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Exhibit A
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IN THB UNITBD STATIS DISTRICT COURT
rOR TH. MIDDLI DXSTRICT 0' PBNNSYLVANIA
SHAWN A. CAMPBBLL,
Plaintirr
CIVIL ACTION
V. _
NORTHWBSTBRN NATIONAL LIPB
INSURANCB COMPANY, BANKBRS
SBCURITY LIPB INSURANCB
SOCIBTY, RBLIABTAR BMPLOYBB
BBNBPITS INSURANCB,
Oerendants
NO. _
arOTIC. or ....nV.Alt
Derendant. Northwe.tern National Lire Insurance
Company, Banklrs Security Lire Insurance Society and aeliaStar
Bmployee Senerit. Insurance ("Defendant."), ror the purpose or
removing thi. case to the United State. Di.trict Court ror the
Middle Di.trict or Pennsylvania, statel
1. Thi. action was commenced on September 4, 1996, by
the riling or a Writ or Summon. by Plaintifr in The Court of
Common Plea. of cumberland County, penn.ylvania, entitled
Shawn A. Campbell VB. Northwestern National Lifs Insurance
Company, Bankers Securitv Life InBUJ:'ance Societv. ReliaStar
~loy~e Benefits InBurance, CaBe No. 96-4910, Civil Term. The
Writ or Summons did not Bet rorth any fact. about Plaintifr's
claims or from which any conclusion could be made concerning the
jurisdiction of this Court, Therearter, on October 22, 1996,
Plaintirr riled hi. Complaint in which Plaintirf a..ert. denial
lDG/J...,/JOIJ..003
1
.
of inaurance ooverage and bad faith purauant to 42 Pa.C,S.A.
I 8371.
2. The above-deecribed action ie one in whioh thi.
Court has original jurisdiction under the provieione ot 28 U.S.C,
-
I 1331, and may be removed to thie Court by Detendante pureuant
to the provieione or. 28 U,S.C, S 1441,
3, Allot the allegations ot the Complaint againet
Defendante arose pursuant to an empl.oyee benetit plan, thus
bringing the cause ot action under the auspices ot ERISA,
29 U.S.C, S 1001 Sl..t. Al.WL. Pursuant to ERISA liS 502(e) (1) and (t),
29 U.S,C. 118 1132 (e) (1) and (f), the district courts ot the
United Statee-have original jurisdiction over all claims and
actions brought under BRISA, without regard to the amount in
controversy or the citizenship ot the parties.
4, Because this action arises pursuant to the laws of
the United States in a matter over which this Court has original
jurisdiction, the action "may be romoved by the [Defendants) to
the district court ot the United States for the district and
division embracing the place where Buch action is pending".
28 U.S,C. S 1441(a) I Metrocolitan Life Insurance Co. v, Taylor,
481 U.S. 58 (1987), Without admitting sarne, to the extent any
claim does not arise pursuant to BRISA, it ilS a claim cognizable
by this Court pursuant to its supplemental jurisdiction under
28 U.S,C, S 1367.
lDO/'1.11/)O.'I,ooa
2
.
5. In addition, because Pla1nt1rr's causes or action
against Derendants arise. trom .tat. law, they are entirely
preempted under I 514(a) or BRISA, ~g U.S.C. I 1144(a). Pilot
Lite Inluranee COmDany, v, Dedeaux, 481 U.S, 41 (1987).
~
6. In the alternative, removal is proper becaus., to
the extent Plaintirr'l claims were not preempted by BRlSA, the
Court has jurildiction pursuant to ~8 U.S.C. I 1332 in that the
part1em are diverse and the amount in controversy alleged in the
Complaint exceedl $50,000.00.
7. Removal is timely under 28 U,S.C. I 1446(b), which
allows Derendants thirty (30) daYI trom the earlier or service or
receipt or Plaint1tt's complaint within which to file luch Notice
or Removal. The Complaint wal serv.d upon Derendants' counsel on
October 22, 1996.
8. 'frue and correct copiel ot the original Summonl
and Complaint are attached as Bxhibit A hereto. Attached al
Bxhibit B il Oetenle Counlel'l Notice ot Appearance and Praecipe.
Detendantl have not otherwise appeared in this action. No
turther proceedingl have been had herein, and trial has not yet
commenced, in the Court or Common Pleas or cumberland County,
Pennsylvania.
