Free Answer to Complaint - District Court of California - California

Case 4:07-cv-05044-CW

Document 6

Filed 12/17/2007

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Michele Ballard Miller (SBN 104198) Lisa C. Hamasaki (SBN 197628) 2 Katherine L. Kettler (SBN 231586) MILLER LAW GROUP 3 A Professional Corporation 60 E. Sir Francis Drake Blvd., Ste. 302 4 Larkspur, CA 94939 Tel. (415) 464-4300 5 Fax (415) 464-4336 6 7 Attorneys for Defendants SSC ADVANCED SOLUTIONS, INC., a Delaware Corporation and SEDGWICK CLAIMS MANAGEMENT SERVICES, INC., an Illinois Corporation UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF CALIFORNIA OAKLAND DIVISION

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CATHE GUERRA, Plaintiff,

Case No.: C 07-5044 WDS

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DEFENDANTS SSC ADVANCED SOLUTIONS, INC. AND SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.'S ANSWER TO PLAINTIFF'S COMPLAINT

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SSC ADVANCED SOLUTIONS, INC., a Delaware Corporation; SEDGWICK CLAIMS MANAGEMENT SERVICES, INC., An Illinois Corporation; and PLAN TRUSTEE; Complaint filed: October 1, 2007 Defendants.

Defendants SSC ADVANCED SOLUTIONS, INC., and SEDGWICK CLAIMS MANAGEMENT SERVICES INC. (hereafter "Defendants") hereby answer Plaintiff CATHE GUERRA's Complaint (hereafter "Complaint") as follows:

Defendants generally deny each and every allegation in the Complaint, except those expressly admitted below.

DEFENDANTS SSC ADVANCED SOLUTONS and SEDGWICK'S ANSWER TO PLAINTIFF'S COMPLAINT
Case No.: C 07-5044 WDB


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1.

Answering Paragraph 1 of Plaintiff's Complaint, Defendants admit that

to the extent Plaintiff's allegations relate to benefits sought under the Employment Retirement and Income Security Act ("ERISA"), this Court has subject matter jurisdiction. 2. Answering Paragraph 2 of Plaintiff's Complaint, Defendants are without

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sufficient knowledge and information regarding the location of Plaintiff's residence and on that basis, deny this assertion.
3.

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Answering Paragraph 3 of Plaintiff's Complaint, Defendants denies this

allegation as SSC Advanced Solutions, Inc. ("ASI") is a Delaware corporation registered to do business in Northern California. 4. Answering Paragraph 4 of Plaintiff's Complaint, Defendants admit that

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Sedgwick Claims Management Service, Inc. ("Sedgwick") is an Illinois Corporation. Defendants deny each and every other allegation contained in Paragraph 4 because Sedgwick is not the administrator of the disability plan, which covers plaintiff as an employee of ASI; Sedgwick is and was the claims administrator.

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5.

Answering Paragraph 5 of Plaintiff's Complaint, Defendants deny each

and every allegation contained in Paragraph 5 because there is no trustee for the disability plan applicable to Plaintiff.
6.

Answering Paragraph 4 [sic 6 1] of Plaintiff's Complaint, Defendants

admit each allegation contained in Paragraph 4 [sic 6]. 7. Answering Paragraph 5 [sic 7 2] of Plaintiff's Complaint, Defendants are

without sufficient knowledge and information and on that basis, deny this assertion.

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Answering Paragraph 6 [sic 8 3] of Plaintiff's Complaint, Defendants

deny each and every allegation contained in Paragraph 6 [sic 8] because ASI does not provide telephone services.

1 Plaintiff has erroneously misnumbered paragraphs after Paragraph 5 (on page 2) to the end of the Complaint. Defendants' Answer to this "Paragraph 4" [sic] is on page 2 of Plaintiff's Complaint.

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Defendants' Answer to this "Paragraph 5" [sic] is on page 2 of Plaintiff's Complaint. Defendants' Answer to this "Paragraph 6" [sic] is on page 2 of Plaintiff's Complaint.

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DEFENDANTS SSC ADVANCED SOLUTONS and SEDGWICK'S ANSWER TO PLAINTIFF'S COMPLAINT
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9.

Answering Paragraph 7 [sic 9 4] of Plaintiff's Complaint, Defendants

admit that Plaintiff was and continues to be employed by ASI as an Area Manager Program Management. Defendants further admit that Plaintiff has over 33 years of

employment service with ASI. Defendants deny each and every other allegation contained

5 in Paragraph 7 [sic 9].
6 10. Answering Paragraph 8 [sic 10 5] of Plaintiff's Complaint, Defendants

7 deny that "there exists an expressed written policy agreement between Defendant SSC, and
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its employees regarding short term disability" because the short term disability plan applicable to Plaintiff is not between ASI and its employees. Defendants admit the

