1

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

Steven J. German - State Bar No. 014789

Scott B. Seymann – State Bar No. 027215

ADELMAN GERMAN, P.LC.

8245 North 85th Way

Scottsdale, Arizona 85258

Telephone (480) 607-9166 

Facsimile (480) 607-9031

steve@adelmangerman.com

Steven C. Dawson - State Bar #006674 

Anita Rosenthal – State Bar # 006199

Sander R. Dawson – State Bar #032243

DAWSON & ROSENTHAL, P.C. 

25 Schnebly Hill Road

Sedona, Arizona 86336-4233

Telephone: (928) 282-3111 

Facsimile: (928) 282-3126

dandr@dawsonandrosenthal.com

Attorneys for Plaintiff

UNITED STATES DISTRICT COURT

DISTRICT OF ARIZONA

BENJAMIN McCLURE, an individual,

Plaintiff,

vs.

COUNTRY LIFE INSURANCE COMPANY, 

dba COUNTRY FINANCIAL, previously doing 

business as COUNTRY COMPANIES; CC 

SERVICES, INC. dba COUNTRY 

FINANCIAL; DOES 1-10; ROES 1-10.

Defendants.

NO. CV-15-2597-PHX-DLR

FIRST AMENDED COMPLAINT 

FOR DAMAGES

Breach of Contract; Insurance 

Bad Faith

JURY TRIAL DEMAND

Case 2:15-cv-02597-DLR Document 50 Filed 07/08/16 Page 1 of 14
2

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

Plaintiff Benjamin McClure alleges as follows:

PARTIES, JURISDICTION AND VENUE

1. Plaintiff Benjamin McClure (hereinafter “McClure” or “Plaintiff”) is a 

resident of Maricopa County, residing in Peoria, Arizona. McClure was an Arizona 

resident at all relevant times herein. 

2. Defendant Country Life Insurance Company dba Country Financial, at 

the time of the issuance of the subject policy, was doing business as Country 

Companies, (“COUNTRY”). COUNTRY is an insurance company with its principal

place of business in Bloomington, Illinois. 

3. At all times relevant Defendant COUNTRY was duly licensed to sell 

individual disability insurance in the State of Arizona and engaged in the business of 

issuing policies of insurance to Arizona residents. Defendant COUNTRY caused acts 

to occur in Arizona out of which this Complaint arises and is therefore subject to 

Arizona’s insurance laws, statutes, and regulations. 

4. Upon information and belief, Defendant CC Services, Inc., (“CC 

SERVICES”) is a foreign corporation with its principal place of business in 

Bloomington, Illinois.

5. Upon information and belief, Defendant CC Services is engaged in the 

business of evaluating, adjusting, administering, overseeing, and handling individual 

disability income claims made by COUNTRY insureds, including those in the State of 

Arizona. Defendant CC Services caused acts to occur in Arizona out of which this 

Complaint arises and is therefore subject to Arizona’s insurance laws, statutes, and

Case 2:15-cv-02597-DLR Document 50 Filed 07/08/16 Page 2 of 14
3

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

regulations pertaining to claim handling practices and duties of good faith and fair 

dealing. 

6. Upon information and belief, CC Services and its employees were at all 

times relevant, the actual (or ostensible) agents of Defendant COUNTRY, and acting 

within the scope of its employment or agency. Defendants CC Services and 

COUNTRY acted in concert and are jointly and severally liable for the acts 

complained of herein. CC Services’ employees acted for and on behalf of Defendant 

COUNTRY as lent employees and/or served both Defendants as employees of both 

Defendants.

7. Defendants Does 1-10 and Roes 1-10 are fictitiously identified Defendants 

who, upon information and belief, committed wrongful acts that caused or contributed 

to Plaintiff’s injuries, damages, and claim. When the true identity of these Defendants 

is known, leave of this Court will be sought to amend this Complaint accordingly. 

Upon information and belief, some of the Doe and Roe Defendants are and were at all 

times relevant herein employees, servants, and actual (or ostensible) agents of other 

Defendants, and acting within the scope of their employment or agency. 

