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Patrick Mause, Bar No. 24269

LAW OFFICE OF PATRICK MAUSE, PLLC

290 North Meyer

Tucson, Arizona 85701

Telephone: (520) 342-0000

Facsimile: (520) 342-0001

Patrick@PMauseLaw.com

Attorney for Plaintiff

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

Melanie Flitcraft,

Plaintiff,

 v.

Metropolitan Life Insurance Company, a foreign 

corporation; American Express Life Insurance 

Plan, an ERISA-governed benefit plan; American 

Express Company Employee Benefits 

Administration Committee, an ERISA plan 

administrator,

Defendants.

COMPLAINT 

AND JURY DEMAND

For her Complaint, Melanie Flitcraft (“Plaintiff”) alleges as follows:

Parties, Venue, and Jurisdiction:

1. Ms. Flitcraft is a resident of Maricopa County, Arizona.

2. Ms. Flitcraft’s claims include: breach of contract (Count One) and breach of the 

implied duty of good faith and fair dealing (Count Two). Because one or more of the 

defendants has asserted that Ms. Flitcraft’s claims may be subject to the Employee Retirement 

Income Security Act, 29 U.S.C. § 1001 et seq. (“ERISA”), Ms. Flitcraft pleads in the 

alternative claims for benefits due to her under ERISA (Count Three), equitable relief under 

ERISA (Count Four), waiver under ERISA (Count Five), and statutory penalties due to 

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defendants’ failure to timely provide information relevant to Ms. Flitcraft’s claim under 

ERISA (Count Six). 

3. Defendant Metropolitan Life Insurance Company (“MetLife”) is a foreign 

corporation authorized to do business and doing business in Arizona.

4. Defendant American Express Life Insurance Plan is an ERISA-governed benefit 

plan.

5. Defendant American Express Company Employee Benefits Administration 

Committee is an ERISA plan administrator.

6. As an insurer engaged in the business of insurance, licensed to do business 

within Arizona, MetLife, its officers, directors, employees, and agents are charged with 

knowledge of the laws of Arizona such as those laws pertaining to the business of insurance 

including statutory, regulatory and common law obligations.

7. There is complete diversity between the parties and the amount in controversy 

exceeds $75,000.00. This court has diversity of citizenship subject matter jurisdiction over the 

parties pursuant to 28 U.S.C. § 1332(a)(1). 

8. To the extent ERISA may apply to this action, the Court has jurisdiction under 

29 U.S.C. § 1132(e)(2) and 28 U.S.C. § 1391.

9. Venue is proper in this District.

Background:

10. This case involves Plaintiff Melanie Flitcraft’s claim for life insurance benefits 

under a disability policy issued to her husband, Stephen “Brian” Flitcraft. 

11. Mr. Flitcraft began working for American Express in 1996. 

12. In 2012, Mr. Flitcraft was covered under the American Express Life Insurance 

Plan (the “Plan”). 

13. In 2012, American Express reorganized Mr. Flitcraft’s division and laid him off. 

Upon information and belief, this is a frequent practice of American Express and one which 

often results in the employee being rehired shortly thereafter. 

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14. As part of his severance package, American Express continued Mr. Flitcraft’s 

life insurance coverage under the Plan. 

15. When his severance expired in October 2012, Mr. Flitcraft converted his 

coverage to an individual policy (the “Converted Coverage”) in the amount of $242,000, as 

allowed under the Plan. 

16. After converting his coverage to an individual policy, Mr. Flitcraft paid 

premiums on the Converted Coverage directly to MetLife through an automatic bank account 

withdrawal. 

17. Mr. Flitcraft designated his wife, Ms. Flitcraft, as the primary 100% beneficiary 

under the Converted Coverage.

18. A few months after his severance ended, and consistent with American Express’ 

past practices, American Express rehired Mr. Flitcraft. Upon his rehiring, American Express 

informed Mr. Flitcraft that he was, as he always had been, eligible to enroll in its life insurance 

Plan. 

19. To inform Mr. Flitcraft about the Plan benefits, options, requirements, and 

limitations, American Express provided Mr. Flitcraft with the Plan’s Summary Plan 

Description (“SPD”). A true and correct copy of the SPD American Express provided to Mr. 

Flitcraft is attached hereto as Exhibit 1. 

20. The SPD states: “This document, along with the insurance contracts through 

which benefits are provided, is also the written instrument for the Plan for purposes of section 

402(a)(1) of the Employee Retirement Income Security Act of 1974.”:

See SPD, Ex. 1, at 3.

