COMPLMNT AND JURY DEMAND

Transcription

1 'DISTRICT COURT, CITY AND COUNTY OF DENVER, COLORADO 1437 Bannock Street Denver, CO EFILED Document CO Denver County District Court 2n ~ JD Hling Date: Mar :35PM M!)T Filing 10: Review Clerk: Shelly \'Vestman Plaintiff: ALDRA K. WILSON v. Defendants: CERTAIN UNDERWRITERS AT LLOYD'S LONDON, HCC SPECIALTY UNDERWRITERS, INC., and ASU INTERNATIONAL, LLC... COURT USE ONLy... Attorneys for Plaintiff: THE MAHONEY LAW FIRM, P.C. Paul~.~ahoney,#23298 Kevin S. ~ahoney, #26154 Dennis~.~ahoney,# East 1 st Ave., #480 Denver, CO Phone: (303) Fax: (303) I!aul<a2mahonevlaw.com 1-5-/V/ Case No. i7 ( '- Div. ~~ COMPLMNT AND JURY DEMAND Plaintiff, through his counsel, The ~ahoney Law Firm, P.C., respectfully submits the following Complaint and Jury Demand: I. GENERAL ALLEGATIONS 1. At all times relevant to this Complaint, Plaintiff Aldra K. Wilson (a!k:ia Al Wilson) was a citizen and resident of the state ofcolorado. 2. At all times relevant to this Complaint, Defendants were, and are, an insurance company or companies.

2 3. At all times relevant to this Complaint, Defendants were, and are, doing business in the state of Colorado, including issuing insurance policies to Colorado citizens, and handling claims arising under such policies. 4. At all times relevant to this Complaint, in exchange for payment of a premium, Defendants provided insurance coverage to Plaintiff under Certificate No. L ("the policy" or "the contract"). 5. The policy included insurance against permanent, total disability. 6. At all times relevant to this Complaint, Plaintiff was a professional football player. 7. At all times relevant to this Complaint, Plaintiff was a member of the Denver Broncos football club up until his termination in On December 3, 2006, Plaintiff was injured while playing in a game against the Seattle Seahawks at Invesco Field at Mile High in Denver, Colorado. 9. In the game of December 3, 2006, Plaintiff suffered an injury to his cervical spine and cervical spinal cord. 10. Plaintiff was cleared to play, and did in fact play, in games against the San Diego Chargers on December 10, 2006, the Arizona Cardinals on December 17, 2006, and the Cincinnati Bengals on December 24, After the season ended, Plaintiff was seen by Robert Watkins, M.D., an orthopedic surgeon, in relation to the injury of his cervical spine. 12. On or about March 30, 2007, Dr. Watkins informed Plaintiff that he would not recommend that Plaintiff play football at that time due to the injury to his cervical spine. 13. On or about March 30, 2007, Dr. Watkins concluded that Plaintiff was temporarily totally disabled due to the injury to his cervical spine. 14. Plaintiff provided timely notice of claim to Defendants under the policy. 15. At all times relevant to this Complaint, Plaintiff has cooperated with Defendants' investigation of the claim, including, but not limited to, submitting to a physical examination by a physician chosen and designated by Defendants (Dr. James) on or about May 28, On or about May 28,2009, Dr. James informed Defendants that Plaintiff was totally disabled from playing professional football. 2

3 17. Upon learning of the analysis and opinion of Dr. James, Defendants knew, or should have known, that they were obligated to pay the benefits required under the policy. 18. As of the date of filing of this Complaint, Defendants have not paid any of the benefits to Plaintiff. 19. All conditions precedent to Defendants' obligation to make payment under the policy have been performed or have occurred. II. FIRST CLAIM FOR RELIEF Breach of Contract 20. Plaintiff incorporates all previous paragraphs into this First Claim for Relief. 21. Defendants entered into a contract with Plaintiff, as previously described in this Complaint. 22. As part of the contract, Defendants promised to pay a lump sum benefit to Plaintiff in the event that Plaintiff became unable to engage in his occupation (professional football player) as a result ofpermanent, total disability. 23. Plaintiff became unable to engage in his occupation (professional football player) as a result ofpermanent, total disability. 24. Defendants have failed to pay Plaintiff the lump sum benefit required under the contract. 25. Plaintiff has substantially performed his part of the contract. 26. As a result ofdefendants' breach of contract, Plaintiff has suffered damage, including non-payment ofthe benefit itself and interest thereon. III. SECOND CLAIM FOR RELIEF Bad Faith Breach ofinsurance Contract 27. Plaintiff incorporates all previous paragraphs into this Second Claim for Relief. 28. Plaintiff has sustained damages, including non-payment of insurance benefit, interest thereon, and non-economic damages. 29. Under Colorado law, including C.R.S , Defendants owed Plaintiff a duty ofgood faith and fair dealing. 3

4 30. Defendants acted unreasonably and in breach of their duty of good faith and fair dealing in delaying and/or denying payment of Plaintiffs claim. 31. Defendants knew that their conduct and/or position was unreasonable, and/or Defendants recklessly disregarded the fact that their conduct and/or position was unreasonable. 32. Defendants' unreasonable conduct and/or position was a cause of Plaintiffs damages. 33. Defendants willfully committed numerous unfair claims settlement practices, in violation ofcolorado statutes, including C.R.S and 1O (1)(h). 34. Defendants' commission of numerous unfair claims settlement practices caused or contributed to their delay and/or denial of Plaintiffs claim. 35. Defendants' commission of numerous unfair claims settlement practices caused or contributed to Plaintiffs damages. IV. THIRD CLAIM FOR RELIEF Violation of Colorado Statutes 36. Plaintiff incorporates all previous paragraphs into this Third Claim for Relief. 37. At all times relevant to this Complaint, certain provisions of the Colorado Revised Statutes were in effect, including C.R.S and Under C.R.S , Defendants were prohibited from unreasonably delaying and/or denying payment of a claim for benefits owed to Plaintiff. 39. Defendants unreasonably delayed and/or denied payment of Plaintiff's covered benefit. 40. Defendants delayed and/or denied authorizing payment of Plaintiffs covered benefit without a reasonable basis for that action. 41. Under C.R.S , Defendants are liable for two times the covered benefit, attorneys' fees, and costs. V. FOURTH CLAIM FOR RELIEF Declaratory Judgment 42. Plaintiff incorporates all previous paragraphs into this Fourth Claim for Relief. 4

5 43. A declaration of rights and duties arising under the contract is appropriate under Colorado law, including e.r.c.p. 57 and e.r.s , et seq. 44. Plaintiff requests a declaratory judgment detennining that Defendants are obligated under the contract to make payment ofthe lump sum benefit to Plaintiff. WHEREFORE, Plaintiff prays for damages against Defendants as set forth above in this Complaint, including but not limited to, payment of two times the benefit covered under the policy, non-economic damages, interest as provided by law, costs of suit, attorneys' fees, a declaration of rights, and for such further relief as the Court deems appropriate. PLAINTIFF DEMANDS A TRIAL BY JURY OF ALL ISSUES SO TRIABLE Respectfully submitted this 29 th day of March, THE MAHONEY LAW FIRM, P.C. By: si Paul M. Mahoney, #23298 Attorneysfor Plaintiff Duly signed original on file at the offices of The Mahoney Law Firm, P.e. Plaintiffs Address: Warrington Ct. Parker, CO