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HomeMy WebLinkAbout95-05053 . VIRGINIA C. HASSINGER, Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNA. CIVIL ACTION - LAW v. : NO. UNUM LIFE INSURANCE COMPANY OF AMERICA, Defendant JURY TRIAL DEMANDED NOTICIA Le han demandado a usted en la corte. Si usted qui ere defenderse de estas demandas expuestas en las paqinas suqnuientes, usted tiene viente (20) dias de plazo al partir de la fecha de la escrita 0 en persona 0 por aboqado y archivar en la corte en forma escrita sus defensas 0 sus objectiones alas demandas en contra de su persona. See avisado que si usted no se defiende, la corte tomara medidas y puede entrar una orden contra usted sin previo aviso 0 notificacion y por cualquier queja 0 alivio que es pedido en la peticion de demanda. Usted puede perder dinero 0 SUS propiedades 0 otros derechos importantes para usted. LLEVE ESTA DEMANDA A UN ABOGADO IMMEDIATEHENTE. SI NO TIENE ABOGADO 0 SI NO TIENE EL DINERO SUFICIENTE DE PAGAR TAL SERVICIO, VAYA EN PERSONA 0 LLAME FOR TELEFONO A LA OFICINA CUYA DIRECCION SE ENCUENTRA ESCRITA ABAJO PARA AVERIGUAR DONDE SE PUEDE CONSEGUIR ASISTENCIA LEGAL. Court Administrator cumberland County Courthouse Fourth Floor Carlisle, PA 17013 (717) 240-6200 VIRGINIA C. HASSINGER, Plaintiff : IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNA. CIVIL ACTION - LAW v. . . : NO. UNUM LIFE INSURANCE COMPANY OF AMERICA, : Defendant JURY TRIAL DEMANDED COMPLAINT 1. Plaintiff Virginia C. Hassinger is an adult resident of Carlisle, cumberland County, Pennsylvania. 2. Defendant UNUH Life Insurance Company of America is an insurance company organized under the laws of the state of Maine. 3. At all relevant times, the Plaintiff Virginia C. Hassinger was an employee of Masland Industries, Inc., and insured under a policy providing disability benefits, issued by Defendant UNUM, Policy No. 00353047-0001. A copy of said policy with amendments is attached hereto as Exhibit "A". Any portions of the policy not included are within the possession of UNUM. 4. On or about July 28, 1992, Virginia Hassinger was diagnosed by her physician, Dr. William Graham, with an arthritic hand dysfunction, which eventually resulted in some joint replacements. Plaintiff's right shoulder was also affected. 5. Because of this condition, the Plaintiff missed the following time from work on a partial disability basis: August 9, 1993, through June 14, 1995. 76085/CW 1 6. Because of this condition, the Plaintiff was fully disabled from September 30, 1992, through December 1, 1992, and from January, 1993 through August, 1993. 7. When the Plaintiff returned to work in August, 1993, Masland created a special light duty job for her, accommodating her significant loss of physical function and disability. 8. This position is not one reasonably available to her in the general economy, but was specially created for her by her ex- employer, for reasons of personal loyalty. 9. As of June 15, 1995, Masland decided to terminate the Plaintiff. 10. The substantial disability occasioned by Plaintiff's hand and shoulder problems prevents her from engaging in alternate employment reasonably available. 11. Defendant paid Plaintiff Virginia Hassinger partial disability benefits under the policy between August, 1993, and June 14, 1995, but decided to terminate her benefits altogether when she was terminated by Maaland. Defendant predicates its termination of benefits upon the disability clause of the policy, which is quoted in a letter from Barbara Fuller to Virginia Hassinger dated July 24, 1995, and attached hereto as Exhibit "B". 2 ------- 12. The plaintiff cannot perform each of the material duties of her regular occupation, as that occupation was defined prior to the time when the employer, Masland, created a special position for her. 13. plaintiff virginia Hassinger further fits the definition of disabled because, by virtue of her medical condition, she cannot perform each of the material duties of any gainful occupation for which she is reasonably fit by training, education and experience. 