21. Under ERISA: “Every employee benefit plan shall be established and 

maintained pursuant to a written instrument.” 29 U.S.C. § 1102(a)(1).

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22. Because the SPD states that it is “the written instrument for the Plan,” the SPD is 

the operative plan document and therefore governs Mr. Flitcraft’s rights and obligations under 

the Plan. 

23. The SPD explained to Mr. Flitcraft that American Express provided him with 

“basic life insurance of one times your annual salary at no cost.” See SPD, Ex. 1 at 3. The 

SPD then explained that he could elect optional life coverage of up to “9 times employee’s 

annual salary.” See SPD at 9. 

24. To assist employees in determining how much optional coverage to elect, the 

SPD provided several considerations: 

See SPD, Ex. 1 at10. 

25. Because Mr. Flitcraft had a family, including a wife and two children who relied 

on him for financial support, because he intended to pay for their children’s education, and 

because he had a mortgage on the family home, among other things, Mr. Flitcraft elected 

optional coverage in the amount of four times his annual salary; bringing his total coverage 

under the Plan to five times salary: one times salary automatic coverage plus four times salary 

optional coverage. Mr. Flitcraft’s Plan coverage therefore totaled $529,000. 

26. Thus, Mr. Flitcraft’s total life insurance coverage through MetLife was 

$771,000: $242,000 under the Converted Policy, and $529,000 under the Plan coverage.

27. The SPD also informed Mr. Flitcraft about enrollment and eligibility policies and 

limitations. Regarding enrollment, for example, the SPD informed him that he was 

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“automatically covered for Basic Life Insurance Coverage” and could “elect to participate in 

Optional Life Insurance”:

See SPD, Ex. 1 at 5. 

28. The SPD further explained the limitations on coverage if an employee ceased 

working for American Express and was rehired. Specifically, the SPD informed Mr. Flitcraft 

that if he stopped working for American Express but was rehired “during a subsequent 

calendar year,” he would be “allowed to elect benefits based on your eligibility in the new 

year”:

See SPD, Ex. 1 at 8. 

29. Because Mr. Flitcraft had been laid off and his severance and coverage ended in 

2012, and because he returned to work in 2013 — a different calendar year — he would be 

“allowed to elect benefits based on your eligibility in the new year” under the SPD’s clear 

terms. Id. 

30. Finally, the SPD explained that as long as Mr. Flitcraft enrolled within 60 days 

of being hired, his coverage “starts on the day you begin regular full-time employment with 

the Company”: 

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See SPD, Ex. 1 at 6-7. 

31. Mr. Flitcraft completed all the requirements to enroll for coverage in the amount 

of five times his salary at the time of his hiring, January 2013. 

32. Mr. Flitcraft designated his wife, Melanie Flitcraft, as the primary 100% 

beneficiary under the Plan. 

33. Following his 2013 enrollment, American Express began deducting premiums 

for his Plan coverage from his paychecks. This is consistent with American Express’ previous 

practice of deducting insurance premiums from his paychecks. 

34. Upon information and belief, American Express forwarded Mr. Flitcraft’s 

premiums to MetLife and informed MetLife that Mr. Flitcraft was enrolled under the insurance 

policy issued to the Plan. 

35. At the same time, Mr. Flitcraft continued to pay the premiums for his Converted 

Coverage to MetLife through an automatic bank account deduction. 

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36. As of January 2013, when Mr. Flitcraft enrolled in life insurance coverage under 

the Plan, MetLife was on notice that Mr. Flitcraft was insured under both the Converted 

Coverage and the Plan because it was receiving and accepting his premiums on both policies. 

37. As of January 2013, American Express knew that Mr. Flitcraft could have been 

covered under the Converted Coverage and the Plan because it knew Mr. Flitcraft could have 

elected Converted Coverage, and it knew that he enrolled for five times salary coverage under 

the Plan. Upon information and belief, when Mr. Flitcraft was laid off, American Express 

provided him with the conversion information and forms and was aware that he had elected the 

Converted Coverage.

38. The American Express Employee Benefits Administration Committee (“Benefits 

Committee”) and MetLife are ERISA fiduciaries under the Plan. See SPD, Ex. 1 at 22.

