plaintiff’s rights to future benefits under an

short term and long term health and welfare plan. Plaintiff seeks relief, including but 

not limited to, payment of benefits, prejudgment and post-judgment interest, 

reinstatement to the benefit plans at issue herein, and attorneys’ fees and costs.

3. Plaintiff was at all times relevant an employee of Box, Inc. and a resident 

of the County of Santa Clara, State of California.

4. Plaintiff is informed and believes that defendant, The Guardian Life 

Insurance Company of America (hereinafter “The Guardian”), is a corporation with its 

principal place of business in the State of New York, authorized to transact and 

transacting business in the Northern District of California and can be found in the 

Northern District of California. 

5. Plaintiff is informed and believes that Box, Inc. insured its STD and LTD 

plans in whole or in part via the purchase of a short term and long term disability 

insurance policies through The Guardian. The Guardian is the insurer of all or some 

portion of benefits under the Box, Inc. Health & Welfare Plans (“the STD and LTD 

Plans”). The Guardian administered the claims, interpreted Plan terms, and issued a 

claim denial, all while operating under a conflict of interest; and the bias this created 

adversely affected the claims determination.

6. Plaintiff is informed and believes that The Guardian identifies the group 

short term and long term disability policy it issues to Box, Inc. as Group Policy No. 

G- 00463378-HC.

Case 5:17-cv-00384-NC Document 1 Filed 01/25/17 Page 2 of 7
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COMPLAINT

KANTOR & KANTOR LLP

19839 Nordhoff Street

Northridge, California 91324

(818) 886 2525

7. Plaintiff is informed and believes that the Policy was intended by Box, 

Inc. and The Guardian to insure citizens of the State of California, including plaintiff

herein, Nicholas Zakas.

8. Plaintiff is informed and believes that the Policy was in effect after 

January 1, 2012. The policy had a contract year from January 1, 2011 to January 1, 

2012.

9. The Policy was renewed after January 1, 2012. 

10. Plaintiff is informed and believes that the Policy had an anniversary date 

after January 1, 2012.

11. Plaintiff is informed and believes that the STD and LTD Health & 

Welfare Plans are employee welfare plans regulated by ERISA, established by Box, 

Inc., under which plaintiff is and was a participant, and pursuant to which plaintiff is 

entitled to STD and LTD benefits. Pursuant to the terms and conditions of the Plan, 

plaintiff is entitled to STD and LTD benefits for the duration of plaintiff’s disability, 

for so long as plaintiff remains disabled as required under the terms of the STD and 

LTD Plans. The Plans are doing business in this judicial district, in that they cover 

employees residing in this judicial district.

12. Defendants operate and, at all relevant times, have done business in this 

judicial district, in that they cover participants who reside in this judicial district. 

Thus, venue is proper in this judicial district pursuant to 29 U.S.C. § 1132(e)(2). 

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Case 5:17-cv-00384-NC Document 1 Filed 01/25/17 Page 3 of 7
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COMPLAINT

KANTOR & KANTOR LLP

19839 Nordhoff Street

Northridge, California 91324

(818) 886 2525

FIRST CAUSE OF ACTION

AGAINST THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA

AND BOX, INC. HEALTH AND WELFARE PLANS

FOR PLAN BENEFITS, ENFORCEMENT AND CLARIFICATION OF 

RIGHTS, PREJUDGMENT AND POSTJUDGMENT INTEREST, AND 

ATTORNEYS’ FEES AND COSTS

(29 U.S.C. § 1132(a)(1)(B))

13. Plaintiff incorporates by reference all preceding paragraphs as though 

fully set forth herein.

14. At all times relevant, Plaintiff was employed by Box, Inc., and was a 

covered participant under the terms and conditions of the STD and LTD Plans. The 

STD and LTD plans were insured by defendant The Guardian, and The Guardian was 

also the Plan claims administrator and made all decisions to pay or deny benefit 

claims. 

15. During the course of plaintiff’s employment, plaintiff became entitled to 

benefits under the terms and conditions of the STD and LTD Plans. Specifically, 

while plaintiff was covered under the STD and LTD Plans, plaintiff suffered a 

disability rendering plaintiff disabled as defined under the terms of the STD and LTD 

Plans.

16. Pursuant to the terms of the STD and LTD Plans, plaintiff made a claim 

to The Guardian for STD and LTD benefits under the STD and LTD Plans. 

Specifically, while plaintiff was covered under the STD and LTD Plans, plaintiff

suffered a disability rendering plaintiff disabled as defined under the terms of the STD 

and LTD Plan. Plaintiff’s medical leave resulting from his disabling condition 

commenced on or about February 12, 2016. Around that time, Plaintiff applied for 

Short Term disability benefits under the terms of the Short Term Disability Plan.

17. The Guardian denied Plaintiff’s claim on May 6, 2016. On August 16, 

2016, Plaintiff appealed the denial of his claim for short term disability benefits.

