HomeMy WebLinkAbout97-05491
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MO:<iRAW.IIAIT ol llEITl'IIMAN
.. l.ibaty Avenue
l"""ide, PA 1701J
""one: C7171249-4lOO
Fax: 17171249-4500
Allomcys r~ ~inli"
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
Joseph Nesmith, a/k/a Joe Nesmith, Jr.,
Plaintiff,
vs.
Nationwide Mutual Insurance Company,
Defendant
Civil Action - Law
Case No,: 97-5491
PRAECIPE FOR DEFAULT JUDGMENT
PURSUANT TO PA.R.C.P. IOJ7(b}
TO: Prothonotary
Please enter default judgment against Defendant, Nationwide Mutual Insurance
Company, pursuant to Pa.R.C.P, 1037(b), PlaintifT's counsel hereby CERTIFIES
pursuant to Pa,R.C,P, 231.l(a)(2)(ii) that written notice of intention to file the praecipe
was delivered to Defendant's counsel of record more than ten days prior to the date of
filing thi~ praecipe, Said notice is attached hereto as Exhibit "A."
Respectfully submitted,
McGRAW, HAlT & DEITCHMAN
(Allomeys for Plaintiffi
Date:
L/j)-J /J F
/ /
B
JeMlfer C. It:
Pa. ID #72779
4 Liberty A venue
Carlisle, PA 17013
Phone: (717) 249-4500
Fax: (717)249-450
CERTIFICATE OF SERVICE
I, JENNIFER C, DEITCHMAN, hereby certify that this 291h day of April 1998, I
served a copy ofthe foregoing PRAECIPE FOR DEFAULT JUDGMENT IJURSUANT
TO PA,R.C.P, 1037(b) upon the following individual(s) or entity(ies) by U.S, First Class
postage pre-paid mail:
Karen Durkin, Esquire
JAMES, SMITH, DURKIN & CONNELL Y
P.O. Box 650
Hershey. PA 17033 ~I
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Jennifer C, Deitchman (Attorney for Plaintiff)
Pa, ID #72779
McGRAW, HAlT & DEITCHMAN
4 Liberty A venue
Carlisle, PA 17013
Phone: (717)249-4500
Fax. (717)249-4500
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
Joseph Nesmith, aIkIa Joe Nesmith, Jr.,
PlaintitT.
Case No,: q., - 54'1 I C-<.~l N_
COMPLAINT NOTICE
vs,
Nationwide Mutual Insurance Company.
Defendant
NOTICE
You have been sued in court, If you wish to defend against the claims set forth in the followin
pages, you must take action within twenty (20) davs after this Complaint and Notice are served, b
entering a written appearance personally or by attorney and filing in writing with the court your defens
or objections to the claims set forth against you, You are warned that if you fail to do so. the case ma
proceed without you and judgment may be entered against you by the court without further notice for an
money claimed in the Complaint or for any other claim or relief requested by the PlaintitT(s), You ma
lose money or property or other rights important to you.
YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NO
HA VE A LAWYER OR CANNOT AFFORD ONE. GO TO OR TELEPHONE THE OFFICE SE
FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP,
Court Administrator
Fourth Floor
Cumberland County Courthouse
Carlisle, P A 17013
(717)697-0371
(717)240,6200
excess of the minimum co~erage required by the Pennsyl~ania Motor Vehicle Financial
Responsibility Law ("MVFRL"). 7S Pa,C,S, ~ 1701, fl. f,fq., as amended.
