SANBORN Et Al v. CENTURY INDEMNITY COMPANY Complaint

Case 3:15-cv-05952-KLS Document 1-2 Filed 12/30/15 Page 1 of 8
E-FILED
IN COUNTY CLERK'S OFFICE
PIERCE COUNTY, WASHINGTON
December 23 2015 2:09 PM
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KEVIN STOCK
COUNTY CLERK
NO: 15-2-14121-5
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The Honorable K.A. van Doornick
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IN THE SUPERIOR COURT OF THE COUNTY OF PIERCE
STATE OF WASHINGTON
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) Case No.: 15-2-14121-5

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AMENDED COMPLAINT
Plaintiffs,
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v.
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CENTURY INDEMNITY COMPANY, a
foreign corporation authorized to engage in )
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business in Washington.
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Defendant(s).
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_____________________________________ )
KATHRYN M. SANBORN and KEVIN M.
SANBORN, a marital community,
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Plaintiffs KATHRYN M. SANBORN and KEVIN M. SANBORN allege:
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I.
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JURISDICTION AND VENUE
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1.
This court has jurisdiction because under RCW 4.12.025 (1):
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An action may be brought in any county in which the defendant

resides the residence of a corporation defendant shall be deemed
to be in any county where the corporation:
AMENDED COMPLAINT - 1
LEANNE M. LUCAS
ATTORNEY AT LAW
3828 BEACH DRIVE S.W., Suite 303
SEATTLE, WASHINGTON 98116
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(a) Transacts business; (b) has an office for the transaction of

business; (c) transacted business at the time the cause of action
arose; or (d) where any person resides upon whom process may be
served upon the corporation.
2.
Plaintiff KATHRYN M. SANBORN resides at 1039 Rosewood Lane,
Fircrest, Washington 98466-6531, in the COUNTY OF PIERCE, in the STATE OF

WASHINGTON.
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3.
Plaintiff KEVIN M. SANBORN resides at 1039 Rosewood Lane,
Fircrest, Washington 98466-6531, in the COUNTY OF PIERCE, in the STATE OF

WASHINGTON.
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4.
The Defendant CENTURY INDEMNITY COMPANY is a foreign
corporation authorized to engage in the business of insurance in the STATE OF

WASHINGTON.
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5.
The Plaintiff KATHRYN M. SANBORN is fully covered under a
personal medical insurance policy provided by the defendant through its subsidiary
ACE INSURANCE COMPANY.
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II.
BACKGROUND FACTS
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6.
The Plaintiff KATHRYN M. SANBORN was involved in an automobile-trolley
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car accident and was critically injured on December 12, 1980.
LEANNE M. LUCAS
ATTORNEY AT LAW
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The accident left Mrs. Sanborn with debilitating injuries to her head and spine,
which do not improve over time, but require treatment to prevent deterioration of her condition
and to reduce chronic pain.
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8.
At the time of the accident, Mrs. Sanborn was covered under a lifetime medical
policy through INA Insurance Company.
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9.
Later her policy was transferred to CIGNA Insurance, then to Defendant
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CENTURY IMDEMNITY COMPANY through its subsidiary ACE INSURANCE COMPANY
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because of corporate purchases and transfers occurring over the last thirty-five years.
10.
In June 2013, Mrs. Sanborn rejected an offer from Trina Faison-Washington of
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ESIS Claims INC, the claims representative for ACE INSURANCE COMPANY (ACE), to
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discuss the purchase of her insurance policy.
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11.
Immediately after Mrs. Sanborns rejection of the offer, the defendant(s) failed to
approve and pay any of Mrs. Sanborns current or later claims.

12.
After requiring the plaintiff to repeat the submission of the same claim forms
numerous times, defendant through ESIS, INC. (ESIS) finally disclosed through its claims
representative Ms. Faison-Washington that Mrs. Sanborn did indeed have lifetime coverage
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under her policy, yet because of Mrs. Sanborns own description of her spinal condition as
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scoliosis, the claimed treatments were not covered, because scoliosis is a natural condition, not
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based upon injury.

13.
Mrs. Sanborns claims included the same type of medical treatments which had
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been covered by the defendant(s) prior to this time and had been covered by all former
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insurance providers.
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LEANNE M. LUCAS
ATTORNEY AT LAW
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14.
After months had lapsed, defendant(s) through ESIS required an independent
medical exam which was performed on August 19, 2014.

15.
The independent medical exam was performed by Drs. Jeremey P. Walton, D.C.
and Neal Shonnard, M.D. of MES Solutions. The report defined different types of scoliosis and
the physicians identified Mrs. Sanborns scoliosis as the type that was caused by her injuries
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from the accident in 1980.
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16.
The defendant(s) had a duty to pay all claims before the independent medical
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exam and after it was completed.

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The refusal to pay the claims, and failure to put the reasons for denial in writing,
constitute bad faith under Washington State law.