14. The plaintiff's medical condition, additionally, made it impossible for her to fulfill any supposed contract requirement that within thirty (30) days she find another part-time position for which she was fit, given her serious physical dysfunctions. 15. The plaintiff has fulfilled all conditions precedent required under the contract for the payment of disability benefits. As a result of Defendant's breach of contract, the plaintiff has been deprived of disability benefits from June 24, 1995 to the present, with such loss continuing. WHEREFORE, plaintiff requests damages against the Defendant in the amount of disability benefits owed from June 24, 1995, to the 3 1\ II present date, together with such interest and attorney fees as is provided by law. Respectfully submitted, ANGINO & ROVNER, P.C. ) ) I ' }) It M. Mel llo, re No. 26211 4503 North Front street Harrisburg, PA 17110 (717) 238-6791 Counsel for plaintiff Dated: ).ep~ ,;ifJ, JQr5' 4 ~ .-..... VERIFICATION I, VIRGINIA BASSINGER, hereby verify that the facts set forth in the foreqoinq COMPLAINT are true and correct to the best of my knowledqe, information and belief. I understand that any false statements therein are made subject to the penalties of 18 Pa. C.S. 54904, relatinq to unsworn falsification to authorities. WITNESS: ~ ~J -'/,J,/!// ,Ir . IL~/!.. , ,~ ( . ~i {:,. 4",,~ V r a Hass nqer Dated: ..J;plIl~H...<'" I~ /'It?J 1\ ~ UNUM. GROUP LONG TERM DISABI L1TY INSURANCE POLICY NON PARTICIPATING Policyholder: C.H, MASLAND & SONS. DOING BUSINESS AS MASLAND INDUSTRIES Policy Number: 353047 Policy Effective Date: January 1. 1991 Premium Due Dates: January 1 and tha first day of each following month. , Governing Jurisdiction: PENNSYLVANIA I ~ ; . Policy Anniversary: January 1, 1992, and each following January 1. UNUM Life Insurance Company of America' (referred to as the Company) will pay the benefits. provided in this policy. The Company makes this promise subject to all of this policy's provisions. The policyholder should read the policy specifications carefully and contact the Company promptly with any questions, This policy is delivered in and governed by the laws of the governing jurisdiction. Signed for the Company at Portland. Maine on the policy effective date, ~ 9 ~ {2~-1 CL-- Secretary l---'president ~ UNUM Life Insurance Company of Americi L" Exhibif "A'l This policy is divided into sections as follows: Section POLICY SPECI FICA TIONS Section II DEFINITIONS Section III ELIGIBILITY AND EFFECTIVE DATES Section IV BENEFITS Section V TERMINATION PROVISIONS Section VI GENERAL POLICY PROVISIONS Section VII PREMIUMS This policy follows a number-letter sequence. It is not necessary that it include all numbers or letters in complete sequence to be correct. l'IND-l AMENDMENT NO, 3 This amendment forms a part of Group Policy No. 353047 issued to C,H. MASlAND & SONS, DOING BUSINESS AS MASLAND INDUSTRIES. the Policyholder. .his policy is changed by the addition or deletion of the pages listed below. ADDITIONS 1. L-DEF-2 (1/1/93) 2. l-DEF-4 (1/1/93) 3. L-BEN-l (111193) DELETIONS L-DEF-2 L-DEF-4 L-BEN-l Th. .ff~ttv. dat. .f th... 'h"g.. t, J.n.."" I, 1993. Th. 'hang.. only a..,y to disabilities which start on or after the effective date, Th. ""'y', t.~, and .~vl,ton, wm a..ly oth" th.n a, '''t,d In thl, am.nd. ment. Dated at Portland, Maine this 29th day of March, 1994. UNUM Life By an~e Company of America If thl, am.ndm.nt t, """.t.bl.. .1.... "gn b.low and "to," thl, .mondmont to UNUM Llf. 'no""." Com.any of Ametl.. at Port'and. M"n. wlthln 90 day, of March 29, 1994. YOUR FAILURE TO 51GN AND RETURN THIS AMENDMENT BY THAT DATE WILL CONSTITUTE ACCEPTANCE OF THIS AMENDMENT. C.H. MASLAND & SONS, DOING BUSINESS AS MASlAND INDUSTRIES POliCYhOlder By Signature and Title of Officer KO/jc L-PA-J SECTION II - DEFINITIONS (continued) C,j_D f:l{6 "Employer" means the policyholder and includes any division, any subsidiary or any affiliated company named in the policy specifications. "Evidence of insurability" means a statement or proof of an employee's medical history upon which acceptance for insurance will be determined by the Company. "G race period" is the 31 days following a premium due date during which premium payment may be made. "Gross monthly