39. Under ERISA, defendants MetLife, the Benefits Committee, and the Plan must 

discharge their obligations solely in Mr. Flitcraft’s interests. See 29 U.S.C. § 1104; see also 

SPD, Ex. 1 at 31. 

40. On October 11, 2014, one week before his and Ms. Flitcraft’s 17th wedding 

anniversary and nearly two years after being rehired and beginning to pay premiums on the 

Plan coverage — Mr. Flitcraft passed away suddenly and unexpectedly due to sepsis 

secondary to bronchopneumonia. 

41. A few weeks later, in November 2014, Ms. Flitcraft contacted MetLife to perfect 

her claims for benefits under Mr. Flitcraft’s Converted Coverage in the amount of $242,000 

and under the Plan coverage in the amount of $529,000. 

42. When Ms. Flitcraft contacted MetLife, MetLife confirmed that Mr. Flitcraft was 

covered under both policies. MetLife further informed Ms. Flitcraft that even though Mr. 

Flitcraft had two policies, she could submit one claim form for both claims. At no point 

during that discussion did MetLife indicate that there was any alleged conflict in Mr. 

Flitcraft’s being covered under both policies. 

43. After receiving Ms. Flitcraft’s claim, MetLife began attempting to determine 

whether it could avoid paying Ms. Flitcraft’s claims. 

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44. On November 14, 2014, MetLife wondered in an internal claim note why there 

was a gap in Mr. Flitcraft’s optional Plan coverage between October 5, 2012 and January 1, 

2013:1

45. On November 17, 2014, MetLife contacted American Express’s Human 

Resources consultant, AON Hewitt, “to know the exact reason” for the coverage gap, which it 

said was “necessary to know as it impacts the insured’s eligibility”:

46. The next day, MetLife learned that Mr. Flitcraft “was terminated for that 

timeframe (10/6/2012 to 1/1/2013) because it was the end of his serial severance and he was 

rehired on 1/2/2013.” 

47. Three months later, on February 16, 2015, MetLife concluded that it needed to 

contact American Express to “inquire the correct Plan doc this insured would be covered 

under.” The reasons for MetLife’s inquiry was because it had noted an exclusion in reviewing 

“a few Certs [Certificates of Insurance]” that might apply and allegedly preclude coverage: 

48. MetLife paid Ms. Flitcraft the benefits due under the Converted Coverage, 

$242,000, plus interest, by letter dated February 17, 2015. Upon information and belief, 

MetLife approved benefits under the lower Converted Coverage policy due to its inherent 

 1 Screen shots are from MetLife’s claim file regarding Mr. Flitcraft’s claim, and are true and 

correct representations of MetLife’s internal claim notes.

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financial conflict of interest, which creates an incentive for MetLife to minimize claim payouts 

in order to maximize profits. 

49. On March 2, 2015, MetLife was still seeking “the correct Plan” to determine 

whether it could apply any exclusions: 

50. Two days later, on March 4, 2015, MetLife preliminarily determined that the 

claimed policy limitation it relied on to deny Ms. Flitcraft’s claim might apply. Specifically, 

MetLife noted that “the SPD indicates on pg 42/84” that if Mr. Flitcraft were rehired within 

two years of his employment terminating, he could only become covered under the American 

Express Plan if he “surrendered” any converted individual policies: 

51. Contrary to MetLife’s note, however, the SPD provided to Mr. Flitcraft (Ex. 1), 

as well as the SPD provided by American Express during the claim appeal process, contain no 

such limitation. In fact, both the SPD Mr. Flitcraft received and the SPD American Express 

produced are only 33 pages long — there is no SPD “page 42/84” as MetLife contended.

52. Nevertheless, MetLife began drafting a letter denying Ms. Flitcraft’s claim, 

noting on March 17, 2015:

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53. That same day, March 17, 2015, MetLife sent Ms. Flitcraft its letter formally 

denying payment of the $529,000 in Plan life insurance coverage; Claim No. 21411004835. In 

that letter, MetLife asserted that the “Plan states on page 40 of the Summary Plan Description” 

that if an employee were “re-hired by the Policyholder within 2 years after such employment 

ended,” he would not be eligible for Plan coverage unless he surrendered “any individual 

policy of life insurance to [sic] which You converted when Your employment ended; and any 

certificate of insurance continued as ported insurance when such employment ended.”

