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R. Scott Wilson 

TN Bar Number 019661 

Pro hac vice Motion simultaneously filed 

The Wilson Firm, PLLC

2288 Gunbarrel Road 

Suite 154, #225 

Chattanooga, TN 37421

(423) 498-6511 

Fax (423) 498-6512 

Eric Buchanan & Associates, PLLC 

Of Counsel 

swilson@wilsondisability.com

IN THE UNITED STATES DISTRICT COURT 

FOR THE DISTRICT OF ARIZONA

Ian Peterson, ) Case No.

 ) 

Plaintiff, ) 

 ) 

vs. ) 

 ) 

Aetna Life Insurance Company, ) Complaint for Recovery of Plan 

 ) Benefits and For the Enforcement 

 Defendant. ) of Rights Under ERISA 

 ) 

__________________________________ ____) 

COMPLAINT FOR RECOVERY OF PLAN BENEFITS AND FOR THE 

ENFORCEMENT OF RIGHTS UNDER ERISA 

COMES NOW, Plaintiff, Ian Peterson, and makes the following representations to 

the Court for the purpose of obtaining relief from Defendant’s refusal to pay long term 

disability (LTD) benefits due under an employee benefits plan under ERISA, and for 

Defendant’s other violations of the Employee Retirement Security Act of 1974 

(“ERISA”):

Case 2:18-cv-00122-JJT Document 1 Filed 01/12/18 Page 1 of 7
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 JURISDICTION AND VENUE 

 1. This Court’s jurisdiction over the Plaintiff’s claim for long term disability 

benefits is invoked under federal question jurisdiction pursuant to 28 U.S.C. § 1331 and 

under the express jurisdiction found in the ERISA statute under 29 U.S.C. § 1132(e) 

(ERISA § 502(e)). Plaintiff’s claims “relate to” an “employee welfare benefits plan” as 

defined by ERISA, 29 U.S.C. § 1001 et seq. and the subject long-term disability policy 

constitutes a “plan under ERISA.” 

 2. The ERISA statute, at 29 U.S.C. § 1133, as well as Department of Labor 

regulations, at 29 C.F.R. § 2560.503-1 provide a mechanism for administrative or internal 

appeal of benefits denials. In this case, those avenues of appeal have been exhausted and 

this matter is now properly before this court for judicial review. 

 3. Venue is proper within the District of Arizona pursuant to 29 U.S.C. § 1132(e)

(2). 

PARTIES 

 4. Plaintiff, Ian Peterson, (hereinafter “Plaintiff”), is, and was at all relevant times, 

a resident of Maricopa County, Arizona. 

 5. Plaintiff alleges upon information and belief that Defendant Aetna Life 

Insurance Company (hereinafter, “Aetna”) is the party obligated to administer claims and 

pay benefits under the Bombardier Transportation (Holdings) USA, Inc., Long Term 

Disability Insurance Benefit Plan, of which Plaintiff is a beneficiary. 

2

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 6. Aetna is the underwriter for Long Term Disability Group Policy Number 

877081, issued by Aetna to the Bombardier Transportation (Holdings) USA, Inc. 

 7. Aetna is an insurance company authorized to transact the business of insurance 

in this state, and may be served with process through the CT Corporation System, North 

Central Avenue, Suite 460, Phoenix, Arizona, 85012. 

FACTS 

8. Plaintiff was employed by Bombardier Transportation (Holdings) USA, Inc., in 

its Phoenix, Arizona, location. 

 9. By virtue of his employment, Plaintiff is covered by Group Insurance Policy 

877081, issued by Aetna to the Bombardier Transportation (Holdings) USA, Inc. 

10. Bombardier Transportation (Holdings) USA, Inc.’s provision of group 

insurance coverage constitutes an ERISA welfare benefit plan. 

11. Plaintiff is a participant or beneficiary of the Plan and is covered by the Policy 

that provides long term disability benefits under the Plan. 

12. Plaintiff ceased work effective October 14, 2014, due to the effects of brittle 

diabetes. 

13. Plaintiff filed a timely application for benefits under the Plan. 

14. That application for benefits was approved, and Aetna paid benefits through 

April 7, 2017. 

