Free Answer to Complaint - District Court of California - California

Case 5:07-cv-04996-JF

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Filed 10/03/2007

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B URKE , W ILLIAMS & S ORENS EN , LLP
ATTO RNEY S AT LAW LOS A NG EL ES

BURKE, WILLIAMS & SORENSEN, LLP MICHAEL F. BELL, State Bar No. 89046 E-Mail: [email protected] 444 South Flower Street, Suite 2400 Los Angeles, CA 90071-2953 Telephone: (213) 236-0600 Facsimile: (213) 236-2700 Attorneys for Defendant Stonebridge Life Insurance Company

UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF CALIFORNIA, SAN JOSE DIVISION MARVIN CASTRO, Plaintiff, v. JC PENNEY LIFE INSURANCE COMPANY, STRONEBRIDGE LIFE INSURANCE COMPANY AND DOES 1-10, Defendant. CASE NO. C 07-04996 PVT ANSWER BY STONEBRIDGE LIFE INSURANCE COMPANY TO COMPLAINT

Defendant Stonebridge Life Insurance Company ("Stonebridge") answers the Complaint herein as follows: 1. Answering the allegations of Paragraph 1, the alleged fictitious Defendants Does 1 through 10 have not been served with the Summons and Complaint in this action and the Complaint fails to state any claim for relief against these fictitious Defendants. Except as expressly admitted or alleged herein, Stonebridge denies the allegations of this paragraph. /// ///
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CASE NO. C 07-04996 PVT ANSWER BY STONEBRIDGE TO COMPLAINT

Case 5:07-cv-04996-JF

Document 4

Filed 10/03/2007

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B URKE , W ILLIAMS & S ORENS EN , LLP
ATTO RNEY S AT LAW LOS A NG EL ES

2.

Answering the allegations of Paragraph 2, Stonebridge lacks sufficient

information or belief as to the allegations of this paragraph and, on that basis, denies those allegations. 3. Answering the allegations of Paragraph 3, Stonebridge admits and alleges that Plaintiff is a resident of Santa Clara County, California, and a citizen of the State of California. Stonebridge admits the remaining allegations of this paragraph on information and belief. 4. Answering the allegations of Paragraph 4, Stonebridge admits and alleges that Mirian R. Ayllon ("Ayllon") was insured by Stonebridge under Certificate No. 84AHIV3978 for certain accidental death and dismemberment benefits, subject to the terms and conditions of the Certificate and Group Policy; that the Policy provides, under Part I, benefits for travel by common carrier; and specifically that the Policy provides a benefit of $1,000,000 if a Covered Person dies from bodily injuries caused by an accident as a direct result of a collision, crash, or sinking of a duly licensed Common Carrier while riding as a fare-paying passenger; and a Common Carrier is specifically defined by the Policy to mean "an air, land, or water public conveyance operated under a license for regularly scheduled passenger service; and that Exhibit A to the Complaint is an incomplete copy of the Policy. Except as expressly admitted or alleged herein, Stonebridge denies the remaining allegations of this paragraph. 5. Answering the allegations of Paragraphs 5 and 6, Stonebridge admits and alleges that is a corporation, organized and existing under the laws of the State of Vermont, with its principal place of business in the State of Texas; that Stonebridge was formerly known as J. C. Penney Life Insurance Company; Stonebridge is the proper party with respect to the Policy and Certificate at issue; and that venue is proper in this judicial district. Except as expressly admitted or alleged herein, Stonebridge lacks sufficient information or belief as to the remaining allegations of this paragraph and, on that basis, denies those allegations.
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CASE NO. C 07-04996 PVT ANSWER BY STONEBRIDGE TO COMPLAINT

Case 5:07-cv-04996-JF

Document 4

Filed 10/03/2007

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B URKE , W ILLIAMS & S ORENS EN , LLP
ATTO RNEY S AT LAW LOS A NG EL ES

6.

Answering the allegations of Paragraph 7, Stonebridge admits and

alleges that Ayllon died on August 13, 2006, when she drowned during a whitewater rafting excursion in Bolivia; and that Plaintiff is the beneficiary under the Certificate issued to Ayllon. Except as expressly admitted or alleged herein, Stonebridge lacks sufficient information or belief as to the remaining allegations of this paragraph and, on that basis, denies those allegations. 7. Answering the allegations of Paragraph 8, Stonebridge admits and alleges that it was provided notice of Ayllon's death; that Stonebridge paid Plaintiff benefits under Part III of the Certificate, which provides benefits if a Covered Person dies from accidental bodily injuries not otherwise covered under Part I or Part II of the Certificate; that benefits under Part I were denied because Ayllon's death did not occur while she was a passenger in a duly licensed Common Carrier since the excursion operator was not a common carrier, did not operate under a license for regularly scheduled passenger service, and did not provide regularly scheduled passenger service; and that the excursion operator was licensed as a tour operator, was not licensed in Bolivia to provide regularly scheduled passenger service, provided excursions upon request at time and over routes that varied and were selected by the interested parties. Except as expressly admitted or alleged herein, Stonebridge denies the allegations of this paragraph. 8. Answering the allegations of Paragraph 9, Stonebridge admits and alleges that it is a member of the California Life and Health Insurance Guarantee Association and that it complies, where applicable, with the laws of California. Except as expressly admitted or alleged herein, Stonebridge denies the remaining allegations of this paragraph. /// /// /// ///
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CASE NO. C 07-04996 PVT ANSWER BY STONEBRIDGE TO COMPLAINT

Case 5:07-cv-04996-JF

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Filed 10/03/2007

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B URKE , W ILLIAMS & S ORENS EN , LLP
ATTO RNEY S AT LAW LOS A NG EL ES

FIRST CAUSE OF ACTION.