54. On March 19, 2015, after being notified of MetLife’s decision denying her 

claim, Ms. Flitcraft called MetLife to discuss its decision. MetLife explained that “premiums 

[are] not done thru claims, and we we[re] not aware of issue until we received the files”: 

55. On April 10, 2015, Ms. Flitcraft wrote to MetLife and the American Express 

Life Insurance Plan Administrator requesting copies of Mr. Flitcraft’s claim file, all relevant 

documents, and multiple documents related to her claim. 

56. By letter dated April 21, 2015, MetLife forwarded Ms. Flitcraft certain 

information related to her claim, but withheld other information that MetLife has in its 

possession.

57. By e-mail dated April 29, 2015, the Plan forwarded the SPD and the alleged Life 

Certificate plan document to Ms. Flitcraft. In that e-mail, the Plan directed Ms. Flitcraft to 

MetLife to obtain the “life insurance claim file for Mr. Flitcraft.” The Plan then confirmed 

that, relating to the Plan coverage, “Mr. Flitcraft paid his premiums through biweekly payroll 

deductions, and there were no premiums outstanding as of his date of death.”

58. By letter dated May 14, 2015, Ms. Flitcraft appealed MetLife’s decision to 

MetLife, the Life Insurance Plan, and the Benefits Committee. Ms. Flitcraft sent her appeal by 

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facsimile to MetLife, by Priority Mail to MetLife, and by Priority Mail to the Benefits 

Committee and the Plan.

59. With her appeal, Ms. Flitcraft submitted her sworn testimony in the form of a 

Declaration, testifying, among other things: about Mr. Flitcraft’s work history with American 

Express; the reasons Mr. Flitcraft elected five times salary life insurance coverage under the 

Plan when he was re-hired by American Express in 2013; the failures by MetLife and 

American Express to notify Mr. Flitcraft of any alleged conflict between his Converted 

Coverage and the Plan coverage; and the failure of MetLife to promptly and reasonably handle 

her claim for benefits under the Plan coverage.

60. On June 11, 2015, MetLife sent Ms. Flitcraft a check in the amount of $287,000 

plus interest. MetLife did not send Ms. Flitcraft any correspondence or other information 

explaining the reasons it was sending the check.

61. After receiving MetLife’s check, Ms. Flitcraft inferred that MetLife had 

determined that Mr. Flitcraft was entitled to the $529,000 in Plan life insurance coverage and 

was paying the difference between what it had previously paid, and what remained due.

62. Because MetLife had paid the balance of the $529,000 Plan coverage, the 

Converted Coverage in the amount of $242,000 was now unpaid and remained at issue. Thus, 

MetLife had effectively denied Ms. Flitcraft’s claim for benefits under the Converted 

Coverage. 

63. On June 25, 2015, Ms. Flitcraft appealed MetLife’s decision denying her 

entitlement to the Converted Coverage. Ms. Flitcraft sent her appeal by facsimile to MetLife, 

by Priority Mail to MetLife, and by Priority Mail to the Benefits Committee and the Plan.

64. With her second appeal, Ms. Flitcraft submitted her sworn testimony in the form 

of a Declaration, testifying, among other things: that Mr. Flitcraft wanted the full value of the 

Converted Coverage and the Plan coverage; that he intended to purchase such coverage; and 

that if anyone from American Express or MetLife had told Mr. Flitcraft that he allegedly had 

to surrender the Converted Coverage, he would have elected seven or eight times his salary 

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(the Plan allowed him to elect up to nine times salary in coverage) to ensure he had 

commensurate coverage.

65. On June 24, 2015, thirteen days after sending Ms. Flitcraft a check for $287,000 

plus interest, MetLife mailed a letter to Ms. Flitcraft through her counsel. In that letter, 

MetLife stated that its “decision to deny your client’s claim was partially upheld, but 

additional benefits were released to your client, so that your client should have received a total 

of $529,000 from us, comprised of Basic Life Insurance in the amount of $106,000 and 

Optional Life Insurance in the amount of $423,000.” In other words, MetLife had determined 

that it was liable for the Plan coverage of $529,000 but was now treating Mr. Flitcraft’s 

Converted Coverage as surrendered by MetLife decree.

66. Ms. Flitcraft did not receive MetLife’s June 24, 2015 letter until several days 

after submitting her June 25, 2015 appeal. 

67. On July 10, 2015, the Benefits Committee and the Plan e-mailed Ms. Flitcraft’s 

counsel stating, among other things: “MetLife serves as the Claim Fiduciary for the American 

Express Life Insurance Plan, as indicated on page 23 of the attached Summary Plan 

Description, and therefore makes all claim and appeal decisions. We have confirmed with 

MetLife that they received your letter. MetLife will review the appeal and will respond to you 

directly.”