benefit" means the insured's benefit amount before any re- duction for other income benefits and earnings. "Home office" means the UNUM Life Insurance Company of America, 2211 Congress Street, Portland, Maine 04122. I "Indexed pre-disability earnings" means the insured's basic monthly earnings in effect just prior to the date his disability began adjusted on the first anniversary of benefit payments and each following anniversary. Each ad- justment will be based on the lesser of 10\ or the current annual percentage increase in the Consumer Price Index. Note: The Consumer Price Index (CP\-W) is published by the U. S. De- partment of Labor. The Company reserves the right to use some other si- milar measurement if the Department of Labor changes or stops publishing the CPI-W. , , t . I i , I i I I i , "I njury" means bodily injury resulting directly from an accident and inde- pendently of all other causes. The injury must occur and disability must begin while the employee is insured under this policy. "Insured" means an employee insured under this policy. "Male pronoun" whenever used includes the female. "Monthly Benefit" means the amount payable by the Company to the disabled insured. I I i . t \ I I "Partial disability" or "partially disabled" - see last page of Section II. "Physician" means a person who is: " operating within the scope of his license; and either 2. licensed to practice medicine and prescribe and administer drugs or to perform surgery; or 3, legally qualified as a medical practitioner and required to be re- cognized, under this policy for insurance purposes, according to the insurance statutes or the insurance regulations of the gov' erning jurisdiction, It will not include an employee or his spouse, daughler, son, father, mother, sister or brother. L-DEF-2 SECTION II - DEFIN IT IONS (continued) --L ,..... C-v '1 ' / '(:-1<::< "Disability" and "disabled" mean that because of injury or sickness: 1. the insured cannot perform each of the material duties of his regular occupation; and 2. after benefits have been paid for 24 months, the insured cannot perform each of the material duties of any gainful occupation for which he is reasonably fitted by training, education or experience. For employees employed as airplane pilots, co-pilots and crew members "Disability" and "disabled" mean that because of injury or sickness the insured cannot perform each of the material duties of any gainful occupation for which he is reasonably fitted by training, education or experience. The loss of a pilot's license for any reason does not, in itself, constitute disability. "Partial disability" and "partially disabled" mean that because of injury or sickness the insured, while unable to perform all the material duties of his regular occupation on a full-time basis, is: 1, performing at least one of the material duties of his regular occupation or another occupation on a part-time or full-time basis; and 2. earning currently at least 2O't. less per month than his indexed pre- disability earnings due to that same injury or sickness. L-DEF-4 SECTION IV - BENEFITS 01.;) ~ ' ,/ ':.'ft ec' . DISABILITY When the Company receives proof that an insured is disabled due to sickness or injury and requires the regular attendance of a physician, the Company will pay the insured a monthly benefit after the end of the elimination period. The benefit will be paid for the period of disability if the insured gives to the Company proof of continued: 1, disability; and 2, regular attendance of a physician. The proof must be given upon request and at the insured's expense. 