STATE OF CALIFORNIA Ricardo Lara, Insurance Commissioner

DEPARTMENT OF INSURANCE
CONSUMER SERVICES AND MARKET CONDUCT BRANCH
HEALTH CLAIMS BUREAU
300 SOUTH SPRING STREET
LOS ANGELES, CA 90013
www.insurance.ca.gov

January 24, 2023

Jaroslaw Waszczuk
2216 Katzakian Way
Lodi, CA 95242

Our File Number: HCB - 8376574

Regarding: The Lincoln National Life Insurance Company

Dear Mr. Waszczuk:

The California Department of Insurance has completed its review into your recent Request for
Assistance that involved The Lincoln National Life Insurance Company’s handling of your disability claim.
We thank you for your patience while we completed our review.

While we have attempted to mediate this claim dispute and have thoroughly reviewed the insurance
company's claims process, we regret that we are unable to resolve this particular dispute. State law, as
outlined in the California Insurance Code and Fair Claims Settlement Practice Regulations, does not
provide the Department with the authority to determine disability status or decide how much should be
paid on a claim. When two parties disagree on the facts or the appropriate amount of benefits to be paid,
the ultimate decision is left to a court of law. Only a court of law has the authority to weigh the evidence
and the merits of each party's position and arrive at a formal binding decision.

Although the Department was unable to assist in resolving your insurance dispute, each case we receive
is reviewed to monitor compliance with the Insurance Code and the Fair Claims Settlement Practices
Regulations and ascertain any patterns of noncompliance. While the Department cannot share the
findings on individual cases, as that would jeopardize any present or future action that may be taken
against this company, the cumulative results of the regulatory findings are published annually in the
Consumer Complaint Study, which is available for your review on the Department's public web site.

We appreciate your contacting us with your concerns. If you have any further questions on your case,
please contact the undersigned. If you have questions on other insurance-related matters, a good
source of information can be found on our internet website at www.insurance.ca.gov or you can call our
toll-free Consumer Hotline at 1-800-927-HELP (4357).

Sincerely,

Insurance Protection for All Californians

Consumer Hotline (800) 927-4357 (HELP) * Licensing Hotline (800) 967-9331
HCB – 8376574
Page 2 of 2

Eva Terrio
Associate Insurance Compliance Officer
Phone: 213-346-6053
Email: Eva.Terrio@insurance.ca.gov

Please refer to our file number when responding.

Insurance Protection for All Californians

Consumer Hotline (800) 927-4357 (HELP) * Licensing Hotline (800) 967-9331
2216 Katzakian Way
Lodi, CA 95242
Phone: 209-687-1180
Fax: 209-729-5154
E-mail: jjw1980@live.com

December 9, 2022

Eva Terrio
Associate Insurance Compliance Officer
State of California
Department of Insurance
Consumer Services and Market Conduct Branch
Consumer Services Division
300 South Spring Street, South Tower
Los Angeles, CA 90013

LINCOLN NATIONAL LIFE INSURANCE COMPANY-FILE NUMBER:

HCB – 8376574
Re: Response to your letter dated December 7, 2022

Dear Ms. Terrio:

Thank you for your December 7, 2022 response to my November 29, 2022 inquiry with your
office. However, for clarification purposes and to avoid any misunderstanding, my short-term
disability claim #4154074, which was wrongly denied to me in November 2011 by Liberty Life
Assurance Company Of Boston (Liberty), was never the subject of litigation by me against Liberty or
Liberty’s successor, Lincoln National Life Insurance Company (Lincoln). Further, neither Liberty nor
Lincoln was a co-defendant in my wrongful termination lawsuit against the University of California,
and my short-term disability claim was not a cause of action in any of my cases. I clearly marked this
on the Health Request for Assistance (HRFA) form submitted to your office on November 28, 2022.
In addition to my inquiry with the Department of Insurance, on November 28, 2022, I
submitted another follow up inquiry to the State Controller’s Public Record Acts Office, in hopes of
learning when, exactly, Liberty submitted $4,546.08 to the State Controller as compensation for my
-1-
Request to Open Investigation- CLAIM CSB-6707505
2011 short-term disability insurance benefits (Attachment #1).
Yesterday , on December 8, 202,2 I received an emailed response from the State Controller’s
Office, the reply which I should have receive three years ago, in May or June 2019, after my denied
in 2011 short-term disability benefits resurfaced after 11 years, on March 21, 2019 (Attachment #2).
The attachment to the e-mail I received on December 8, 2022 contained the following information or
documents:
1. A memo, signed December 10, 2018, from the State Controller Office (SCO) to Liberty about
receiving a Holder Notice Report on April 27, 2018 in the amount of $310,184.74 (Attachment
#3).
2. A redacted memo dated December 7, 2018 from Lincoln that informed the SCO that, on May 1,
2018, Liberty was acquired by Lincoln (Attachment #4).
3. A redacted copy of a December 11, 2018 Lincoln money transfer to Wells Fargo Bank in the
amount of $272,037.51 (Attachment #5).
Right now, I do not know how the above amount of $272,037.51 is related to my short-term
disability insurance claim; thus, I am asking your office for help in solving this puzzle.
4. A redacted copy of a December 13, 2018 statement to the SCO showing that it, on that date,
received a check from Lincoln in amount of $4546.08 — these are my denied in 2011 short-term
disability insurance benefits) (Attachment #6).
5. Attachment #7 is a seven-page list of individual disability claims paid or unpaid by Liberty in
2014. My disability claim, in the amount of $4546.08, is listed on last page, as No. 415, and
shows a paid date of October 6, 2014. I am not sure whether my name was inserted for item No.
415 in lieu of someone else’s name, because it looks this line item was altered and perhaps
highlighted. I think it is likely that Liberty’s litigation manager, Paula McGee, paid the $4546.08
in October 2014 to my former attorney, Douglas Stein, after Stein cut a deal with her in August
2014. It is also possible that Stein cut a much better deal for himself with McGee, and the
aforementioned $272,037.51 (Attachment #5) has something do to with Stein. In November
2014, just prior Thanksgiving, I offered Stein an additional $20,000 to get help in handling my
wrongful termination suit. He did not want to take it, but a few days later he withdrew all the
money from the Wells Fargo retainer account I helped to open for him in June 2014, which was

-2-
Request to Open Investigation- CLAIM CSB-6707505
 opened with $20,000 of my funds. When Wells Fargo Bank called me on December 14 or 15,
2014 and informed me that the retainer account was empty and had a negative balance, I
questioned Stein about it. He disclosed in a panic that he was expecting a lot of money in January
2015 and would repay all the money to me. He was looking to sell my case to my adversaries for
$300,000. I dismissed Stein on December 16, 2014 for gross misconduct.
Attachment No. 6, shows that, on December 13, 2018, the State Controller received a check
from Lincoln in the amount of $4546.08 and held the check for another four months, until March 6,
2019. It cleared on March 18, 2019 as unclaimed property and was assigned ID No. 998812640.
Three days later, on March 21, 2019, I was surprised to receive a letter-settlement agreement to sign
from Pettinato & Associates, Unclaimed Property Consultants and Investigators, based in
Sacramento, California, a copy of which your office has already received along with my HRFA form
on November 28, 2022. A day after I submitted the HRFA with an addendum explaining why I
needed the Department of Insurance’s help with this claim, I sent a follow-up letter to the secretary to
trial counsel, Michele Kem, in the State of California’s Commission on Judicial Performance
(Attachment #8). In that letter, I briefly explained what happened to me after I sent my September 4,
2018 inquiry to Liberty about my short-term disability insurance benefits.
CONCLUSION
The record clearly shows that, if I had not sent the inquiry to Liberty on September 4,
2018, I would never have seen a penny. I am asking your office to investigate why Liberty did not
send me the money after my former attorney Stein cut a deal with Liberty’s litigation manager Paula
McGee for $4546.08. Liberty and McGee had known my new address since October 21, 2013. On
that day, I sent an inquiry for compensation to Liberty’s headquarters and its CEO, David Long, by
fax and certified mail (Attachment # 9). I never received any response. Also, from June 2 through
December 16, 2014, I was represented by Douglas Stein, who without my consent settled the
disability claim in August 2014 with McGee for little money, which resurfaced on five years later, on
March 21, 2019, as unclaimed property. Stein had to provide my new address to Paula McGee . Even
in September 2018, McGee, by then the assistant vice president and senior counsel for Lincoln, could
easily have sent the check directly to my home after receiving my September 4, 2018 letter.
Based on new information provided, I am asking your office to convince Lincoln to
-3-
Request to Open Investigation- CLAIM CSB-6707505
voluntarily pay all damages caused by the conspiracy among Liberty’s representatives with my
former employer’s attorneys from the University of California Office of the President, including but
not limited to, penalties and interest from at least the amount settled between my former attorney
Stein and McGee in August 2014. Ms. McGee deliberately and with malice withheld the payment of
$4546.08 due to me for five years.
Also , please provide to me your fax number . The e-mail is not always reliable