9. Allo attached hereto as Bxhibit C il a copy or the
Notice or Piling Notice or Removal which is being tiled in the
Court or Cornrnon Pleal of CUmborland County, Pennlylv~nia and
lerved on opposing counsel.
aDG/~.'111)o'~',003
3
t'0'd 'J;1LO!
Dt~Wt t. ."1 'HK!llr.'
$" 5 Il~, ~H '96
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~HMm A.. CAt>lUUL,
PL&l.nt~~~
I IN THE COURT or COtfr.<ON :nlCAS
or CUMBERLANO COUl.'lTY, nNNS'(L'IAHIA
~r()l\'rHIII!:STERN ~'ATIONI\.L
L t FE INsr.If\At.:~I COMPANY,
S,vrl<ERS s:tcr.'~!..y LIFE
WSIJMNCE K.I::ET'(,
RELIAIITM EH?t.OYU
BENEFITS INS~RANCE,
Oel!ltndar.l:'
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I ~O. 96-49LO CI'IIt. TEN{
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I CIVIL ACTION - LAN
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I JUR'i TP.IAL OEHANDED
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~9U~LA~~T
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i".~~l'.':':'l!~ ~s Shawn A. Campbltll, Ill\ adult 1ncJiv1';Iud
.ll: .~.; .<linlt Road, Shippensbur<1, PennsvlvISnS.a, L ;:457.
o~.ndAnts are N~rthw'lt.rn NIlt10nal Lir. Insur~nc.
t:ft:tidi rlQ
~.
... ,
i:'~mlJ'l\:I (NOI:':;',''''.Lfr:ern) or lts atUliate, Bankers SltcurLtv LH.
~nll.l:an~l! Sr:ctttt1 (Bankersl and P.lll1astar Emplovee BlIIndl.t1S
Insurance. All Oerend~nts arft related and afl!il1ated and hav~
r.lHices in t-l1.nn..apolilf, M1nn8ll0ta, 554010- L540 and are believed to
bit Oel~w.r~ C~r.porations.
3) O.,:!..ndantB provided to Plainl.!ff two PQl1c:iltlS of Life
3:ld 'l<:c:i,l..n:':"1. dellth and dl.lmftm.bement Lnsur~nC:lIl, cr.l!;)lGlt
unAv~11abLft. Sal~ poLlc1eft were 1n erf~c:t durlnq 1994.
41 T:... m:.'.ttlll'l infot1llatlon provided to l:'La1ntHf. by
O.tecd~nt~ ~= th~~~ ~Qents, stated that Pllllntlff had inaurance
,;:'I,'Gr.l.;lft ,,,,,,'~::i poly ,me-half of the amount "'! thfl poLic:y ~or the
~os~ ~C the B~qhC of on. (L) eye. I!:ac:h p"l~~y had c",veraqe in
.
. ".
,
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in the ,mount ot 'lOO,OOO,OO. Copi.s ot the documents p~ovid.d
to Plaintite are att4ch.d he~eto and incorporat.d her.in by
rere~enc. .
5) On May 13, L994, Plaintiff wa. involved in tn accidenc
-.
and .uf~.r.d sov.re traumatic injury to both eyes.
6) PLaintifrs .ight in his Lert eye ha. be.n lost for all
pr&ctid'al intents and purpo.e., in that, .u he were to lo.. the
si~hc in hi. good right lye, the remair,ing vi.ion in bit lert eye
would r~nder him blind ror all int.nt. and purpo....
7) IHal.ntitts sight deficiency is relat.d to a permanent
10'B of ceneral vision related tQ choroidal rupture complicated
-
by a ~ho~oidal nltovascular membran..
S) Plaintire avers that all condition. p~c.dent to
recovery hav" belln rul tilled.
9) Olaintirr haG been d.ni.d coverage under the policies
of insurance issued by the Defendant..
WHlREFORS, Pla1ntitr demand. judgment again"t the Def.ndant.
in the amount of $100,000.00, plus interest and co.t. and a~y
other relief deemed just and proper.
conN'!' It
10) The averm.nt. made in Paragraph. 1 thrDugh 9 are
incoJ:'tj)Qrate<t hereby by reeerence.