1. exceed the insured's amount of insurance; nor I The monthly benefit will not: 2. be paid for longer than the maximum benefit period. The amount of insurance and the maximum benefit period are shown in the policy specifications. PARTIAL DISABILITY When proof is received that an insured is partially disabled within 31 days of the end of a period during which he received disability benefits, the Company will pay a monthly benefit. The partial disability must result from the injury or sickness that caused the disability. MONTHLY BENEFIT To figure the amount of monthly benefit: , . Take the lesser of: b. the amount of the maximum monthly benefit shown in the policy specifi- cations; and I a. 50\ of the insured's basic monthly earnings; or 2. Deduct other income benefits, shown below. from this amount, L-BEN-' -- ...... AMENDMENT NO. 4 This amendment forms a part of Group Policy No. 353047 issued to C,H. MASLAND r. SONS, DOING BUSINESS AS MASLAND INDUSTRIES, the Policyholder. This policy is changed by the addition or deletion of the pages listed below, ADDITIONS 1. L-PS-1 (3/1/94) 2. L-PS-2 (3/1/94) 3. L-PS-3 (3/1/94) DELETIONS L-PS-1 L-PS-2 (10/1/93) L-PS-3 The effective date of these changes is March 1, 1994. The changes only apply to disabilities which start on or after the effective date. The policy's tenns and provisions will apply other than as stated in this amend- ment. Dated at Portland, Maine this 30th day of March, 1994. . UNUM Life I urance Company of America By If this amendment is unacceptable, please sign below and return this amendment to UNUM Life Insurance Company of America at Portland, Maine within 90 days of March 30, 1994. YOUR FAILURE TO SIGN AND RETURN THIS AMENDMENT BY THAT DATE WILL CONSTITUTE ACCEPTANCE OF THIS AMENDMENT. C.H, MASLAND r. SONS, DOING BUSINESS AS MASLAND INDUSTRIES Policyholder By Signature and Title of Officer KO/jc L-PA-l SECT10~ _ POLICY SPECIFICATIONS (c Inued) 5-:5 :) c! 7 6. Definition of Basic Monthly Earnings "Basic monthly earnings" means the insured's monthly rate of earnings from the employer in effect just prior to the date disability begins. It does not include commissions. bonuses, overtime pay and other extra compensation. 7. Waiti n9 Period: a. Employees in an eligible class on or before the policy effective date: None b. Employees entering an eligible class after the policy effective date: On completion of 30 days of active employment The employee must be in continuoUS active employment in an eligible class during the specified waiting period. 8. Employee Contributions Required: No 9. Divisions, Subsidiaries or Affiliated Companies included ~ Location (City and State) . Amtex Lebanon. OH Amtex Manteca. CA Masland Industries Carlisle, PA Masland Industries Sidney, PA Masland 'ndustries Lewistown. PA 10. Changes Effective Subject to the Delayed Effective Date subsections. changes in insurance take effect immediately, L-PS-2 (3/1/94) SECTIOI' - POLICY SPECIFICATIONS (, .inued) 11. Continuation of Employee I nsurance During Absences Tvoe of Absence Time Limit Leave of Absence To the end of the month following the month in which the leave of absence begins. Temporary Layoff To the end of the third month following the month in which the layoff begins. L-PS-3 (3/1/94) SECTION I . POLICY SPECIFICATIONS (continued) Initial Premium Rates , Monthly Premium: .17\ of total covered payroll per month. (, -:Jo/7 J "Total covered payroll" is the total amount of basic monthly earnings for which all employees are insured under this policy. i i I i I I \ Rate Guarantee (replaces the initial rate guarantee shown in Section VII of this policy) No change in premium rates will become effective prior to January " 1993 unless: " the eligibility and/or benefits are changed; or 2. the number of insured employees changes by 25\ or more; or 3, a subsidiary, division or affiliate is added to this policy. If any of the above events occurs. the premium rates may be changed. After such a premium rate change has been made, any further changes will be made according to the Premium section of this policy. \ ps- RI-1 SECTION \I - DEFINITIONS For the purposes of this policy: "Active employment" means the employee must be working: 1. for the employer on a full-time basis and paid regular earnings (temporary or seasonal employees are excluded); 2. at least the minimum number of hours shown in the policY spec- ifications; and either 3. at the employer's usual place of business; or 4. at a location to which the employer's business requires the em- ployee to travel, "Basic monthly earnings"--As defined in the policy specifications. "Certificate" means a written statement prepared by the Company including all riders and supplements, if any, setting forth a summary of: ,. the