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Additionally, the defendants(s) repeated requests to Mrs. Sanborn and her
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medical providers to send duplicate forms and claims, and defendants(s) failure to respond to
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repeated requests for payment within thirty days, constitute bad faith in Washington.
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defendants(s) failure to act after Mrs. Sanborn refused the offer to buy her out
of her policy was particularly egregious and caused financial damage and pain and suffering for
her and Mr. Sanborn.
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III.
CLAIMS AND CAUSES OF ACTION
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The Plaintiffs allege the following claims and causes of action against
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the defendants:
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LEANNE M. LUCAS
ATTORNEY AT LAW
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A.
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CONSUMER PROTECTION VIOLATION
Under RCW 19.86.020 Unfair competition, practices, declared
unlawful, [u]nfair methods of competition and unfair or deceptive acts or practices in

the conduct of any trade or commerce are hereby declared unlawful. Further, under
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RCW 19.86.093 Civil action Unfair or deceptive act or practice Claim
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elements:
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In a private action in which an unfair or deceptive act or practice is alleged

under RCW 19.86.020, a claimant may establish that the act or practice
is injurious to the public interest because it:
(1) Violates a statute that incorporates this chapter;
(2) Violates a statute that contains a specific legislative declaration of
public interest impact; or (3)(a) Injured other persons; (b) had the capacity
to injure other persons; or (c) has the capacity to injure other persons.
RCW 19.86.020
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Under RCW 19.86.090 Civil action for damages Treble damages
authorized Action by governmental entity:

Any person who is injured in his or her business or property by a violation of
RCW 19.86.020, 19.86.030, 19.86.040, 19.86.050, or 19.86.060, or any person
so injured because he or she refuses to accede to a proposal for an arrangement
which, if consummated, would be in violation of RCW 19.86.030, 19.86.040,
19.86.050, or 19.86.060, may bring a civil action in superior court to enjoin
further violations, to recover the actual damages sustained by him or her, or
both, together with the costs of the suit, including a reasonable attorney's fee. In
addition, the court may, in its discretion, increase the award of damages up to an
amount not to exceed three times the actual damages sustained.
The defendants(s) actions or failure to act violated RCW 19.86 et seq. There was
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never a concern for my clients physical or emotional pain and suffering during the continual
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violation of Washington law. This is true even though the defendant(s) was cognizant that Mrs.
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Sanborn has and continues to suffer from permanent injuries and she was and is entitled to
lifetime medical coverage under her policy.
LEANNE M. LUCAS
ATTORNEY AT LAW
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The defendant(s) has injured and continue to injure the plaintiffs under Washington State
Consumer Protection statutes.
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B.
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INSURANCE BAD FAITH
Under RCW 48.30.015, a first party claimant to an insurance policy
who is unreasonably denied a claim for coverage or payment of benefits, may bring an
action in superior court to recover actual damages sustained, costs, reasonable
attorneys fees, and litigation costs. Additionally, the court may decide in its discretion
to increase the total award of damages to an amount not to exceed three times the actual
damages.
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Under the Washington Administrative Code 284-30-330 Specific Unfair Claims
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Settlement Practices Defined the following is identified as an unfair method of competition and
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an unfair or deceptive act or practice of the insurer: Misrepresenting pertinent facts or insurance
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policy provisions.
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Under the Washington Administrative Code 284-30-350 the following is
identified as an unfair method of competition and an unfair or deceptive act or practice

of the insurer: Misrepresentation of Policy Provisions.
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of the insurer: Failure to Acknowledge Pertinent Communications.
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of the insurer: Failure to Follow Standards for Prompt Investigation of Claims.
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identified as an unfair method of competition and an unfair or deceptive act or practice of the
LEANNE M. LUCAS
ATTORNEY AT LAW
insurer: Failure to Follow Settlement Standards for Prompt, Fair and Equitable Settlements
Applicable to All Insurers.
The defendant(s) has injured and continue to injure the plaintiffs under
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Washington State Insurance Bad Faith Statutes and Washington Administrative Code
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violations.
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C.
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29.
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The interest rate for tort judgments is prescribed by RCW 4.56.110(3),
which provides:
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PRE AND POST JUDGMENT INTEREST
Interest on judgments shall accrue as follows:

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(3) Judgments founded on the tortious conduct of individuals or other entities,

whether acting in their personal or representative capacities, shall bear interest
from the date of entry at two percentage points above the equivalent coupon
issue yield, as published by the board of governors of the federal reserve
system, of the average bill rate for twenty-six week treasury bills as determined
at the first bill market auction conducted during the calendar month immediately
preceding the date of entry. In any case where a court is directed on review to
enter judgment on a verdict or in any case where a judgment entered on a
verdict is wholly or partly affirmed on review, interest on the judgment or on
that portion of the judgment affirmed shall date back to and shall accrue from
the date the verdict was rendered.
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The plaintiffs request the Court to order pre and post judgment interest as is statutorily
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proper and within the discretion of the Court.
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IV.
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DAMAGES
The plaintiffs have sustained the following damages due to the
defendants (s) bad faith:

