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DISTRICT COURT, CITY AND COUNTY OF DENVER

COLORADO
Court address: 1437 Bannock Street
Denver, Colorado 80204
Plaintiff: DWAYNE APPELGREN

v.

Defendants: COMBINED INSURANCE COMPANY
OF AMERICA

Attorney for Plaintiff:
Thomas A. Bulger, Reg. #29390 Case No.
Silvern & Bulger, P.C.
4800 Wadsworth Blvd., Suite 307
Wheat Ridge, Colorado 80033
Phone Number: 303-292-0044
Fax Number: 303-292-1466
e-mail: counsel@silvernbulger.com Div.:



COMPLAINT AND JURY TRIAL DEMAND


COMES NOW the Plaintiff, Dwayne Appelgren, by and through his undersigned counsel,
Thomas A. Bulger, of Silvern & Bulger, P.C., and respectfully submits his Complaint and Jury
Trial Demand and respectfully states as follows:

PARTIES

1. Plaintiff, Dwayne Appelgren, is a natural person and citizen of the State of
Colorado. Plaintiffs address is 2390 South Evans, Englewood, Colorado 80110.

2. Defendant, Combined Insurance Company of America (Defendant Combined)
is a corporation and/or similar business entity which regularly conducts business in the State of
Colorado, including but not limited to the advertisement, sale, processing and adjustment of
group and individual disability insurance claims. The Defendants registered agent for service of
process is The Corporation Company, 1675 Broadway, Suite 1200, Denver, Colorado 80202.
DATE FILED: May 15, 2014 7:50 AM
FILING ID: 843BB8D08E2F7
CASE NUMBER: 2014CV31929
EXHIBIT A
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JURISDICTION AND VENUE

3. This matter is authorized and instituted pursuant to Colorado law, to address
violations of Plaintiffs rights protected by Colorado law, including his rights under his insurance
contract with the Defendants.

4. Venue is proper in the City and County of Denver where the Defendants regularly
conduct business and have a registered agent, and where all, or part, of the wrongful conduct
occurred.

STATEMENT OF THE FACTS

5. At all pertinent times, Plaintiff was insured pursuant to policy of insurance
purchased by Plaintiff, and issued by Defendant.

6. The policy provides short-term disability (STD) and long term disability
(LTD) benefits and/or similar insurance coverage pursuant to the terms and conditions of the
contract and/or Colorado law.

7. The policy provides for additional benefits in the event of accident or injury,
including medical benefits.

8. At all pertinent times, Plaintiff had paid all premiums required to Defendant, and
the policy was therefore in full force and effect.

9. In or around 2010, Plaintiff was diagnosed with various orthopedic issues,
including but not limited to lumbar stenosis requiring surgery.

10. Plaintiffs injuries arose out of a lifting injury to his back on or about September
2, 2010.

11. Plaintiff was unable to work as a result.

12. Plaintiff therefore requested payment of STD and LTD disability benefits, and
other benefits under his contract with Defendant.

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13. Defendant, following multiple appeals by Plaintiff, tendered a payment of
$48,675.00 in or around December, 2013. No further benefit payments have been made under its
policies.

14. Since that time, Defendant has refused and/or failed to process Plaintiffs claim in
a timely manner, and/or unreasonably failed to pay benefits due and owing under the policy.

15. Plaintiff submits that he was and is disabled as defined by the policy; that the
stated reasons for the denial of benefits are baseless; and Defendant has therefore breached the
contract of insurance with Plaintiff.

16. Plaintiff has been injured and damaged by Defendants conduct as alleged herein,
including but not limited to the denial of his claim for STD and/or LTD benefits, and other
consequential damages.

FIRST CLAIM FOR RELIEF BREACH OF CONTRACT

17. Plaintiff incorporates and realleges by reference the previous paragraphs of this
Complaint.

18. At all pertinent times, Plaintiff was insured by Defendant, including for STD
and/or LTD benefits subject to Colorado law and pursuant to a valid contract of insurance.

19. Plaintiff timely made claims for Defendant for said STD and/or LTD benefits for
the period of September 2010 to the present, and ongoing.

20. Defendant has failed to tender STD and/or LTD benefits due and owing under the
policy for that period, and/or delayed payment of said expenses for several months without
reasonable basis in fact or law.

21. Defendant has breached its contracts with Plaintiff as a result.

22. Plaintiff has been injured as a result.

23. The Defendants conduct was a cause of the Plaintiffs injuries and damages as
alleged herein.

SECOND CLAIM FOR RELIEF BAD FAITH
BREACH OF INSURANCE CONTRACT
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24. Plaintiff incorporates and realleges by reference the previous paragraphs of this
Complaint.

25. Defendants denial of coverage is without reasonable basis and Defendant has
acted with knowledge thereof, and/or in reckless disregard of such fact, and has therefore acted in
bad faith.

26. Plaintiff has been injured as a result, including a loss of insurance benefits.

27. The Defendants conduct was a cause of the Plaintiffs injuries and damages as
alleged herein.

THIRD CLAIM FOR RELIEF-STATUTORY DAMAGES
PURSUANT TO C.R.S. 10-3-1115 AND 1116

28. Plaintiff incorporates and realleges by reference the previous paragraphs of this
Complaint.

29. Defendants denial and/or delay in payment of benefits was unreasonable and
violated the provision of C.R.S. 10-3-1115 and 1116, and/or other Colorado law.

30. Plaintiff therefore seeks twice the covered benefits delayed and/or denied, and
attorneys fees, interest and costs incurred as a result per the above statutes.

DAMAGES

31. The Defendants above-alleged wrongful conduct caused the injuries and damages
to the Plaintiff, including but not limited to all benefits due and owing under the contract which
includes: Past and future economic damages, including but not limited to medical and related
expenses and past and future lost wages; past and future non-economic damages, including but
not limited to bodily; pain and suffering; inconvenience; emotional stress; anxiety; loss of
enjoyment of life; impairment of the quality of life; and any and all other consequential losses
arising from Defendants wrongful conduct as provided by law.

32. Plaintiff seeks additional damages for Defendants bad-faith refusal to honor its
contractual obligations, including for additional pain and suffering, stress, anxiety, inconvenience
and all other consequential losses caused by Defendant.

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LEAVE TO AMEND

33. Plaintiff respectfully requests leave to amend his Complaint to add or delete any
claims or parties after discovery reveals the facts regarding same, including but not limited to a
claim for exemplary damages.

WHEREFORE, Plaintiff respectfully requests damages against the Defendant,
individually, jointly, and/or severally as follows:

A. Compensatory damages as proven.

B. Costs of suit according to law, including but not limited to expert witness fees.

C. Attorney fees according to law for attorney time expended as a result of any
frivolous position which may be taken by Defendant, or on its behalf, during the
course of this litigation, including but not limited to groundlessly denying
negligence, or asserting any substantially groundless affirmative defenses.

D. Interest pursuant to C.R.C. 13-21-101 and/or other provisions of law.

E. Such other and further relief as the Court deems fit.

JURY DEMAND

Plaintiff respectfully demands TRIAL BY A JURY OF SIX (6) PERSONS in the above
cause, on all issues so triable.

Respectfully submitted,

SILVERN & BULGER, P.C.


s/Thomas A. Bulger
Thomas A. Bulger
Attorney for Plaintiff

Plaintiffs Address:
2390 South Evans
Englewood, CO 80110
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