Preview
JORDANS. ALTURA (SBN: 209431) ELECTRONICALLY FILED
Superior Court of California
KARGARET MI[ DRUGAN (SBN: 175324) County of Placer
GORDON REES SCULLY
S MANSUKHANT, LLP 09/18/2020
633 West Fifth Street, 52™ floor By: Olivia Lucatuorto, Deputy Clerk
Los les, CA 90071
Telephone: (213) 576-5000
Facsimile: (213) 680-4470
Attomeys for Plaintiff
STANDARD INSURANCE COMPANY
SUPERIOR COURT OF CALIFORNIA.
COUNTY OF PLACER
10
11 STANDARD INSURANCE COMPANY, an ) CASE NO. SCV0043710
ak 12
Oregon corporation,
FIRST AMENDED COMPLAINT IN
a 13
vs.
Plaintiff,
14
DAVID TEFERA, an individual; AMANUEL
15 TEFERA, a minor, by his guardian ad litem;
HERMELA TEFERA, a minor, her
16 guardian ad litem; and DOES 1 through 10,
inclusive.
17
Defendants.
18
19 Plaintiff Standard Insurance Company (“Standard”) hereby files its First Amended
20 Complaint in Interpleader against Defendants David Tefera, Amanuel Tefera, a minor, by his
21 guardian
ad litem; and Henmela Tefera, a minor, by her guardian
ad litem, and alleges
as follows:
I PARTIES
1 Standard Insurance Company is an insurance company, domiciled in Oregon, and
24 doing business in the State of Califomia. Standard issued a Group Life Insurance Policy, Policy
25 No. 608009 (the “Policy”) to the policyholder Professional Engineers in Califomia Goverment
26 (“PECG’). This is anon-ERISA group policy. The deceased Tsegereda Tefiera (the “Decedent”)
27 ‘was employed
as an engineer
for the State of Califomia
and a member of a class of insureds
covered under the Policy.
“1
FIRST AMENDED COMPLAINT IN INTERPLEADER
1 On information and belief, defendant David Tefera is a resident of Oakley,
Califomia
in Placer County. David Tefera is the husband of the Decedent and was married to
her at the time of her death. David Tefera was designated by the Decedent as the beneficiary to
receive the proceeds of the Policy upon Decedent's death.
2. On information and belief, defendant Amanuel Tefera, a minor, by his guardian
ad litem, is a resident of Roseville, Califomia in Placer County. Amanuel Tefera is the minor son
of the Decedent and would be among the class of individuals eligible to receive the proceeds of
the Policy upon Decedent's death should the Decedent not be survived by a named beneficiary.
3, On information and belief, defendant Hermela Tefera, a minor, by her guardian ad
10 litem, is a resident of Roseville, Califomia in Placer County. Hermela Tefera is the minor
11 daughter
of the Decedent and would be among the class of individuals eligible
to receive the
ak 12 proceeds of the Policy upon Decedent's death should the Decedent not be survived by a named.
a 13 beneficiary.
14 4. The Decedent
was a resident
of Roseville, Califomia
in Placer County at the time
15 of her death.
16 I FACTS
17 5, At the time of her death, the Decedent was employed
as an engineer for the State
18 of Califomia and was a member of a class of employees that was eligible for term life insurance
19 coverage under the Policy issued to PECG
by Standard. The Decedent was hired by the State of
20 Califomia
in 2006 and joined PECG at that time. At some point, the Decedent
left her job with
21 the State of Califomia and her membership in PECG. Then, on February 7, 2011, the Decedent
was hired again as an engineer for the State of Califomia
and she rejoined PECG in February
2011. At the time of her death, the applicable beneficiary designation submitted on May 19,
24 2014 identified David Tefera as the sole primary beneficiary of the Decedent's group term life
25 insurance benefits and Accidental Death & Dismemberment (“AD&D”) benefits (“death
26 benefits”). There were no contingent beneficiary(ies) listed. A true and correct copy of the May
27 19, 2014 Enrollment Form isattached hereto as “Exhibit 1.”
-2
FIRST AMENDED COMPLAINT IN INTERPLEADER
6. Decedent died on January 19, 2018. The cause of death was homicide
by manual
strangulation. Through PECG a claim was submitted to Standard on March 19, 2018. As part of
the claim submission, Standard was informed that the Roseville Police Department
had arrested
David Tefera, the husband
of the decedent, for the murder
of his wife Tsegereda Tefera.
7, Under the terms of the Policy at the time of Decedent's death, the group
term life
insurance benefits totaled $526,000. This amount was comprised of $5,000 in basic life
insurance and $521,000 in supplemental life insurance benefits. In addition, the Policy included
AD&D benefits totaling $522,500. This amount was comprised of $1,500 in basic AD&D,
$26,000 in supplemental AD&D, and $495,000 in supplemental plus AD&D. The total amount
10 of death benefits payable at the time of the Decedent's death was $1,048,500.
11 8. The Policy provides for the right of a member to name his or her beneficiary
to
ak 12 receive the death benefits of the Policy if the member dies. The Policy provides payment of
a 13 death benefits will be to the surviving beneficiary(ies) in the highest class starting
with primary
14 beneficiary(ies) followed by first contingent beneficiary(ies) and second contingent
15 beneficiary(ies). Further, the Policy provides that if there is no surviving beneficiary, or if the
16 member did not name a beneficiary, “all death benefits will be paid in equal shares
to the first
17 surviving class of the following classes: a. Y our spouse. b. Y our children. c. Y our parents. If
18 none of them survives
you, the benefits will be paid to your estate.” A copy of the relevant
19 pages of the Policy are attached hereto as Exhibit “2.” Mr. Tefera was the named primary
20 beneficiary on the Policy. There were no contingent beneficiaries named. Mr. Tefera was named
21 as the defendant to a sole count of murder, violation of Penal Code section 187(a) in a complaint
filed with the Placer County Superior Court on February 26, 2018 in Case No. 62-158175.