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remaining allegation to the extent it accurately quotes text from the Summary Plan Description (SPD) of the applicable short term disability plan. 11. Answering Paragraph 9 [sic 11 6] of Plaintiff's Complaint, Defendants

admit the allegation to the extent it represents that the SPD quoted in Paragraph 8 [sic 10] is applicable to Plaintiff. 12. Answering Paragraph 10 [sic 12 7] of Plaintiff's Complaint, Defendants

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deny the statement "Defendants' STD policy" because the STD plan was not established by the Defendants. Defendants admit any and all remaining allegations contained in

Paragraph 10 [sic 12]. 13. Answering Paragraph 11 [sic 13 8] of Plaintiff's Complaint, Defendants

admit that Plaintiff was and remains employed by ASI. Defendants further admit that ASI is an employer engages in interstate commerce within the meaning of 29 U.S.C. 1003(a). Defendants deny each and every remaining allegations contained in Paragraph 11 [sic 13].

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Defendants' Answer to this "Paragraph 7" [sic] is on page 2 of Plaintiff's Complaint. Defendants' Answer to this "Paragraph 8" [sic] is on page 2 of Plaintiff's Complaint. Defendants' Answer to this "Paragraph 9" [sic] is on page 2 of Plaintiff's Complaint. Defendants' Answer to this "Paragraph 1Oil [sic] is on page 2 of Plaintiff's Complaint. Defendants' Answer to this "Paragraph 11" [sic] is on page 3 of Plaintiff's Complaint.

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DEFENDANTS SSC ADVANCED SOLUTONS and SEDGWICK'S ANSWER TO PLAINTIFF'S COMPLAINT
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14.

Answering Paragraph 12 [sic 14 9] of Plaintiff's Complaint, Defendants

deny each and every allegation contained therein. 15. Answering Paragraph 13 [sic 15
10]

of Plaintiff's Complaint, Defendants

deny each and every allegation contained therein. 16. Answering Paragraph 14 [sic 16
11]

of Plaintiff's Complaint, Defendants

deny each and every allegation contained therein. 17. Answering Paragraph 15 [sic 17
12]

of Plaintiff's Complaint, Defendants

deny the statement "individually and as agent for [ASI] and/or the Plan Trustee." Defendants admit each and every remaining allegation contained in Paragraph 15 [sic 17]. 18. Answering Paragraph 16 [sic 18
13]

of Plaintiff's Complaint, Defendants

deny each and every allegation contained therein. 19. Answering Paragraph 17 [sic 19
14]

of Plaintiff's Complaint, Defendants

are without sufficient knowledge and information and on that basis deny the allegations contained in Paragraph 17 [sic 19]. 20. Answering Paragraph 18 [sic 20
15]

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of Plaintiff's Complaint, Defendants

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deny each and every allegation contained therein. 21. Defendants deny the allegations contained in Paragraph 1 of Plaintiff's

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prayer for relief, and deny that Plaintiff was injured or damaged in any sum, or at all. 22. Defendants deny the allegations contained in Paragraph 2 of Plaintiff's

prayer for relief, and deny that Plaintiff was injured or damaged in any sum, or at all.

Defendants' Answer to this "Paragraph 12" [sic] is on page 3 of Plaintiff's Complaint. Defendants' Answer to this "Paragraph 13" [sic] is on page 3 of Plaintiff's Complaint. Defendants' Answer to this "Paragraph 14" [sic] is on page 3 of Plaintiff's Complaint. Defendants' Answer to this "Paragraph 15" [sic] is on page 3 of Plaintiff's Complaint. Defendants' Answer to this "Paragraph 16" [sic] is on page 3 of Plaintiff's Complaint. Defendants' Answer to this "Paragraph 17" [sic] is on page 3 of Plaintiff's Complaint. Defendants' Answer to this "Paragraph 18" [sic] is on page 3 of Plaintiff's Complaint. 4

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DEFENDANTS SSC ADVANCED SOLUTONS and SEDGWICK'S ANSWER TO PLAINTIFF'S COMPLAINT
Case No.: C 07-5044 WDB


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23.

Defendants deny the allegations contained in Paragraph 3 of Plaintiff's

prayer for relief, and deny that Plaintiff was injured or damaged in any sum, or at all. 24. Defendants deny the allegations contained in Paragraph 4 of Plaintiff's

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prayer for relief, and deny that Plaintiff was injured or damaged in any sum, or at all. Defendants deny the allegations contained in Paragraph 5 of Plaintiff's prayer for relief, and deny that Plaintiff was injured or damaged in any sum, or at all.

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AFFIRMATIVE DEFENSES

For and as a separate and affirmative defense to each and every claim for relief set forth in the Complaint, Defendants allege as follows:

FIRST AFFIRMATIVE DEFENSE

(Failure to State a Claim)

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Plaintiff's Complaint fails to allege facts sufficient to state a claim upon which relief can be granted.