68. On August 27, 2015, Ms. Flitcraft’s counsel contacted MetLife and was 

informed that MetLife was not considering Ms. Flitcraft’s second appeal and that its June 24, 

2015 decision was final.

69. Accordingly, defendants have refused to pay the Converted Coverage due under 

Mr. Flitcraft’s individual disability policy.

70. Ms. Flitcraft has suffered financial damage as a result of defendants’ wrongful 

refusal to pay her the benefits due under the Converted Coverage.

71. As a result of defendants’ wrongful decision denying Ms. Flitcraft the full life 

insurance benefits to which she is entitled, Ms. Flitcraft has suffered financial harm and

emotional distress. 

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72. Ms. Flitcraft has exhausted her administrative remedies. 

73. Ms. Flitcraft’s claim is ripe. 

Count One: Breach of Contract (MetLife)

74. Plaintiff Melanie Flitcraft incorporates paragraphs 1 through 73 as though fully 

set forth herein.

75. When Mr. Flitcraft was an employee with American Express in 2012, he was 

covered under an ERISA-governed life insurance plan provided by his employer.

76. When Mr. Flitcraft retired in 2012, he converted his coverage under the life 

insurance plan to an individual policy not subject to ERISA. Waks v. Empire Blue Cross/Blue 

Shield, 263 F.3d 872 (9th Cir. 2001).

77. When Mr. Flitcraft converted his coverage under the life insurance plan to a nonERISA insurance policy, he had a contract for life insurance with MetLife.

78. Ms. Flitcraft is the named 100% primary beneficiary of the life insurance 

contract.

79. Mr. Flitcraft complied with each and every term of his contract, including timely 

paying all premiums due under the contract.

80. Without just cause or excuse, MetLife has refused to pay Ms. Flitcraft the 

benefits to which she is entitled under the contract.

81. As a consequence of MetLife’s breach of the contract, Ms. Flitcraft has suffered 

damages including, but not limited to: the loss of the benefits to which she is entitled under 

the contract and attorney’s fees expended when Ms. Flitcraft was forced to retain an attorney 

to appeal MetLife’s wrongful decision.

Count Two: Breach of the Obligation of Good Faith and Fair Dealing (MetLife)

82. Plaintiff Melanie Flitcraft incorporates paragraphs 1 through 81 as though fully 

set forth herein.

83. MetLife ignored information in the file that supported Ms. Flitcraft’s entitlement 

to full life insurance benefits under the Plan coverage and under the Converted Coverage.

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84. MetLife chose to focus and rely on one document and purposefully disregarded 

other documents, information, and the complete picture regarding Ms. Flitcraft’s claim to find 

any ostensible support for its desire to deny Ms. Flitcraft’s claim.

85. MetLife had no reasonable basis to delay and deny payment of benefits under the 

Converted Coverage life insurance policy.

86. In delaying and denying benefits to Ms. Flitcraft, MetLife knew that it was 

acting without a reasonable basis in its investigation and evaluation of her claim.

87. In all aspects of investigating or evaluating Ms. Flitcraft’s claim for benefits 

under the life insurance policy, MetLife failed to give Ms. Flitcraft’s interests at least as much 

consideration as its own, and instead elevated its interests above Ms. Flitcraft’s.

88. MetLife failed to reasonably or fairly investigate Ms. Flitcraft’s claim, failed to 

take reasonable measures to ensure the proper payment of Ms. Flitcraft’s claim, and 

deliberately conducted a biased and outcome-focused investigation in order to deny Ms. 

Flitcraft’s claim.

89. MetLife acted unreasonably by ignoring the weight of the evidence and 

disregarding information supporting Ms. Flitcraft’s claim, despite having no reasonable basis 

for doing so.

90. MetLife intended to injure Ms. Flitcraft and/or acted to serve its own interests, 

having reason to know and consciously disregarding the substantial risk that its conduct would 

significantly injure Ms. Flitcraft financially, emotionally, and mentally, and would cause her 

anger, frustration, and emotional suffering, among other things.

91. As a direct and proximate result of MetLife’s wrongful conduct, Ms. Flitcraft has 

suffered anxiety, worry, frustration, and mental and emotional distress.