8. Jurisdiction and venue are appropriate in this Court. 

GENERAL ALLEGATIONS

9. Plaintiff re-alleges the allegations above as though fully restated herein.

10. On or about November 7, 1995, Defendant COUNTRY sold and then 

issued an Individual Disability Income Policy (Policy No: H373449) (hereinafter, the 

"Policy") to the Plaintiff. The Policy provides a monthly individual disability income 

Case 2:15-cv-02597-DLR Document 50 Filed 07/08/16 Page 3 of 14
4

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

benefit (and other benefits) in the event Plaintiff became disabled under the terms of 

the Policy.

11. Plaintiff satisfied and performed all terms and conditions required of him 

under the Policy. He has timely paid monthly premiums throughout the Policy’s 

existence, and the Policy has otherwise been in effect at all relevant times.

12. The Policy provided a total monthly benefit of no less than $1,500.00 

upon proof of disability.

13. The Policy defines “disability” as a:

[c]ontinuous inability to perform substantially all

important duties of your regular occupation because of 

your injury or sickness. After benefits have been paid for 

two years, it means continuous inability to engage in 

any occupation because of your injury or sickness. 

14. The Policy defines Regular Occupation as, “your occupation at the time 

disability begins.” 

15. The Policy defines Any Occupation as, “any occupation in which you 

could be expected to engage. Consideration is given to your education and training 

or experience.” 

16. At all times relevant hereto, Plaintiff’s regular occupation was that of a

Manager of the Contact Call Center for Progressive Insurance. His duties included 

managing over 100 call center employees and supervisors.

17. On November 26, 2012 Plaintiff suffered a traumatic brain injury with 

post-concussive syndrome when he accidentally walked into a pole, striking his head. 

Ever since that incident Plaintiff suffers from memory loss, intermittent seizures, 

Case 2:15-cv-02597-DLR Document 50 Filed 07/08/16 Page 4 of 14
5

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

headaches, vertigo, confusion, fatigue, difficulty focusing, and an inability to multitask, among many other symptoms. 

18. As a result of plaintiff’s injury, and since November 26, 2012, Plaintiff has 

been periodically hospitalized, and requires ongoing medical care and therapy. He

has restrictions that include an inability to drive, requires assistance with activities of 

daily living, and suffers from attendant medical conditions and symptoms, making 

him unable to engage in his regular or any other occupation for which he is 

reasonably trained, educated, or experienced.

19. As a result of the brain injury suffered on November 26, 2012, Plaintiff 

has been unable to perform substantially all important duties of his regular

occupation and is unable to and has not continuously engaged in any occupation.

20. Plaintiff timely submitted a claim for benefits under the Policy, and in 

January 2013, Defendants COUNTRY and CC Services opened a claim and

sometime later began paying Plaintiff a monthly disability benefit of $1,500.00. 

21. The Policy calls for a waiting period of 90-days from the date of disability, 

and thereafter insurance premiums are waived while the insured remains disabled. 

22. On September 26, 2013 Defendants notified Plaintiff of the waiver of 

premium benefit and refunded premium payments Defendants collected from the 

Plaintiff during the waiver period. 

23. While paying monthly benefits, Defendants gathered and are in 

possession of Plaintiff's medical records as well as certifications of disability from 

Plaintiff’s treating physicians, which more fully describe the conditions that 

Case 2:15-cv-02597-DLR Document 50 Filed 07/08/16 Page 5 of 14
6

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

permanently restrict and limit Plaintiff from practicing both his “regular” and “any”

occupation. 

24. On December 17, 2013, and over a year after Plaintiff was first injured, 

Defendants notified Plaintiff that their review of medical correspondence from 

Plaintiff’s treating physicians did not support disability from a physical standpoint of 

performing the job duties of an Insurance Manager and requested a 

neuropsychological evaluation and additional medical information.

25. On February 10, 2014 Plaintiff underwent a neuropsychological 

evaluation and testing. 