Attached
hereto as Exhibit “3” is a true and correct
copy of the criminal complaint against Mr.
24 Tefera.
25 9, On Apnil 26, 2018, Standard sent out a letter
to David Tefera advising him that
26 the claim investigation for the Decedent's death benefits
were on hold until the court
has heard
27 the criminal case against him. On May 4, 2018, Standard was provided
with a General Durable
Power of Attomey identifying Michael Hailu as the attomey-in-fact for David Tefera. On May
3
FIRST AMENDED COMPLAINT IN INTERPLEADER
15, 2018, Standard
sent a letter to Mr. Hailu which explained
that Standard
could not proceed.
with releasing any death benefits to Mr. Tefera due his having been arrested and charged with
the murder
of the Decedent. Standard specifically advised Mr. Hailu of the Califomia statute,
which prevents a person convicted of murdering an insured from collecting life insurance
proceeds. Standard advised that it would have to wait until the completion of the criminal tial or
that Mr. Tefera
had the option to disclaim his interest in the death benefits if he so chooses. By
disclaiming
his interest in the proceeds, it would
be as if Mr. Tefera did not exist as a beneficiary
and the death benefits would be paid to the next surviving beneficiary(ies) which
in this case
would be the surviving children of the Decedent. Thereafter
on May 24, 2018, Standard sent
10 another letter direct to Mr. Tefera in which it reiterated to Mr. Tefera the same information it
11 previously advised Mr. Hailu.
ak 12 10. On August 7, 2018, Standard received a letter from Mr. Tefera which enclosed a
a 13 notarized Revocation
of Power
of Attomey. In that letter, Mr. Tefera asked how he could set up
14 atrust for his children with the proceeds of the life insurance. On August 10, 2018, Standard sent
15 Mr. Tefera another letter providing an update on the claim investigation and notifying Mr. Tefera
16 that he could disclaim the death benefits using the Disclaimer and Release forms provided and.
17 then Standard would contact the guardian for the children to arrange payment options. Despite
18 monthly letters sent to Mr. Tefera advising him of the status of the claim investigation and his
19 option to disclaim the death benefits, Mr. Tefera maintains his position as the policy beneficiary
20 and he has made no indication that he intends to disclaim the death benefits.
21 11. On or about April 16, 2019, Standard received a letter from attomey Barbara
Bender, counsel for Janet Welbom, the court appointed administrator of the Estate of Tsegereda
Tefera, Placer County Superior Court, Case No. S-PR-0009137. In the letter, Standard was
24 advised
that the Estate of Tsegereda
Tefera was making a claim to the policy proceeds.
25 Thereafter, on or about June 14, 2019, the Court
in the Matter of the Estate of Tsegereda Tefera,
26 Placer County Superior Court, Case No. S-PR-0009137 issued an Order based on a Stipulation
27 that Standard was not a party thereto that Standard distribute
to Janet Welbom, Administrator
of
the Estate of Tsegereda
Tefera, for deposit in an interest bearing account the life insurance
-4-
FIRST AMENDED COMPLAINT IN INTERPLEADER
proceeds pending the outcome of the Mr. Tefera’s criminal trial in Placer County Case No. 62-
158175. Standard
has advised counsel for Ms. Welbom that it must interplead
the funds and
seek an Order
from this Court to deposit the death benefits
and to dismiss Standard from this
action. Ms. Welbom has been appointed as the guardian ad litem for both minor defendants,
Amanuel Tefera and Hermela Tefera.
12. As of the date of filing this action, Standard has not received any information,
which leads it to believe
that Mr. Tefera will disclaim any right as the beneficiary to the death
benefits of the Policy. Inasmuch as cases against Mr. Tefera for the homicide death of the
Decedent remains open, Standard cannot determine whether a court would find that Mr. Tefera is
10 and/or may be disqualified from receiving the death benefits based on Califomia Probate Code
11 section
252 et seq. as state
law prohibits an individual from receiving funds if that person is
ak 12 convicted in the death of the Deceased.
a 13 Ti. INTERPLEADER
14 (Pursuant to Code of Civil Procedure 386(b))
15 13. Based on the foregoing facts set forth in paragraphs 1-12, which are incorporated.
16 herein by reference, Standard cannot determine the proper beneficiary or beneficiaries of the
17 death benefits at issue without risking exposure of itself and the Policy to double liability.
18 14. If Mr Teferais not convicted and if a court were to detemmine that Mr. Teferais
19 not disqualified from receiving the death benefits, then the Policy benefits would be payable to
20 Mr. Tefera based on the May 19, 2014 beneficiary designation.
21 15. Tf acourt were to determine that Mr. Tefera is disqualified
either due to his
conviction for the death of the Decedent and/or by application of Califomia Probate Code section
254, Mr. Tefera would be precluded from receiving the death benefits as it would
be as if he
24 predeceased
the Decedent. Therefore, pursuant to the terms of the Policy, the death benefits
25 would be payable to the surviving children of the Decedent, Amanuel Tefera
and Hermela Tefera
26 in equal shares.
27 16. In order
to resolve
the uncertainty of the situation
and to satisfy
its final
obligations in relation to the Policy, Standard filed this Complaint in Interpleader, seeking
3
FIRST AMENDED COMPLAINT IN INTERPLEADER
pemnission
to deposit the proceeds of the Policy with the Clerk of the Court. By Order
of this
Court dated June 8, 2020, Standard deposited with the Clerk of the Court the Policy proceeds of
$1,048,500 plus applicable interest totaling $62,490.01, fora total deposit of $1,110,990.01
made on July 8, 2020.
