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Scott E. Davis 

State Bar No. 016160 

SCOTT E. DAVIS, P.C. 

8360 E. Raintree Drive, Suite 140 

Scottsdale, AZ 85260 

Telephone: (602) 482-4300 

Facsimile: (602) 569-9720 

email: davis@scottdavispc.com

Attorney for Plaintiff Francene Rosenkrans 

UNITED STATES DISTRICT COURT 

DISTRICT OF ARIZONA 

Francene Rosenkrans, 

 Plaintiff, 

 v. 

American General Life Insurance Company 

AIG Life Insurance Company; Camden 

Property Trust; Camden Property Trust 

Disability Plan, 

 Defendants. 

Case No. 2:15-cv-02620-ESW

PLAINTIFF’S FIRST AMENDED 

COMPLAINT 

 

 Now comes the Plaintiff Francene Rosenkrans (hereinafter referred to as “Plaintiff”), 

by and through her attorney, Scott E. Davis, and complaining against the Defendants in her 

First Amended Complaint, she states: 

Jurisdiction 

 1. Jurisdiction of the court is based upon the Employee Retirement Income 

Security Act of 1974 (ERISA); and in particular, 29 U.S.C. §§1132(e)(1) and 1132(f). 

Those provisions give the district courts jurisdiction to hear civil actions brought to recover 

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employee benefits. In addition, this action may be brought before this Court pursuant to 28 

U.S.C. §1331, which gives the Court jurisdiction over actions that arise under the laws of 

the United States. 

Parties 

 2. Plaintiff is a resident of Maricopa County, Arizona. 

3. Upon information and belief, Camden Property Trust (hereinafter referred to 

as the “Company”) sponsored, administered and purchased a group long-term disability 

insurance policy which was fully insured by American General Life Insurance Company 

(hereinafter referred to as “American General”) AIG Life Insurance Company (hereinafter 

referred to as “AIG”). The specific American General AIG long term disability group 

insurance policy is known as Group Policy No.: GLTD-50978 (hereinafter referred to as 

the "Policy"). The Company’s purpose in sponsoring, administering and purchasing the 

Policy was to provide long-term disability insurance for its employees. Upon information 

and belief, the American General AIG Policy may have been included in and part of an 

employee benefit plan, specifically named the Camden Property Trust Disability Plan 

(hereinafter referred to as the “Plan”) which may have been created to provide the 

Company’s employees with welfare benefits. At all times relevant hereto, the Plan 

constituted an “employee welfare benefit plan” as defined by 29 U.S.C. §1002(1). 

4. Upon information and belief, American General AIG functioned as the claim 

administrator of the policy; however, pursuant to the relevant ERISA regulation, the 

Company and/or the Plan may not have made a proper delegation or properly vested 

fiduciary authority or power for claim administration in American General AIG. 

5. American General AIG operated under a conflict of interest in evaluating her 

long-term disability claim due to the fact that it operated in dual roles as the decision maker 

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with regard to whether Plaintiff was disabled as well as the payor of benefits. American 

General’s AIG’s conflict existed in that if it found Plaintiff was disabled, it was then liable 

for the payment of her disability benefits. 

6. The Company, American General AIG and the Plan conduct business within 

Maricopa County and all events giving rise to this Complaint occurred within Arizona. 

Venue 

7. Venue is proper in this district pursuant to 29 U.S.C. §1132(e)(2) and 28 

U.S.C. §1391. 

Nature of the Complaint 

8. Incident to her employment, Plaintiff was a covered employee pursuant to 

the Plan and the relevant Policy and a “participant” as defined by 29 U.S.C. §1002(7). 

Plaintiff seeks disability income benefits from the Plan and the relevant Policy pursuant to 

§502(a)(1)(B) of ERISA, 29 U.S.C. §1132(a)(1)(B), as well as any other potential nondisability employee benefits she may be entitled to from the Plan and any other Company 

Plan, as a result of being found disabled in this action. 