'--.-'
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I v,rie1 that the Itatlmentl made in the f.orlgoing
Complaint a~1 t~1 and cor~eat to the be.t oe my knowLedge,
ineol:'lllAtion and belie I! . I uru1eretand that ral.. .eatem.entl
h.erdn ar. mAde lubj eat to the penaLei.. or 18 Ii'a. C. S. t 490"',
-
relating to un.worn l!aLlieiaation to luthoriti...
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~_I tJv ~ LJ!
. SHAWN A. C~BB['t.
..
Dated I
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SKAIIN A. CAMPB~LL/
Plaintifr
I IN TNt COURT or COHMOH PLIAS
I or CtlHIlERLAND cotmTY, PlltfflS'tXNAtfIA
I
I
, NO. gSw4910 CIVIL TIlRK
I
I CIVIL ACTION - LAW
c
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I JURY TI\IAI. DDU\NDIlD
I
v.
NORTHWESTERN NATIONAL
LIrE INSllNUICE COHPANY,
BANKERS S~CURITY LIFE
INSURANCE SOCIETY,
RELIASTAR ~LOYEE
BENEFITS INSURANCE/
Defendante
"*
I hereby certil!y that Dn october ~ , L996, I, David A. Baric,
Eequ1re, of O'Brien, Baric' Scherer/ did serve a copy ot the Complaint,
by U.S. l!ir.t cla.e mail/ pOdtaqe prepaid, to the partie. listed below,
...
lIS tollowe,
,
No~thweetern National Life Insurance Company
P,O. Box 20
MinneapOlis, Minnesota 55440
Reliastar Employee Benetits
P.O, eOlC 20
Minneapolis, Minnesota 55440
Banker. Security Lite Insurance Society
P.O. BOlC 20
MinneapOlis, Minnesota 55440
~~~.
David A, iLric, E.quire
-
WEtlE'
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(" "'I.)>~
..... '..., U
SHAWN A. CAHPBELr"
Plal.ntitt
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I IN THB COURT OF CDMNON 'LIAS or
1 CUMolRLAHD COUNTY, PENNSYLVANIA
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I CIVIL ACTION - LA~
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I NO. 96-4910
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NORTHWESTERN NATIONAL LIFE
INSURANCE COMPANY, BANXIRS
SECURITY LIrE INSURANCI
SOCIBTY and nLIASTAR
EMPLOYEE BENZrITS INSURANCB,
Defendantl
ZNTRY OP APPEARAHC2
TO THB PROTHONOTARY OF CUMBERLAND COUNTY 1
Kindly enter the appearance of Kenneth D. Rleinman,
Ilquire, I. Thoma. Heneter, Esquire and Steven I , Lee, P.C. on
behalf of the defendantl in the abovl-captioned aotion.
-
ITIVDI , LII
Byr
enne D. e nm re
Attorney 1.0. No. 3177
E. Thomas Henerer, Isqu
Attorney 1.0. No. 53343
111 North sixth Street
P.O. Box 679
Readinq, PA 19603-D679
Attorneys for Defendant.
EXHIBIT B
r
,
SHAWN A. CAHPBlLL, I IN TH~ COURT or C~MMON PLEAS or
Pla.l.nt:.l.l!t I OUMBIRLAND COlmTY, PlNNSYLVAHIA
I
v. I ,-, " -,
CIVIL ACTION - LAW . ' II
I - " I
NORTHHISTIRN NATIONAL LIr. I " " 1;1
,.,
INSUJWfCI COMPANY, BANJ(!RS I I '~
.-.,
SICURITY LIPB INSURANCI I I. - J~
SOCXITY and RILIASTAR r ,..
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DlPLOYlI BINDITS INSURANCE, I NO. U-4Il10 ~.. ' ..
. . io,)
Defendant. & " ~
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PRAICIPB
TO THI PROTHONOTARY or CUHBBlUJUfO COUNTY I
Pur.uant to Pennsylvania RUle ol! civil Procedure 1037(a),
kindly enter a rule upon the pla1ntll!l!, shawn A, campbell, to
l!ile a complaint within twenty (20) day. atter the service ol!
...
said rule.
.TIIVD. I LII
BYI
enne .
Attorney 1.0. No. 31770
B. Thomas Henel!er, I.quire
Attorney 1.0. No. e3343
111 North sixth stre.t
P.O. Box 679
Readinq, PA 19603-0679
Attorney. tor Oel!endants
P'MlyIVIIIII, to .fl'llClt remllvII plll1Ullltto 28 U,S,C, f 1446(d).
