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97-05292
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HM.ILO'''''.lt.II,"11fr5'~lUl :OHlWO. ;)Nl "IWlllOll....W!UM .t!YLI"1,.,jQ JitOIIWCI 'I""" lI'fU-'" .... ," 5, As a result of the accident, Progressive Insurance offered to Plaintiffs counsel the polley limits In the amount of $25,000, (A copy of the settlement letter and accompanying declaration page Is attached as Exhibit A and Incorporated herein by reference thereto. 6, Petitioners retained the law firm of Gary, Williams, Parenti, Finney, Lewis and McManus of Ft. Pierce, Florida to handle the personal Injury claim regarding the decedent's estate, 7. Undersigned counsel has been retained by the above mentioned firm to facilitate the approval of such settlement. 8. A Certificate of Grant of letters of administration (Exhibit B) was Issued on August 11, 1995 by the Dauphin County Register of Wills naming Caron L. White and John W. White Sr. as personal representatives of the decedent. 9. Further, the personal representatives are the only heirs who would be allowed to recovery under the applicable Intestate laws. Records Indicating the decedent's demise are attached as Exhibit C and Incorporated herein by reference thereto. 10. A copy of the police report is attached as Exhibit D and Incorporated herein by reference thereto. 11. Under the circumstances of Progressive Insurance paying It's limits of liability, Petitioner's would respectfully ask that this Honorable Court approve this settlement as set forth In this petition. ", , , " I, , ' , , , ", , , " , , , ' " " " " I,ll , , " , " " , , , , '" , ',' , " I ~ , , ,,' , , " " I , , ' " " " I . ," In~.-! ~"'!(" '~'~ALTHOFPENNSYLV~NIA '~J.(:" ',; \-,.. y'rl(1ENT ~tt()r, .i ". ~l~'~.!O~::e.~~~.:" lrftS ~~~~.;"I: . "'_:".! _~..:.":~ ~~_l'.-""'j [-~~. PINNO<1tlJ.~_~' POLICE IN'OlllMAnC:, ACCIDeNf LCeATlON ') - (','j- 10 CQu;;f,i '--' - '<i:'~1 .~~C:> . ~ ._ __ .~l'j.~,) '_' _'_'__ 2 -.OINC," ., lr "'IJIl.lI<"'JlALIf'V ~ NAill HAl", 1)~N _7{,..':' I', (.(; L...;,', q(,\",P\)~t-.J ,-,.:.,' I ~~'~~ -. -[, ~~~'~'" . - PRINCjpALROADWA Y INFORM.'. rtr.': IINIJII".t"A,'\'j''i - eAoGi- n TlNOOA. --,--- -~,' I ~~i!:\.'\"...: ..~,.~__r1L~ .~'JM~.l~l..!~. ST~IITNMAf ,~')~~I \.~,_',.l\''',J~J'':-';) " ..1 I' , . llAOOt iJ INtO ~. ,wi '. ) - .. 'f:S"I. . ;r ';:. . NU~KR LIMIT ...tG~A l I- ~ CWt' P..... .. ~_=--=-r5J~:"H__="-_-~ -- INTERSECT/NG ROAD:- .- ACCIDENT INFORMATION 18 .1Oun NO OR 8T~;n N';/,:C , 10 "'" OI'WEEK 1 $''HC r'\'PI -. ~;"T7', ..-...-- ~, t~/!':t. __ _bJ~ _ ':.!!<!!.!..__.._ M,aHWAr ._J..:. :,:,!,.V' . ':","i ~ Il"~ II ~~~~~T~ \ IF Nor A TIN TcRSE:CTlOr. ., ~T. 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Page 3 of 4 POLICE ACCIDENT REPORT # 1418428 (Handwriting clarification) John White Jr., Deceased 1031 3rd street or 1723 Foster Street Harrisburg, Pennsylvania (84 ) (85) Penn 001 Guard Rail (86) See attached Diagram (87) Narrative - Vehicle 1 was traveling west on state road 0581 at the Carlisle Pike off ramp. The vehicle veered to the right and traveled onto the berm, striking the guard rail. The vehicle traveled along the guard rail ?ft 7" then left the roadway completely and entered a construction aree. The vehicle traveled 35ft 9" to the point of secondary impact where the passenger front side impacted on the ground near the base of a dl.rt mound. It then flipped and ??? catapulted over the dirt mound, traveling 30' 12" and again impacted with the ground on the passenger side. The vehicle then rolled over and came to final rest position on the passenger side, 35' 3" from the third impact point, with the vehicle leaning so that all four tires were not touching the ground. The rear seat passenger was ejected from the vehicle after second impact and landed on the dirt mound. He was sent to Hershey Medical Center. The operator, front seat passenger, were still in the vehicle-while at final rest position. The operator managed to climb out of the vehicle through the rear drivers side window. The front seat passenger, who was wearing a seat belt, was pinned in the vehicle and had to be extracted by ( rescue personel1. He was take to Hershey Medical Center by Life Lion? Helicopter. The operator was taken to Holy Spirit HOSpital by Ambulance. cant inued " , ' " 1\ " '_J l' , ' " " .,' , , , , , i " ., m I) " .' , " , , . , " " , . " , , , " , , , . . . . PROPOSED Ct.O.... It1461 SU'BJ&C'l' or CABB I PBRSQMAL IIIJVRY 1 CARQII IfIII'l'B aDd JOIIII WIII'l'B sa., .. CO-PDSOIIAL RUUSBII'l'A'l':tVBS or 'l'RII .S'l'A'l'II OP .ro1Dl .. WIII'l'B JR. v. CBRI8'l'IIfA SU'RFIBLD AD4 I'ROOUSSJ:VJI USUIl.AIICII CC*PAIIY 1 1IOIfI.. Uca:tVBD PROII l'ROGRJrSSIVI/ IRsmuurc. COIIPAIIY - PULL . FIlIAL SBftY,1R1VIT '.' >, ,I ,Us.ooo.oo .=......a................ LIISS DBDUC'l'IORS: (a) Atto~eY'e fe.e - 1/3 ...............~=......... $ 8,333.33 (b) COB'ts. .........'tIed by Law Pira: Photocopi.. .oaeege Long-dietane. talephon. calle Bxpre... Mail Pax Clerk of the Court Inv..tigativ. Servic.e - CSP Inveetigetion. "cUeel __o~. H.alth Information Servicem - H.rehey "ediaal center: Court "Dart.rel Hugh.e, Albrigbt, polta - ewo~ .tat.mante of Ar..cia Whit. Noel Whit. . Kar.n lfhit. 'tOTAL ADVAIfCaD COStS $ 88.00 $ 15.33 $ 31.31 $ 49.00 $ 42.00 $ 5.00 $ 121.90 $ 8.75 $ t7,50 I J...J.ILZl