Free Answer to Complaint - District Court of California - California

Case 3:08-cv-01257-H-WMC

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Filed 08/11/2008

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1 Cheryl L. Schreck, State Bar No. 130083 [email protected] 2 OGLETREE, DEAKINS, NASH, SMOAK & STEWART, P.C. 3 633 West Fifth Street, 53rd Floor Los Angeles, California 90071 4 Telephone: (213) 239-9800 Facsimile: (213) 239-9045 5 Attorneys for Defendants 6 FIRST NATIONAL BANK HOLDING COMPANY EMPLOYEE BENEFIT 7 PLAN AND FIRST NATIONAL BANK HOLDING COMPANY 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28
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UNITED STATES DISTRICT COURT FOR THE SOUTHERN DISTRICT OF CALIFORNIA

ANN SANTILLI, Plaintiff, v. FIRST NATIONAL BANK HOLDING COMPANY EMPLOYEE BENEFIT PLAN; FIRST NATIONAL BANK HOLDING COMPANY, Defendants.

Case No. 08 CV 1257 H WMc ANSWER OF DEFENDANTS FIRST NATIONAL BANK HOLDING COMPANY EMPLOYEE BENEFIT PLAN AND FIRST NATIONAL BANK HOLDING COMPANY TO PLAINTIFF ANN SANTILLI'S COMPAINT Trial Date: Not Yet Set

1 CASE NO. 08 CV 1257 H WMc ANSWER OF DEFENDANTS FIRST NATIONAL BANK HOLDING COMPANY EMPLOYEE BENEFIT PLAN and FIRST NATIONAL BANK HOLDING COMPANY TO PLAINTIFF ANN SANTILLI'S COMPAINT

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TO PLAINTIFF ANN SANTILLI AND HER ATTORNEYS OF Defendants First National Bank Holding Company Employee Benefit Plan

2 RECORD: 4 (the "Plan") and First National Bank Holding Company ("First National") 5 (collectively, "Defendants"), hereby respond to Plaintiff Ann Santilli's Complaint as 6 follows: 7 1. Answering paragraph 1 of the Complaint, Defendants admit that the 8 claims alleged in the Plaintiff's Complaint arise under, and are governed by, the 9 Employee Retirement Income Security Act of 1974, as amended ("ERISA"). 10 2. Answering paragraph 2 of the Complaint, Defendants admit that this 11 Court is vested with jurisdiction over the subject matter of this case pursuant to 12 Section 502(e)(1) of ERISA, 29 U.S.C.§ 1132(e)(1). 13 3. Answering paragraph 3 of the Complaint, Defendants admit that venue 14 is proper in this Court pursuant to Section 502(e)(2) of ERISA, 29 U.S.C.§ 15 1132(e)(2). 16 4. Answering paragraph 4 of the Complaint, Defendants admit that 17 Plaintiff was employed by First National Bank of Arizona as an underwriter. 18 Defendants admit that Plaintiff left work on or about March 2, 2007. Defendants are 19 without sufficient information to admit or deny the remaining allegations of 20 paragraph 4 of the Complaint and therefore deny the same. 21 5. Answering paragraph 5 of the Complaint, Defendants admit that First 22 National does business and has done business through a number of banks, including 23 First National Bank of Arizona. Defendants admit that Plaintiff was employed by 24 First National Bank of Arizona. Defendants admit that Plaintiff's employer now 25 does business as First National Bank of Nevada. Defendants are without sufficient 26 information to admit or deny the remaining allegations of paragraph 5 of the 27 Complaint and therefore deny the same. 28 ///
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6.

