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Case 4:12-cv-00088-JHM-HBB Document 1-1 Filed 08/03/12 Page 1 of 8 PageID #: 4

Exhibit A
Case 4:12-cv-00088-JHM-HBB Document 1-1 Filed 08/03/12 Page 2 of 8 PageID #: 5
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Alison Lundergan Grimes

Comm.onvyealth.of
6f{ice C?f the of
J,uly 13, 201:2'
COMBINED INSURAN,CE COMPANY
P'O BOX' 670D
SCRANJON;'PA 18505,
FROM: SUMMONS DIVISION
SECRETARY OF STATE
, ,
. . - . .
COURT: Circuit Court Clerk
U.niory . .
-Courthouse
PO.Bdx 59
KY 424?7
'Phone: (270)
Summons-Division
POBQX718
FRANKFORT, KY 40602'{)718
Legal acti Qn':has: 'been.filed againstyol.,l intlie captiQne9 case. As provided uhqet
. Kentucky dt;icument;:; ene
rega.rding this action sl'jQuld J:>e
(1) Your attorney; or'
(2) The attorney fjl!ng -this suit narllE!'shdulq.appear
of.the
'(3) ' colJ.rt which the sl,Iit.i$-fJled
at the.clt?rk's number
Secretary of $tateHas.NO POWER to make a disP9sition of tliis
YOI,!r. responsiye:ple.qdings should befiled with tfle.c.lerkqfthe.court or
wherethe suifis yquropposing.party. "
No t;:opyof future 'pleadings be sent ,to this us
under, statute or rule.an.Q pay for sai9 service: .
Kentucky Seaetary of -1' tate's Office Summons Division 7I13J?:012
Case 4:12-cv-00088-JHM-HBB Document 1-1 Filed 08/03/12 Page 3 of 8 PageID #: 6
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. AOC-S-I.OS CI
Rey. 7-99
COMBINEDINSURANCE
POBOX 670Q
SCRAm-ON PA
The ommomyealth 10 tlie above-na1.ned
CaSeNllmbcr 12-CEQ0143
Court CI
,<;ollnty UNION
.you are hereby notified that .a legal h;J.s been filed against.you In'(his court"demanding relief as shown the document
to you witli sunimons. a wi"lUen is' madt;; !?y:you or by 'yitJ"lin days
following the by-default nuiy be fal,cn for.t.l:!e.':elief .. i.n the
complaint ..
The nime(s) and Qfthe or'partico? demanding relief against you or hls!hcr (their) attorney(s) are shown on
the document delivere4 to You:w!t.h this summons. .
Cireui . istrict Cieri.<, SUE W SEA VEN
By_---.(&""--___ , DC
Dale: 07/lOn012
SERVE: -KYSECRETARY OF STATE'
, '
A TRUECOPYATIEST
DATE: :7!to!.i-,;)/;;"
SOE W. BEAVEN, CLERK'
' UNION CIRCUIT" ISTRicT COURTS
BY: ___ __ D.C.
RAISED SEAL
CI 12Ct-0014)
o MASON. RANDY E. ,vs. COMBINED INS,URANCE COMPANY,
"
ml illl ml mllIl lllll ill!lIll1lllllm III! 11m 1111
3
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B
COMMONWEALTH OF KENTUCKY
UNION CIRCUIT COURT
CIVIL ACTION NO: 12 C1 00143
12071700712008
RAISED SEAL
RANDY E. MASON
PLAINTIFF
vs.
COMBINED INSURANCE COMPANY
Po Box 6700
DEFENDANT
Scranton, Pennsylvania
Serve via: Kentucky Secretary of State
Office of Secretary of State
The Capitol Building
700 Capital Avenue
Suite 152
Frankfort, KY 40601
VERIFIED COMPLAINT
A COYY.ATI\,ST
DATE: . . 7] JO /0<>0.
$UE.w. BEAVEN, ClERK
UNION COURTS
BY. .. D.C.
COMES, the Plaintiff. Randy E. Mason, by Counsel, and for his Complaint as
against the Defendant, Combined Insurance Company of America states as follows:
1.
2.
3.
COUNT I
That the Plaintiffs is a resident of Morganfield, Union County, Kentucky residing.
at 508 Union Street, Morganfield, Kentucky.
That Defendant, Combined Insurance Company of America is an Insurance
Company formed under the laws of the state of Illinois and is authorized to dq
business in the state of Kentucky. Said Defendant has failed to designate an
Agent for Service of Process in the Commonwealth of Kentucky. Its Service of
Process agent is the Kentucky Secretary of State.
That on or about August 6, 2010, the Plaintiff purchased policy number
T 4067986 from the Defendant herein.
Said policy was to provide ac \ident FilED
sickness protectionto the Plaintiff in theevent of Plaintiffs disability.
JUL 10 1011
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12071700712008
4. That on or about February 5, 2007, Plaintiff purchased a second accident policy-
from the Defendant with policy being number T1352342 which provides
hospital emergency recovery-outpatient benefits and intensive care recovery care
benefits to the Plaintiff in the event of his disability.
5. That on or about May 2, 2011, the Plaintiff purchased a third disability policy from
the Defendant namely policy number T4069311 providing disability benefits to
the Plaintiff in the event of his disability.
6. That the Plaintiff has paid all premiums due and payable under the policies sold
by the Defendant to the Plaintiff herein.
7. That on or about May 4, 2011, the Plaintiff was diagnosed wilh Cancer. Since
that time and until the current date. the Plaintiff has been unable to return to work
