THE AMMENDED COMPLAINT
UNITED STATES FEDERAL COURT
DISTRICT OF MASSACHUSETTS
JUDY E. MORRIS, MD )
Plaintiff ) Civil Action No. CA 98-30204 FHF
UNUM CORPORATION OF AMERICA, )
et al. )
FIRST AMENDED COMPLAINT FOR DAMAGES FOR VIOLATION OF
ERISA AND FOR DECLARATORY AND INJUNCTIVE RELIEF
Dr. Judy Morris, acting Pro Se, for reasons previously specified brings
this Court ordered amended complaint to her previously filed complaint
against UNUM Insurance Company and 59 other defendants. Plaintiff
brings this amended complaint to comply with orders of District Court
Judge Frank H. Freedman to attempt to comply with Rule 8 of the Fed.
Rules of Civ. P. For the sake of expediency plaintiff is filing here a
lawsuit for disability benefits under an ERISA Long Term Disability Plan
provided by her employer. However, plaintiff reserves all rights and
obligations afforded by the 14th Amendment of the US Constitution
and the legal system to re-introduce at the appropriate time any or all
causes of actions previously submitted regarding her individual
disability policy and her RICO allegations. Plaintiff wishes to remind
the court that she has an Individual Disability Policy which UNUM has
also failed to honor, that contains almost the exact same nexus of facts
(in fact UNUM conducted one ^”investigation^‘ for both of plaintiff^“s
claims), that should be joined with this action if the judge will grant
leave for this. Otherwise plaintiff will be forced to file this action
in state court with the added expense and inconvenience to all
litigants. Plaintiff reserves her constitutional right to a jury trial.
1. This Court has jurisdiction over this amended complaint pursuant to
29 U.S.C. ß 1132 and 28 U.S.C. ß 1331.
2. The Plan (^”Harrington Plan^‘) is an employee benefit plan as defined
by 29 U.S.C. ßß1002 and 1003.
3. The breach which is the subject of this complaint occurred in the
State of Massachusetts. Venue is proper in this Court pursuant to 29
U.S.C. ß1132(e)(2). Plaintiff, Judy Morris, MD is a resident of Monson,
MA, Hampden County. Plaintiff is a 41 year old physician, Board
Certified in Family Practice, but practicing Emergency Medicine full
time since 1989.
4. On or about March, 1995, plaintiff began her employment at
Harrington Memorial Hospital. At that time she was given as a benefit
of employment, the Harrington Plan for the benefit of its employees, as
part of her employment contract. The Plan continued to be in full force
and effect at all times relevant to this amended complaint.
5. At all times relevant to this amended complaint Plaintiff was a
participant in the Plan.
6. On or about October 28, 1996, the Plaintiff was determined to be
disabled from her occupation according to the terms of her Plan.
Plaintiff was determined to be completely disabled from her specialty of
Emergency Medicine by her treating physician, Dr. Patricia McIlvaine,
and by her employer, Harrington Hospital. Effective February 1, 1997,
Plaintiff was eligible to receive benefits under the Plan. Prior to
this time of disability determination, Plaintiff was employed by
Hospital as a full time Emergency Room Physician.
7. The Plan provides that a disabled individual is to receive an annual
disability benefit, payable in monthly installments, in an amount equal
to 60% of the individual^“s pre-disability earnings if the person is
completely disabled from the specialty she was practicing at the time
the disability began, and continues to be disabled from that specialty
even if she is able to return to work in another occupation.
8. Plaintiff cooperated with UNUM in all reasonable requests during the
pendancy of her claim, submitting requested proofs of loss from herself
and her treating physician, and all other requested documents, and in
fact, requested repeatedly that she be told if further documentation of
her disability was needed to perfect her claim.
9. Plaintiff has a disability, Chronic Fatigue Syndrome and
Fibromyalgia, that is, in many cases, generally considered to be
permanent and has no know cure and recovery/remission is extremely
10. On or about April, 1997, after conducting a joint ^”investigation^‘
of both of plaintiff^“s claims, plaintiff was handed 2 denial letters for
her disability claims from UNUM representative Steve Harris. The letter
from the Group Insurance Adjuster Frankie Puthoff, stated that Plaintiff
was disabled only until February 14, 1997 and the reason stated
conflicted with the written reports of plaintiff^“s treating physicians.