Case 5:17-cv-00384-NC Document 1 Filed 01/25/17 Page 4 of 7
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COMPLAINT

KANTOR & KANTOR LLP

19839 Nordhoff Street

Northridge, California 91324

(818) 886 2525

18. On August 23, 2016, Plaintiff submitted his application for Long Term 

Disability benefits.

19. On or about October 27, 2016, The Guardian a rendered its decision on 

appeal, upholding the original denial of Short Term Disability benefits. Guardian 

never addressed Plaintiff’s claim for Long Term Disability benefits.

20. Plaintiff exhausted his administrative remedies under the terms of the 

Short Term Disability plan by filing a timely appeal.

21. Plaintiff has exhausted his administrative remedies under the terms of the 

Long Term Disability Plan, as Guardian failed to render a decision on Plaintiff’s claim 

for Long Term disability benefits in a timely fashion, and as such, Plaintiff, in 

submitting his claim for LTD benefits has been deemed to have exhausted his prelitigation remedies.

22. The Guardian and the Plan have breached the Plans and violated ERISA 

in the following respects:

(a) Failing to pay STD & LTD benefit payments to plaintiff at a time 

when The Guardian and the Plan knew, or should have known, that plaintiff

was entitled to those benefits under the terms of the STD & LTD Plans, as 

plaintiff was disabled and unable to work and therefore entitled to benefits. 

Even though The Guardian and the Plans had such knowledge, The Guardian

denied plaintiff’s STD benefits, and never rendered a decision on Plaintiff’s 

claim for LTD benefits;

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

relied on under the terms of the Plan documents, in relation to the applicable 

facts and Plan provisions, for the denial of plaintiff’s claims for benefits;

(c) After plaintiff’s claim was denied in whole or in part, The 

Guardian failed to adequately describe to plaintiff any additional material or 

information necessary for plaintiff to perfect his claim along with an 

explanation of why such material is or was necessary; and

Case 5:17-cv-00384-NC Document 1 Filed 01/25/17 Page 5 of 7
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COMPLAINT

KANTOR & KANTOR LLP

19839 Nordhoff Street

Northridge, California 91324

(818) 886 2525

(d) Failing to properly and adequately investigate the merits of 

plaintiff’s disability claim and failing to provide a full and fair review of 

plaintiff’s claim.

23. Plaintiff is informed and believes and thereon alleges that defendants

wrongfully denied plaintiff’s disability benefits under the Plans, by other acts or 

omissions of which plaintiff is presently unaware, but which may be discovered in this 

future litigation and which plaintiff will immediately make defendants aware of once 

said acts or omissions are discovered by plaintiff. 

24. Following the denial of benefits under the STD Plan, and failure to 

render a decision under the LTD Plan, plaintiff exhausted all administrative remedies 

required under ERISA, and plaintiff has performed all duties and obligations on 

plaintiff’s part to be performed under the Plans. 

25. As a proximate result of the aforementioned wrongful conduct of The 

Guardian, plaintiff has damages for loss of disability benefits in a total sum to be 

shown at the time of trial.

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

regarding plaintiff’s STD claim, and failure to render a decision of Plaintiff’s LTD 

claim, Plaintiff, in pursuing this action, has been required to incur attorneys’ costs and 

fees. Pursuant to 29 U.S.C. § 1132(g)(1), plaintiff is entitled to have such fees and 

costs paid by Defendants.

27. The wrongful conduct of The Guardian and the Plans has created 

uncertainty where none should exist. Therefore, plaintiff is entitled to enforce his

rights under the terms of the Plans and to clarify his right to future benefits under the 

terms of the Plans.

REQUEST FOR RELIEF

 WHEREFORE, plaintiff prays for relief against defendants as follows:

1. Payment of disability benefits due plaintiff up to and including the date 

of Judgment;

Case 5:17-cv-00384-NC Document 1 Filed 01/25/17 Page 6 of 7
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COMPLAINT

KANTOR & KANTOR LLP

19839 Nordhoff Street

Northridge, California 91324

(818) 886 2525

2. An order declaring that plaintiff is entitled to immediate payment of all 

past due benefits, reinstatement to the STD & LTD Plan, with all ancillary benefits to 

which she is entitled by virtue of his disability, and that benefits are to continue to be 

paid under the Plans for so long as plaintiff remains disabled under the terms of the 

Plans;

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

remanding plaintiff’s claim to the claims 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 prejudgment and post-judgment interest as allowed for under 

ERISA; and

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

DATED: January 25, 2017 KANTOR & KANTOR, LLP

By: /s/ Andrew M. Kantor

Andrew M. Kantor

Attorneys for Plaintiff

Nicholas Zakas

Case 5:17-cv-00384-NC Document 1 Filed 01/25/17 Page 7 of 7