26. On April 21, 2014 Defendants issued their final monthly disability benefit 

payment to Plaintiff in the amount of $1,500.00.

27. On April 23, 2014, Defendants wrote to Plaintiff and advised that they 

were denying his claim on the basis that the medical information did not show 

physical or cognitive impairments resulting from his injury that would be expected to 

prevent him from performing the duties of his regular occupation.

28. Plaintiff has not been able to return to his regular occupation or any 

occupation as a result of the brain injury he suffered on November 26, 2012. He has 

restrictions and limitations that prevent him from working and is "totally disabled" as 

defined by the Policy. 

29. Defendants COUNTRY and CC Services undertook an outcome based 

investigation designed to lead to the denial of Plaintiff’s claim.

Case 2:15-cv-02597-DLR Document 50 Filed 07/08/16 Page 6 of 14
7

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

30. Defendants COUNTRY and CC Services again refused to pay benefits 

owed under Plaintiff’s Policy after Plaintiff notified Defendants months later that he 

was hospitalized and had undergone significant medical treatment and care for his 

brain injury since Defendants’ April 2014 claim denial.

31. Defendants did not request medical records, did not perform a follow-up 

investigation, and otherwise repeatedly failed to fairly and objectively evaluate 

medical information and other evidence (a) at the time it first denied the claim and (b) 

thereafter when Plaintiff reported he remained disabled, had not returned to work, 

was hospitalized, and underwent significant care and treatment over a year following 

Defendants’ denial of his claim.

32. Plaintiff continues to suffer financial distress and damage to his credit 

reputation, emotional, mental, and physical harm, and other injuries and damages as 

a direct and proximate result of Defendants’ wrongful refusal to pay benefits owed 

per the Policy, and as a result of its violations of other Arizona’s statutes, regulations 

and case law defining standards for claim handling processes and procedures. 

33. Plaintiff was forced to retain the services of an attorney to seek and 

secure benefits under the Policy that are wrongfully being withheld by Defendants, 

while Defendants continue to wrongfully collect premiums that would have been 

waived had Plaintiff’s claim been honored.

34. Plaintiff is making a claim for recovery of reasonable attorneys’ fees per 

A.R.S. §12-341.01, and the costs he is forced to incur herein, along with pre-and 

post-judgment interest at the legal rate.

Case 2:15-cv-02597-DLR Document 50 Filed 07/08/16 Page 7 of 14
8

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

35. The amount in monthly disability benefits Defendants owe, and will 

continue to owe in the future, is “liquidated” to the extent it can be readily calculated 

and has in the past been formally demanded. Therefore, Plaintiff is entitled to prejudgment interest on monies wrongfully withheld.

36. Defendants acted and continue to act with an "evil mind," and with a 

conscious disregard of the rights and entitlements of Plaintiff to such an extent and in 

such a fashion so as to justify the imposition of punitive and exemplary damages. 

These damages, along with other contractual and extra-contractual damages, are 

expressly sought to punish Defendants and to deter other insurance companies from 

the same or similar bad faith claims handling practices. 

FIRST CLAIM FOR RELIEF

(Breach of Contract)

37. Plaintiff re-alleges the above allegations as though fully set forth herein. 

38. Defendants breached Plaintiff’s insurance policy by refusing to pay 

monthly individual disability income benefits legitimately owed per the Policy 

beginning in April 2014 and continuing into the future. 

39. Defendants also breached Plaintiff’s Policy by refusing to waive

insurance premiums per the Policy while Plaintiff remains disabled. 

40. Defendants breached their contract by charging, accepting, and holding 

onto insurance premiums paid by Plaintiff (and the interest earned on those 

premiums), which should have been waived per the Policy’s terms. 

Case 2:15-cv-02597-DLR Document 50 Filed 07/08/16 Page 8 of 14
9

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

41. Plaintiff remains "totally disabled" as defined under the Policy, and is 

owed "total disability" and other benefits under the Policy. 

42. Defendants continue to breach their promises and the terms of the Policy 

by refusing to pay disability insurance benefits owed Plaintiff because of his ongoing 

disability. 