17. Standard
has no claim to or beneficial interest in the Policy proceeds at issue.
Standard
claims no beneficial interest in the proceeds and wishes to distribute them to the person
or persons legally entitled thereto, but cannot do so under the circumstances, consistent
with the
terms of the Policy. Standard is uncertain who the proper recipient of the proceeds of the Policy
is at this time.
10 18. Since Standard may be exposed to double or multiple liability based on
11 conflicting claims it hereby seeks the protection provided by Califomia Code of Civil Procedure
ak 12 386(b). Accordingly, Standard requests that (1) Defendants
be required to answer herein and
a 13 bring their competing claims to the proceeds of the Policy before this Court; and (2) that
14 Standard
be discharged from all liability upon payment of the account proceeds to the Clerk of
15 the Court, or upon payment of the account proceeds to the appropriate party as determined by
16 this Court.
17 19. Standard also seeks to recover its attomeys’ fees and costs since it is an innocent
18 stakeholder
in this instance, and that recovery of such fees and costs be out of the proceeds of the
19 Policy.
20 WHEREFORE, Standard prays forjudgment as follows:
21 1 That the entirety of the proceeds of the Policy be ordered deposited with the Cle
of the Court to be held in an interest-bearing account for future disbursement according
to a
judgment entered by this Court;
24 2. That Defendants
be required to appear and interplead their conflicting rights and
25 claims as beneficiaries to the Policy in this action;
26 3, That payment
be made to Standard out of the funds deposited with the Clerk of
27 the Court in the amount of attomeys’ fees and costs incurred herein;
-6-
FIRST AMENDED COMPLAINT IN INTERPLEADER
1 4. That Standard be discharged
from all further liability
as to the Policy, and be
2 || dismissed from this action with prejudice following deposit of the proceeds to the Clerk of the
3 || Court; and
4 5, For such other relief
as the Court deems
just and proper.
5
6 || Dated: September
18, 2020 GORDON REES SCULLY MANSUKHANI, LLP
By: MN A R——
Jordan S-Altura
10 Attomeys for Plaintiff,
STANDARD INSURANCE COMPANY
11
ak 12
a 13
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1n91634/475ee21v.1
-7
FIRST AMENDED COMPLAINT IN INTERPLEADER
EXHIBIT “1”
Taze 2 of 3s
F.
Trenease inG ENROLLMENT FORM AND
Standard Insuran Compény MEDICAL HISTORY: STATEMENT: Medical.
fine ee ard OR &
SRE OH as
ip ah ae A
ft 5
ant es aa8
HERTS Egeb
AME
GE GROUP), GROUP NUNBER TYEE OF APPLICATION. DATE OF osESPLOYEENT
WITH THE OF. ATE OF MEMBERSHIP RECS.
(een 2006
EMBERS MAME: | WG SAR (On a ay
ala Fras BE MeMEt OU: Ochi
NAMIE PEiLSpATT
He SZATT AP
‘HOME. Prone oe
BE CIM, ‘BABE MONTH Se FROM THE
44
BIRTADAT | BIRT GOCLAL SECU
Ayal 17: er Adal AD: STATE OF CALIOANM SLA 30>
Pigase check option dhsired:
1. Suppiementy
Flan (Magner On) $26,600 °~
‘Madical History. Statements 90 days.
Piaage complete the: ‘ignaiion pelow’ ie Page bu.
R2 Basic Dependants. 0}
He mda ants Lite wi days of ‘yoursppfaval tot Suselonion r-Sopendents
will nead t6:cemptete the: SIONS) ig¢ twa. Your Dene: lecome | gured for. Basi
Depandants Li only-it yo ide/athe. plementel plant ‘option ea) esate each: pendent
compl paratei icat history ‘statement, ifapplicabt
Bs Suy lus (Membar Cnty) Muliple
at $15,000 upto 498.000. (E:9..$15,000, $30,000, $45,000, E000 atc)
Amount/Paquestad
The Met isto’ t always
De completed. A physicale! jedi ‘reais vB quired
for: er mal Plus. pie fad undertt Supplemental
{| above! the Benefict Designation deiow and ica}: questions on page
Bs Sutiplamanial Flus Bapondanis Lite.(Soovsa, Oniyhany Mulliple-of $18,00,.up sesso
to $715,000, $30,000, $45,000,
SED.500, Sic.)
Amount Requaved $
Amount requester’ (Oa
ect goed 50%. Mefhber's total Lite: tance Amount The Madica} History Statement must
always be-compisted.. amination
‘Ba requ uation.
and/or medic pepouse may
become-insured for.sSubpismen 0 inde: Mal -Pius.Pian
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(opilox:
kit: Be RECEIVED,
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EMIDENCE
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may be.cequire: for-evalual
You must
be inayc Ibe Supplemental tempntat io
“Basic Depandenis. p op late be pligible for
the "Supplementat Plu: ite lan’ (opt
FORTHOSE TRANSFERRING FHUMG.S EA? you: rangiaing Iie insurance: from GSEA. you do ndbnesdito’ ompleie, the
Medical Questions on pe me jollowi \era.a mamber¢ SE)
Yes.Lam iba, aaa
3 copy Of th ors payel
which dotorpanies your Salary Ws
BENEFICIARY DESIGNATION:
ican devignation and Life/ADAD coverages above, Designalidns. veilt inless signed, dated, and delivered
othe Enclover. ‘fleuimne.. ones rae fear interna gan.