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SECOND AFFIRMATIVE DEFENSE

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(Not Eligible for Benefits)

Plaintiff's claims are barred in that Plaintiff is not eligible for benefits under the terms and conditions of the applicable disability plan. /// /// ///

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DEFENDANTS SSC ADVANCED SOLUTONS and SEDGWICK'S ANSWER TO PLAINTIFF'S COMPLAINT
Case No.: C 07-5044 WDS


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THIRD AFFIRMATIVE DEFENSE (Good Faith)

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FOURTH AFFIRMATIVE DEFENSE (Waiver and Estoppel)

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Plaintiff, by her acts and omissions, has waived and is estopped and barred

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FIFTH AFFIRMATIVE DEFENSE (Unclean Hands)

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Defendants allege that Plaintiff is barred from any relief by the doctrine of unclean hands.

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SIXTH AFFIRMATIVE DEFENSE (Failure to Mitigate)

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Plaintiff has failed to mitigate the damages alleged in the Complaint.

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DEFENDANTS SSC ADVANCED SOLUTONS and SEDGWICK'S ANSWER TO PLAINTIFF'S COMPLAINT
Case No.: C 07-5044 WDS


Case 4:07-cv-05044-CW

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SEVENTH AFFIRMATIVE DEFENSE

(Offset)

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Any award of benefits to Plaintiff should be offset by any other earnings, benefits and/or income received by Plaintiff (including but not limited to disability benefits, workers' compensation benefits and/or settlement monies, unemployment benefits, and/or benefits from the Social Security Administration or the state), and/or should be offset by any damages caused by Plaintiff to each and/or any of the Defendants, including any unjust enrichment to Plaintiff by virtue of fraud.

EIGHTH AFFIRMATIVE DEFENSE

(Attorneys Fees)

Defendants are entitled to their attorneys' fees pursuant to 29 U.S.C.

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§ 1132(g) and/or Rule 11 (c)(2), Federal Rules of Civil Procedure.

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NINTH AFFIRMATIVE DEFENSE

(Conduct In Accordance With the Plan)

Defendants and their agents at all relevant times acted and conducted themselves in accordance with the documents and instruments governing the Plan insofar as such documents and instruments were and are consistent with the provisions of ERISA.

TENTH AFFIRMATIVE DEFENSE

(Failure to Name Proper Defendants)

Plaintiff's claims are barred in that Plaintiff failed to name the proper defendant responsible for pyajent of Plan benefits, if any.
7 DEFENDANTS SSC ADVANCED SOLUTONS and SEDGWICK'S ANSWER TO PLAINTIFF'S COMPLAINT
Case No.: C 07-5044 WDB


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Defendants have not yet completed a thorough investigation and study or completed discovery of all facts and circumstances of the subject matter of the Complaint, and, accordingly, reserves the right to amend, modify, revise or supplement this General Denial, and to plead such further defenses and take such further actions as it may deem proper and necessary in its defense upon the completion of said investigation and study. THEREFORE, Defendants demand judgment in its favor, costs of suit, and attorney's fees, and all other proper relief.

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9 Dated: December 17, 2007 MILLER LAW GROUP A Professional Corporation

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By:

/S/ Katherine L. Kettler Attorneys for Defendants SBC ADVANCED SOLUTIONS, INC., a Delaware Corporation and SEDGWICK CLAIMS MANAGEMENT SERVICES, INC., an Illinois Corporation

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DEFENDANTS SSC ADVANCED SOLUTONS and SEDGWICK'S ANSWER TO PLAINTIFF'S COMPLAINT
Case No.: C 07-5044 WDB


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CERTIFICATION OF INTERESTED ENTITIES OR PERSONS

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Pursuant to Civil L.R. 3-16, the undersigned certifies that the following listed persons, associations of persons, firms, partnerships, corporations (including parent corporations) or other entities (i) have a financial interest in the subject matter in controversy or in a party to the proceeding, or (ii) have a non-financial interest in that subject matter or in a party that could be substantially affected by the outcome of this

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ENTITY
SBC Advanced Solutions, Inc. AT&T Inc. Defendant

CONNECTION TO OR INTEREST IN CASE
Joint owner of SBC Advanced Solutions, Inc.

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AT&T Teleholdings, Inc.

Joint owner of SBC Advanced Inc.

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Sedgwick Claims Management Services, Inc. Sedgwick CMS Holding, Inc.

Defendant

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Owner of Sedgwick Claims Management Services, Inc.

Fidelity Sedgwick Corporation Fidelity Sedgwick Holding, Inc.

Owner of Sedgwick CMS Holding, Inc. Part owner of Fidelity Sedgwick Corp.

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Dated: December 17, 2007

MILLER LAW GROUP A Professional Corporation

By:

/S/
Katherine L. Kettler
Attorneys for Defendants SBC ADVANCED SOLUTIONS, INC., a Delaware Corporation and SEDGWICK CLAIMS MANAGEMENT SERVICES, INC., an Illinois Corporation

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DEFENDANTS SSC ADVANCED SOLUTONS and SEDGWICK'S ANSWER TO PLAINTIFF'S COMPLAINT
Case No.: C 07-5044 WDB