Sincerely,

____________________________________
Jaroslaw Waszczuk

CC . Michelle Kem -State of California Commission on Judicial Performance

State Bar of California Executives

-4-
Request to Open Investigation- CLAIM CSB-6707505
2216 Katzakian Way
Lodi, CA 95242
Phone: 209-687-1180
Fax: 209-729-5154
Email: jjw1980@live.com

November 29, 2022

Via Fax

Michele Kem
Secretary to Trial Counsel
State of California
Commission on Judicial Performance
455 Golden Gate Avenue, Suite 14400
San Francisco, CA 94102

COPY OF REQUEST TO OPEN THE 2011–2012 STATE OF CALIFORNIA

DEPARTMENT OF INSURANCE INVESTIGATION (CLAIM CSB-6707505) INTO
LIBERTY ASSURANCE COMPANY OF BOSTON, ACQUIRED BY LINCOLN
NATIONAL LIFE INSURANCE COMPANY ON MAY 1, 2018, WHICH WRONGLY
DENIED MY 2011 SHORT-TERM/SUPPLEMENT DISABILITY CLAIM # 4154074
SUBMITTED TO THE STATE OF CALIFORNIA’S DEPARTMENT OF INSURANCE

Re: The Court of Appeal Third Appellate District (3DCA) Case No. C095488 -
Waszczuk v. Regents of the University of California et al.
Appeal from the Judgment After an Order Granting a Summary
Judgment Motion October 28, 2021. Hon. Christopher Krueger,
Sacramento Superior Court Wrongful Termination Case Jaroslaw
Waszczuk v. The Regents of the University of California Case No. 34-2013-
00155479

Dear Ms. Kem:

This letter contains additional information following up on my Request for Intervention and my
Response to the November 1, 2022 Commission on Judicial Performance Secretary to Staff
Counsel Mary Harvey’s letter, submitted to your office on November 10, 2022 and November
18, 2002. For the record, enclosed is a copy of my Request to Open the 2011–2012 State of
California Department of Insurance Investigation (Claim CSB-6707505) into Liberty Assurance

1
Michelle Kem -Commission on Judicial Performance – Follow up Letter
Company of Boston, Acquired by Lincoln National Life Insurance company on May 1, 2018,
which wrongly denied my 2011 short-term/supplement disability claim #4154074, submitted to
the State of California’s Department of Insurance. The full inquiry with attachments is enclosed
on the flash drive (Attachment #1 on flash drive and DVD).

EXPLANATION OF WHY I AM SENDING A COPY OF MY INQUIRY WITH THE

STATE OF CALIFORNIA’S DEPARTMENT OF INSURANCE TO YOUR OFFICE

On July 16, 2018, I submitted a letter to the Sacramento County Court Clerk of Dept. 53,
working under Judge David I. Brown, requesting that the Clerk file UC Regents counsel David
Burkett’s letter dated June 26, 2016 and the PLAINTIFF’S DISAPPROVAL OF THE PROPOSED
ORDER AND JUDGMENT GRANTING LEGAL FEES AND COSTS TO DEFENDANTS IN
ANTI-SLAPP MOTION C.C.P 425.16 (c)— Part of my disapproval of the above proposed order was
about my denied in November 2011 short-term disability insurance benefits, which resurfaced in
March 2019 as unclaimed property in the California Controller’s office and about what was done to
my psychologist, Dr. Franklin O. Bernhoft, and his family in 2011–2012 (pp. 68–86).

Furthermore, I requested that the Clerk of Department 53 inform Judge Brown that my
Motion for Consideration hearing was scheduled for July 19, 2018, and that I would like to schedule
oral arguments, if I was dissatisfied with the tentative court ruling. I was denied a Court hearing with
Judge Brown for my Motion for Reconsideration. This was unprecedented. Judge Brown, regardless
of his rulings in my case, had never denied me a hearing prior this letter, nor after sending the letter
to Clerek , until he left Department 53 in December 2020 and was replaced by Judge Hakim
Mesiwala on January 1, 2021.
Following the letter I filed on July 18, 2018 with the Court Clerk in Dept. 53, on August 3,
2018, in addition to my tax evasion and fraud application for award submitted to the IRS’
Whistleblower Office (see https://www.scribd.com/document/476787351/20180803-UTC-20180803-
IRS-New-Application-for-Award-WBO-Claim-No-2018-012118-full-document), I submitted to
3DCA an appellant request that the court place Case No. C079254, Waszczuk v. California
Unemployment Insurance Appeal Board (CUIAB), on the calendar and schedule the oral argument.
The request was filed on August 6, 2018 and was denied by 3DCA’s rubber stamp justice under the
name of Presiding Justice Vance Raye. Four years later, I am still looking to recover my stolen in
2014 unemployment insurance benefits.

2
Michelle Kem -Commission on Judicial Performance – Follow up Letter
 In addition to the request for oral arguments in 3DCA Case No. C079254, Waszczuk v. Cal.
Unemployment Ins. Appeals Bd., No. C079254 (Cal. Ct. App. Dec. 27, 2018), on August 30, 2018, I
submitted to the State Bar of California an Application for Reimbursement of the retainer stolen by
my former attorney, Douglas Stein, In re Stein, No. S245982 (Cal. Mar. 1, 2018). I was reimbursed in
July 2019.

Four days later, on September 4, 2018, I sent an inquiry to Liberty’s Life Litigation Manager
(Re: Unfinished Business with Liberty Life Assurance Company of Boston, University of California,
Short-Term/Supplemental Disability August 1, 2011 through December 31, 2011, Claim #4154074).
With this inquiry, I wanted to find out what happened to the settlement Liberty offered to my former
attorney, Douglas Stein, in August 2014, regarding its unjust November 2011 denial of my short-term
disability benefits. I also sent a copy of the letter to Lincoln Financial Group, which acquired Liberty
in May 2018.

On September 13, 2018, I received a response from Lincoln Financial Group representative
Paula McGee, the same person who cut a deal in August 2014 with Stein The denied in 2011 short-
term/supplemental disability benefits resurfaced as unclaimed property in the California Controller’s
office in March 2019.

Following my inquires, in an attempt to recover my stolen benefits, the Porter Scott attorneys
representing the UC Regents in the Sacramento Superior Court wrongful termination case Jaroslaw
Waszczuk v. The Regents of the University of California, Case No. 34-2013-00155479, and in Writ of
Mandamus Case No. 34-2013-80001699, Jaroslaw Waszczuk v. California Unemployment Insurance
Appeal Board (CUIAB) and Real Party of Interest (RPii)—The Regents of the University of
California (UC Regents) bypassed Judge Brown, who had president over my wrongful termination
case since September 2014 and engaged simultaneously in October 2018 two Sacramento County
judges, Christopher E. Krueger and Jennifer K. Rockwell, to end my litigation by termination
sanctions and attempt to frame me for a bench warrant and criminal prosecution, and to break into
my wife’s bank and her and 401(K) accounts. This did not work with me in 2018–2019, so the Porter
Scott attorneys attacked and terrorized my wife from April–July 2021 in an attempt to frame her for
criminal prosecution with the help of Judge Thadd Blizzard, from Department 43, and his clerk. The
ambush failed, yet they stole from my wife more than $20,000, besides the terror she experienced in
the courtroom. I have already briefed your office about this.