Answering paragraph 6 of the Complaint, Defendants admit that the

2 Plan is an employee welfare benefit plan, as that term is defined by Section 3(1) of 3 ERISA, 29 U.S.C. § 1002(1). Defendants admit that the Plan provides welfare 4 benefits to eligible employees of First National and certain other related employers 5 that have adopted the Plan. Defendants admit that Plaintiff was eligible to 6 participate, and was a participant, in the Plan. Defendants deny the remaining 7 allegations of paragraph 6 of the Complaint. 8 7. Answering paragraph 7 of the Complaint, Defendants admit that 9 Plaintiff was offered the opportunity to participate in the Plan. Defendants admit 10 that the benefits offered under the Plan include long-term disability benefits. 11 Defendants admit that the long-term disability benefits offered under the Plan were, 12 and are, fully insured by a group policy. Defendants admit that the group long-term 13 disability benefits offered by the Plan were fully insured by a policy of insurance. 14 Defendants admit that Plaintiff was a participant in the Plan. Defendants admit that 15 Plaintiff ceased to be actively at work on or about March 2, 2007. Upon information 16 and belief, Defendants deny that Plaintiff was entitled to long-term disability benefits 17 as of June 2, 2007. Upon information and belief, Defendants deny that Plaintiff is 18 disabled under the terms of the Plan and/or the policy of insurance governing long19 term disability benefits. Defendants deny that Plaintiff met or meets the Plan's or the 20 policy's requirements for benefits. Defendants deny the remaining allegations of 21 paragraph 7 of the Complaint. 22 8. Answering paragraph 8 of the Complaint, Defendants respond that the 23 Plan is administered in accordance with its written terms and the written terms of the 24 policy of insurance through which long-term benefits are provided, and that the 25 written terms of the Plan's governing documents and the policy of insurance speak 26 for themselves. Defendants deny that the allegations of paragraph 8 of the 27 Complaint accurately represent the terms of the Plan or the terms of the policy of 28 insurance through which long-term disability benefits are provided. Defendants
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1 admit that Plaintiff was provided with short-term disability benefits under the Plan, 2 and admit that Plaintiff was denied long-term disability benefits under the Plan. 3 Defendants deny that the allegations of paragraph 8 of the Complaint fully or 4 accurately describe the term of the Plan relating to benefits. Upon information and 5 belief, Defendants admit that Plaintiff was approximately 62 years of age when her 6 employment terminated. Defendants lack sufficient information regarding what 7 Plaintiff thinks with respect to the terms of the Plan, and therefore deny the 8 allegations of the fifth sentence of paragraph 8 of the Complaint. Defendants deny 9 the remaining allegations of paragraph 8 of the Complaint. 10 9. Answering paragraph 9 of the Complaint, Defendants admit that First 11 National is the administrator (as that term is defined by Section 3(16) of ERISA, 29 12 U.S.C. § 1002(16)) of the Plan. Defendants deny that First National has, at any time, 13 breached any fiduciary duty to the Plaintiff. Defendants deny the remaining 14 allegations of paragraph 9 of the Complaint. 15 10. Answering paragraph 10 of the Complaint, Defendants admit the insurer 16 of the long-term disability benefits under the Plan was vested with discretion to 17 render decisions on claims, initially and on appeal, for long-term disability benefits 18 under the Plan. Defendants deny the remaining allegations of paragraph 10 of the 19 Complaint. 20 11. Answering paragraph 11 of the Complaint, Defendants deny that 21 Plaintiff met the Plan's requirements for long-term disability benefits. Defendants 22 deny the remaining allegations of paragraph 11 of the Complaint. 23 12. Answering paragraph 12 of the Complaint, Defendants admit that 24 Plaintiff submitted a claim for long-term benefits under the Plan. Defendants deny 25 that Plaintiff met the Plan's criteria for eligibility for long-term disability benefits 26 under the Plan. Defendants deny the remaining allegations of paragraph 12 of the 27 Complaint. 28 ///
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13.

Answering paragraph 13 of the Complaint, Defendants admit that

2 Plaintiff submitted a claim for long-term disability benefits. Defendants deny that 3 Plaintiff met the requirements for eligibility for long-term disability benefits under 4 the Plan. Defendants deny any remaining allegations of paragraph 13 of the 5 Complaint. 6 14. Answering paragraph 14 of the Complaint, upon information and belief, 7 Defendants admit that Plaintiff has exhausted the Plan's administrative claims and 8 appeals procedures. Defendants deny any remaining allegations of paragraph 14 of 9 the Complaint. 10 15. Answering paragraph 15 of the Complaint, Defendants deny that 11 Plaintiff is entitled to any relief whatsoever under the terms of the Plan, including but 12 not limited to long-term disability benefits, attorney's fees, or costs of this action. 13 Defendants deny that the amount of the benefit Plaintiff alleges in paragraph 15 of 14 the Complaint accurately reflects the amount of any long-term disability benefit to 15 which Plaintiff could possibly become entitled under the terms of the Plan. The last 16 sentence of paragraph 15 of the Complaint sets forth a legal conclusion to which no 17 response is necessary. To the extent a response is deemed necessary, Defendants 18 deny that the last sentence of paragraph 15 of the Complaint accurately sets forth the 19 law. Defendants deny the remaining allegations of paragraph 15 of the Complaint. 20 22 23 25 26 17. 16. Additionally, Defendants assert the following affirmative defenses as set forth FIRST AFFIRMATIVE DEFENSE Any allegation not specifically admitted, controverted or denied SECOND AFFIRMATIVE DEFENSE The decision to deny Plaintiff's claim was in accordance with the terms 21 below:

24 previously in this Answer is hereby denied.

27 of the employee benefit plan and policy, and were in no way demonstrative of any 28 abuse of the discretion pursuant to which such decision was rendered.
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1 2 4 5 19. 18. 3 granted.