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on page below for an; 2 Baparaty
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In the sax. Je.Yone Nea yo ar oats unl nal. weight 3S.01°10 pounds
plage ih ‘sweats, preunra. tesions;" No:
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Bo yeu paar sont ow oa Salter anes ohana
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Are you-now regi ent
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FADLITERIM ARPLICARTS POMPLET pant RECORDS:
FAL UtARNS ALORS
Desccba Belo ‘any?ay ee bows which wereaber dor qurestiong above: (Pines provide. te. entre
Quasich «| Daserpin cf juries Qpenitons| ‘nrantvraar
| Guration Flat Frost PRUSABRS, Consulted City& Sets |
Acknowledatrent andA. n for. Reel lion. (Please.read carehully,
| ropresant
that the stalemens ¢ Stein hbeateie cs pages mad aes oer a ‘and correla, ‘the basi.ol
my
knowdedge
and heist, anc | undersiand
that thay.tornithe basis of any coverage
undsr the.Group Policy; underptand
that eny missiatemants or
{dlure to report information which is matarial te the lesuane Ol.coverage tay ba used as 2 basis for rescission, Seiad oe
Of a claire | agree to nofily Standard Insurance Comeany of.any change in. my madial condition
it my sppieetion Is agprowst- by Standard, Sn fein of coverage be ar I ear
including ary applicable
Atve Work req Ig. pany premihum
whieh may have bean paid,
lacknowerge that! have.rad: Noticg
(on, page 3} and: have keata cagy: fisiory Statement.
bay Reali cane: provider: ipSUEanieg Cr. mangumance company, the Medical Iniarmation Bursa, he, (MIB), ‘acy. emgicyer: |
authorize you 00 release to! tandard oy os teinsisere dl mecca! intonation you have aboud me inctuding medical history MOgNOSS End Yeatinant
‘mentel.of @ noone! condition, | understand that Seanad wil use the information cotanad by tris to determine Try eiguiliy for
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STND 19-04634-000150
EXHIBIT “2”
rea Erase
STANDARD INSURANCE COMPANY
P,Q, BOX 711
2 PORTLAND, OREGON 97207
GROUP POLICY NUMBER 608009
PROFESSIONAL ENGINEERS
NAME OF POLICYOWNER
IN CALIFORNIA GOVERNMENT
LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT,
TYPE OF COVERAGE and DEPENDENTS LIFE INSURANCE
EFFECTIVE DATE May 1, 1990
INITLAL POLICY TERM One Year
May 1 1990 and the first day of
PREMIUM OUE DATES each calendar month thereafter
POLICY DELIVERED IN California and governed by ‘he laws of that state.
STANDARD INSURANCE COMPANY agrees ‘opay the benefits provided by this GROUP POLICY.
in accordance with the provisions of this GROUP POLICY.
The consideration for this GROUP POLICY is the application of the POLICYOWNER and the
payment by the POLICYOWNER of premiums as provided herein.
The GROUP POLICY is issued for the Initial Policy Term shown above, ending on the first day after
the end of such policy term at 12:01 A.M. Standard Time a: the POLICYOWNER'S address. This
GROUP POLICY may he renewed for sucressive renewal periods by the payment of the premium on
each renewal date, provided the number of persons insured on each renewa) date is neither less than
the Minimum Participation Number nor less than the Minimum Participation Percentage (shown in
the Policy Data). The length of each renewal period will be determined by STANDARD, but will not
be less than 12 months.
All provisions on this and the following pages are a part of this GROUP POLICY. The Certificate of
Insurance issued for ery to each insured MEMBER will include Section One of this CROUP
POLICY. The terms ‘you” and “your” used in Section One refer to the insured MEMBER. The
definitions of terms in *Sretian One spply whenever the terms are used anywhere in this GROUP
POLICY. Defined terms are printed in all capital letters.
STANDARD INSURANCE COMPANY
By
Secretary
Lays7 President
E COPY
ranee Campany
go
Group Insurance Policy
MICROFILMED
GP186-LIFE tandard Insurance
STND 19-04634-000021
~
.
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POLICY DATA
POLICY NUMBER 608009
INITIAL PREMIUM RATE
BASIC LIFE INSURANCE $.32 monthly per MEMBER
BASIC ACCIDENTAL DEATH
AND DISMEMBERMENT INSURANCE %.05 monthly per MEMBER
SUPPLEMENTAL INSURANCE
Monthly rates per MEMBER
Life Accident
“Supplemental” plan: Insurance Insurance
MEMBER’S age as of the
preceding October 1:
Under age 30 $1 85 34 00
Age 30 through 34 oo 00
Age 35 through 39 7s 00
Age 40 through 44
Preview
JORDANS. ALTURA (SBN: 209431) ELECTRONICALLY FILED Superior Court of California KARGARET MI[ DRUGAN (SBN: 175324) County of Placer GORDON REES SCULLY S MANSUKHANT, LLP 09/18/2020 633 West Fifth Street, 52™ floor By: Olivia Lucatuorto, Deputy Clerk Los les, CA 90071 Telephone: (213) 576-5000 Facsimile: (213) 680-4470 Attomeys for Plaintiff STANDARD INSURANCE COMPANY SUPERIOR COURT OF CALIFORNIA. COUNTY OF PLACER 10 11 STANDARD INSURANCE COMPANY, an ) CASE NO. SCV0043710 ak 12 Oregon corporation, FIRST AMENDED COMPLAINT IN a 13 vs. Plaintiff, 14 DAVID TEFERA, an individual; AMANUEL 15 TEFERA, a minor, by his guardian ad litem; HERMELA TEFERA, a minor, her 16 guardian ad litem; and DOES 1 through 10, inclusive. 17 Defendants. 