3
Michelle Kem -Commission on Judicial Performance – Follow up Letter
 This is what I have been experiencing for nine years, since 2013, in my dealings with state
and federal agencies and courts, and prior to 2013, including but not limited to the State Bar of
California and Sacramento Courts. All of this has led me to the conclusion that, in June 1999, I was
in the wrong place at the wrong time when I was hired as a plant operator for the 27-MW
cogeneration power plant located at the UC Davis Medical Center. It appears the illegal profits from
the power sold from this plant (approx. $130 million laundered via UC accounts ) and two other
University of California plants from May 2000–September 2001 were most likely used to support a
group of foreigners who were invited to California and arrived near San Diego in 2000 to learn how
fly jumbo jets (see https://www.scribd.com/document/480228482/Ashton-et-al-v-Kingdom-of-Saudi-
Arabia-No-1-03-MD-01570-GBD-SN-In-Re-Terrorist-Attacks-on-September-11-2001).
I believe that former State Bar of California Executive Director Elizabeth Rindskopf Parker knows
a lot about not to mention UC former President Janet Napolitano , UC General Counsel
Charles F. Robinson , the Sacramento Superior Court Judge Shelleyanne W. L. Chang and few
others . (Attachment #2)
I will file an official complaint with the Commission on Judicial Performance against
Sacramento County Superior Court Judges Shelleyanne Chang, Christopher E. Krueger, Jennifer K.
Rockwell, Thadd A. Blizzard, and George A. Acero, and 3DCA Justice Elena Duarte, after the
Regents of the University of California attorneys from Porter Scott and Horovitz and Levy file their
Respondent Brief in the 3DCA case Waszczuk v. Regents of the University of California et al., Case
No. C095488.
Also, in my November 17, 2022 inquiry with your office, I asked you to provide me with
information concerning whether former 3DCA Presiding Justice Raye was placed on investigatory or
administrative leave after March 1, 2021 until the Commission’s investigation was concluded and
until he was removed from his post on June 1, 2022. I am asking for this information because I would
like to know whether Raye, after March 1, 2021, participated in any case reviews, oral arguments, or
the issuance of published and unpublished opinions between March 1 and June 1, 2022. This is a very
important piece of information I am requesting in relation to the April–July 2021 ill-crafted attack on
my 70-year-old wife by the UC Regents attorneys from Porter Scott, which resulted in them stealing
more than $ 20,000 from her. It would be greatly appreciated if you could provide me with this vital
information.

4
Michelle Kem -Commission on Judicial Performance – Follow up Letter
Sincerely,

Jaroslaw Waszczuk

Enclosure:

CC : Sate Bar of California Executives via e-mail .

5
Michelle Kem -Commission on Judicial Performance – Follow up Letter
Fax Transmission
Attention to:- From:-
Name: David H. Long -Chairman of Liberty Life Assurance Name: Jaroslaw Waszczuk
Date: 2013-10-21 Pages: 24
Time: 02:31:35 A Sender's Fax#: 2092471089

RE: Claim #4154074-Request for Compensation

Corn ments/Notes:

Supplemental -Term Disability Benefits University of California Claim #4154074

N.A.I.C. 4 0111a€65315 Liberty Life Assurance Company of Boston,
CSB Number AC" 6707505. Request for Compensation

Dear Mr. Long:

This letter is not a request to review the Supplemental Disability Claim that I filed with Liberty Assurance Company of Boston in
September 2011, which was denied in December 2011.

However, this letter is to make you aware of and begin an investigation into the Liberty Assurance Company of Boston (Liberty
Assurance) claims reviewing staffaCs deceptive behavior and conspiracy with my employer (University of California), causing to me
enormous amount of emotional distress, anxiety, and financial hardship.

Regards

Jaroslaw Waszczuk

Furthermore, I believe Liberty Life Assurance has undoubtedly contributed to attacks on my co-workers, whom I was and still am
representing; this led to an unsuccessful attempt to provoke me to kill or to end my employment at UC Davis Medical Center Trauma
Unit on May 31, 2012 by specially assembled UC Davis group of employees to which I nicknamed the UC Davis Death Squad. My
employment w University of California ultimately ended in termination in December 2012.
realized after filing the claim that [was ineligible for disability based on work-related sick leave
due to stress: My physician placed me on leave from September 22, 2012, to January 5, 2012,
but is not covered by Supplemental Insurance Disability (SID) benefits, as cited:

You are not eligible for benefits under the Supplemental Disability Plan for the
University of California because your partial or total disability arises out of or in the
course of employment; or Sickness when a benefit is payable under a Workers'
Compensation law, or any other act or law of like intent. (SID Policy, § 4-
Exclusions, p. 37)

The above policy is straightforward and indisputable. However, in the course of my 12-year
employment with University of California, I thought that the SID premiums I was paying were
for extension of the University sick leave benefits, automatically granted when an employee who
has run out of sick leave hours is placed on sick leave by a physician.

I read the above SID policy only as I was preparing for the meeting on October 2, 2013, with
UCOP Investigator Rosenberg. I was writing a chronological brief of events and examining all
facts and documents received under the Public Information Act provision. What caught my
ultimate attention was UC Davis Medical Center (UCDMC) FIR Workers' Compensation
Manager Hugh Parker's unusual involvement in the planned but unsuccessful termination of my
employment on September 23, 2011, including an attempt to force me to retire, orchestrated with
involvement of UCDMC EIR Benefits Manager John Peklar.

It appears from the documents that Mr. Parker took a lead role in the unsuccessful attempt to
provoke me and physically harm and end my employment in UCDMC Trauma Unit on May 31,
2012, in preparation for other attacks against me in August and September 2012. The HR
Workers' Compensation Manager's involvement to commit such a heinous crime makes me
suspicious that there is misuse or fraud of the Workers' Compensation system throughout 1.1C
Davis Medical Center or University of California.

It is worth mentioning that in July 2011. Mr. Parker—along with UCDMC Facilities Director
Mike Boyd tried to convince me to file a fraudulent Workers' Compensation claim. I refused
and thereafter filed a fraud report against them with State of California Workers' Compensation
Fraud Division. The report was confirmed by the State employee in September 2011—but the
claim vanished and I never heard any more about it.

Due to failed attempts to end of my employment in July 2011 through the fraudulent Workers'
Compensation claim and the provocation on September 23, 2011, the UCDMC took advantage
of my SID Claim with Liberty Assurance. Instead of sending me a letter right away, enclosing
SID's exclusion policy (stated above) and denying my claim based on that exclusion, three
Liberty Assurance claim reviewers worked together with UC of California, putting me on a
roller-coaster of intimidation, threats, harassment, and financial hardship trying to force me to
retire from the UC system. When that attempt failed, UC Davis had the Trauma Unit ready for
me in May 2012.

Request for compensation -Claim No. 4154074 2

Was this strategic game aimed at me by UC Davis FIR in collusion with Liberty Assurance? I
am unclear what role State of California Associate Insurance Compliance Officer Lee Shirrunin
played in these circumstances. Mr. Shirnmin was handling my complaint against Liberty
Assurance Company of Boston, filed on November 14, 2011. This made me curious whether Mr.
Shimnring knew about UC SID's exclusion policy or whether he was misled, unaware, by
Liberty Assurance claim reviewers. I am hoping to get the answers from State of California
Department of Insurance Commissioner and State of California Office of the Attorney General.

I am holding Liberty Assurance Company of Boston equally responsible and liable—together

with my former employer, the University of California—for conspiring against me and causing
me unspeakable hardship.

The conduct Liberty Assurance Company of Boston displayed in conjunction with my former
employer was extreme and outrageous, as well as an abuse of authority. Such actions by Liberty
Assurance Company of Boston were done with the intention of causing me severe emotional
distress with willful and conscious disregard in causing said distress.

Liberty Assurance Company of Boston's conduct caused me to suffer severe emotional distress,
embarrassment, humiliation, pain and anguish, stress and depression. The joint conduct of
Assurance Company of Boston and my former employer caused me other incidental and
consequential damages and expenses. These acts were done in a malicious, fraudulent, and
oppressive manner intended to injure me—with conscious disregard of my rights. Therefore. I
am entitled for compensation from Liberty Assurance Company of Boston and University of
California.