9. After working for the Company as a loyal employee, Plaintiff became 

disabled on or about August 21, 1999, due to serious medical conditions and was unable to 

work in her designated occupation as a Leasing Consultant. Plaintiff has remained disabled 

as that term is defined in the relevant Policy continuously since that date and has not been 

able to return to any occupation as a result of her serious medical conditions. 

10. Following her disability, Plaintiff filed a claim for short term disability 

benefits which was approved by American General AIG, and those benefits have been paid 

and exhausted. 

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11. Following the exhaustion of her short-term disability benefits, Plaintiff then 

filed for long-term disability benefits under the relevant Policy which was administered by 

American General AIG. American General AIG made every decision in Plaintiff’s longterm disability claim. 

12. Upon information and belief, the relevant American General AIG Policy and 

definition of disability governing Plaintiff’s long term disability claim is as follows: 

“Disability” or “Disabled” means: 

1. You cannot perform each of the material duties of your regular 

occupation; and 

2. After benefits have been paid for 24 months, you cannot 

perform each of the material duties of any gainful occupation 

for which you are reasonably fitted taking into consideration 

training, education or experience; or 

3. You, while unable to perform all of the material duties of your 

regular occupation on a full-time basis, are: 

a. Performing at least one of the material duties of your 

regular occupation or another occupation on a part-time 

or full-time basis; and 

b. Earning currently at least 20% less per month than your 

indexed pre-disability earnings due to that same injury 

or sickness. 

13. In support of her claim for long-term disability benefits, Plaintiff submitted to 

American General AIG, medical evidence which supported her allegation that she met any 

definition of disability as defined in the relevant Policy. 

14. American General AIG approved Plaintiff’s long-term disability claim and 

paid her long-term disability benefits through July 10, 2014, for a total of approximately 

fourteen (14) years. 

15. During the period of time Plaintiff was receiving long-term disability benefits, 

she also applied for, was approved for and is currently receiving Social Security disability 

benefits through the Social Security Administration (hereinafter referred to as “SSA”). 

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16. Plaintiff informed American General AIG that her claim for Social Security 

disability benefits had been approved and she submitted to American General AIG 

documentation from the SSA which confirmed the approval. 

17. The SSA found Plaintiff became disabled from engaging in any gainful 

occupation which may have existed in the national economy. 

18. The SSA’s definition of disability is more stringent and difficult to meet than 

the aforementioned definition of disability in the American General AIG Policy for the first 

24 months of disability and substantially similar to the Policy’s definition of disability after 

the first 24 months of disability. Therefore, the SSA’s approval of Plaintiff's claim and the 

fact that SSA has continued to pay her benefits for so many years is relevant evidence for 

this Court to consider with regard to the unreasonableness of American General’s AIG’s 

decision to terminate and deny Plaintiff’s claim and benefits. 

19. In a letter dated July 17, 2014 American General AIG informed Plaintiff it 

was terminating her long term disability benefits beyond July 10, 2014, without any medical 

documentation or evidence that Plaintiff’s medical conditions had improved or that she was 

capable of returning to work. 

20. Pursuant to 29 U.S.C. §1133, Plaintiff timely appealed American General’s 

AIG’s July 10, 2014 termination of her benefits. 

21. In support of her appeal and claim for long-term disability benefits, Plaintiff 

submitted to American General AIG additional medical evidence demonstrating that she 

met any definition of disability set forth in the Policy. 

22. In a letter dated September 17, 2014, American General AIG informed 

Plaintiff it was again denying her claim for long-term disability benefits, which Plaintiff 

timely appealed. 

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23. In support of her appeal and claim for long-term disability benefits, Plaintiff 

submitted to American General AIG additional medical evidence demonstrating that she 

met any definition of disability set forth in the Policy. 