insurance benefits to which an employee is entitled; 2. to whom the benefits are payable; and 3. limitations or requirements that may apply. "Disability" or "disabled" - see last page of Section II. "Disability benefits," when used with the term retirement plan, means money which: ,. is payable under a retirement plan due to disability as defined in that plan; and 2. does not reduce the amount of money which would have been paid as retirement benefits at the normal retirement age under the plan if the disability had not occurred. (If the payment does cause such a reduction, it will be deemed a retirement benefit as defined in this policy.) "Eligibility date" means the date an employee becomes eligible for insurance under this policy. Classes eligible are shown in the policy specifications. "Elimination period" means a period of consecutive days of disability for which no benefit is payable. The elimination period is shown in the policy specifications and begins on the first day of disability. Note: If disability stops during the elimination period for any 30 (or less) days, then the disability will be treated as continuous. But days that the insured is not disabled will not count toward the elimination period. "Employee" means a person in active employment with the employer, \ ./ - i, ,) J(1 J j I. l-DEF-1 (6/1/92) SE.!.-""iON II - C'EFINITIONS Icontinucc:lJ "Employer" means the policyholder and includes any division, any subsidiary or any affiliated company named in the policy specifications. "Evidence of insurability" means a statement or proof of an employee's medical history upon which acceptance for insurance will be determined by the Company. "G/'ace period" is the 31 days following a premium due date during which premium payment may be made. "Gross monthly benefit" means the insured's benefit amount before any re- duction for other income benefits and earnings. "Home office" means the UNUM Life Insurance Company of America, 2211 Congress Street, Portland, Maine 04122. "Indexed pre-disability earnings" means the insured's basic monthly earnings in effect just prior to the date his disability began adjusted on the first anniversary of benefit payments and each following anniversary. Each ad- justment will be based on the lesser of 10% or the current annual percentage increase in the Consumer Price Index. Note: The Consumer Price Index (CPI-W) is published by the U. S. De- partment of Labor. The Company reserves the right to use some other si- milar measurement if the Department of Labor changes or stops publishing the CPI-W, "Injury" means bodily injury resulting directly from an accident and inde- pendently of all other causes. The injury must occur and disability must begin while the employee is insured under this policy. "Insured" means an employee insured under this policy. "Male pronoun" whenever used includes the female. "Monthly Benefit" means the amount payable by the Company to the disabled insured. "Ph-ysician" means a person who is: 1, operating within the scope of his license; and either 2, licensed to practice medicine and prescribe and administer drugs or to perform surgery; or 3, legally qualified as a medical practitioner and required to be re- cognized, under this policy for insurance purposes, according to the insurance statutes or the insurance regulations of the gov- erning jurisdiction. It will not include an employee or his spouse, daughter. son, father, mother, sister or brother. L-DEF-2 (1/1/93) SECTION II - DEFINITIONS (continued) "Policy Specifications" is the document showing the eligible classes, the amounts of insurance and other relevant information pertaining to the plan of insurance applied for by the policyholder. This document. designated Section I, is attached to and is part of this policy. l-DEF-3 "Retirement benefits", when used with the term retirement plan, means mo- ney which: 1. is payable under a retirement plan either in a lump sum or in the form of periodic payments; 2. does not represent contributions made by an employee; and Note: payments which represent employee contributions are deemed to be received over the employee's expected remaining life regardless of when such payments are actually received. 