I was placed by Liberty Assurance Company and University of California in a particularly

dependent and vulnerable position: I was not in an equal bargaining position with Liberty
Assurance Company of Boston and University of California with their substantial size, assets,
and legal resources. Liberty Assurance Company of Boston and University of California were
aware of my vulnerability and risk of grave financial and emotional harm.

Without conducting any reasonable investigation concerning its obligations under my contract,
Liberty Assurance Company of Boston breached its contract, without good or sufficient cause,
for reasons extraneous to the contract and for the purpose of frustrating my enjoyment of the
benefits of the contract. Accordingly, Liberty Assurance Company of Boston complicit with
the University of California—breached its duty of good faith and fair dealing, treating me
differently and applying different standards of conduct than with other claimants and other
University of California employees, without any legitimate justification. As a result of Liberty
Assurance Company of Boston's breach and subsequent actions, I have suffered and incurred
(and continue to suffer and incur) substantial losses of past and future earnings, compensation,
and other benefits.

Ftequest for compensation —Claim No. 4154074

In Step 1 of employment termination appeal under UC Policy PPSM 70,1 wrote:

"lam requesting in good faith the following resolution to end the conflict without
further costly litigations.

"After receiving and reviewing my request/complaint, the UC immediately shall

restore my employment in the spirit of the signed 2009 settlement agreement with
the UC Regents with an increased salary to $82,000/year and all of the benefits
that I had prior to the termination of my employment.

"For the enormous amount of emotional distress inflicted on me as a result of the

malicious and ill-planned provocations and planned May 31, 2012, assault on me
with deadly force, which will probably occupy my mind for the rest of his life, I
am requesting from the UC compensation in the amount of $10,000,000 dollars
(ten million dollars). The amount of the requested compensation looks and sounds
big. However, if taking into consideration the astronomical jury award in the Ani
Chopourian v. Catholic Healthcare West lawsuit and the reason behind the
astronomical compensation for harassment and retaliation in that case, Waszczuk
should be awarded at least twice what the plaintiff was awarded in Ani
Chopourian v. Catholic Healthcare West if my wrongful termination goes to
court."

In conclusion, by this letter, I am asking Liberty Assurance Company of Boston to compensate

me in amount of $500,000 (five hundred thousand dollars) for malicious conspiracy with my
employer, having caused and continuing to cause me enormous and unspeakable emotional and
financial harm.

I am not 100% certain what caused Liberty Assurance Company's three claims reviewers to
agree to conspire with my employer to harm me—whether they were bribed or received orders
from their supervisors to help harm me because University of California is an enormously
profitable client.

If you would have any questions please feel free to contact me at your convenience

However I am expecting prompt response from your office within two weeks from the date of
this letter

Si e ely, w

c/R
Jaroslaw Waszczuk

Enc.: Chronology of facts and events in relation to the September 2011 Supplemental Insurance
Disability claim and November 2011 complaint against Liberty Assurance Company of Boston

Request for compensation -Claim rio. 4154074 4

with State of California Insurance Department plus some other documents which give some
insight into the case.

cc: UC President Janet Napolitano, UC Regents, State of California Insurance Commissioner

Office, State of California Director of Department of Industrial Relation — Workers'
Compensation Division, State of California Office of the Attorney General

Request for compensation —Claim No 4151074

CHRONOLOGY OF FACTS AND EVENTS FROM JULY 18, 2011 TO DECEMBER 7, 2013

THE WORKERS' COMPENSATION CLAIM, SUPLEMENTAL DISABILITY INSURANCE

CLAIM

AND

THE COMPLAINT WITH THE STATE OF CALIFORNIA DEPARTMENT OF INSURANCE

ON NOVEMBER 14, 2011 AGAINST THE LIBERTY LIFE BENEFITS ASSURANCE
COMPANY OF BOSTON.

On July 18, 2011 chic to endless harassment, sabotaging my job and stress caused by my supervisors I asked
Facility Director to grant me 30 days of administrative leave from work

In his response dated July 19, 2011, Director Mike Boyd, rather than granting administrative leave or using
his executive power to stop the attacks against me, advised me to go to the emergency room and file a
workers' compensation claim. Such advice and resolution coming from the director was so unexpected, and I
viewed it as an invitation to defraud the workers' compensation system, which, to my understanding, is not
intended to resolve conflict in the work place.

On July 20, 2011, UCDMC HR Workers' Compensation Manager Mr. Hugh Parker sent me a letter to
which he had attached the forms to file a workers' compensation claim. I refused for the reason mentioned
above. I exchanged e-mail correspondence with Mr. Hugh Parker in this matter, and I clearly stated that I
would not participate in fraudulent activity

The problems you have outlined in your letter are important, but the safe and normal
working environment is more important."

On August 3, 2011, my physician placed me on work stress sick leave until September 1, 2011 due to the
maliciously harassing behavior of my department management and the HR Department Since I could not
perform my duties due to unspeakable stress and depression, 1 had no other choice but to leave the work site.

On August 3, 2011, I received two phone calls from the UCDMC HR Workers' Compensation Office, and
HR Workers' Compensation Manager Mr. Hugh Parker again sent me forms to file a workers' compensation
claim. I refused again to file such a claim and exchanged further e-mail correspondence with Mr. Parker in
regard to filing fraudulent workers' compensation claims. I got very suspicious that after I sent my letter dated
July 3 1, 20 11 to UC Davis Chief Compliance Officer Wendi Delmendo, UCDM Management was trying to
get out of the picture through a fraudulent workers' compensation claim. Nly letter to Ms. Delmendo outlined
quite a few violations of LIC policies and law and the involvement of two LTC MAC directors in very
questionable activities.

In an e-mail dated August 5, 2011, I expressed my opinion about Mr. Hugh Parker's attempts to make me
file a workers' compensation claim:

C'hronalogY —Disability Claim with Liberty Life tsuranre 1

Company of Batten
 Why are you so anxious to abuse the workers' compensation system? Because it is
not your savings account and you don't feel the pain? Do you know that 43 million
people in the USA are on food stamps? Do you know who is paying for them?
Taxpayers like we are!

I have known you for quite some time, and we have had problems before to solve.
You need to be more responsible with workers' compensation claims as a manager.
The workers' compensation system is not a "Give Away Oprah Show" or a way to
reward irresponsible supervisors and managers for the creation of a hostile working
environment.

On August 22, 2011, I filed a fraud report with the State of California Department of Insurance
Fraud Division alleging improper and fraudulent application and use of the State of California
workers' compensation system by UC Davis Medical Center Management.

On September 8, 2011, I received an e-mail from the State of California Department of

Insurance Fraud Division informing me that my fraud claim reporting UCDMC HR Workers'
Compensation Office fraudulent activities had been forwarded to the Sacramento Fraud Regional
Office for processing:

To: 'Jaroslaw Waszczuk' .cjaroslaw.wasz (10 cdmc.uedavis.edu>

From: Fraud
Sent by: "Jaquez, Linda"
Date: 09/08/2011 01:36PM
Subject: RE: Worker's Compensation Program abuse/fraud

Mr. Waszczuk,

I have forwarded your Fraud Claim form to the Sacramento Fraud Regional office for
processing. Please allow 10 days for review and processing. If you have not heard from
the office within the 10 days you may call the office to inquire as to the status of your
claim. The telephone ntunbers to the Sacramento Regional office is 916-854-5700 and
ask for a duty officer.

Thank you for helping fight insurance fraud.

I forwarded the above e-mail to HR Investigator Danesha Nichols with the suggestion that she should
use her energy to take care of frauds and misuse of UC resources instead of attacking me for no
reason.