THIRD AFFIRMATIVE DEFENSE Plaintiff's Complaint fails to state a claim upon which relief can be FOURTH AFFIRMATIVE DEFENSE While denying that Plaintiff is entitled to recover the benefits or other

6 relief she seeks in this matter, any benefit found to be due to Plaintiff is payable, if at 7 all, only in accordance with the terms of the policy, and is subject to various set-offs 8 and other reductions under express the terms of the Plan and the policy. 9 10 12 13 14 15 17 18 23. 22. 21. 20. FIFTH AFFIRMATIVE DEFENSE Plaintiff has failed to implead a party whose absence would preclude the SIXTH AFFIRMATIVE DEFENSE Plaintiff is not entitled to long-term disability benefits in this matter. SEVENTH AFFIRMATIVE DEFENSE Any remedy available to Plaintiff for an act or omission alleged in her EIGHTH AFFIRMATIVE DEFENSE To the extent that Plaintiff seeks them, Plaintiff is not entitled to recover

11 Court from granting complete relief.

16 Complaint is solely and exclusively limited to the relief afforded by ERISA.

19 compensatory, extra-contractual or punitive damages as to her claim for benefits 20 under ERISA. To the extent Plaintiffs' Complaint is construed to request 21 compensatory, extra-contractual or punitive damages as to her ERISA claim, that 22 request should be stricken pursuant to Federal Rule of Civil Procedure 12(f). 23 24 24. NINTH AFFIRMATIVE DEFENSE The documents pursuant to which the Plan is administered vested the

25 decision-maker with respect to Plaintiff's claims with the full discretion and 26 authority to determine eligibility for benefits and to construe and interpret all terms 27 and provisions of the Policy. Therefore, the appropriate standard of review in this 28 matter is for an abuse of discretion. The decision to deny Plaintiff long-term
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1 disability benefit claim was not an abuse of discretion and thus is binding on 2 Plaintiff. 3 4 6 7 8 9 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28
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TENTH AFFIRMATIVE DEFENSE 25. Defendants reserve the right to raise additional defenses as they may

5 appear. WHEREFORE, Defendants pray as follows: 1. 2. 3. 4. That Plaintiff take nothing by this action; That judgment be entered in favor of Defendants; For Defendants' costs of suit and for reasonable attorneys' fees incurred For such other and further relief as the Court deems just and proper. OGLETREE, DEAKINS, NASH, SMOAK & STEWART, P.C. By:/s/Cheryl L. Schrek Cheryl L. Schreck Attorneys for Defendants FIRST NATIONAL BANK HOLDING COMPANY EMPLOYEE BENEFIT PLAN and FIRST NATIONAL BANK HOLDING COMPANY

10 herein; and

DATED: August 11, 2008

7 CASE NO. 08 CV 1257 H WMc ANSWER OF DEFENDANTS FIRST NATIONAL BANK HOLDING COMPANY EMPLOYEE BENEFIT PLAN and FIRST NATIONAL BANK HOLDING COMPANY TO PLAINTIFF ANN SANTILLI'S COMPAINT

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PROOF OF SERVICE BY UNITED STATES MAIL

2 STATE OF CALIFORNIA, COUNTY OF LOS ANGELES I am employed in the County of Los Angeles, State of California; I am over the age of 18 years and not a party to this action. My business address is 633 West 4 Fifth Street, 53rd Floor, Los Angeles, California 90071. On August 11, 2008, I served the following document(s) described as: ANSWER OF DEFENDANTS FIRST NATIONAL BANK HOLDING COMPANY EMPLOYEE BENEFIT PLAN AND FIRST NATIONAL BANK HOLDING COMPANY TO PLAINTIFF ANN SANTILLI'S COMPAINT

9 on the persons below as follows: 10 John P. Stennet, Esq. Attorneys For Stennet & Stennet Plaintiff Ann Santilli 11 501 West Broadway, Suite 1340 San Diego, CA 92101 12 I enclosed the documents in a sealed envelope or package addressed to the 13 persons at the addresses as indicated above and: 14 deposited the sealed envelope or package with the United States Postal Service, with the postage fully prepaid.* 15 placed the envelope or package for collection and mailing, following our 16 ordinary business practices. I am readily familiar with this business's practice for collecting and processing correspondence for mailing. On the same day 17 that correspondence is placed for collection and mailing, it is deposited in the ordinary course of business with the United State Postal Service, in a sealed 18 envelope or package with postage fully prepaid. 19 I am employed in the county where the mailing occurred. The envelope or package was placed in the mail at Los Angeles, California. 20 21 22 23 24 25 26 (State) (Federal) I declare under penalty of perjury under the laws of the State of California that the above is true and correct. I declare that I am employed in the office of a member of the Bar of this Court at whose direction the service was made. I declare under penalty of perjury under the laws of the United States of America that the above is true and correct.

Executed on August 11, 2008, at Los Angeles, California.

Robin Marie Goodwin /s/Robin Marie Goodwin Signature 27 Type Name * (SIGNATURE MUST BE OF PERSON DEPOSITING ENVELOPE IN MAIL SLOT, BOX OR BAG) 28