Plaintiff was advised in this letter that in order to appeal this
decision she would need to supply UNUM with ^”more compelling^‘ evidence
of her disability.
11. UNUM repeatedly refused to answer plaintiff^“s questions about how
she could perfect her claim.
12. Plaintiff submitted 2 second opinions confirming her diagnosis,
laboratory evidence of her disease and material from the Centers for
Disease Control and National Institutes of Health and other mainstream
experts, regarding treatment recommendations for her disability which
clearly precluded plaintiff from returning to work in her occupation as
an Emergency Physician.
13. On or about August, 1997, plaintiff^“s attorney (at that time)
received a letter parroting UNUM^“s previous denial of April and ignoring
the further evidence submitted by plaintiff.
14. UNUM has consistently failed to engage in any meaningful
interaction with this Plaintiff, despite Plaintiff^“s repeated and well
documented attempts. UNUM^“s employees attempted to encourage plaintiff
to return to her former employment against the expressed recommendations
of plaintiff^“s doctors that returning to this occupation would be
hazardous to plaintiff and to the patients she would be treating.
15. Plaintiff had exhausted all administrative remedies available to
her under the terms of the Plan and believes any further administrative
remedies if administered by UNUM would prove futile.
16. Plaintiff is and continues to be disabled as defined by the
[CLAIM FOR BENEFITS DUE UNDER U.S.C. ß1132 (a)(1)(B)]
17. Plaintiff realleges and incorporates the allegations contained in
paragraphs 1 through 16 inclusive.
18. Pursuant to the terms of the Harrington Plan that has been, and
continues to be in effect, Plaintiff was and is entitled to receive
monthly disability benefits in the amount of 60% of her former salary.
The policy does not grant discretion to UNUM to override the opinions of
plaintiff^“s treating physicians. It only requires that plaintiff submit
to UNUM ^”proof of claim.^‘
19. In accordance with the procedures set forth in the Summary Plan
Description of the Plan, Plaintiff has made written demands upon UNUM,
for payment of her full benefits under the Plan.
20. UNUM has failed to respond to Plaintiff^“s request for payment of
benefits due under the Plan and Plaintiff has exhausted all of her
administrative remedies under the Plan.
[BREACH OF FIDUCIARY DUTY UNDER U.S.C. ß1104(a)(1)(D) and ß1132(a)(2)]
21. Plaintiff alleges and incorporates the allegation contained in
paragraphs 1 through 20 inclusive.
22. By reason of its general administration of the Plan and its
exercise of discretion over the assets of the Plan, UNUM owes fiduciary
duties to the participants and beneficiaries under the Harrington Plan.
23. UNUM has breached its fiduciary duties to Plaintiff by failing to
administer the Harrington Plan in accordance with the written
documentation governing the Harrington Plan.
[BREACH OF FIDUCIARY DUTY UNDER 29 U.S.C. ß U.S.C. 1104(a)(1)(A) and
24. Plaintiff alleges and incorporates the allegations contained in
paragraphs 1 through 23, inclusive.
25. By reason of its general administration of the Plan and its
exercise of discretion over the assets of the Plan, UNUM owes fiduciary
duties to the participants and beneficiaries under the Plan.
26. UNUM has breached its fiduciary duties to Plaintiff by failing to
administer the Plan for the exclusive purpose of providing benefits for
the participants and their beneficiaries
and has thus operated under a Conflict of Interest requiring a de novo
review of UNUM^“s Long Term Disability benefits denial to plaintiff.
27. UNUM has also breached its fiduciary duties to Plaintiff by using a
statutorily deficient denial letter that failed to inform plaintiff of
how she could perfect her claim under ERISA.
Other courts have stated that when the letter is statutorily deficient,
the standard of review must be de novo.
[CLAIM TO ENJOIN ACTION UNDER 29 U.S.C. ß1132 (a)(3)]
28. Plaintiff alleges and incorporates the allegations contained in
paragraphs 1 through 27 inclusive.
29. UNUM has breached its fiduciary duties to Plaintiff by failing to
administer the Plan in accordance with the written documentation
governing the Harrington Plan.
30. Plaintiff has made repeated written demands upon UNUM that her
benefits be paid in full or she be given an understandable reason why
they have not, and instructions on how she can perfect her claim, in
accordance with Plan documents and ERISA 29 U.S.C. ß1132. UNUM has
consistently failed to comply with the requirement that plaintiff be
given a ^”description of any additional material or information necessary
to complete the claim and an explanation of why that material or
information is necessary.^‘
31. UNUM has failed to pay benefits or comply with Federal Law and Plan
32. UNUM failed to conduct a ^”full and fair^‘ review of plaintiff^“s
claim on appeal.