92. MetLife’s intentional and wrongful actions were guided by an evil mind and 

meant to cause harm, and did cause harm to Ms. Flitcraft, who seeks exemplary and punitive 

damages against MetLife to deter similar conduct in the future and to redress the bad conduct 

complained of herein.

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93. MetLife’s duty of good faith and fair dealing towards Ms. Flitcraft is continuous 

and did not end with the denials of her claim in March 2015 or June 2015.

Count Three (In the Alternative): Claim For Benefits Under ERISA (All Defendants)

94. To the extent Ms. Flitcraft’s claims are subject to ERISA, she pleads in the 

alternative as follows. 

95. With respect to all ERISA claims, Ms. Flitcraft asserts that defendants acted 

under an inherent financial conflict of interest, that their financial conflicts of interest infected 

the claim handling process and drove the decisions seeking to minimize defendants’ claim 

exposure, that Ms. Flitcraft is entitled to discovery to show the effect of those conflicts of 

interest on the claim decision, and that defendants’ decisions are entitled to little or no 

deference under ERISA because those decisions were driven or influenced by defendants’ 

inherent financial conflicts of interest.

96. Plaintiff Melanie Flitcraft incorporates paragraphs 1 through 95 as though fully 

set forth herein.

97. The SPD states: “This document, along with the insurance contracts through 

which benefits are provided, is also the written instrument for the Plan...” See SPD, Ex. 1 at 

3. Accordingly, the SPD is the operative Plan instrument pursuant to 29 U.S.C. § 1102(a)(1) 

and the terms of the SPD therefore control Ms. Flitcraft’s entitlement to benefits. 

98. The SPD permits Mr. Flitcraft to maintain Plan coverage and Converted 

Coverage. 

99. The SPD does not require Mr. Flitcraft to surrender any converted or ported 

coverage upon being rehired within two years of his employment ending.

100. Under the plain language of the SPD, there is no conflict in Mr. Flitcraft 

maintaining the Plan coverage and the Converted Coverage simultaneously.

101. Under the plain language of the SPD, Ms. Flitcraft is entitled to benefits under 

the Converted Coverage. 

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102. Defendants’ decision denying Ms. Flitcraft the benefits to which she is entitled is 

wrongful and has caused Ms. Flitcraft to suffer harm, entitling her to recover the benefits due 

under ERISA.

Count Four (In the Alternative): Equitable Relief Under ERISA Due To Defendants’ 

Breaches of Their Fiduciary Duties (All Defendants)

103. Plaintiff Melanie Flitcraft incorporates paragraphs 1 through 102 as though fully 

set forth herein.

104. Under Cigna Corp. v. Amara, 131 S.Ct. 1866 (2011), ERISA plan participants

who are harmed by a fiduciary’s misstatements or misrepresentations regarding plan terms are 

entitled to equitable relief under 29 U.S.C. § 1132(a)(3) to remedy the harm caused by the 

misstatements or misrepresentations.

105. Under Amara, equitable relief may include: reformation of the plan to conform 

to the fiduciary’s representations; equitable estoppel; or a “surcharge” to compensate the 

participant for the harm caused by the fiduciary’s breach. Id. at. 1879-1880. 

106. Neither plan reformation nor surcharge “insist upon a showing of detrimental 

reliance.” Id. at 1880. The plan participant “need only show harm and causation.” Id. at 

1881. 

107. Defendants have breached their fiduciary duties under ERISA by, among other 

things: failing to provide Mr. Flitcraft with any notice of the claimed policy limitation 

requiring him to surrender the Converted Coverage upon being rehired within two years; 

misrepresenting that Mr. Flitcraft was automatically covered upon his rehiring and could elect 

new optional life coverage as long as he was hired in a “subsequent” calendar year; providing 

Mr. Flitcraft with an SPD that constitutes the operative plan document but then disclaiming 

that documents’ terms to support a wrongful claim denial; having information that Mr. 

Flitcraft was enrolled under the Plan and the Converted Coverage through, among other things 

his payment of monthly premiums under both policies, and failing to inform him of any 

alleged conflict in the coverage; and more. 

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108. Mr. Flitcraft relied on defendants’ breaches of their fiduciary duties, including 

their representations and omissions, in electing his life insurance coverage amounts. 

109. Based on defendants’ representations and omissions, Mr. Flitcraft decided to 

forego electing seven, eight, or nine times his salary in optional life coverage as he was 

permitted to do under the Plan, and relied on his having five times salary coverage under the 

Plan in addition to the Converted Coverage. 