18 19 Plaintiff Standard Insurance Company (“Standard”) hereby files its First Amended 20 Complaint in Interpleader against Defendants David Tefera, Amanuel Tefera, a minor, by his 21 guardian ad litem; and Henmela Tefera, a minor, by her guardian ad litem, and alleges as follows: I PARTIES 1 Standard Insurance Company is an insurance company, domiciled in Oregon, and 24 doing business in the State of Califomia. Standard issued a Group Life Insurance Policy, Policy 25 No. 608009 (the “Policy”) to the policyholder Professional Engineers in Califomia Goverment 26 (“PECG’). This is anon-ERISA group policy. The deceased Tsegereda Tefiera (the “Decedent”) 27 ‘was employed as an engineer for the State of Califomia and a member of a class of insureds covered under the Policy. “1 FIRST AMENDED COMPLAINT IN INTERPLEADER 1 On information and belief, defendant David Tefera is a resident of Oakley, Califomia in Placer County. David Tefera is the husband of the Decedent and was married to her at the time of her death. David Tefera was designated by the Decedent as the beneficiary to receive the proceeds of the Policy upon Decedent's death. 2. On information and belief, defendant Amanuel Tefera, a minor, by his guardian ad litem, is a resident of Roseville, Califomia in Placer County. Amanuel Tefera is the minor son of the Decedent and would be among the class of individuals eligible to receive the proceeds of the Policy upon Decedent's death should the Decedent not be survived by a named beneficiary. 3, On information and belief, defendant Hermela Tefera, a minor, by her guardian ad 10 litem, is a resident of Roseville, Califomia in Placer County. Hermela Tefera is the minor 11 daughter of the Decedent and would be among the class of individuals eligible to receive the ak 12 proceeds of the Policy upon Decedent's death should the Decedent not be survived by a named. a 13 beneficiary. 14 4. The Decedent was a resident of Roseville, Califomia in Placer County at the time 15 of her death. 16 I FACTS 17 5, At the time of her death, the Decedent was employed as an engineer for the State 18 of Califomia and was a member of a class of employees that was eligible for term life insurance 19 coverage under the Policy issued to PECG by Standard. The Decedent was hired by the State of 20 Califomia in 2006 and joined PECG at that time. At some point, the Decedent left her job with 21 the State of Califomia and her membership in PECG. Then, on February 7, 2011, the Decedent was hired again as an engineer for the State of Califomia and she rejoined PECG in February 2011. At the time of her death, the applicable beneficiary designation submitted on May 19, 24 2014 identified David Tefera as the sole primary beneficiary of the Decedent's group term life 25 insurance benefits and Accidental Death & Dismemberment (“AD&D”) benefits (“death 26 benefits”). There were no contingent beneficiary(ies) listed. A true and correct copy of the May 27 19, 2014 Enrollment Form isattached hereto as “Exhibit 1.” -2 FIRST AMENDED COMPLAINT IN INTERPLEADER 6. Decedent died on January 19, 2018. The cause of death was homicide by manual strangulation. Through PECG a claim was submitted to Standard on March 19, 2018. As part of the claim submission, Standard was informed that the Roseville Police Department had arrested David Tefera, the husband of the decedent, for the murder of his wife Tsegereda Tefera. 7, Under the terms of the Policy at the time of Decedent's death, the group term life insurance benefits totaled $526,000. This amount was comprised of $5,000 in basic life insurance and $521,000 in supplemental life insurance benefits. In addition, the Policy included AD&D benefits totaling $522,500. This amount was comprised of $1,500 in basic AD&D, $26,000 in supplemental AD&D, and $495,000 in supplemental plus AD&D. The total amount 10 of death benefits payable at the time of the Decedent's death was $1,048,500. 11 8. The Policy provides for the right of a member to name his or her beneficiary to ak 12 receive the death benefits of the Policy if the member dies. The Policy provides payment of a 13 death benefits will be to the surviving beneficiary(ies) in the highest class starting with primary 14 beneficiary(ies) followed by first contingent beneficiary(ies) and second contingent 15 beneficiary(ies). Further, the Policy provides that if there is no surviving beneficiary, or if the 16 member did not name a beneficiary, “all death benefits will be paid in equal shares to the first 17 surviving class of the following classes: a. Y our spouse. b. Y our children. c. Y our parents. If 18 none of them survives you, the benefits will be paid to your estate.” A copy of the relevant 19 pages of the Policy are attached hereto as Exhibit “2.” Mr. Tefera was the named primary 20 beneficiary on the Policy. There were no contingent beneficiaries named. Mr. Tefera was named 21 as the defendant to a sole count of murder, violation of Penal Code section 187(a) in a complaint filed with the Placer County Superior Court on February 26, 2018 in Case No. 62-158175. Attached hereto as Exhibit “3” is a true and correct copy of the criminal complaint against Mr. 24 Tefera. 