3. is payable upon: a. early or normal retirement; or b, disability if the payment does reduce the amount of money which would have been paid at the normal re- tirement age under the plan if the disability had not occurred. "Retirement plan" means a plan which provides retirement benefits to em- ployees and which is not funded wholly by employee contributions. The term shall not include a profit-sharing plan, a thrift plan, an individual retire- ment account (I RA), a tax sheltered annuity (TSAL a stock ownership plan, or a non-qualified plan of deferred compensation. "Sickness" means illness or disease. It will include pregnancy unless ex- cluded in the General Exclusions section of this policy, The disability must begin while the employee is insured under this policy, "Waiting period," as shown in the policy specifications, means the continuous length of time an employee must serve in an eligible class to reach his el- igibility date. SE ON 11 - DEFINITIONS (contini ) "Disability" and "disabled" mean that because of .njury or sickness: 1, the insured cannot perform each of the material duties of his regular occupation: and 2. after benefits have been paid for 24 months, the insured cannot perform each of the material duties of any gainful occupation for which he is reasonably fitted by training, education or experience; or 3. the insured, while unable to perform all of the material duties of his regular occupation on a full-time basis, is: a. performing at least one of the material duties of his regular oc- cupation or another occupation on a part-time or full-time basis; and b. earning currently at least 20% less per month than his indexed pre-disability earnings due to that same injury or sickness. For employees employed as airplane pilots, co-pilots and crew members "Disability" and "disabled" mean that because of injury or sickness the insured cannot perform each of the material duties of any gainful occupation for which he is reasonably fitted by training, education or experience. The loss of a pilot's license for any reason does not, in itself, constitute disability. I , L-DEF-4 (1/1/93) SECTION III - ELIGIBILITY AND EFFECTIVE DATES . A, ELIGIBLE CLASSES The classes eligible for insurance are shown in the policy specifications. B, ELIGIBILITY DATE An employee in an eligible class will be eligible for insurance on the later of: 1, the policy effective date; or 2. the day after the employee completes the waiting period. If a former employee is rehired within one year of the date his employment terminated, his previous service in an eligible class will apply toward the waiting period to determine that employee's eligibility date. C. EFFECTIVE DATES OF INSURANCE I , 1. Insurance will be effective at 12:01 a.m. on the day determined as fol- lows, but only if the employee's written application for insurance is: a. made with the Company through his employer; and b. on a form satisfactory to the Company. 2. An employee will be insured for noncontributory insurance on his eligi- bility date. 3, An employee will be insured for contributory insurance on the latest of these dates: a. the employee's eligibility date, if he has made written application for insurance on or before this date. b. the date the employee makes written application for insurance, if he does it on or before the 31 st day after his eligibility date. c. the date the Company gives its approval, if the employee: J. makes written application for insurance more than 31 days after his eligibility date; or ii, terminated his insurance while continuing to be eligible. I I I . I I i I In the case of i. and ii. above, the employee must submit an ap- plication and evidence of insurability to the Company for approval. This will be at the employee's expense, 4, Delayed Effective Date for Insurance - The effective date of any initial, increased or additional insurance will be delayed for an employee if he is not in active employment because of a disability. The initial, increased or additional insurance will start on the date that employee returns to active employment. L-EFF -1 6 UNUM. Carbon UNUM Ulelnl_Compony 01_ Mid