33. UNUM^“s initial ^”investigation^‘ was biased and slanted towards
finding a pretense to deny plaintiff^“s claim, while not investigating
nor interviewing any material or persons that would support plaintiff^“s
claims and ignoring or dismissing the evidence that was submitted by
plaintiff and her doctors.
34. As a proximate result of these breaches plaintiff has been denied
benefits under the Harrington Plan.
35. Plaintiff is entitled to a retroactive award of benefits including
pre-judgment interest, and cost of living increases and an award of
future benefits, and cost of living increases and re-instatement in her
employers health and benefits plans that were also denied to her.
Plaintiff is entitled to be made whole as to her position had her
benefits not been wrongly denied.
36. To prevent further unjustified action by UNUM, plaintiff is
entitled to an injunction preventing the termination of benefits without
On Counts I, II, III, and IV:
WHEREFORE, the Plaintiff, Judy Morris, MD, demands that this Honorable
Court enter a judgment against the Defendant,
1) enjoining or ordering injunction against the Defendant from refusing,
terminating, suspending or otherwise not paying the monthly benefits and
requiring Defendant to pay Plaintiff $6703 per month as contractually
stipulated benefits under the Harrington Plan in monthly distributions;
(2) awarding Plaintiff a lump sum amount, representing unpaid benefits
from the date of her disability through the date of the judgment;
(3) awarding Plaintiff prejudgment interest and Cost of Living
increases, at 4% annually, through the date of the judgment on the lump
(4) awarding Plaintiff her reasonable costs that she has incurred, and
attorney^“s fees (if she hires an attorney) pursuant to 29 U.S.C
(5) for such other relief as the Court deems just and proper [Benefits
on her Individual Policy, Premiums paid on Individual policy after
disability date, costs plaintiff has incurred in bringing this action
for relief, pre- and post-judgment interest, anticipated sanctions or
penalties for defendant not complying with the Court^“s orders in a
(6) That defendant abused its discretion in determining that Plaintiff
was not entitled to benefits under the policy, and
(7) That defendant is operating under a Conflict of Interest which
significantly impairs its ability to function as a fiduciary for
beneficiaries of its Plans and that it has been shown to put its own
financial interests ahead of those of policyholders and beneficiaries.
UNUM has failed in its fiduciary duties to administer group disability
benefit plans ^”solely in the interest of the participants and
29 U.S.C. 1104(a)(1).
(8) That defendant has continued to use statutorily deficient denial
letters and should be enjoined from continuing to do this.
WHEREFORE, Plaintiff requests that this Honorable Court enter judgment
in her favor and against Defendant.
Signed under the penalties of perjury this 15 day of March, 1999.
Judy E. Morris, MD
261 Bumstead Rd.
Monson, MA 01057
CERTIFICATE OF SERVICE
I hereby certify that a true copy of the above document was
delivered in person March 15, 1999 to US District Court, District of
Massachusetts, Springfield and served by United States Postal Mail,
postage prepaid upon the following attorneys representing all defendants
in Morris v. UNUM, et al. Mailed on March 16, 1999.
Judy E. Morris, MD
261 Bumstead Rd.
Monson, MA 01057
Patricia A. Peard, Esq. representing ^”UNUM^‘ Katherine A. Robertson,
Esq. ^”UNUM^“s^‘ local counsel
William J. Kayatta, Esq. representing Robert Crispin
H. Gregory Williams representing State of Mass.,
Harshbarger, Melconian, DOI,
Ruthardt, Goetz, Marcinkus,
Tracy L. Devlin, Esq. representing IFB and Michael
E. Michael Sloman, Esq. Gray
Thomas H. Hayman, Esq. representing Betty Rae Poppo
Robert Pierce, Esq. representing Harrington and
Christopher N. Jones Co-Counsel for Transunion
Carolyn G. Sullivan representing Jack Taylor
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Email Judy Morris
at: judydoc AT the-spa DOT com
at: bhammel AT graham DOT main DOT nc DOT us
The URL for this document is:
Created: March 15, 1999
Last Updated: May 28, 2000