5, On or about June 10, 1993. while said automobile policy was in full force and elTect, Plaintiff was
in~ol~ed in a motor ~ehicle collision in which the ~ehicle in which he occupied, the 1966 Cadillace
co~ered under the aforementioned policy of insurance, was rear-ended by a ~ehicle dri~en by a third
party,
6. Plaintiff suffered injuries as a resull of said collision, namely:
a) cervical strain/spmin with spondylosis;
b) left shoulder rotator cuff syndrome and shoulder tendonitis;
c) lumbar strain/sprain; and
d) herniated lumbar disc at L5/S I and compression on the S I nerve root ("left S I mdiculopathy"),
7. As a result of said injuries due to the June 10, 1993 collision, Plaintiff has been obliged to seck and
recei~e treatment and care for his injuries, thereby incurring ~arious medical expenses for which
medical benefits under the aforesaid policy are payable. Plaintiff is expected to be obliged to
continue to recei~e medical care and treatment for the collision-related injures and expend ~arious
sums of money for an indefinite period of time in the future for such treatment for her injuries,
8. Plaintiff sought treatment by a specialist, Jay J, Cho, M.D., on or about January 21, 1994, who
performed an examination of plaintiff and diagnosed Plaintiff with low back pain with herniated disc
and radiculopathy; cer~ical pain with spondylosis and shoulder tendonitis. Thereafter, PlaintitT
sought and recei~ed further medical treatment from Dr, Cho and Trindlc Rehabilitation Center,
9. Trindle Rehabilitation Center was the precursor of Rehab Medicine Associates,
10. After initially paying for treatment by Dr, Cho and Rehab Medicine Associates, Defendant submitted
the issue of the treatment performed by Dr, Cho and Rehab Medicine Associates to a Peer Review
which was performed in March of 1995,
11. It was the reviewer's d<1ermination that "the physical therapy services at the Trindle Rehabilitation
Center were medically necessary and were reasonable through 7/31/94 and that the services of Dr,
Cho were medically reasonable and necessary through 9115/94," The PRO doctor ..'so opined that
"treatment beyond those dates would not be reasonable or necessary lor the motor vehicle accident
injuries 01'6/10/93,"
12. One factor in the PRO determination was that a fall in July of 1994 during which the PRO report
states that Plaintiff "twisted his left ankle and developed severe pain along the left side of his low
back," In his "Peer Review Recommendations" the reviewer cites to an "incident" and a "fall" in
June of 1994 which, in his opinion, aggravated a pre-existing degenerative arthritis condition and
caused bilateral pain, although the reviewer does not cite to a specific finding in his clinical summary
to support the assertion that Plaintiff was also experiencing right sided pain.
13. The reviewer thus stated: "Because of the aggravating incident in June [sic] of 1994, it is my opinion
that the additional treatment especially the pelvic traction and therapeutic exercises were due to a
separate incident which in all medical probability aggravat":d the pre-existing conditions from the
June of 1993 accident and also from the underlying degenerative arthritis,"
14, Defendant has refused payment for treatment rendered to Plaintiff by Dr, Cho and Rehab Medicine
Associates on the basis that such treatment has not been reasonable or necessary,
15. Plaintiff asserts that his fall in July of 1994 was directly related to th.lnjuries he sustained in the
June, 1993 motor vehicle accident. The injuries he sulTered in the June 1993 motor vehicle accident
were a proximate cause of his fall and thus any treatment for injuries related to the fall arise out of the
motor vehicle accident.
16, As an alternative to the above paragraph, the fall did not cause an exacerbation a pre,existing arthritic
condition. but rather aggravated the disc herniation caused by the June 1993 motor vehicle accident.
and is tbus related,
17. As such. PlaintilT contcnds that all of his treatment relaled to his low back impairments and
radiculopathy which has been provided by Dr, Cho and Rehab Medicine Associates is reasonable and
necessary and related to the June 1993 motor vehicle accident.
18, Additionally, Plaintitl'treals with Dr, Cho and Rehab Medicine Associates for other injuries sustained
in the June. 1993 accident. namely neck and shoulder pain, which Defendant was aware of at the lime
that it submitted the issue of Dr, Cho's treatment to the PRO.
19, PlaintitT. therefore claims that Defendant improperly invoked the PRO process to deny him benefits
for treatment of injuries which were causally related to the June, 1993 vehicle collision; lhat said
treatment was and continues to be reasonable and necessary. and that the PRO determination was
done in bad faith and with reckless disregard for the contractual and legal rights of PlaintilT.
20. Under the MVFRL, peer reviews are not to be used to determine the causal nature of treatment.
21, The PRO at issue concludes that the fall in June or July of 1994; not the June. 1993 motor vehicle
accident is the cause of the pain for which Mr, Nesmith treated with Rehab Medicine Associates after
7/31/97 and with Dr. Cho after 9/15/94, As such. this is an improper determination under the PRO
procedures allowed under the MVFRL.