24. As part of its review of Plaintiff’s claims for disability benefits, American 

General AIG obtained a medical records only "paper review" of Plaintiff’s claim from 

Randall King, M.D., who is consulting physician for the University Disability Consortium 

(hereinafter "UDC"). As the attached interrogatory answers confirm (See Exhibit "A" to 

this Complaint), UDC has a long business relationship with the disability insurance industry 

by providing the type of medical records reviews as occurred in this case and Plaintiff 

alleges UDC may derive a significant amount of its annual revenue from its relationship 

with the industry. As a result, Plaintiff alleges that in the review of her claim, Dr. King was 

not independent, objective or impartial with regard to the opinions he rendered regarding 

whether or not Plaintiff was disabled. 

25. Upon information and belief, Plaintiff believes Dr. King may be long time 

medical consultant for the disability insurance industry, UDC and/or American General 

AIG. As a result, Plaintiff believes Dr. King may have an incentive to protect his own 

consulting relationship with the disability insurance industry, UDC and/or American 

General AIG by providing medical records only paper reviews, which selectively review or 

ignore evidence such as occurred in Plaintiff’s claim, in order to provide opinions and 

report(s) which are favorable to insurance companies and/or American General AIG and 

which supported the denial of Plaintiff’s long-term disability claim. 

26. In a letter dated February 26, 2015, American General AIG notified Plaintiff 

it had denied her claim for long-term disability benefits under the Policy. In the letter, 

American General AIG also notified Plaintiff she had exhausted her administrative levels of 

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review and could file a civil action lawsuit in federal court pursuant to ERISA. American 

General’s decision to terminate Plaintiff’s disability benefits after paying her those benefits 

for approximately fourteen years and without any evidence that her medical conditions had 

improved in a manner which would allow her to return to work in any gainful occupation is 

arbitrary, erroneous and simply wrong. 

27. Upon information and belief, American General’s AIG’s February 26, 2015 

denial letter confirms it failed to provide a full and fair review, and in the process committed 

several procedural violations pursuant to ERISA due to among other reasons, completely 

failing to credit, reference, consider, and/or selectively reviewing and/or de-emphasizing 

most, if not all of Plaintiff’s reliable evidence. 

28. In evaluating Plaintiff’s claim on appeal, American General AIG had an 

obligation pursuant to ERISA to administer Plaintiff’s claim “solely in her best interests and 

other participants” which it failed to do. 1

 

29. American General AIG failed to adequately investigate and failed to engage 

Plaintiff in a dialogue during the appeal of her claim with regard to what evidence was 

necessary so Plaintiff could perfect her appeal and claim. American General’s AIG’s 

failure to investigate the claim and to engage in this dialogue or to obtain the evidence it 

 

1

 It sets forth a special standard of care upon a plan administrator, namely, that the 

administrator "discharge [its] duties" in respect to discretionary claims processing "solely 

in the interests of the participants and beneficiaries" of the plan, § 1104(a)(1); it 

simultaneously underscores the particular importance of accurate claims processing by 

insisting that administrators "provide a 'full and fair review' of claim denials," Firestone, 

489 U.S., at 113, 109 S. Ct. 948, 103 L. Ed. 2d 80 (quoting § 1133(2)); and it 

supplements marketplace and regulatory controls with judicial review of individual claim 

denials, see § 1132(a)(1)(B). Metro. Life Ins. Co. v. Glenn, 128 S. Ct. 2343, 2350 (U.S. 

2008). 

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believed was important to perfect Plaintiff's claim is a violation of ERISA and Ninth Circuit 

case law, and a reason she did not receive a full and fair review. 

30. Plaintiff alleges American General AIG provided an unlawful review which 

was neither full nor fair and that violated ERISA, specifically, 29 U.S.C. § 2560.503-1, by 

failing to adequately investigate her claim; by providing a one sided review of Plaintiff’s 

claim that failed to consider all the evidence submitted by her and/or de-emphasizing 

medical evidence which supported Plaintiff’s claim; by failing to adequately consider the 

fact that SSA continued to find Plaintiff was entitled to SSA disability benefits; by failing 

to credit Plaintiff’s reliable evidence; by disregarding Plaintiff’s self-reported symptoms; 

failing to consider all the diagnoses and/or limitations set forth in her medical evidence as 

well as the impact the combination of those diagnoses and impairments would have on her 

ability to work; by failing to engage Plaintiff in a dialogue so she could perfect her claim 

and failing to consider the impact the side effects from Plaintiff's medications would have 

on her ability to engage in any occupation. 