On September 12,2011, HR Investigator Danesha Nichols also sent to UCDMC HR Workers'

Compensation and Ergonomic Manager Hugh Parker an e-mail entitled "CONFIDENTIAL-
Waszczuk Summary" with an attachment marked as "Waszczuk Summary 09_12_2011.docx."
It made me wonder why UCDMC HR Workers' Compensation Manager Hugh Parker needed a
Confidential Report on me from the HR Investigator. Mr. Hugh Parker was not a member of the
HR Labor Relation Team but was the subject of my complaint with the State of California

Chronalotv —Disability Claim with Liberty Life tsurance 2

Company of Bostun
Department of Insurance Fraud Division for using the State workers' compensation system as a
solution to cover up harassment, retaliation, misuse of UC resources, and abuse of power by UC
Davis Medical Center Management.

I requested a copy the "CONFIDENTIAL—Waszczuk Summary" e-mail under the provision of

the Public Information Act (PRA). However, the response from the UC Davis PRA office to my
inquiry was negative, and I was informed that the report did not exist anymore. What might have
been a very important piece of evidence in this case was destroyed.

On the same day, PO&M Manager Charles Witcher, to intimidate me further and in preparation
for terminating my employment, sent me a provocative letter pointing at my harsh words taken
out of context from my correspondence with HR Investigator Danesha Nichols. It appears that all
letters I received from Charles Witcher were crafted by HR Labor Relation Department
personnel.

Obviously, the letter was crafted by the HR Labor Relation Department after the meeting
mentioned in Danesha Nichols' e-mail to HR Workers' Compensation Manager Hugh Parker on
the same day.

On September 21, 2011 at 9:45 PM, PO&M Manager Charles Witcher sent me a letter by e-mail marked
'CONFIDENTIAL" and ordered me to attend the interview in the UC Davis Medical Center HR Tycon II
Building on Friday, September 23, 2011.

On that day, I did not have HR Investigator Danesha Nichols' e-mails dated September 12, 2011 which she
sent to Dennis Curry, Patrick Putney, Donn Daniluc, and HR Workers' Compensation Manager Hugh
Parker. However, Charles Witcher's letter sounded like an ill-crafted attempt to make somebody angry. The
sentence"On this Friday, you are to report to the receptionist on the third floor of Human
Resources at the Ticon III Building (see address above) shortly before 9:00 a.m, and you will be
escorted to a conference room for the interview meeting" did not leave me any doubt that it was
a termination letter.

First, it was Friday, a customary day for management to discipline employees. Second, the
statement about being escorted to the conference room, as if I were a criminal, told me that I
would also be escorted out like a criminal after the interview. I was already under enormous
stress, taking two anti-depressants every day and under a psychologist's care. Under such
circumstances, I did not have any desire to be escorted, interrogated, and land in a hospital
emergency room.

On September 22, 2011, I send a request for information about the situation to my doctor via the
physician's network and asked my doctor to place me on work-related sick leave. My physician
was aware of what was going on in my place of employment. Later that day, I sent the following
e-mail message to Charles Witcher in response to his letter.

I would like to inform you that I will not attend the meeting with Danesha Nichols
tomorrow. I am waiting for a response from my physician in relation to this matter.

On thal same day, I received a phone call and a lengthy e-mail from UCDHS Vocational Rehabilitation HR
Analyst Dennis J. Dark that contained the following statement: "I understand that you were

C'hronalotv —Disability Claim with Liberty Life tsurance 3

Company of Boston
previously provided information about Workers' Compensation and the necessary forms to file a claim, but
you declined to do so. If you have changed your mind, please let me know. I can assist you in making sure a
specialist in Workers' Compensation works with you or answers any questions you may have about it."

Dennis Dark also explained his role in HR and advised me that I could get help through his vocational
rehabilitation and accommodation services.

I responded to Mr. Dennis Dark's offer as follows:

I don't who you are, and your title has no meaning for me, but thank you for your
call and your e-mail. At this point, I am most concerned about the vacation hours I
accumulated and which were used improperly to cover my sick leave hours in
August 2001. 1 exchanged correspondence about this matter with Mn. Regine Hi
today. The horrifying situation the PO&M management got me into with some
individuals from the HR Department has made me very nervous and stressed out to
the extent that my priority is to get this vacation problem behind me and make sure
that my wife will get paid if something happens to me. The threats I have received
from PO&M Manager Witcher in the last three weeks (the most recent being last
night at 9:45 pm) forced me to send an e-mail to my physician early today with a
request for additional work-related sick leave. I did not get a response yet. I am
working on the GOODBYE letter for Mr. Witcher. I do not need any job
accommodation. I need to go back to my normal duties, but somebody is doing
everything possible to kill me and prevent me from returning to work. Who is
behind Mr. Witcher's actions, I don't know, but I have a general idea. It is blowing
my mind that a super medical facility is transforming itself into a vicious killing
machine.

If you would like to contact my physician, I would not have a problem with
that. His name is Haney Hashimoto (209-339-1982). I know for sure that
Mr. Witcher won't see me tomorrow in Mrs. Danesha Nichols' office.

I am also under the care of a psychologist named Franklin 0. Bernhoft (209-366-

1516). I am not sure which e-mail you have read. I will attach my last letter to Mr.
Witcher.

I did not want be rude to Mr. Dennis Dark, but I found his e-mail very inappropriate, disturbing,
and harassing. I was outraged that HR was offering me workers' compensation and other
accommodations instead of addressing the real problem and letting me go back to work and my
position provided to me by the February 2009 Settlement — Agreement with UC Regents.

On the same day, my physician Dr. Harvey Hashimoto, placed me on work-related sick leave
until January 5, 2012.

On September 25, 2011, I sent a seven-page letter to the University of California HR Vice
President Dwain Duckett with the following statement at the beginning of the letter:

C'hronaloof —Disability Claim with Liberty Life tsurance 4

Company of Batten
 By this letter, I am respectfully requesting from your office intervention to stop the
constant assault, harassment, and vicious vendetta that has been waged against me
for the last few months by UCDMC PO&M and HR Department Management.
The conspiracy against me to end my employment with the University of
California is unspeakable. I have a problem finding words to describe the
deception and heinous vendetta against a 60-year-old Polish immigrant and
employee of 12 years with the University of California.

On September 27, 2011, I filed a claim for short-tem/supplemental disability insurance benefits with the
Liberty Life Benefits Assurance Company of Boston. This short-tenn disability insurance benefit is provided
for UC employees through the UC Benefits System with premiums collected through the UC payroll system.
On the same day, HR Executive Director Stephen Chilean exchanged an interesting correspondence with the
HR Workers' Compensation Nlanager about my having been contacted by Mr. Dennis Dark on Septeniber
22, 2011. The correspondence shows that I won't be encouraged any more to file a workers' compensation
claim due to my work stress-related sick leave.

On October 5, 2011,! filed a complaint against the UC Davis Medical Center HR Department attorneys
Stephen Edward Chilleott, Bar #196905, and Danesha Nicole Nichols Bar 1t222784, who engaged in
unethical behavior, gross misconduct and conspiracy against me.

On October 6, 2011, I sent a seven-page request to UC Davis Police Captain Joyce Souza
of the Support Service Division Professional Standard Unit to check my record due to constant
unfounded and fabricated accusations against me that were coming from HR Investigator Danesha Nichols,
PO&M Department Manager Charles Witcher, and HR:

I have worked for 12 years in the UC Davis Medical Center Plant Operation and
Maintenance Sacramento Department. In the last few months, UCDMC HR
Attorney Danesha Nichols and PO&M Department Manager Charles Witcher have
been making unfounded accusations against me of being violent, making
discriminatory comments, etc., without any factual evidence in my employment
record, such as an evaluation or a written or verbal warning.

I would appreciate if you let me know if any complaint has been filed against me
with the UC Davis Police Department (UC Campus or UC Medical Center) during
the period from March 1, 2011 to the present time.

If so, then! would be glad to hear from the UC Davis Police Department that the
allegations against me are being investigated, and I will be glad to answer any question
related to the complaint. I would gladly talk with the UC Police Investigation
Unit/Detectives instead of the crooked FIR attorney from UCDNIC.