25 9, On Apnil 26, 2018, Standard sent out a letter to David Tefera advising him that 26 the claim investigation for the Decedent's death benefits were on hold until the court has heard 27 the criminal case against him. On May 4, 2018, Standard was provided with a General Durable Power of Attomey identifying Michael Hailu as the attomey-in-fact for David Tefera. On May 3 FIRST AMENDED COMPLAINT IN INTERPLEADER 15, 2018, Standard sent a letter to Mr. Hailu which explained that Standard could not proceed. with releasing any death benefits to Mr. Tefera due his having been arrested and charged with the murder of the Decedent. Standard specifically advised Mr. Hailu of the Califomia statute, which prevents a person convicted of murdering an insured from collecting life insurance proceeds. Standard advised that it would have to wait until the completion of the criminal tial or that Mr. Tefera had the option to disclaim his interest in the death benefits if he so chooses. By disclaiming his interest in the proceeds, it would be as if Mr. Tefera did not exist as a beneficiary and the death benefits would be paid to the next surviving beneficiary(ies) which in this case would be the surviving children of the Decedent. Thereafter on May 24, 2018, Standard sent 10 another letter direct to Mr. Tefera in which it reiterated to Mr. Tefera the same information it 11 previously advised Mr. Hailu. ak 12 10. On August 7, 2018, Standard received a letter from Mr. Tefera which enclosed a a 13 notarized Revocation of Power of Attomey. In that letter, Mr. Tefera asked how he could set up 14 atrust for his children with the proceeds of the life insurance. On August 10, 2018, Standard sent 15 Mr. Tefera another letter providing an update on the claim investigation and notifying Mr. Tefera 16 that he could disclaim the death benefits using the Disclaimer and Release forms provided and. 17 then Standard would contact the guardian for the children to arrange payment options. Despite 18 monthly letters sent to Mr. Tefera advising him of the status of the claim investigation and his 19 option to disclaim the death benefits, Mr. Tefera maintains his position as the policy beneficiary 20 and he has made no indication that he intends to disclaim the death benefits. 21 11. On or about April 16, 2019, Standard received a letter from attomey Barbara Bender, counsel for Janet Welbom, the court appointed administrator of the Estate of Tsegereda Tefera, Placer County Superior Court, Case No. S-PR-0009137. In the letter, Standard was 24 advised that the Estate of Tsegereda Tefera was making a claim to the policy proceeds. 25 Thereafter, on or about June 14, 2019, the Court in the Matter of the Estate of Tsegereda Tefera, 26 Placer County Superior Court, Case No. S-PR-0009137 issued an Order based on a Stipulation 27 that Standard was not a party thereto that Standard distribute to Janet Welbom, Administrator of the Estate of Tsegereda Tefera, for deposit in an interest bearing account the life insurance -4- FIRST AMENDED COMPLAINT IN INTERPLEADER proceeds pending the outcome of the Mr. Tefera’s criminal trial in Placer County Case No. 62- 158175. Standard has advised counsel for Ms. Welbom that it must interplead the funds and seek an Order from this Court to deposit the death benefits and to dismiss Standard from this action. Ms. Welbom has been appointed as the guardian ad litem for both minor defendants, Amanuel Tefera and Hermela Tefera. 12. As of the date of filing this action, Standard has not received any information, which leads it to believe that Mr. Tefera will disclaim any right as the beneficiary to the death benefits of the Policy. Inasmuch as cases against Mr. Tefera for the homicide death of the Decedent remains open, Standard cannot determine whether a court would find that Mr. Tefera is 10 and/or may be disqualified from receiving the death benefits based on Califomia Probate Code 11 section 252 et seq. as state law prohibits an individual from receiving funds if that person is ak 12 convicted in the death of the Deceased. a 13 Ti. INTERPLEADER 14 (Pursuant to Code of Civil Procedure 386(b)) 15 13. Based on the foregoing facts set forth in paragraphs 1-12, which are incorporated. 16 herein by reference, Standard cannot determine the proper beneficiary or beneficiaries of the 17 death benefits at issue without risking exposure of itself and the Policy to double liability. 18 14. If Mr Teferais not convicted and if a court were to detemmine that Mr. Teferais 19 not disqualified from receiving the death benefits, then the Policy benefits would be payable to 20 Mr. Tefera based on the May 19, 2014 beneficiary designation. 21 15. Tf acourt were to determine that Mr. Tefera is disqualified either due to his conviction for the death of the Decedent and/or by application of Califomia Probate Code section 254, Mr. Tefera would be precluded from receiving the death benefits as it would be as if he 24 predeceased the Decedent. Therefore, pursuant to the terms of the Policy, the death benefits 25 would be payable to the surviving children of the Decedent, Amanuel Tefera and Hermela Tefera 26 in equal shares. 27 16. In order to resolve the uncertainty of the situation and to satisfy its final obligations in relation to the Policy, Standard filed this Complaint in Interpleader, seeking 3 FIRST AMENDED COMPLAINT IN INTERPLEADER pemnission to deposit the proceeds of the Policy with the Clerk of the Court. By Order of this Court dated June 8, 2020, Standard deposited with the Clerk of the Court the Policy proceeds of $1,048,500 plus applicable interest totaling $62,490.01, fora total deposit of $1,110,990.01 made on July 8, 2020. 