22. The amount of unpaid bills known to Plaintiff as of June of 1997 was $982.00, Moreover. PlaintilT
has undertaken to make payments for such treatment on his own, or through other insurance coverage
available to him, The amount of bills paid by sources other than Nationwide for treatment rendered
after 7/31/94 by Dr, Cho and Rehab Medicine associates is approximatcly $889.00.
23, The care which Dr. Cho and Rehab Medicine Associates have provided has been reasonable and
necessary and is related to the injuries sustained in the June 10, 1993 collision,
24, It is anticipated that PlaintilT will require continuing care and treatment and surgery is contemplated
to allemptto alleviate PlaintitT's painful back condition.
25. Defendant's refusal to pay for the reasonable and n.'Cessary care of Plaintirrs injuries nnd its
submission of Dr, Cho and Rehab Medicine Associates' billings to a PRO violate both the applicable
insurance polley and the MVFRL.
26. Defendant's refusal to pay for the reasonable and necessary treatment of Plaintitrs injuries on the
basis ofa PRO determination that certain lreatmcnts after 7/31/94 and 915/94 were not casually
related to the June 10, 1993 motor vehicle collision Is outside of the scope of Act 6, Denials for
payments for further treatments have thus been made in bad faith in violation of42 Pa,C,S,A. ~8371.
WHEREFORE, Plaintiff claims damages in the amount of:
a) any unpaid bills by Defendant for Dr. Cho and Rehab Medicine Associates;
b) reimbursement for payments made by Plaintiff and/or any third parties for treatment rendered
by Dr, Cho and Rehab Medicine Associates;
c) as well as interest in the amount of the prime rate plus 3%;
d) allomey fees;
e) costs ohuit;
I) punitive damages;
g) and an order requiring Defendant to either payor challenge all future bills for treatment
related to the June 10, 1993 motor vehicle collision in accordance with the MVFRL.
h) and any other remedy the court deems appropriate,
I
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..
i) The ~alue of Ihis aelion is !!!1l in eKeess of $25,000,
1 '
Daled this 61h day ofO~ )),9;7 . -11-'--"
By: c/ 1/1 J'
mnifer C. Deitehman
Pa. ID #72779
MeORA W, HAlT &.
DEITCHMAN
4 Liberty A ~enue
Carlisle, PA 17013
Phone: (717)249-4500
Fax: (717)249-4500
AFFIDA vir
I verify that the statements made in the foregoing Complaint are trut and correct to the best of m
knowledge, information. and belief, The language is that of counsel. but ( have reviewed it for it
accuracy and I acknowledge that any false statements herein are made subject to the penalties of 18 Pa
C.S,A. Section 4904 relating to unsworn falsification to authorities.
Dat~' //~J~~~-:>
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initially paying for treatment by Dr. Cho and Rehab Medicine
Associates".
6, Paragraph fourteen (14) of Plaintiff's complaint alleges
that "Defendant has refused payment for treatment rendered to
Plaintiff by Dr. Cho and Rehab Medicine Associates on the basis
that such treatment has not been reasonable or necessary".
7. Pa.R.C,P, 1019{f) requires that "averments of time, place
and items of special damages shall be specifically stated."
8, The aforementioned paragraph ten (10) fails to state
specifically the time period or dates corresponding with the phrase
"initially" used by Plaintiff to indicate prior instances of
payment by Defendant,
9. The aforementioned paragraph fourteen (14) fails to state
in any respect the time or date of Nationwide's denial of coverage
or refusal to pay for Plaintiff's medical treatment.
10. Paragraph nineteen (19) of Plaintiff's complaint purports
to allege bad faith on the part of the Defendant by alleging that
"Defendant improperly invoked the PRO process to deny him benefits
for treatment of injuries that were causally related to the June
1993 vehicle collision; that said treatment was and continues to be
reasonable and necessary, and that the PRO determination was done
in bad faith and with reckless disregard for the contractual and
legal rights of Plaintiff".
11, Paragraph twenty-one (21) of Plaintiff's complaint
purports to allege bad faith on the part of the Defendant by
alleging that Defendant's Peer Review constituted "an improper
determination under the PRO procedures allowed under the MVFRL".