I already know that the accusations and allegations are fabricated to prevent me
from pursuing my compliant against my psychopath supervisor, who is a cheater
and a thief, together with his assistant. The most recent event in this whole case is a
child pornography issue in the PO&M HVAC shop which had been reported by my
coworker. However, just three days after it had been reported, the porn love mob

C'hronalotv —Disability Claim with Liberty Life tsurance 5

Company of Boston
 from the UCDM PO&M and HR Department hit me hard with endless investigatory
leave to scare the reporting coworker and others so that they would not complain
about it.

The premature termination of my employment was announced by an individual

who, together with my supervisor, Patrick Putney, and Dennis Curry, is directly
responsible for the illegal presence in the HVAC shop of a felon convicted of child
pornography who had been given access to the company computers. Due to his close
friendship vvith the PO& NI Assistant Manager and his unusual friendship with my
supervisor, he was given my job and my office as a reward. My office is a very good,
cozy spot for child-porn-loving, sick-in-the-head individuals.

On the same day, UC Davis Police Department Captain Joyce Souza responded to my inquiry,
saying, "1 have pp formed a check of our records system and there is nothing noting your name. Please
let me know if you need any further assistance."

On October 7, 2011, HR Vocational Rehabilitation Consultant Dennis Dark sent me a letter

with some weird proposal to me as if he did not know that my job was given to the daddy of a
child porn convict, my goal was to get my job back, and I had no need of any other
accommodation from his and Hugh Parker's Workers' Compensation Office.
I was getting frustrated that Liberty Life Benefits Assurance Company of Boston was delaying
my claim for supplemental disability benefits due to using all my sick leave and being forced to
use my vacation hours to substitute for my sick leave.

On October 8, 2011, I sent a letter to the Liberty Life Benefits Assurance Company Disability
Claims Case Manager with a request to pay my benefits as soon as possible. I did not expect
that 1 would get into a very fierce, no-win, and unpleasant battle with the Liberty Life
Benefits Assurance Company to receive my benefits to which I was entitled due to work-
related sick leave.
On October 30, 2011, I sent a request to Ms. Patricia Combs from Liberty Life Benefits
Assurance Company of Boston for an update of my claim status. I sent copies of my request to the UC DMC
HR Benefits office.

On Novemher 14, 2011, I filed a complaint with the State of California Department of
Insurance against Liberty Life Benefits Assurance Company of Boston for delaying forever my
supplemental disability claim filed in September 2011.

On November_15,20.11, I received a letter from HR Consultant Gina Harwood, who offered me an

additional 12 weeks of FMLA. Her offer clearly indicated that termination of my employment
based on FN1LA protection being exhausted was not an option for Stephen Chillcott, Wendi
Delmendo, Mike Boyd, and others. I had no doubt that the ILICDMC HR Department was in
close communication with Liberty Life Benefits Assurance Company of Boston to knock me down
financially and force me to retire from University of California at age 60 or find another legally sound cause
to finish me.

Chrondoff —Disability Claim with Liberty Life tsurance 6

Company of Baden
On or around November 16, 2011, I received two letters from Liberty Life Benefits Assurance
Company of Boston in regard to my supplemental disability claim. One letter was dated
November 10, 2011 and authored by Claim Manager Patricia Combs, and other letter came from
Liberty Life Benefits Assurance Company of Boston Headquarters dated November 15, 2011 and was
signed by Ms. Karen McKenzie. Both letters denied my supplemental disability claim's based on
the fact that I am not totally disabled, without mentioning that supplemental disability applies
also to partial disability in the first 12 months, which is described in the policy as a short-tenn
disability.
I was not aware at that time that a specially assembled team led by HR Workers' Compensation
Manager Hugh Parker and others would be working very hard in May 2012 to make me totally
disabled or kill me.

On November 17, 2011, I sent HR Vocational Rehabilitation Consultant Dennis Dark a letter
dated November 7, 2011 with an offer to meet and discuss his propositions. Also on that day I
sent an e-mail to PO&M Manager Charles Witcher and repeated my request to give me back my
private belongings from my office.

On November 18 , 2011, I received a letter from Mr. Lee Shimmin of the State of California
Department of Insurance, who confirmed that my complaint against Liberty Life Benefits Assurance
Company of Boston would be investigated under File #CSB-6707505. Mr. Shimming's letter gave me
sonic hope that I eventually would be able to recover losses due to the denial of my claim by
Liberty Life Benefits Assurance Company of Boston Headquarters.

Also on that day, I received a phone call from HR Benefits Office Manager John Peklar, who
tried to convince me take my university retirement and go away. It was a perfect time to make
such an offer after I ran out of sick leave hours, vacation hours, and my supplemental disability
claim with Liberty Life Benefits Assurance Company of Boston had been denied. Everything was working
against me.

On November 20, 2011, I responded thankfialy to Mr. Lee Shimming's letter because in such
situation he was my last hope that I would survive the financial holocaust inflicted on me by my
employer.

On November 21, 2011, I filed an appeal with the Liberty Life Benefits Assurance Company of
Boston Claims Review Office of their November 10,2011 decision denying me my supplemental
disability benefits.

On December 12,2011, HR Benefits Manager John Peklar called me and left me a message that on
December 13, 2011, I had scheduled an appointment with him regarding my retirement. I responded to his
message:

I got your phone message about the appointment in your office on December 13, 2011.
Apparently, your as.sistant or secretary did not pass the message to you that canceled my
appointment with you. She called me on November 30, 2011. On the same day Nit. Dark
called me about the "investigatory leave accommodation." At this point, I don't see any reason

C'hronalotv —Disability Claim with Liberty Life tsurance 7

Company of Boston
 to have a meeting with you. My employment with UC is unresolved, and investigatory leave is
not the resolution I am looking for.

I am looking to get my job back which was granted to me by the 2009 Settlement—Agreement
with the UC Regents phis compensation for Nuassment, retaliation, and violation of my civil
rights by the UCDNIC PO&M and HR Department Management.

In conclusion of my short letter, I would like to mention that tomorrow, December 13th, is a
very important day for me.

I think that the best expression of the importance of this day is provided by my daughter
Joanna in her school essay written in 1993. She graduated in 1996 from CC Santa Cruz as a
cellular and molecular biologist

*************************************************************************************
********•*****•*******************•******•**•************ Jo. a waszczuk

Essay about December 13, 1981

One of my most vividly remembered experiences which has also affected me greatly is when my father
went to prison.

I was nine years old, living in Poland, which was undergoing political upheaval struggling for
democracy. I knew that my father was involved with some sort of underground and that he was being
followed as well One night, a man came to our home at two o'clock in the morning and just took my
father away, only allowing him to put on his boots and jacket over his pajamas.

Two weeks after that night, my family learned that my father was taken by a secret government agent
to a prison for political activism and trying to overthrow communism..

After a few more weeks, my father was allowed to write letters, but they were censored to the point
that half the words were cut out with a razor or completely blacked out.

After five months, as I Liter found out, of being guarded by attack dogs and guards armed with
machine guns, being brainwashed, being fed rotten food and having no rights, my father was released
on the condition that he either leave the country quickly or go back to prison So, within two weeks my
parents, brother, and I received passports, sold or gave away everything, and came to the United
States.

Although I was angry with my father for bringing our family into this country and severing ties with
the only type of life I had !mown, coming here has also taught me that with hard work, challenges can
be overcome, and that being able to express oneself is very important. I especially had the latter
instilled in me, because for the first six months hi the United States, due to a language barrier, I could
barely express myself. I am now inspired by my father's standing up for his cause as I am by Freud,
Darwin, and Pasteur, because despite challenges, hardships and the opposition of society, they all
struggled for their causes and beliefs for the benefit of humanity.

On December 12,2011, the appeal I filed on November 21, 2011 with Liberty Life Benefits Assurance
Company of Boston Claims Review Office was denied on the same basis as the initial claim—that! was not
totally disabled.

C'hronalotv —Disability Claim with Liberty Life tsurance 8

Company of Boston
On December 19, 2011, I informed the State of California Department of Insurance Associate Compliance
Officer Lee Shimming that the Liberty Life Benefits Assurance Company of Boston had denied my
supplemental disability claim appeal and closed the case.

OnJanum-y12,2012„ I received a letter from NILS National Medical Evaluation Services informing
me that the Liberty Life Assurance Company of Boston, my disability benefits provider, had
requested that I be scheduled for an independent psychiatric evaluation.

