Free Other Notice - District Court of Arizona - Arizona

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40 North Central Avenue Phoenix, Arizona 85004-4429 Facsimile (602) 262-5747 Telephone (602) 262-5311 Stephen M. Bressler (09032) Ann-Martha Andrews (012616) Scott Bennett (0022350) Attorneys for Defendants UnumProvident Corporation and Provident Life and Accident Insurance Company

UNITED STATES DISTRICT COURT DISTRICT OF ARIZONA ) ) ) Plaintiff, ) ) vs. ) UNUMProvident Corporation and Provident ) ) Life and Accident Insurance Company, ) ) Defendants. ) ) )

8 Brett D. Leavey, 9 10 11 12 13 14 15

No. CIV-02-2281-PHX-SMM DEFENDANTS' REVISED PROPOSED VERDICT FORMS (SECOND REVISED VERSION)

Defendants UnumProvident Corporation and Provident Life and Accident

16 Insurance Company submit the following revised proposed verdict forms. This is the 17 second set of revised forms that the defendants have submitted. 18 RESPECTFULLY SUBMITTED this 29th day of September, 2005. 19 20 21 22 23 24 25 26 27 28
Case 2:02-cv-02281-SMM Document 209 Filed 09/29/2005 Page 1 of 8
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LEWIS AND ROCA LLP BY: s/ Scott Bennett Stephen M. Bressler Ann-Martha Andrews Scott Bennett Attorneys for Defendant Provident Life and Accident Insurance Company

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Case 2:02-cv-02281-SMM Document 209 2 Filed 09/29/2005 Page 2 of 8
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CERTIFICATE OF SERVICE I hereby certify that on September 29, 2005, I electronically transmitted the attached document to the Clerk's Office using the CM/ECF System for filing and transmittal of a Notice of Electronic Filing to the following CM/ECF registrants: Steve Dawson Anita Rosenthal Dawson & Rosenthal 11801 N. Tatum Blvd., Suite 247 Phoenix, Arizona 85028 Attorneys for Plaintiff Gregg H. Temple Gregg H. Temple, P.C. 11801 North Tatum Boulevard, Ste. 247 Phoenix, Arizona 85028 Attorneys for Plaintiff

s/Jody A. Crain

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Case 2:02-cv-02281-SMM Document 209 3 Filed 09/29/2005 Page 3 of 8
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TABLE OF CONTENTS
VERDICT FORMS...........................................................................................................4
Verdict for Plaintiff on Claim for Breach of Duty of Good Faith and Fair Dealing ............................. 5 Verdict for Plaintiff on Claim for Punitive Damages............................................................................. 6 Verdict for Defendants on All Claims .................................................................................................... 7 Verdict for Defendants on Claim for Punitive Damages ....................................................................... 8

1 2 3 4 5 VERDICT FORMS 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28
Case 2:02-cv-02281-SMM Document 209 4 Filed 09/29/2005 Page 4 of 8
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Case 2:02-cv-02281-SMM Document 209 5 Filed 09/29/2005 Page 5 of 8
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Verdict for Plaintiff on Claim for Breach of Duty of Good Faith and Fair Dealing

We the Jury, duly empanelled and sworn in the above-entitled action, upon our oaths, do find in favor of plaintiff Brett Leavey on his claim of breach of the covenant of good faith and fair dealing against defendants UnumProvident Corporation and Provident Life and Accident Insurance Company in the following amounts, if applicable: A. B. For emotional distress, humiliation, and inconvenience: $_____________. For policy benefits (reduced to present value) for the period in which it is

more likely than not that the plaintiff will be totally disabled in the future: $__________.

(1) (2) (3) (4)

(5) (6) (7) (8) PRESIDING JUROR

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Case 2:02-cv-02281-SMM Document 209 6 Filed 09/29/2005 Page 6 of 8
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Verdict for Plaintiff on Claim for Punitive Damages

We the Jury, duly empanelled and sworn in the above-entitled action, upon our oaths, do find in favor of plaintiff Brett Leavey on his punitive damages claim against defendants UnumProvident and Provident Life and Accident Insurance Company in the amount of $____________.

(1) (2) (3) (4)

(5) (6) (7) (8) PRESIDING JUROR

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Case 2:02-cv-02281-SMM Document 209 7 Filed 09/29/2005 Page 7 of 8
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Verdict for Defendants on All Claims

We the Jury, duly empanelled and sworn in the above-entitled action, upon our oaths, do find in favor of defendants UnumProvident Corporation and Provident Life and Accident Insurance Company on all claims.

(1) (2) (3) (4)

(5) (6) (7) (8) PRESIDING JUROR

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Case 2:02-cv-02281-SMM Document 209 8 Filed 09/29/2005 Page 8 of 8
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Verdict for Defendants on Claim for Punitive Damages

We the Jury, duly empanelled and sworn in the above-entitled action, upon our oaths, do find in favor of defendants UnumProvident Corporation and Provident Life and Accident Insurance Company on the claim for punitive damages.

(1) (2) (3) (4)

(5) (6) (7) (8) PRESIDING JUROR