12, Paragl'aph twenty,five (25i of Plaintiff's complaint
purports to allege bad faith on the part of Defendant by alleging
that "Defendant's refusal to pay for the reasonable and necessary
care of Plaintiff's injuries. ,violates both the applicable
insurance policy and the MVFRL" ,
13. Paragraph twenty-six (26) of Plaintiff's complaint
purports to allege bad faith on the part of Defendant by alleging
that "Defendant's refusal to pay for the reasonable and necessary
treatment of Plaintiff's injuries, . . is outside of the scope of
Act 6",
14, Pa. R,C.P. 1019(a) requires that material facts on which
a cause of action is based shall be stated in a concise and summary
form.
15. The aforementioned paragraphs nineteen (19), twenty-one
(21), twenty-five (25), and twenty-six (26) of the Plaintiff's
Complaint containing bare allegations of reckless and unreasonable
conduct fail to set forth with sufficient specificity the material
facts on which a cause of action for bad faith may be based.
16. Plaintiff's Complaint lacks sufficient specificity to
apprise Defendant of the issues to be litigated, to allow it to
adequately prepare to assert defenses to Plaintiff's allegations.
WHEREFORE, Defendant Nationwide respectfully requests this
Honorable Court order Plaintiff to more specifically plead the
averments of paragraphs Ten (10), Fourteen (14), Nineteen (19),
Twenty'one (21), Twenty-five (25), and Twenty-six (26) of his
Complaint.
PRELIMINARY OBJECTION RAISING FAILURE OF PLEADING
TO CONFORM TO LAW OR RULE OF COURT
Defendant, by its undersigned attorney, preliminarily objects
to Plaintiff's Complaint pursuant to Pa, R,C,P. 1028(a) (2) as
follows:
17, Paragraphs eleven (11)
through thirteen
(13)
of
Plaintiff's complaint contain allegations based upon the report
generated by the Peer Review Organization.
18. Paragraph twenty-two (22) of Plaintiff's complaint
contains allegations purporting the amount of unpaid medical bills
and suggests that "Plaintiff has undertaken to make payments for
such treatment on his own, or through other insurance coverage
available to him",
19. Pa, R.C.P, 1019(h) requires that" [al pleading shall state
specifically whether any claim or defense set forth therein is
based upon a writing.
If so, the pleader shall attach a copy of
the writing .
"
20. The Plaintiff failed to attach the documents mentioned
specifically in paragraphs eleven (11), twelve (12), thirteen (13),
and twenty-two (22) of the Complaint,
WHEREFORE, Defendant Nationwide respectfully requests this
Honorable Court order Plaintiff to attach a copy of the writings
relied upon in paragraphs Eleven (11), Twelve (12), Thirteen (13),
and Twenty- two (22) of his Complaint to his answer to these
preliminary objections.
Exhibit A
Jennifer C. Deitchmun
Pa. ID #72779
McGRAW, HAlT & DEITCHMAN
4 Liberty A venue t
Carlisle, PA 17013
Phone: (717)249-4500
Fax: (717)249-4500
~
Attorneys for Plaintiff
,
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
Joseph Nesmith, nlk/a Joe Nesmith, Jr"
Plaintiff,
Civil Action - Law
Case No,: q 7 - S-Y?, fu.:.I -r..L-
vs.
Nationwide Mutual Insurance Company,
.
COMPLAINT
Defendant
\, Plaintiff, Joseph Nesmith, nlk/a Joe Nesmith, Jr., is an adult Individual residing at 424 Fairground
Avenue, Carlisle, Cumberland County, PA 17013.
2, Defendant, Nationwide Mutual Insurance Company, is a company duly licensed to transact business
in the Commonwealth of Pennsylvania, Defendant maintains a place of business at 1000 Nationwide
Drive, Harrisburg, Dauphin County, Pennsylvania,
3, Prior to June 10, 1993, Defendant issued to Plaintiff a policy of automobile insurance bearing number
5837 C 311026,
4. Thc insurance policy provided for $100,000,00 in First Party Medical Loss Benefit coverage on both
vehicles covered under the policy, a 1976 Cadillac and a 1977 Ford Pickup, which amount was in
17. As such, PlaintifT contends that all of his trealment related to his low back impairments and
radieulopathy which has been provided by Dr, Cho and Rehab Medicine Associates is reasonable and
-
necessary and related to the June 1993 motor vehicle accident,
18, Additionally, PlaintifTtreats with Dr, Cho and Rehab Medicine Associates for other injuries sustained
in the June, 1993 accident, namely neck and shoulder pain, which Defendant was aware of at the time
that it submitted the issue of Dr, Cho's treatment to the PRO.