Allanllc RIgionIllllnlftto PO 80r 203 I Tonytown, NY 105el-l1031 I eoo 321.Q751 Fu ".52..5815 Copy July 24, 1995 VIRGINIA C HASSINGER 1631 PINE RD CAJWSLE PA 17013 ~OS MMEULLO , GINO" ROVNER, P,C. ~503 NORTII FRONT STREET HARRISBURG PA 1711~1708 RE: V~ C Hassinger DOB: July 29, 1942 Claim Number: 4532658146 Policy Number: 00353047 - 0001 Dear Ms. Hassinger: We have complelcd our review of your UNUM disability claim and have made a final cJetcnn!nation regarding your benefit eligibility. Our revJew has concluded that we are unable to continue benefits. According to the policy under which you are covered: "Disability" and "disabled" mean that because of injury or sickness: I. the insured cannot perform each of the material duties of his regular occupation; and 2. after benefits have been paid for 24 months, the insured cannot perform each of the material duties of any gainful occupation for which he is reasonably fitted by training, education, or experience; or .. 3. the insured, while unable to perform all of the material duties of his regular occupation on a full-time basis, is: a. performing at least one of the material duties of his regular occupation or another occupation on a part-time or full-time basis; and b, earning currently at least 20" less per month than his indexed pre-disability earnings due to that same injury or sickness. As pn:viously discussed, you are panially disabled and have demonstrated part time work ClplCity, You worked part time at your occupation from 7/94 to 6/95, when your position wu terminated. In order to continue to receive a partial benefit you must continue to work part time, You had 30 days, or until 7/24/95 to fmd another part time postion. As of today you have not secured employment and no further benefits are payable. Your final benefit i:hec:k for the period 6/25/95 10 7/25/95 has already been sent. , f lIh;h;i lilY' ~, , c&;' No (ltrf!:!r P"'(l)v/~ . I- ({~~ cr:"it J't I- o~ A .....r....... ,- . I" , . ..:...,... III ''If '-"''''''~'''''''" .. SEPZI 3 0& PH '95 Cf 7 ri;~FFICE rll"'" ',,/fOHGTA,~Y .. . /. ~o en n 'fll~":.;' ,V~T\' ~,! .,!~jA ~ '0 4g:~ ~ frJl u /r;4-2,L 4J:J-( 33 ".,"'~----",,-~,,"-<-"""~-' - VIRGINIA c. HASSINGER, . IN THE COURT OF COMMON PLEAS . plaintiff CUMBERLAND COUNTY, PENNA. CIVIL ACTION - LAW v. . . . NO. 95-5053 civil Term . UNUM LIFE INSURANCE COMPANY : OF AMERICA, : Defendant . JURY TRIAL DEMANDED . PRAECIPE TO THE PROTHONOTARY: please reinstate the complaint in the above-referenced action for service upon Defendant. ANGINO & ROVNER, P.C. Dated: 11-'1- tf."; ..'},i w, 0. oil' cV E In , , & ~ lR ~ ,j ;~ " , .~ '-,,,'. ~ . . ; ~ .' CERTIFICATE OF SERVICE I hereby certify that a true and correct copy of the foregoing Notice of Filing the Notice of Removal wu served on the following counsel of record by deposit in the United States mail, first class postage prepaid, this ~ day of December, 1995. Joseph M, Melillo, Esquire 4S03 North Front Street Harrisburg, PA 17110 !iJf~ 94647.1 ~ .......i'.... " '. . ,~~"-'- ,,'~-'...><,_.... -""'!''''';,;,-J(i~~~,A;i.~\",,, '";P~y"",'.,,",,.~.,",... ,-,.;.",,,;,Jtf;!>Fi':"~'t'f"~t!'ml~', ~l~:W-_~~~,",^,___~___",,,,____,,,,,,,,,, " ~"",\-'- .... l...., I > ~ \ \ .. . i i I I I :l IN THE UNITED STATES DISTRICT COURT FOR THE MIDDLE DISTRICT OF PENNSYLVANIA VIRGINIA C. HASSINGER, Plaintiff v. NO, UNUM UFE INSURANCE COMPANY OF AMERICA, CIVIL ACTION - LAW JURY TRIAL DEMANDED Defendant ~OTlCE OF REMOV AL Pursuant to 28 U.S,C. U 1441 and 1446(a), UNUM Life Insurance Company of America ("UNUM"), by and through its attorneys, Eckert Seamans Cherin & Mellott, gives notice of the removal of this action from the Cumberland County Court of Common Pleas, No, 95-5053 Civil Term, to the United States District Court for the Middle District of Pennsylvania. Removal is based upon the following: 1. Plaintiff filed its Complaint on or about September 21, 1995, at Docket No. 95-5053 Civil Term, A true and correct copy of the Complaint as served upon UNUM is attached hereto as Exhibit "A". 