This happened after my work-related sick leave ended on January 5, 2012 and after the Liberty
Life Assurance Company of Boston denied my initial claim for supplemental disability benefits
and after the appeal of the decision, not to mention hundreds of pages of documents I exchanged
with the Liberty Life Assurance Company of Boston and State of California Insurance
Department. I thought that denying my claim was nothing but a big conspiracy of Liberty Life
Assurance Company of Boston and my employer to defraud thousands of IX employees through
the UC payroll system. In my response to the above-mentioned letter, I rejected Liberty Life
Assurance Company of Boston's request for psychiatric evaluation.

On January 18,2012, I found out that I had no medical, dental and vision insurance as a UC
employee. I sent a request for explanation to HR Benefits Manager John Peklar. Also I requested
cancellation of my supplemental disability insurance since my claim was denied by Liberty Life
Assurance Company of Boston.

On January 25,2012, I sent a complaint letter against Liberty Life Assurance Company of
Boston to UC Customer Service Manager and UC Liaison with insurance companies Michael
Waldman. I never got any response from Mr. Waldman.

On February 8, 2012, Ms. Cindy G. Oropeza, HR Manager Benefits, EEO, Resident/Fellow

Program HR Administrator, Title IX Officer - Sexual Harassment, Mediation Services,
ASAP, Early Resolution/Inclusion called my residence and asked me if I were considering
informal resolution of the ongoing dispute and conflict. On the same day, I confirmed by e-
mail that I am always open to discussion to resolve the conflict:

As per today's phone conversation, I am forwarding to you my most recent

correspondence with Ms. Danesha Nichols.

To avoid any misunderstanding, I would like to emphasize that I am always open to

discussion to find the best resolution for both sides in this unpleasant conflict
between an employee and employer. However, my priority is to go back to work
as soon as possible and I don't like to be accused of soliciting for settlement or
money from employer. This is not my goal or desire. I had a good job granted me
by a Settlement Agreement with the UC Regents and would like to get my job
back

As I stated in my correspondence mith Danesha, if it is inconvenient for my employer to not

let me go back to my duties, and my employer is looking for a different resolution to resolve

C'hronalotv —Disability Claim with Liberty Life tsurance 9

Company of Boston
 the conflict than I would not like to see or read Ms. Danesha Nichols' investigation findings
and the PO&M Management action based on them. It would save my and others' time to get
into new dispute and spin. I am very tired and stressed out from dealing with this conflict

If you have any questions, please do not hesitate to contact me at your convenience.

Following the phone conversation with Ms. Cindy Oropeza, the meeting was set with the
UCDNI HR Labor Relation Manager on February 14, 2012.

The meeting with Mr. Mike Garcia was pleasant. I expressed my concerns about the ongoing
conflict and I gave a proposition for Mr. Garcia to end the conflict if UCDMC won't let be
back to work. Mr. Mike Garcia did not promise or make any offers and I never have heard
from him or from anybody about the informal resolution. I am still not sure why this meeting
was scheduled.

On March 26, 2012, I received a letter from the State of California Department of Insurantx in regard to the
investigation against Liberty life Benefits Assurance Company of Boston, which I filed in November 2011.

Our File Number: CSB-6707505

Regarding: Liberty Life Assurance Company of Boston

Dear Jaroslaw Waszczuk•

Your inquiry is receiving our continued attention. Proper review, however, has
necessitated additional investigation and evaluation of the issues involved.

We regret this delay and will bring this matter to a conclusion as soon as possible.

Lee I. Shimmin, Associate Insurance Compliance Officer

On March 28, 2012, I responded to Mr. Lee Shimmin with a short update about my situation in
relation to employment and I forwarded my letter to UC Business Manager and Liaison with
Insurance Companies Michael Waldman.

On April 5, 2012, LiC Davis Health System Executive Director Mr. Stephen Chilcott wrote a letter to
me which I never received, addressing my concerns outlined in my response to Mr. Lee Shimmin. In
the letter, Mr. Chillcott addressed briefly my status, and he mentioned the option of my returning to
work being reviewed.

April 5,2012

Mr. Jaroslaw Waszczuk

524 Swallow Lane
Lodi, CA 95240

Chronaloff —Disability Claim with Liberty Life tsurance 10

Company of Bostun
 RE: March 28, 2012 Letter to Mr. Lee I. Shimmin, California Department of
Insurance

Dear Mr. Waszczuk:

In your letter of March 28,2012, you summarized the concerns you have with your Liberty
Mutual Short Term Disability claim. Liberty Mutual in letters dated November 10,2011
(Patricia Coombs) and November 15,2011 (Karen Mckenzie) advised you of their decision to
deny your disability claim. You were also advised how to appeal the denial of your claim both
internally within Liberty Mutual and through the State of California Depautnent of
Insurance. The University of California is not in the posifion to influence Liberty Mutual
claims decisions.
You are currently on UCDHS Administrative Leave with Pay while options for
possibly returning you to work are being reviewed. Your UC-sponsored insurance
coverage is current UCDHS Labor Relations will contact you when the
administrative review has been completed.

Very truly yours,

STEPHEN CHILCOTT, JD

Executive Director, Human Resources UC Davis Health System

cc: Senior Vice President Sheryl Vacca Vice President Dwaine Duckett
Executive Director John Fox Manager Michael Waldman File

The most interesting statement in Mr. Chilcott's letter is statement that the University of California is
not in the position to influence Liberty Mutual claims decisions. Contrary to Mr. Chilcott's statement,
I would say that Liberty Mutual has no need to be influenced by UC. The UC is probably one of the
biggest clients for Liberty Mutual, which will do anything to keep such a profitable client.

On April 12, 2012, UCDMC HR Benefits Manager John Peklar sent to me his concerns about
my correspondence with Mr. Lee Shimmin from the California Department of Insurance.

April 12, 2012

Mr. Jaroslaw Waszezuk
524 Swallow Lane
Lodi, CA 95240

RE: March 28, 2012 Letter to Mr. Lee I. Shimmin, California Department of
Insurance

Dear Mr. Waszczuk:

I have been asked to respond in part to your March 28, 2012 letter to Mr. Shimmin,
California Department of Insurance.

Chronolotv —Disability Claim with Liberty Life Assurance 11

Company of Baden
 In your letter, you summarized the concerns you have with your Liberty Mutual
Short Term Disability claim. Liberty Mutual in letters dated November 10, 2011
(Patricia Coombs) and November 15, 2011 (Karen McKenzie) advised you of
their decision to deny your disability claim. The letters also advised how to
appeal the denial of your claim both internally to Liberty Mutual and through
the State of California Department of Insurance.

I understand you have appealed the denial of your claim and it's currently under
review. In addition, your UCDHS-sponsored insurance coverage is current.

Feel free to call me at (916) 734-5388 should you have any questions.

Very truly yours,

A. Peklar, M.S. CDHS Benefits Manager

On April 13, 2012, I received a Letter of Intent to Suspend signed by UCDMC PO&M Manager
Charles Witcher. The letter was based on outrageous, fabricated, one-year-old accusations and
allegations incorporated into HR Investigator Danesha Nichol's investigatory report issued in
February 2012. It is most likely that the Letter of Intent to Suspend was based on the September
12, 2011 report fabricated for my unsuccessful employment termination scheduled for September
23, 2011, and most likely originally it was a Letter of Intent to Dismiss.

On May 11, 2012, I was served with a despicable, retaliatory 10-day suspension without pay
letter based on a fabricated accusation by HR Labor Relation outlined in HR Investigator
Danesha Nichols' report.