31. Plaintiff alleges a reason American General AIG provided an unlawful 

review which was neither full nor fair and that violated ERISA, specifically, 29 U.S.C. § 

2560.503-1, is due to its conflict of interest that manifested as a result of the dual roles 

American General AIG undertook as the decision maker and the payor of benefits. 

American General’s AIG’s conflict of interest provided it with a financial incentive to deny 

Plaintiff’s claim, thereby saving itself money. 

32. Plaintiff is entitled to discovery regarding American General’s AIG’s 

aforementioned conflicts of interest. UDC’s and any individual who reviewed her claim and 

the Court may properly weigh and consider extrinsic evidence regarding the nature, extent 

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and effect of any conflict of interest and/or ERISA procedural violation which may have 

impacted or influenced American General’s AIG’s decision to deny her claim. 

33. With regard to whether Plaintiff meets the definition of disability set forth in 

the policy, the standard of review for the Court to apply is de novo, because even though the 

Policy unlawfully contains discretionary language, it was issued in the State of Texas where 

Camden Property Trust is headquartered and Texas banned discretionary clauses in 

disability policies in 2011. In denying her claim, Plaintiff alleges American General AIG 

failed to provide a full and fair review pursuant to ERISA, and American General’s AIG’s 

decision to terminate her benefits is de novo wrong. If the Court concludes the Policy 

confers discretion and that the standard of review is for an abuse of discretion, Plaintiff 

alleges American General’s AIG’s unlawful ERISA violations as referenced herein are an 

abuse of discretion, that they precluded a Full and Fair review as required by ERISA and are 

so flagrant that they justify de novo review. 

34. As a direct result of American General’s AIG’s decision to deny Plaintiff’s 

disability claim, she has been injured and suffered damages in the form of lost long term 

disability benefits, in addition to other potential non-disability employee benefits she may 

have been entitled to receive or was receiving through or from the Plan, from any other 

Company Plan and/or the Company as a result of being found disabled. Plaintiff believes 

other potential non-disability employee benefits may include but not be limited to, health 

and other insurance related coverage or benefits, retirement benefits or a pension, life 

insurance coverage and/or the waiver of the premium on a life insurance policy which 

provided coverage for her and her family/dependents. 

35. Pursuant to 29 U.S.C. §1132, Plaintiff is entitled to recover unpaid benefits, 

prejudgment interest, reasonable attorney's fees and costs from Defendants. 

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36. Plaintiff is entitled to prejudgment interest at the legal rate pursuant to A.R.S. 

§20-462, or at such other rate as is appropriate to compensate her for losses she incurred 

as a result of Defendants’ nonpayment of benefits. 

 WHEREFORE, Plaintiff prays for judgment as follows: 

 A. For an Order finding that Plaintiff meets the definition of disability set forth 

in the Plan and/or Policy and requiring Defendants to pay her the long-term disability 

benefits she is due as well as any other non-disability employee benefits she may be 

entitled to as a result of being found disabled, from the date she was first denied all of 

these benefits through the date of judgment and prejudgment interest thereon; 

 B. For an Order directing Defendants to continue paying Plaintiff the 

aforementioned benefits until such time as she meets the conditions for the termination of 

benefits; 

 C. For attorney’s fees and costs incurred as a result of prosecuting this suit 

pursuant to 29 U.S.C. §1132(g); and 

 D. For such other and further relief as the Court deems just and proper. 

 

DATED this 15th day of January, 2016. 

 SCOTT E. DAVIS. P.C.

 By: /s/ Scott E. Davis Scott E. Davis 

 Attorney for Plaintiff

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