and has been totally disabled.
6. That the Plaintiff. filed a claim with the Defendant for coverage under all of the
aforementioned policies and the has denied said claims.
9.
That as a result of the Defendants failure to pay Plaintiffs claims as stated herein
above, the Defendant has viol.led the following provisions of KRS 304.12-230, 10
wit:
A. Failing to acknowledge and act reasonably prompt on
communications with respect to claims. rising under said insurance policies.
B. Failing to adopt and implement reasonable standards for the
prompt investigation of claims arising insurance pOlicies.
C. Misrepresenting pertinent facts or insurance policy provisions
relating to coverage at issue.
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12071700712008
D. Failing to promptly provide reasonable explanation of the basis in
the Insurance Policy in relation to the facts or applicable law for denial of a claim or for
the offer of a compromise settlement.
E. Refusing said claim conducting a reasonable
upon all available information.
F. Not attempting in good faith to effectuate prompt, fair, and equitable
settlements of Plaintiffs claims of which liability.has been reasonably clear.
o. Compelling the Plaintiff to institut? lit,igatlon to recover amounts due
under an insurance policy by offering substantially less than what is.due Plaintiff.
H. Attempting to settll Plaintiff's claim for less than the amount to
which a reasonable man would have believed he was entilled.
I. Failingto promptly provide a reasonable expJanati9n of the basis of
the Defendant's denial in relation to the facts and applicable law.
10. That as a result of the aforementioned violations of the Kentucky Unfair
Claims Settlement Practice.s Act, the Plaintiff has incurred damages in excess of .the
minimum jurisdictiona.! limits of this Court.
COUNT II
1. Plaintiff incorporates by .reference, the averments of Count I in Plaintiffs
Complaint filed herein.
2. As heretofore described, the Defendant, Cpmbined Insurance Company of
America has acted in bad faith in .dealing with the Plaintiff with respect to Contracts of
Insurance as described herein.
3. As a result of the Defendants bad faith dealings, the Plaintiff has endured mental
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12071700712008
suffering, mental anguish, emotional distress, a reduction of standard of living, and had
incurred substantial and continuing consequential damages for all of which he may
recover from the Defendant, Combined Insurance Company of America, all in excess of
the minimum jiJrisdictionallimits of this Court.
COUNT III
1. Plaintiff incorporates by reference, the averments of Count I and Count II of the
Plaintiffs Complaint filed herein.
2. Under the Kentucky Consumer Protection Act, namely KRS 367.170, the
Defendant, Combined Insurance Company of America had a duty not to commit any
unfair. false, misleading or deceptive act.
3. The Defendant's failure to deal in good faith as to the Plaintiffs claims
constitutes a violation of KRS 376.170.
4. The acts of the Defendant, Combined Insurance Company of America in
connection with the Defendant's violation with the Kentucky Consumer Protection Act
were carried out with oppression and malice, or intentionCilI, so that the Plaintiff is
entitled to recover attorney fees and punitive damages purs!Jant to KRS 4.01.184.
WHEREFORE, the Plaintiff, Randy E. Mason prays as follows:
1 For judgment as against the Defendant, Combined Insurance Company of
America as set out in Counts I, " and III of Plaintiffs Complaint.
2 For judgmE;!nt as against the Defendant, Combined Insurance CQmpany of
America awarding punitive damages to the Plaintiff herein.
3 For his costs herein expended including reasonable attorney fees
pursuant to KRS 401.184.
4. For pre-judgment and post-judgment interest on all sums recovered
herein.
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1.2071700712008
5. For trial by jury.
6. For all and proper relief to which he maybe entitled.
ARNETT LAW.OFFICE, PLLC
109 South Morgan Street
Post Office Box 419
M'organfield, Kentucky 42437
Telephone: (270) 389-2006
Facsimile: (270) 389-2007
admin@arnettlawoffice.com
Attorney for Plaintiff f\
( J
'-.J TEPHEN M. ARNETT
I RANDY E. MASON, state I am the Plaintiff herein, and the statements
contained in the foregoing Complaint are rue nd correct to/the my knowledge
and belief. I J J I
- , r: f. jV! Cv-.
I'.NDY!'\, MASON
STATE OF KENTUCKY
COUNTY OF UNION
sUbCfribed, sworn
MASON on this t!L day of
RANDY E.
My commission L{-l '?J- IS"

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