17. Standard has no claim to or beneficial interest in the Policy proceeds at issue. Standard claims no beneficial interest in the proceeds and wishes to distribute them to the person or persons legally entitled thereto, but cannot do so under the circumstances, consistent with the terms of the Policy. Standard is uncertain who the proper recipient of the proceeds of the Policy is at this time. 10 18. Since Standard may be exposed to double or multiple liability based on 11 conflicting claims it hereby seeks the protection provided by Califomia Code of Civil Procedure ak 12 386(b). Accordingly, Standard requests that (1) Defendants be required to answer herein and a 13 bring their competing claims to the proceeds of the Policy before this Court; and (2) that 14 Standard be discharged from all liability upon payment of the account proceeds to the Clerk of 15 the Court, or upon payment of the account proceeds to the appropriate party as determined by 16 this Court. 17 19. Standard also seeks to recover its attomeys’ fees and costs since it is an innocent 18 stakeholder in this instance, and that recovery of such fees and costs be out of the proceeds of the 19 Policy. 20 WHEREFORE, Standard prays forjudgment as follows: 21 1 That the entirety of the proceeds of the Policy be ordered deposited with the Cle of the Court to be held in an interest-bearing account for future disbursement according to a judgment entered by this Court; 24 2. That Defendants be required to appear and interplead their conflicting rights and 25 claims as beneficiaries to the Policy in this action; 26 3, That payment be made to Standard out of the funds deposited with the Clerk of 27 the Court in the amount of attomeys’ fees and costs incurred herein; -6- FIRST AMENDED COMPLAINT IN INTERPLEADER 1 4. That Standard be discharged from all further liability as to the Policy, and be 2 || dismissed from this action with prejudice following deposit of the proceeds to the Clerk of the 3 || Court; and 4 5, For such other relief as the Court deems just and proper. 5 6 || Dated: September 18, 2020 GORDON REES SCULLY MANSUKHANI, LLP By: MN A R—— Jordan S-Altura 10 Attomeys for Plaintiff, STANDARD INSURANCE COMPANY 11 ak 12 a 13 14 15 16 17 18 19 20 21 24 25 26 27 1n91634/475ee21v.1 -7 FIRST AMENDED COMPLAINT IN INTERPLEADER EXHIBIT “1” Taze 2 of 3s F. Trenease inG ENROLLMENT FORM AND Standard Insuran Compény MEDICAL HISTORY: STATEMENT: Medical. fine ee ard OR & SRE OH as ip ah ae A ft 5 ant es aa8 HERTS Egeb AME GE GROUP), GROUP NUNBER TYEE OF APPLICATION. DATE OF osESPLOYEENT WITH THE OF. ATE OF MEMBERSHIP RECS. (een 2006 EMBERS MAME: | WG SAR (On a ay ala Fras BE MeMEt OU: Ochi NAMIE PEiLSpATT He SZATT AP ‘HOME. Prone oe BE CIM, ‘BABE MONTH Se FROM THE 44 BIRTADAT | BIRT GOCLAL SECU Ayal 17: er Adal AD: STATE OF CALIOANM SLA 30> Pigase check option dhsired: 1. Suppiementy Flan (Magner On) $26,600 °~ ‘Madical History. Statements 90 days. Piaage complete the: ‘ignaiion pelow’ ie Page bu. R2 Basic Dependants. 0} He mda ants Lite wi days of ‘yoursppfaval tot Suselonion r-Sopendents will nead t6:cemptete the: SIONS) ig¢ twa. Your Dene: lecome | gured for. Basi Depandants Li only-it yo ide/athe. plementel plant ‘option ea) esate each: pendent compl paratei icat history ‘statement, ifapplicabt Bs Suy lus (Membar Cnty) Muliple at $15,000 upto 498.000. (E:9..$15,000, $30,000, $45,000, E000 atc) Amount/Paquestad The Met isto’ t always De completed. A physicale! jedi ‘reais vB quired for: er mal Plus. pie fad undertt Supplemental {| above! the Benefict Designation deiow and ica}: questions on page Bs Sutiplamanial Flus Bapondanis Lite.(Soovsa, Oniyhany Mulliple-of $18,00,.up sesso to $715,000, $30,000, $45,000, SED.500, Sic.) Amount Requaved $ Amount requester’ (Oa ect goed 50%. Mefhber's total Lite: tance Amount The Madica} History Statement must always be-compisted.. amination ‘Ba requ uation. and/or medic pepouse may become-insured for.sSubpismen 0 inde: Mal -Pius.Pian os (opilox: kit: Be RECEIVED, at ChB ya ieant a jedi tan os Long-Term Disabil Oso FArasdqays MAY.1 9 2014 Promium rates are hased “on a9 Sin fot you wee tedacce. Check'oneof tie tol vio EMIDENCE Cy fuse tatiance CT" rag net.us The Medical qunstiots on-pag be. campletad: A phi may be.cequire: for-evalual You must be inayc Ibe Supplemental tempntat io “Basic Depandenis. p op late be pligible for the "Supplementat Plu: ite lan’ (opt FORTHOSE TRANSFERRING FHUMG.S EA? you: rangiaing Iie insurance: from GSEA. you do ndbnesdito’ ompleie, the Medical Questions on pe me jollowi \era.a mamber¢ SE) Yes.Lam iba, aaa 3 copy Of th ors payel which dotorpanies your Salary Ws BENEFICIARY DESIGNATION: ican devignation and Life/ADAD coverages above, Designalidns. veilt inless signed, dated, and delivered othe Enclover. ‘fleuimne.. ones rae fear interna gan. han. ‘See, B20. No. Fool Bs Dowid (elena eas. wighull Sail Jasrar: Sau ian} cont = Ful Narne “Tess ~ ‘Soc. Sec. No- Aststonstip soot Benefit Ta ce ‘SSGMATURE AP APPLICANT. lis] pee ‘Siagrasenenan-eauoes 1ok3 gos) Sol 301440 x3034 69bp-Eld-3T6 e:tt PIOZ/5T/o8 zo 30d STND 19-04634-000149 ge 3 of£ 2 For-apptoved.spplicanis, pr i be paw aaccomdance-wiir the provisi Of the:Grot sc 4 édinatoes: ‘do not ailectether Guat ccverages already into ‘Company: Coverage . we AUD cys) anid state lird ino for each af thase questions, aru give datalla‘as shawn. on page below for an; 2 Baparaty shoot € nacessary self