43. Defendants owes Plaintiff individual disability income benefits of no less 

than $1,500 per month plus interest on those benefits beginning in April 2014 and 

continuing until the jury renders a verdict in this case, and into the future. 

44. As a result of Defendants’ contractual breaches and their its bad faith 

conduct as more fully described herein, Plaintiff is entitled to an acceleration of all 

future benefits owed under the Policy.

45. As a direct and proximate result of the Defendants’ breaches, Plaintiff 

has incurred damages in a sum total to be proved at the time of trial, but which are 

liquidated and now owed. 

46. This matter arises out of contract (the Policy), and the Plaintiff is entitled 

to reasonable costs and attorneys’ fees pursuant to A.R.S. §12-341 and §12-341.01, 

as well as pre-and post-judgment interest.

47. Plaintiff is also entitled to recover attorneys’ fees, costs and out of pocket 

expenses he incurs to recover insurance benefits that the Defendants owe, as a 

separate component of his economic damages. 

Case 2:15-cv-02597-DLR Document 50 Filed 07/08/16 Page 9 of 14
10

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

SECOND CLAIM FOR RELIEF

(Insurance Bad Faith - Breach of Covenants of 

Good Faith and Fair Dealing)

48. Plaintiff re-alleges the above allegations as though fully stated herein. 

49. Defendants owe Plaintiff duties of good faith and fair dealing as part of 

the handling of Plaintiff’s claim under the Policy. 

50. The duties Defendants owe to Plaintiff include but are not limited to a 

prompt, thorough and fair handling of his claim, and payment of benefits without 

unreasonable delay. Defendants are required to give equal considerations to Plaintiff 

and cannot place their own interests ahead of those of Mr. McClure. 

51. Defendants have breached and continue to breach duties of good faith 

and fair dealing owed to the Plaintiff. 

52. Defendants wrongfully, and in violation of the above described duties of 

good faith and fair dealing, withheld, delayed, denied, and continue to deny and 

withhold Plaintiff disability insurance benefits owed under the Policy.

53. Defendants failed to conduct a reasonable investigation into Plaintiff’s 

claim, and instead engaged in an outcome based investigation designed to lead to 

the denial of Plaintiff’s claim.

54. Defendants failed to reasonably and fairly investigate Plaintiff’s claim, 

failed to take reasonable measures to ensure prompt payment of Plaintiff’s claim, and 

deliberately conducted a biased investigation for the wrongful and purposeful intent to 

avoid paying Plaintiff benefits owed under his Policy. 

Case 2:15-cv-02597-DLR Document 50 Filed 07/08/16 Page 10 of 14
11

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

55. Defendants repeatedly failed to fairly and objectively evaluate medical 

information and other evidence, and ignored information in medical records that 

clearly supported Plaintiff’s claim for disability.

56. Defendants violated and continue to violate duties of good faith and fair

dealing owed to Plaintiff by (1) relying on non-treating, non-examining medical 

professionals who are biased and do not qualify to render medical opinions regarding 

Plaintiff McClure’s claim, by (2) relying on non-treating and non-examining personnel 

who have not considered the totality of Plaintiff’s medical records and conditions, and 

(3) have and continue to act unreasonably by denying Plaintiff McClure’s claim 

without medical foundation to do so. 

57. Defendants failed to conduct an investigation into Plaintiff’s claim when 

requested to do so in 2014 and 2015, and failed and continues to fail to provide any 

reasonable or legitimate explanation for its claims decisions.

58. Defendants unreasonably interpreted the Policy’s provisions to their

advantage disregarding the interests of the Plaintiff.

59. Defendants unreasonably interpreted Arizona statutes, laws, and 

regulations applicable to the Policy’s provisions. 