On May 24, 2012, I sent a 13-page letter to IIR Labor Relation Consultant Jill Vandeyiver
protesting malicious, retaliatory HR and Plant Operation and Maintenance Department
Management action against me and the two coworkers I represent. At the time, I did not know
that the attacks against my coworkers and against me were a planned action by HR Executive
Director Stephen Chilcott, HR Labor Relation Manager Travis Lindsey, HR Labor Relation
Supervisor Brent Seifert, Consultant Gina Harwood, Investigator Danesha Nichols, HR EEO
Manager Cindy Oropeza, HR Workers' Compensation Mgr, Hugh Parker, LTC Davis Police
Chief Matt Carmichael, IA. James Barbour, UC Davis Chief Compliance Officer Wendy
Delmendo, UCDMC Facility Design & Construction Executive Director Mike Boyd, UCDMC
PO&M Department Mgr. Charles Witcher, Marjorie Tragadon and Carol Kirshnit from the HR
Academic and Staff Assistance Office, Glynis Faulk from UCDNIC Environmental Services,
UCDMC Counsel David Levine and few others ill minded individuals to provoke me and kill me
or end my employment in UC Davis Medical Center Trauma Unit #11.
Apparently, HR Labor Relation Consultant Jill Vandeviver and her boss, Mike Garcia, were
aware of what was coming. Ms. Vandeviver expressed her feeling about it in her e-mail dated
May 17, 2012.

After the unsuccessful May 31, 2012 provocation to kill me or end my employment in the UCDMC Trauma
Unit assembled by the IJCDMC Management "Death Squad," the PO&M Department Managers and HR
Labor Relation vendetta against me and my coworkers continues today, almost one year after termination of

Chronalotv —Disability Claim with Liberty Life Aviurance 12

Company of Boston
my employment. In May2012, I rep esentod two coworkers. Today, !represent three, which indicates that
hir. Gerry Preciado's services did not work at all and the situation is worse today than it was in May2012.

To conclude this chronology, I would like to mention that on June 14, 2012 I received a decision from
the State of California Department of Insurance in Case CSF3-6707505 against Liberty Life
Assurance Companyof Boston, which had been pending since November 14, 2011.

June 14, 2012

Jaroslavi Waszczuk
524 Swallow Lane
Lodi, CA 95240

Our File Number: CSB-6707505

Regarding: Liberty Life Assurance Companyof Boston

Dear Jaroslaw 'Waszczuk:

We have completed our investigation into the insurance company's handling of your
claim and we thank you for your patience.

At our request, the insurance company has reviewed its handling of your claim. The
insurer believes it has properly considered your claim under the terms of the
insurance contract and has cited the reasons supporting its position. These reasons
are outlined in its letter of December 12, 2011, a copy of which was sent to you.

After reviewing the information provided, we conclude that we are unable to assist
you further with this matter. The issues involved with your complaint indicate that
there is a difference of opinion between you and the insurance company that this
Department, as outlined in California Insurance Code Section 12921.4(a), does not
have the authority to decide.

The Department's action on your file is not meant to reflect on the ultimate merits of
any potential legal case nor is it intended to discourage you from taking further
action that you deem appropriate. The Department's review is hased on the
information and documents that you and the insurer have provided and does not
necessarily involve consideration of all potential legal authorities or theories that
may apply. This letter is not intended to constitute legal advice, If you need or want legal
advice, please contact an attorney.

Sincerely,

Lee I. Shimmin, Associate Insurance Compliance Officer

Mr. Lee Shimmin in his decision not to have authority to decide relied on the California
Insurance Code Section 12921.4(a) and most likely on the J10). 2010 Cal.App.4th Schwartz v.

Chronalotv —Disability Claim with Liberty Life teurance 13

Company of Bostun
Poisner case. However, Mr. Lee Shinuning's decision Ixas issued two weeks after the unsuccsful attempt
to provoke me on May 31, 2012 and to end my employment in UCDMC Trauma Unit # 11 .I could
speculate only that if that provocation on May 31, 2012 had worked, Mr. Lee Shinunin would never have
had to write this decision

Lack of any response from UC Business Manager Michael Waldman and the HR Director
Stephen Chilcott's and HR Benefits Manager John Peklar's April 2012 concerns about my
correspondence with Mr. Lee Shimmin followed right after by the Letter of Intent to Suspend
made me suspicious that something was wrong with my claim for Supplemental disability
insurance benefits. I engaged myself in the long and fierce battle with Liberty Life Assurance
Companyof Boston to get pay for my work-related sick leave under the provision of short term
disability.

On September 25, 2012 base on outrageously fabricated accusation I received Notice Intent to
dismiss for serious misconduct, and "Most Unwanted" Posters with my photo was issued by
UC Davis Police and distributed around the UC Davis Campuses.

On December 742012, my employment with University of California was terminated.

Chrondoff —Disability Claim with Liberty Life Avatrance 14

Company of Bostun
upplemental
bility
ce Plan
of California
 Section 4 — Exclusions
General Exclusions
Disabilities That Are Not Covered
This plan will not cover any Total or Partial Disability due to:

1. war, declared or undeclared or any act of war;

2. intentionally self-intlicted injuries;

3. active Participation in A Riot;

4. your committing of or attempting to commit an indictable offense;

41111%111%%%* 5. For ShortTerm Disability Plan benefits only; a Monthly Benefit will not be payable if you
become llitally or Partially Disabled due to:

11110%. • Injury that arises out of or in the course of employment; or

• Sickness when a benefit is payable under a Workers' Compensation law, or any other
act or law of like intent.

"Participation" in A riot shall include promoting, inciting, conspiring to promote or incite,

aiding, abetting, and all forms of taking part in, but shall not include actions taken in defense
of public or private property, or actions taken in defense of yourself, as long as such actions of
defense are not taken against persons seeking to maintain or restore law and order including,
but not limited to police officers and firemen.

"Riot" shall include all forms or public violence, disorder or disturbance of the public peace,
by three or more persons assembled together, whether or not acting with a common intent
and whether or not damage to persons or property or unlawful act or acts is the intent or the
consequence of such disorder.
Pre-Existing Condition Exclusion
Short term period benefits (first 12 months) under the Supplemental Disability plan will not
be subject to a pre-existing condition exclusion.

After 712 months of benefits, the Pre-Existing Condition Exclusion will apply to any long term
period Sickness or Injury as follows:

Supplemental Disability Insumnce Plan

 Section 4— Exclusions
GENERAL EXCLUSIONS
Disabilities That Are Not Covered
This plan will not cover any Total or Partial Disability
due to:
1. war, declared or undeclared or any act of war;
1 intentionally self-inflicted injuries;
3. active Participation in a Riot;
4. your committing of or attempting to con-Unit an
indictable offense;
5. injury that arises out of or in the course of
employment;
6. Sickness when a benefit is payable un era
Workers' Compensation law, or any other act or
law of like intent.
"Participation" in a riot shall include promoting,
inciting, conspiring to promote or incite, aiding,
abetting, and all forms of taking part in, but shall not
include actions taken in defense of public or private
property, or actions taken in defense of yourself, as long
as such actions of defense are not taken against persons
seeking to maintain or restore law and order including,
but not limited to, police officers and firefighters.
"Riot" shall include all forms of public violence,
disorder or disturbance of the public peace, by three or
more persons assembled together, whether or not
acting with a common intent and whether or not
damage to persons or property or unlawful act or acts
is the intent or the consequence of such disorder.
24 Short-Term Disability Insurance Plan
Section 5 — Termination Provisions
End Of Your Insnrance
Yon will Cease to lie insured on the earliest of the
following dates:
1, the date this plan terminates, but without
prejudice to any claim originating prior to the time
of terinination;
2. the date you are no longer in an eligible class;
3. the dare your class is no longer included for
insurance;
4, the last day for which your required contribution
has been made, or for which the University has
made a contribution on your behalf;
5. the date your employment terminates. Cessation
of Active Employment will be deemed termination
of employment, except insurance will be continued
for you if you were absent due to disability during
your Waiting Period and the period during which
premium is being waived. Refer to Employment
Actions That Affect Coverage, which follows, for
additional information.
Liberty reserves the right to review and terminate all
classes insured under this plan if any class(es) cease(s)
to be covered.
EMPLOYMENT ACTIONS THATAFFECT
COVERAGE
iermination Or Retirement
If you leave or retire from University employment,
your disability insurance coverage ends on your last day
in Active Employment before your termination or
retirement.
If you become Totally Disabled before you are laid off,
terminate, or retire from employment, your eligibility
Short-Term Disability Insurance Plan