2. UNUM was served with a copy of the Complaint on November 13, 1995. Accordingly, consistent with 28 U.S.C. f 1446(b), this Notice of Removal has been filed within thirty (30) days after the receipt by UNUM of a copy of the Complaint, 3. Exhibit" A" attached to this Notice constitutes all process, pleadings and orders served to date upon UNUM in this action. 4. In its Complaint. Plaintiff states that "Plaintiff Virginia C. Hassinger was an employee of Masland Industries. Inc.. and insured under a policy providing disability benefits, issued by Defendant UNUM. Policy No. 00353047-0001. A copy of said policy with amendments is attached hereto as Exhibit. A"." ~. Complaint, 1 3. 5. Plaintiff seeks "damages against the Defendant in the amount of disability benefits [allegedly] owed from June 24, 1995, to the present date...." Id.., at Wherefore Clause. 6, The group long term disability insurance policy purchased by Masland Industries, Inc. from UNUM is a "plan, fund. or program which was.. .established or maintained by an employer...for the purpose of providing for its participants.... through the purchase of insurance or otherwise,...benefits in the event of sickness, accident, disability...," and, therefore, constitutes an "employee welfare benefit plan" governed by the Employee Retirement Income Security Act of 1974 ("ERISA"). as amended. 29 U.S.C. f 1002(1)(A). 7. As averred, WIIi, a copy of the "policy with amendments is attached" to the Complaint as Exhibit "A". ~,Complaint, 13. 8. Plaintifrs action is, therefore, based upon Federal law because it arises from ERISA which is a Federal statute. 9. The above-described civil action is one in which this Court has original jurisdiction punuant to 28 U.S.C. f 1331 because it arises from Federal law. It is, therefore, an action which can be removed to this Court by Notice pursuant to 28 U.S,C. f 1441. -2- CERTIFICATE OF SERVICE I hereby certify that a true and correct copy of the foregoing Notice of Removal was served on the following counsel of record by deposit in the United States mail, first class postage prepaid, this ~ day of December, 1995. Joseph M. Melillo, Esquire 4503 North Front Street Harrisburg, PA 17110 J,.!m M6S1,1 VIRGINIA C. HASSINGER, Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNA. CIVIL ACTION - LAW v. : : NO. 95-5053 Civil Term UNUM LIFE INSURANCE COMPANY OF AMERICA, . , Defendant JURY TRIAL DEMANDED AFFIDAVIT OF SERVICE This is to certify that on the 8th day of November, 1995, a true and correct copy of the Complaint filed in the above-captioned action was mailed to Defendant, UNUM Life Insurance Company of America, via certified mail, return receipt requested. A copy of the Receipt for Certified Mail, No. P098959663, is attached hereto. This is to certify that on the 13th day of November, 1995, a true and correct copy of the above-noted Complaint was served upon Defendant UNUM via certified mail, return receipt requested, as evidenced by the signed Certified Mail Receipt, No. P098959663, attached hereto. flk~ rf. !JftUbA-/ Cheryl Walker Secretary to Joseph M. Melillo 4503 North Front street Harrisburg, PA 17110 (717) 238-6791 Counsel for Plaintiff Sworn and sUbscribed~o before ~ this QJ d~y of ~",h>,,--, 1995. NOtl\llW IUI SHlIIt"f J '^,,"'O,.U ""'..'..,...... Humw-V"\}. (lok. . t-, I.t, ,f., r'A ,.., (", ", ., ~~{tL1.tc-l_ tary blic -.-".-. . , .., I 79143/CW P 0'18 '15'1 bb3 ..... Rec";.... illr ~. Certified Mail -.Ii No Insurance Coverage Provided =."..\':ll 00 not use for International Mal' (See Reversel l->...., I UNUM LIFE INS. CO OF AHERI 't:!1t'Congress Street P PortlBnci ME 04122 $ f"',~!."" L.,,,,f"-lf.., Sl'f"o.,IOl......,i" A"5"" r~,l .~. ...... I.... a; R..lv', H"''''I'I '..".... '''.J eft 10 ~\-. 'n to ,; ,',- ~~,... ""'.l CI Rt>I\J..',....""I'\"".....fcll ........." 5 D.tlt' ...,'0\.11..'\....., "''t.!" ' .., fotA, h,q,t'j. g .f.,,, l1Il E o ... $ p(l~!r' .1'. ,~, :' tl~ Complaint - 11/8/95 K' ,~_ ~ : .!:;::"tJ-~: !:-.,:,~i,":;:~.".':.;~.! f1i.~=,..lft~iti;J: ,.,. .. ....'1 fIeI:' "",....'... ., ".., . .,' ....'. ',,', ._',,'y '<:, _','0' ", _ .~. ,"'- :-,'<-' -,:. ": . -~.:',::}:,~ " I, [J Ul ,iJd.... . . - , ::~:.:,~.;.-:-:,'~.:'"";~-,..-: ,~' '; - 2. [J n ..' j' .a...iY' :,.' _ _ _ ....,~.., c ,. _ ,_ '. . . : .",' . .1 '1 .... NunlIlIr P098959663 IIr. I!F=.=~ I 1'" tJ\ .