Sr sona| pond iy, SRN, Eurgery.iq the page5' Yes Bi.No Havas) sansulbid oc Practitioner: Cause 'Pie-a6st 5. © Yes & No Ave you now inatia! so wort ‘Dhysical: manta: or, inyury of sickness’ {3- Yes &,No fife pea sad fagnosad.you as havi acribed yeui'or. jar. terlosciarosis;: or Yes No’ epressi agilapsy, of fervous system disorder? Yes. No naphiiis? Yes.2 No ‘Arthritis, sttainadiot DiS Pee Se rNe SeCe a5" BB-NO Long, Knox stomach. genital, urinary, ‘or intostinal allies 6.25" No. Binsnéss or Yes 2 No Acquifed'imiiuna Detldtiency Syacrome (AIDS), an immame sysiom.disordes ‘3No Haye you spught'cr received auview ocreatment for tne use of alcolicl or drugsin the past:t0 years? In the sax. Je.Yone Nea yo ar oats unl nal. weight 3S.01°10 pounds plage ih ‘sweats, preunra. tesions;" No: (Do you fake mec ieieal, I CF SICKNESS? BN Bo yeu paar sont ow oa Salter anes ohana Injury,.or sickness’. EN Are you-now regi ent ee FADLITERIM ARPLICARTS POMPLET pant RECORDS: FAL UtARNS ALORS Desccba Belo ‘any?ay ee bows which wereaber dor qurestiong above: (Pines provide. te. entre Quasich «| Daserpin cf juries Qpenitons| ‘nrantvraar | Guration Flat Frost PRUSABRS, Consulted City& Sets | Acknowledatrent andA. n for. Reel lion. (Please.read carehully, | ropresant that the stalemens ¢ Stein hbeateie cs pages mad aes oer a ‘and correla, ‘the basi.ol my knowdedge and heist, anc | undersiand that thay.tornithe basis of any coverage undsr the.Group Policy; underptand that eny missiatemants or {dlure to report information which is matarial te the lesuane Ol.coverage tay ba used as 2 basis for rescission, Seiad oe Of a claire | agree to nofily Standard Insurance Comeany of.any change in. my madial condition it my sppieetion Is agprowst- by Standard, Sn fein of coverage be ar I ear including ary applicable Atve Work req Ig. pany premihum whieh may have bean paid, lacknowerge that! have.rad: Noticg (on, page 3} and: have keata cagy: fisiory Statement. bay Reali cane: provider: ipSUEanieg Cr. mangumance company, the Medical Iniarmation Bursa, he, (MIB), ‘acy. emgicyer: | authorize you 00 release to! tandard oy os teinsisere dl mecca! intonation you have aboud me inctuding medical history MOgNOSS End Yeatinant ‘mentel.of @ noone! condition, | understand that Seanad wil use the information cotanad by tris to determine Try eiguiliy for aemTange coverage. |further auth Seandard to reiease ths rnatin to its renawers, MiB, to Ot rane: Ap neucance. age.o¢ baneis. aunorauint eequest: Tris autharizatior wil romaln vill er yaar imi data of this elithorzaton shi wal§3 nd stat I hava: Tevore, this Sialemant to Standand, t uiderstand Me:tibite 1¢ eign ‘May Mpau. Slandants abuty to ovaluate Or process my: agaiigaton end may be a bass. fos cenyity iy application for Insurange coverage: rer ¥ em ipigitda) ia repens ~ SE OSTP cneve _ PLBASE IETUN.A COPY.FCR YOUR RECORDS, Shipwe-soenNBgA 08 2013 = oud) 9pp-EL2-ST6 ZElTT PieZ/et/se €@ 39vd isp aO1440 x3d34 STND 19-04634-000150 EXHIBIT “2” rea Erase STANDARD INSURANCE COMPANY P,Q, BOX 711 2 PORTLAND, OREGON 97207 GROUP POLICY NUMBER 608009 PROFESSIONAL ENGINEERS NAME OF POLICYOWNER IN CALIFORNIA GOVERNMENT LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT, TYPE OF COVERAGE and DEPENDENTS LIFE INSURANCE EFFECTIVE DATE May 1, 1990 INITLAL POLICY TERM One Year May 1 1990 and the first day of PREMIUM OUE DATES each calendar month thereafter POLICY DELIVERED IN California and governed by ‘he laws of that state. STANDARD INSURANCE COMPANY agrees ‘opay the benefits provided by this GROUP POLICY. in accordance with the provisions of this GROUP POLICY. The consideration for this GROUP POLICY is the application of the POLICYOWNER and the payment by the POLICYOWNER of premiums as provided herein. The GROUP POLICY is issued for the Initial Policy Term shown above, ending on the first day after the end of such policy term at 12:01 A.M. Standard Time a: the POLICYOWNER'S address. This GROUP POLICY may he renewed for sucressive renewal periods by the payment of the premium on each renewal date, provided the number of persons insured on each renewa) date is neither less than the Minimum Participation Number nor less than the Minimum Participation Percentage (shown in the Policy Data). The length of each renewal period will be determined by STANDARD, but will not be less than 12 months. All provisions on this and the following pages are a part of this GROUP POLICY. The Certificate of Insurance issued for ery to each insured MEMBER will include Section One of this CROUP POLICY. The terms ‘you” and “your” used in Section One refer to the insured MEMBER. The definitions of terms in *Sretian One spply whenever the terms are used anywhere in this GROUP POLICY. Defined terms are printed in all capital letters. STANDARD INSURANCE COMPANY By Secretary Lays7 President E COPY ranee Campany go Group Insurance Policy MICROFILMED GP186-LIFE tandard Insurance STND 19-04634-000021 ~ . x POLICY DATA POLICY NUMBER 608009 INITIAL PREMIUM RATE BASIC LIFE INSURANCE $.32 monthly per MEMBER BASIC ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE %.05 monthly per MEMBER SUPPLEMENTAL INSURANCE Monthly rates per MEMBER Life Accident “Supplemental” plan: Insurance Insurance MEMBER’S age as of the preceding October 1: Under age 30 $1 85 34 00 Age 30 through 34 oo 00 Age 35 through 39 7s 00 Age 40 through 44