Olted thl, ~ day ofNovemb.r, 1996,
STEVENS & LEE
I I
B)'~ t::. I I
KIlMoth 0, Klo nJnlll, EIIIUI
A"omo)' 1.0. Nil. 3t770
E, Thomlll Honoror, Eaqulro
Altomo)' I,D. No. .5.5773
III North Sheth S\reol
Poat Office Box 679
Rellll"lI, PennlylvlUllB 19603.0679
1-
, I
.
--
ATTORNEYS FOR DEFENDANTS
NORTHWESTERN NATIONAL LIFE
mSURANCECOMPANY,BANKBRS
SECURITY LIFE INSURANCE SOCIBTY
AND RELIAST AR EMPLOYEE
BENEFITS INSURANCE
I I
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OOOS06P.OI
.2.
Commonwealth of Pennsylvania
County of Cumberland
, I
SfIAWN A. ~BELL.
Courl of (lommOI) Pie..
w.
No. .....~~::'.4np.s:iv.u..'l:enn..... ..... 19....
OORTHWESTERN NA'rIONI\L
LIFE INSU~E C().lpAN~,
BANKERS SECURITY LIFE
INSU~E SOCUJl'Y,
RELIASTAA EMPLOYEE
BJ:m:FI'l'S INSURANCE
P. O. Box 20 Legal Departlllllnt
Minneapolis, Minnesota 55440-1548
To mBTHWESTERbI.~;r;otW...t.W.i.1NSUliW'l(;i. C().IpJ\NY.
SOCIBl'Y, RELIJIS'l'AR OOLO'iEE BENEFITS INSU~E
You are hereby notlned that
.n .......~tyJJ.~.tAOO..:.. J.,o~~....... .....uu..........
IW/KERS SEX:URrrV LIFE IHSUAAt/CE
....... ~mt .Al..S:;.N1f~.................. ......... ................ ............... ...... ........ ................... ........ ............. ........ ...,..... ........
lhe Plaintlrr hB 8 commenced an action in .....CIY.IL.ACTlOt/.:-.lA\)'..............................
againll you which you are required to derend or B dc/ault Judgment may be entered aplnll )'Ilu,
(SML)
.... r oIIltJ:rPnca..E.. Walke4.l?mthOl'lQt:erf..n..
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Plal-nt lrr
IN 'rlllll coul~'r OV' COMMON PJ,I';AI:l
OV' ClJMllV:I~I,1IN1J C;OUWI'Y I I'V:N/'lI3'/I,vANIA
v.
NOg"'HWII:B'I'F:RN /'IA'I' IONAt,
J.J 1"1r, I/'ItllJP.ANCI!: COMPANY,
IW'HU:HH ~iV;ClJlln'Y I,l V'B
INlllmA/'ICIi af,lC1 Jr:""{ I
g';:!,IAIi'I'Af{ V:Ml'!.OYlet':
I3/!:NI':V'I"'H lNBIJMNClI:,
Dtl,'rmdBl1tll
NO. 96-4910 crVIL, 'J'v;r.M
c t V !I., I\(~'l' WN " 1,1\1'1
JUIW 'finAL IJI!:MIINLiIf.O
~.9J1J!J4HtJ,'!'.
r;@I:l:L!
I) InllJ.nU,rr 1u 1I11,lwn 1\, CII",pbtfL 1, Oil IldulL ind1vldlllJl
r~Hidll1q et J~& Kllna Mond, Sh1ppanllbur~1 Pannllylv~niBI 17267,
2\ Putund~l1tn Bro /'IorthwuBt~rn N~tlonRl Lifa IhllurHl1ca
r:omf'~ny (Nort.hV/l:'r;t.l3rn) tll' I.tll IIffJ.Uotlcl, Bonl-:I'/1'6 :3t,r:ut:Lty J,ifu
rlltll.lrOw") Ilndflty (HRl1kurtl) and Rnllul3tnr F.:lI1pI9Y<'l(! Bf.tnef'ltr;
1I11;Ul'6n,;rt. 1\.11 f)'~f(mrlM1l;tl are ralatrJr.l Mild nfflliator,j and hove
0rrleou in Mlnllo6poli~, Minnalloto, ~5440-L54G nnd nr~ b.lLoved tu
t)(~ i)rll,JWIJl'l1 Cr>rpol'ntlons.