9.

Answering the allegations of Paragraph 10, Stonebridge refers to and

incorporates herein as though set forth in full each of its allegations, admissions, and denials with respect to Paragraphs 1 through 9 of the Complaint. 10. Answering the allegations of Paragraphs 11 and 12, Stonebridge admits and alleges that Stonebridge paid Plaintiff benefits under Part III of the Certificate, which provides benefits if a Covered Person dies from accidental bodily injuries not otherwise covered under Part I or Part II of the Certificate, after she died during a whitewater rafting excursion; that benefits under Part I were denied because Ayllon's death did not occur while she was a passenger in a duly licensed Common Carrier since the excursion operator was not a common carrier, did not operate under a license for regularly scheduled passenger service, and did not provide regularly scheduled passenger service; and that the excursion operator was licensed as a tour operator, was not licensed in Bolivia to provide regularly scheduled passenger service, provided excursions upon request at time and over routes that varied and were selected by the interested parties. Except as expressly admitted or alleged herein, Stonebridge denies the remaining allegations of these paragraphs.

SECOND CAUSE OF ACTION

11.

Answering the allegations of Paragraph 13, Stonebridge refers to and

incorporates herein as though set forth in full each of its allegations, admissions, and denials with respect to Paragraphs 1 through 12 of the Complaint. 12. Answering the allegations of Paragraph 14, Stonebridge admits and alleges that Ayllon was insured by Stonebridge under Certificate No. 84AHIV3978 for certain accidental death and dismemberment benefits, subject to the terms and
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CASE NO. C 07-04996 PVT ANSWER BY STONEBRIDGE TO COMPLAINT

Case 5:07-cv-04996-JF

Document 4

Filed 10/03/2007

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B URKE , W ILLIAMS & S ORENS EN , LLP
ATTO RNEY S AT LAW LOS A NG EL ES

conditions of the Certificate and Group Policy and that the Policy was in force at the time of her death. Except as expressly admitted or alleged herein, Stonebridge denies the remaining allegations of these paragraphs. 13. Answering the allegations of Paragraph 15, Stonebridge admits and alleges that Plaintiff is the beneficiary under the Certificate issued to Ayllon; that the Policy and Certificate provide under Part I, benefits for travel by common carrier; and specifically that the Policy provides a benefit of $1,000,000 if a Covered Person dies from bodily injuries caused by an accident as a direct result of a collision, crash, or sinking of a duly licensed Common Carrier while riding as a fare-paying passenger; and that a Common Carrier is specifically defined by the Policy to mean "an air, land, or water public conveyance operated under a license for regularly scheduled passenger service. Except as expressly admitted or alleged herein, Stonebridge denies the remaining allegations of these paragraphs. 14. Answering the allegations of Paragraphs 16 and 17, Stonebridge denies the allegations of those paragraphs.

THIRD CAUSE OF ACTION

15.

Answering the allegations of Paragraph 18, Stonebridge refers to and

incorporates herein as though set forth in full each of its allegations, admissions, and denials with respect to Paragraphs 1 through 17 of the Complaint. 16. Answering the allegations of Paragraphs 19, 20, 21, and 22, Stonebridge denies the allegations of those paragraphs.

FIRST AFFIRMATIVE DEFENSE

17.

The Complaint and each purported cause of action alleged therein fails

to allege a claim for relief against Stonebridge.
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CASE NO. C 07-04996 PVT ANSWER BY STONEBRIDGE TO COMPLAINT

Case 5:07-cv-04996-JF

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Filed 10/03/2007

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B URKE , W ILLIAMS & S ORENS EN , LLP
ATTO RNEY S AT LAW LOS A NG EL ES

SECOND AFFIRMATIVE DEFENSE

18.

The Certificate issued to Ayllon by Stonebridge provides benefits

under Part I for loss caused by an accident as a direct result of "a collision, crash, or sinking of a duly licensed Common Carrier while [a Covered Person is] riding as a fare-paying passenger inside such Common Carrier." The Certificate defines a "Common Carrier" to mean, "an air, land, or water public conveyance operated under a license for regularly scheduled passenger service." 19. Ayllon died from drowning on August 13, 2006 while on a whitewater rafting excursion conducted by "Deportes Y Excursions De Aventura Bolivia Ranabol" ("Ranabol"). Ranabol is licensed as a tourist operator and provides, among other outdoor activities, whitewater rafting adventures. Ranabol is not licensed in Bolivia to provide and does not provide regularly scheduled passenger service; but instead conducts adventure excursions over different routes and at varying times. 20. Ranabol is not a Common Carrier under the Certificate and, as a result, Ayllon's death was not the direct result of an accident while she was riding as a fare-paying passenger on a duly licensed Common Carrier. Therefore, benefits are not payable for this loss under Part I of the Certificate. WHEREFORE, this answering Defendant prays judgment: 1. 2. /// /// /// /// /// ///
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That Plaintiff take nothing by reason of his Complaint; For costs of suit incurred herein, including attorneys' fees; and

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CASE NO. C 07-04996 PVT ANSWER BY STONEBRIDGE TO COMPLAINT

Case 5:07-cv-04996-JF

Document 4

Filed 10/03/2007

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B URKE , W ILLIAMS & S ORENS EN , LLP
ATTO RNEY S AT LAW LOS A NG EL ES

3. proper.

For such other and further relief as the Court may deem just and

DATED: October 3, 2007

BURKE, WILLIAMS & SORENSEN, LLP MICHAEL F. BELL By: /s/ Michael F. Bell MICHAEL F. BELL Attorneys for Defendant Stonebridge Life Insurance Company

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CASE NO. C 07-04996 PVT ANSWER BY STONEBRIDGE TO COMPLAINT