60. Defendants purposefully intended to injure Plaintiff and/or acted to serve 

their own interests, having reason to know and consciously disregarding the 

substantial risk that their its conduct would significantly injure Plaintiff financially, 

emotionally, mentally, and physically; and, would cause anger, frustration, emotional, 

mental, and physical pain and suffering, among other things. Defendants are liable 

Case 2:15-cv-02597-DLR Document 50 Filed 07/08/16 Page 11 of 14
12

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

for exemplary damages for the conduct described herein as punishment, and as a 

deterrent so that Defendants and others do not act the same way in the future.

61. As a direct and proximate result of Defendants’ wrongful conduct, Plaintiff 

suffered and will continue to suffer significant damages and injuries that have 

affected and will continue to affect his life. 

62. Defendants’ refusal to pay past individual disability income insurance 

benefits, and their refusal to pay disability benefits currently owed and those that will 

be owed in the future, has directly and proximately caused special and compensatory 

damages, and has created a significant foundation for exemplary and punitive 

damages, in an amount to be proved at trial.

63. Plaintiff is owed past and current disability benefits under the Policy, as 

well as an acceleration of future benefits as a direct and proximate result of 

Defendants’ tortious conduct and bad faith refusal to honor the Policy and/or to fairly, 

timely and/or thoroughly investigate the Plaintiff’s accident related disability claim. 

64. As a further direct and proximate result of Defendants’ misconduct,

Plaintiff has suffered and will continue to suffer, anxiety, worry, frustration, mental, 

psychological and emotional distress, physical distress, loss of stability (financial and 

emotional), loss of earnings, and physical pain, all in amounts to be proved at trial. 

65. As a further direct and proximate result of Defendants’ misconduct, the 

Plaintiff incurred and will continue to incur other special damages in amounts to be 

proved at trial. 

Case 2:15-cv-02597-DLR Document 50 Filed 07/08/16 Page 12 of 14
13

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

66. As a further proximate result of Defendants’ conduct, Plaintiff has 

incurred other losses, lost opportunities, and suffered a decrease in the enjoyment 

and quality of his life (i.e., hedonic losses), all in amounts to be proved at trial.

67. At all times herein, Defendants were acting in concert and in furtherance 

of a joint enterprise and are therefore jointly and severally liable for the damages and 

harm inflicted on the Plaintiff.

WHEREFORE, Plaintiff requests a trial by Jury, and seeks damages against 

Defendants jointly and severally, as follows: 

a. Contractual damages for disability benefits owed under the Policy, and a 

refund of premiums Plaintiff paid while disabled under the Policy; 

b. Damages for failure to pay "total disability" benefits (past, ongoing, and 

accelerated future benefits) under the applicable coverage, together with a 

refund of premiums, in amounts to be determined at trial; 

c. Compensatory damages (past and future) for: mental, psychological and 

emotional damages; physical distress and injury; pain and suffering, loss 

of enjoyment of life, damage to credit reputation, and other damages in an 

amount to be determined at trial; 

d. An assessment of punitive and exemplary damages in an amount 

determined at trial to punish, deter and set examples of Defendants;

e. Pre-and post-judgment interest based on the liquidated amounts owed to 

Plaintiff, including disability benefits owed and a refund of premiums that 

Defendants have wrongfully collected from Plaintiff;

Case 2:15-cv-02597-DLR Document 50 Filed 07/08/16 Page 13 of 14
14

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

f. An award of future disability benefits from the date of the jury’s verdict 

until the maximum benefit period under the Policy; 

g. Reasonable attorneys' fees pursuant to A.R.S. Section 12-341.01;

h. All litigation costs incurred; and

i. For whatever other relief the Court deems proper.

TRIAL BY JURY

Pursuant to Federal Rules of Civil Procedure 38(b) Plaintiff has demanded a 

trial by jury.

Dated this 8th day of July, 2016.

ADELMAN GERMAN, P.L.C.

DAWSON & ROSENTHAL, P.C. 

By: Steven J. German

Steven J. German

Scott B. Seymann

8245 North 85th Way

Scottsdale, Arizona 85258

Attorneys for Plaintiff

Case 2:15-cv-02597-DLR Document 50 Filed 07/08/16 Page 14 of 14