:l) 1!I,l"lIldontlJ pr.ovidrlu 1:0 PLairUff I;W() poUcl1tll of liFu
(lnd IIc(:ld,!nl,ol d(1I11:h IJlld dl.Bml;mborlMJnt In/luy.'.~nr:l'l, (,!'Jpill/3
ullflvflllnblo. So id po lici<:lR WQroJ 1.1) Uff.,CI: dur.tnq 1994.
4) The written infonnnl:lon provided to Plnintirr by
CJOi!t<Wr.lllllt.l\ or UHlir 1.1\) on \: II , statod t.hat PIIIl.ntJ.ff hod i.luIUy.llnr:o
~
':'lVeraqfl w0uJd PdY l?nH~hn] f of thfJ amount 01:' Ul<~ pol.lr:y I\H th\l
lO:H; or Lilt! r,J.(JI\I: <ll' 0110 (I) uY<l. Elich polJ..:y had C()VtHlhlH III
. \
I.n the nmnunt; of $100,000.00, copl''''' of the doouments pl.'lJvided
to PlaintH fare att/1ched hereto IInd inlloJ:'porated herein by
rt:!fl!l'oncG.
5) 011 May U, 1994, Plaint.Hf wall invo,lVp.r:J in IJn acddent
/lnd ~uflfl3J:Gd I'ltWIU'a ClolJmatlc injuxy to both eY'HJ.
6) l'lainl:ifflil sight in hill left aye has bal!ll l()llt tor all.
practIcal lntentlil and purpollell, in that, if; he ware to lellle the
~ight ln hla good right eye, the remainlng vision in his left aye
would r~nder hlm blind far all intents and purpo/1es,
'I) J?laintHfll al,ght deficiency ia l'Itlllted to a parmanf.ltlt
lOSB of central vision related to choroldal rupture complicated
by a chorol.dal nrwva/iclllat' memhrane.
ll) J?la i ntH f flVera that all. crmdl.ti()nll precedent to
rec:oV'clry tHlV'P. be<en fulfilled.
9) l'laint iff hlHl been denied coverage under the policies
of lnGuranGEl j,l3sued by the Defendants.
WHF.:REFORL\, plaintif f demands judgment against the Defendants
in the amount of $100,000.00, plul> interest and costl> and any
other relief doemed just and proper.
co.tJNT...u
1.0) 'l'he averments made in Paragraphs 1 thrQugh 9 Ilrll
J.ncortlQrRtp.d hereby by referenoe,
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I V$ritv that the .tatem~nt. mQd~ in the f,orlgoinQ
complaint. a~o true and Qo~reQt to the best ot my knowledgG/
lntol:'lllation end blll.iet. I undllll:ltand thAt r./ilBtl BtlStenlln!:.
hElr.dn 1:11;'(11 Rlnde llubj'Jct to the Plll'lllltillll oC 18 l~a. r.,S. ~ 1\1101\,
relating to unswor.n falsifioation to authorities.
~...I (;,~
. R~J\WN A, C l3ELl,
Pated ~
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SHAWN A, CAMPBmLL,
PlaintiH
IN THE CQijRT OF COMMON PLI!lAS
OF CUMBERLAND COUNTY, PI!lNNSYLVANIA
V.
NOR'fHWI!:STIEI'N NM'IONAL
LIFE INSURANCE COMPANY,
BANKERS sreCURITY 1,1 Fa
INSURANCE SOCII!:TY,
RIELIASTM IEMPLOYEro
BIENEFITS INSURANCIE,
Defendants
NO, 9fi-4910 CIVIL 'rEm
CIVIL ACTION - LAW
JURY TRIAL DI!:MANOI!:D
CERTIrIC~TI!: OF SI!lRVICI!:
I hereby certify that on October ~ , 1996, I, David A. Baric,
resquire, of O'Brlen, Baric & Scherer, did serve a copy of the Complaint,
by U.S. first cLass mail, postage prepaid, to the parties listed below,
as follows I
Northwestern National Life Insurance Company
P,O. Box 20
Minneapolis, Minnesota 55440
Reliastar Employee Beneflts
P.O. Box 20
Minneapolis, Minnesota 55440
Bankers Security Life Insurance Society
P.O. Box 20
Minneapolis, Minnesota 55440
~c&:-.
David A. Baric, Esquire
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