19, PlaintiO; therefore claims that Defendant improperly invoked the PRO process to deny him benefits
.
for treatment of injuries which were causally related to the June, 1993 vehicle collision; that said
treatment was and continues to be reasonable and necessary, and that the PRO determination was
done In bad faith and with reckless disregard for the contractual and legal rights of PlaintifT. .
20. Under the MVFRL, peer reviews are not to be used to determine the causal nature of treatment. .L
21, The PRO at issue concludes that the fall in June or July of 1994; not the June, 1993 motor vehicle
.
accident is the cause of the pain for which Mr, Nesmith treated with Rehab Medicine Associates after
7/31/97 and with Dr, Cho after 9/1 5/94, As such, this is an improper determination under the PRO
procedures allowed under the MVFRL,
22, The amount of unpaid bills known to Plaintiff as of June of 1997 was $982,00, Moreover, PlaintifT
has undertaken to make payments for such treatment on his own, or through other insurance coverage
available to him, The amount of bills paid by sources other than Nationwide for treatment rendered
after 7/31/94 by Dr. Cho and Rehab Medicine associates is approximately $889,00,
23, The care which Dr, Cho and Rehab Medicine Associates have provided has been reasonable and
necessary and is related to the injuries sustained in the June la, 1993 collision,
24. It is anticipatcd that PlaintifT will require continuing care and treatment and surgery is contemplated
to allemptto alleviate PlaintifT's painful back condition.
CERTIFICATE OF SERVICE
I, KAREN DURKIN, ESQUIRE, do hereby certify that I served a
true and correct copy of the foregoing Preliminary Objections upon
the following below-named individual(sl by depositing same in the
U. S. Mail, postage pre-paid at Hershey, Dauphin County,
Pennsylvania this
~
,~ day of December, 1997.
SERVED UPON:
Jennifer C, Deitchman, Esquire
McGraw, Hait & Deitchman
4 Liberty Avenue
Carlisle, PA 17013
r Durkin, Esquire
JAMES, SMITH k DURKIN
.
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Office of the Sheriff
Mary Jane Snyder
\~eal L:ilole OopulV
Ralph Q, McAllister
Chief Ouputy
Michael W. Rinehart
AI..llanl Chlo' Doputy
Wilham T, Tully
80llcllor
Douphin Counly
Hnrrl6bUlg, P(Jnn6~hill,njil1/101
(/11) 255 2660
J. R. Lotwick
Sheriff
COMMONWEALTH OF PBNNSYLVANIA
COUNTY O~ DAUPHIN
SHBRIFF'S RETURN
No. 2309-T - - -97
OTHER COUNTY NO. 97-5491
AND NOW. October 14, 1997 at 11120AM served the within
COMPLAINT (, NOTICE upon
NATIONWIDE MUTUAL INSURANCE CO. by personally handing to
AMY PATTON - ADMIN SECRETARY 1 true attested copy ( ies) of
the original COMPLAINT,. NOTICE and making known to
him/her the contents thereof at 1000 NATIONWIDE DR.
HARRISBURG, PA 00000-0000
Sworn and subscribed to
S;C ~.T~a~19"
I PROTHONOTARY
S~f~
~eriff of Dauphin C
nty, Pa,
Sheriff's COStSI
$29.25 PD 10/09/97
RCPT NO 101974
RB
JoseP41 Nesmith a/kid ,Joe Nesmith. ,Jr.
\'S.
Nationwide Mutual Insurance Crnnpany
No,
97-5491 Civil Term
19_
Now, Dc t. 8.
Dauphin
1997 19_,1 SHERIFF Of Cl'MBERLA:'o1> COl'>'iTY, PA do bmb~ deputize Ibe SberlffoC
COUDl)' 10 UICUlllhls Writ, Ihls depulalloD belni made al tbe request and risk oftbe Plalnlirr,
.~~~
r .. -r.-e;;<- c..f'
Sheriff oC Cumberland Counl), Pa.