110. Ms. Flitcraft has been harmed by defendants’ breaches of their fiduciary 

obligations.

111. Ms. Flitcraft is entitled to equitable relief under ERISA and Amara, including 

but not limited to: reformation of the plan to conform to the fiduciaries’ misrepresentations, 

equitable estoppel, and/or a surcharge in the amount of the benefits available under the 

Converted Coverage. Id.; accord Echague v. Metro. Life Ins. Co., 43 F.Supp.3d 994, 1017 

(N.D. Cal. 2014) (imposing equitable surcharge under nearly identical circumstances).

Count Five (In the Alternative): Waiver Under ERISA (All Defendants)

112. Plaintiff Melanie Flitcraft incorporates paragraphs 1 through 111 as though fully 

set forth herein.

113. Defendants either knew or should have known of the alleged surrender term 

under the life insurance plan.

114. Defendants either knew or should have known that Mr. Flitcraft was enrolled in 

life insurance under the Converted Coverage and under the Plan.

115. Defendants waived the alleged requirement that Mr. Flitcraft surrender the 

Converted Coverage to become covered under the Plan. See e.g. Gaines v. Sargent Fletcher, 

Inc., 329 F.Supp.2d 1198, 1204 (C.D. Cal. 2004).

116. Because defendants have waived the alleged surrender term under the life 

insurance plan, Ms. Flitcraft is entitled to the full benefits under the Converted Coverage in 

addition to the Plan benefits already paid to her.

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Count Six: Statutory Penalties Under ERISA (All Defendants)

117. Plaintiff Melanie Flitcraft incorporates paragraphs 1 through 116 as though fully 

set forth herein.

118. Under ERISA, Ms. Flitcraft is entitled to all information relevant to her claim, 

free of charge. 29 U.S.C. §§ 1132(a)(1)(A) and (c)(1)(B).

119. If an administrator fails to provide requested information within 30 days of a 

request, it is liable for statutory penalties in the amount of $110 per day for each day the 

information is delayed. Id.; 29 C.F.R. 2575.502c-1.

120. On April 10, 2015, Ms. Flitcraft requested all information relevant to her claim, 

and to Mr. Flitcraft’s coverage under the Plan and the Converted Coverage, from MetLife, 

from the Benefits Committee, and from the Plan.

121. While defendants provided some information relevant to Ms. Flitcraft’s claim, 

they failed to provide all relevant and requested information.

122. Because defendants failed to provide all relevant information, Ms. Flitcraft was 

prejudiced in her ability to prepare her appeal.

123. Because defendants failed to provide all relevant information, Ms. Flitcraft was 

prejudiced in her ability to develop the ERISA administrative record.

124. Because defendants failed to provide all relevant information, Ms. Flitcraft is 

entitled to statutory penalties of $110 per day for each day the production of that information 

has been delayed.

125. Because defendants failed to provide all relevant information, Ms. Flitcraft is 

entitled to discovery to enable her to fully develop the ERISA administrative record. 

Demand For Jury Trial:

126. Pursuant to Fed. R. Civ. P. 38(b) Plaintiff demands trial by jury on Counts One 

and Two of her Complaint.

Prayer For Relief:

Wherefore, Plaintiff Melanie Flitcraft prays for relief as follows:

1. The benefits due to her under the Converted Coverage;

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2. Attorney’s fees incurred by Ms. Flitcraft in pursuing her appeal;

3. An award of damages for emotional distress, humiliation, inconvenience, and 

anxiety against MetLife as a result of MetLife’s tortious breach of the 

obligation of good faith and fair dealing, as previously set forth herein;

4. An award of punitive damages against MetLife sufficient to punish MetLife 

and to deter the company and similarly situated defendants from engaging in 

similar conduct in the future, commensurate with the reprehensibility of 

MetLife’s conduct as provided by law; 

5. Reasonable attorneys’ fees pursuant to A.R.S. § 12-341.01 and/or ERISA, 29 

U.S.C. § 1132;

6. Taxable costs; 

7. Interest on all amounts awarded at the highest rate permitted by law; and

8. Such other relief as is just and equitable, or that may be provided by law.

Dated this 8th day of September, 2015.

LAW OFFICE OF PATRICK MAUSE, PLLC

/s/ Patrick W. Mause 

Patrick W. Mause

290 North Meyer

Tucson, Arizona 85701

Attorney for Plaintiff

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