a.
pain and suffering
LEANNE M. LUCAS
ATTORNEY AT LAW
b.
medical costs
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interest and late fees
d.
attorneys fees
e.
punitive damages if statutorily permitted
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V.
REQUEST FOR RELIEF
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PLAINTIFFS KATHRYN M. SANBORN and KEVIN M. SANBORN beg the

court to enter judgment against the defendant(s):
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Awarding plaintiffs all statutory costs and fees, if any, including treble
3.
Awarding plaintiffs all litigation expenses and attorneys fees as
provided by statute.
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2.
damages under RCW 48.30.015.
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Awarding plaintiffs all claimed damages in an amount to be established
at trial.
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1.
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Awarding plaintiffs pre and post-judgment interest on the damages
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Awarding plaintiffs any further or additional relief which the court finds
award.
equitable, appropriate, or just.
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December 23, 2015
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Signed________________________________
Leanne M. Lucas, WSBA # 37414
Attorney at Law
3828 Beach Drive S.W. Suite 303
Seattle, WA 98116-3578
LEANNE M. LUCAS
ATTORNEY AT LAW

SANBORN Et Al v. CENTURY INDEMNITY COMPANY Complaint

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Case 3:15-cv-05952-KLS Document 1-2 Filed 12/30/15 Page 1 of 8

) Case No.: 15-2-14121-5

Plaintiffs KATHRYN M. SANBORN and KEVIN M. SANBORN allege:

JURISDICTION AND VENUE

This court has jurisdiction because under RCW 4.12.025 (1):

An action may be brought in any county in which the defendant

Case 3:15-cv-05952-KLS Document 1-2 Filed 12/30/15 Page 2 of 8

(a) Transacts business; (b) has an office for the transaction of

Plaintiff KATHRYN M. SANBORN resides at 1039 Rosewood Lane,

Fircrest, Washington 98466-6531, in the COUNTY OF PIERCE, in the STATE OF

Plaintiff KEVIN M. SANBORN resides at 1039 Rosewood Lane,

Fircrest, Washington 98466-6531, in the COUNTY OF PIERCE, in the STATE OF

The Defendant CENTURY INDEMNITY COMPANY is a foreign

corporation authorized to engage in the business of insurance in the STATE OF

The Plaintiff KATHRYN M. SANBORN is fully covered under a

The Plaintiff KATHRYN M. SANBORN was involved in an automobile-trolley

Case 3:15-cv-05952-KLS Document 1-2 Filed 12/30/15 Page 3 of 8

and to reduce chronic pain.

policy through INA Insurance Company.

Later her policy was transferred to CIGNA Insurance, then to Defendant

In June 2013, Mrs. Sanborn rejected an offer from Trina Faison-Washington of

discuss the purchase of her insurance policy.

approve and pay any of Mrs. Sanborns current or later claims.

based upon injury.

Case 3:15-cv-05952-KLS Document 1-2 Filed 12/30/15 Page 4 of 8

After months had lapsed, defendant(s) through ESIS required an independent

medical exam which was performed on August 19, 2014.

exam and after it was completed.

constitute bad faith under Washington State law.

Additionally, the defendants(s) repeated requests to Mrs. Sanborn and her

CLAIMS AND CAUSES OF ACTION

Case 3:15-cv-05952-KLS Document 1-2 Filed 12/30/15 Page 5 of 8

CONSUMER PROTECTION VIOLATION

Under RCW 19.86.020 Unfair competition, practices, declared

unlawful, [u]nfair methods of competition and unfair or deceptive acts or practices in

In a private action in which an unfair or deceptive act or practice is alleged

Under RCW 19.86.090 Civil action for damages Treble damages

authorized Action by governmental entity:

Case 3:15-cv-05952-KLS Document 1-2 Filed 12/30/15 Page 6 of 8

INSURANCE BAD FAITH

Under RCW 48.30.015, a first party claimant to an insurance policy

Under the Washington Administrative Code 284-30-330 Specific Unfair Claims

Under the Washington Administrative Code 284-30-350 the following is

identified as an unfair method of competition and an unfair or deceptive act or practice

Under the Washington Administrative Code 284-30-360 the following is

identified as an unfair method of competition and an unfair or deceptive act or practice

Under the Washington Administrative Code 284-30-370 the following is

identified as an unfair method of competition and an unfair or deceptive act or practice

Under the Washington Administrative Code 284-30-380 the following is

Case 3:15-cv-05952-KLS Document 1-2 Filed 12/30/15 Page 7 of 8

Applicable to All Insurers.

The interest rate for tort judgments is prescribed by RCW 4.56.110(3),

PRE AND POST JUDGMENT INTEREST

Interest on judgments shall accrue as follows:

(3) Judgments founded on the tortious conduct of individuals or other entities,

proper and within the discretion of the Court.

The plaintiffs have sustained the following damages due to the

defendants (s) bad faith:

pain and suffering

Case 3:15-cv-05952-KLS Document 1-2 Filed 12/30/15 Page 8 of 8

interest and late fees

punitive damages if statutorily permitted