15. By letter dated April 7,2017, Aetna denied benefits beyond April 11, 2017, 

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finding that Plaintiff was capable of sedentary exertion, and therefore not disabled once 

the policy’s definition of disability shifted from an “own occupation” to and “any 

occupation” standard. 

16. Plaintiff timely appealed Aetna’s decision, citing frequent episodes of hypoand hyperglycemia, preventing him from sustaining a regular work schedule at any 

exertional level. 

17. Plaintiff provided updated medical records demonstrating his uncontrolled 

blood sugar levels, as well as the opinion of his treating physician that Plaintiff should 

remain off work until his blood sugars are resolved. 

18. By letter dated September 15, 2017, Aetna denied Plaintiff’s appeal, and stated 

that the decision was final. 

19. Plaintiff has exhausted his administrative remedies under the Plan.

20. At no time did Aetna exercise its option to have Plaintiff examined by a 

physician of its choosing. 

21. The decision was arbitrary and capricious to deny benefits without a medical 

examination. 

22. The decision was arbitrary and capricious to deny benefits without a change in 

Plaintiff’s underlying condition. 

23. The entity that made the decision to deny benefits would pay any benefits due 

out of its own funds. 

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24. The entity that made the decision to deny benefits was under a perpetual 

conflict of interest because the benefits would have been paid out of its own funds. 

25. The entity that made the decision to deny benefits allowed its concern over its 

own funds to influence its decision-making. 

FIRST CAUSE OF ACTION 

FOR PLAN BENEFITS AGAINST THE DEFENDANT 

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

26. Under the terms of the policy, Defendant agreed to provide Plaintiff with longterm disability benefits in the event that Plaintiff became disabled as defined by the Plan. 

27. Plaintiff is disabled under the terms of the Plan. 

28. Defendant failed to provide benefits due under the terms of the Plan, and this 

denial of benefits to Plaintiff constitutes a breach of the Plan. 

29. The decisions to deny benefits were wrong under the terms of the Plan. 

30. The decisions to deny benefits and decision-making processes were arbitrary 

and capricious. 

31. The decisions to deny benefits were not supported by substantial evidence in 

the record. 

32. As a direct and proximate result of the aforementioned conduct of the 

Defendant in failing to provide benefits for Plaintiff’s disability, Plaintiff has been 

damaged in the amount equal to the amount of benefits to which he would have been 

entitled to under the Plan. 

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33. As a direct and proximate result of the aforementioned conduct of the 

Defendant in failing to provide benefits for Plaintiff’s disability, Plaintiff has suffered, 

and will continue to suffer in the future, damages under the Plan, plus interest and other 

damages, for a total amount to be determined. 

PRAYER FOR RELIEF 

 WHEREFORE. Plaintiff requests that this Court grant him the following relief in this 

case: 

On Plaintiff’s First Cause of Action: 

1. A finding in favor of Plaintiff against the Defendant; 

 2. Damages in the amount equal to the disability income benefits to which he was 

entitled through date of judgment, for unpaid benefits pursuant to 29 U.S.C. § 1132(a)(1)

(B); 

 3. Prejudgment and postjudgment interest; 

 4. An Order requiring the Defendant or appropriate Plan fiduciary to pay continuing 

benefits in the future so long as Plaintiff remains disabled under the terms of the LTD 

Plan. 

 5. Plaintiff's reasonable attorney fees and costs; and 

 6. Such other relief as this court deems just and proper. 

Dated this 12th day of January, 2018. 

 Respectfully submitted, 

6

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 ERIC BUCHANAN & ASSOCIATES, PLLC 

 ATTORNEYS FOR PLAINTIFF 

 

 BY: s/R. Scott Wilson 

 R. Scott Wilson 

 TN Bar No. 019661 

 pro hac vice motion to be filed 

 The Wilson Firm, PLLC

 2288 Gunbarrel Road 

 Suite 154, #225 

 Chattanooga, TN 37421

 (423) 498-6511 

 Fax (423) 498-6512 

 Eric Buchanan & Associates, PLLC 

Of Counsel 

swilson@wilsondisability.com

7

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