Affidlwit of Sen'ice
~.ow,
19
.01
o'clock
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within
UpOD
at
by b3ndi[J~ fa
artelled cop~' of tbe oriilDol
Ibe contenlS IblreoC.
a true and
and made known 10
So answers,
....
Sberlff DC
Counl), Pa.
COSTS
S"orn and lub,cribed beCore
me thi~ da~. or
19_
SERVICE
MILEAGE
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J~nnirer C. Ddlchman (Attorney llJr Plainlin)
I'a. ID #72779
McGRAW, HAlT & DEITCH MAN
4 Liberty A venue
Carlisle,I'A 17013
I'hone: (717)249-4500
Fax: (717)249-4500
IN TIlE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, I'ENNSYL VANIA
Joseph N~'Smith, alkla Joe N.'Smith, Jr.,
PlaintitT,
Case No.: 97-5491
Civil Action - Law
vs.
AMENDED COMPLAINT NOTICE
Nationwide Mutual Insurance Company,
Defendant
NOTICE
You have been sued in court. If you wish 10 defend against the claims set forth in the followin
pages, you must take action within tw:ntv (20) davs aller this Complaint and Notice are served, b
entering a written appearance personally or by attorney and tiling in writing with the court your de fens
or objections to the claims sct forth against you. You arc warn cd that if you fail to do so, the case ma
proceed without you and judgmcnt may be entered against you by the court without further notice for an
money claimed in the Complaint or for any other claim or relief requested by Ihe PlaintitT{s). You ma
lose money or property or other rights important to you.
YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NO
HA VE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SE
FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP.
Court Administrator
Fourth Floor
Cumberland County Courthouse
Carlisle,PA 17013
(717)697-0371
(717)240-6200
Jennifer C. Deilchman
Pa. ID #72779
McGRA W. IlAIT & DEITCIlMAN
4 Liberty A venue
Carlisle. PA 17013
Phone: (717)249-4500
Fax: (717)249-4500
~,'
Attorneys for Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY. PENNSYLVANIA
Joseph Nesmith. a/k1a Joe Nesmith. Jr..
Plaintiff.
Civil Action - Law
Case No.: 97-5491
vs.
AMENDED COMPLAINT
Nationwide Mutual Insurance Company,
Defendant
In response to the Preliminary Objections tiled by Defendant on or about the 5th day of
December, \997, Plaintiff hereby tiles this Amended Complaint in the above-captioned action:
I. Plaintiff, Joseph Nesmith, a/k1a Joe Nesmith. Jr.. is an adult individual rL'Siding at 424 Fairground
Avenue, Carlisle, Cumberland County, PA 17013.
2. Defendant. Nationwide Mutual Insurance Company, is a company duly licensed to transact business
in the Commonwealth of Pennsylvania. Defendant maintains a place of business at 1000 Nationwide
Drive. Harrisburg. Dauphin County, Pennsylvania.
3. Prior to June 10,1993, Defendant issued to Plaintiffa policy of automobile insurance bearing number
5837 C 3\1026.
4. The insurance policy provided for $\ 00,000.00 in First Party Medical Loss Benefit coverage on both
vehicles covered under the policy, a \976 Cadillac and a 1977 Ford Pickup. which amount was in
excess of the minimum coveragc rC4uired hy the Pcnnsylvania Motor Vchicle Financial
Responsibility Law ("MVFRL"), 75 I'a.es. Ii 1701. el, e"q,. as amendcd.
5. On or about June 10, 1993. while said automobile policy was in full force and etTect. Plaintiff was
involved in a motor vehicle collision in which the whicle in which he occapied. the 1966 Cadillac
covered under the aforementioned policy of insurance. was rear-ended by a v~hiclc driven by a third
party.
6. PlaintitT sulTered injuries as a r~'Sult of said collision. namcly:
a) cerllical strain/sprain with spondylosis;
b) lel\ shoulder rotator cuff syndrome and shoulder tendonitis;
c) lumbar strain/sprain; and
d) herniated lumbar disc at LS/5 I and compr~'Ssion on the 5 I nerlle root ("Iel\ S I radiculopathy").
7. As a resalt of said injuries due to the June 10, 1993 collision. Plaintiff has been obliged 10 seck and
receive treatment and care for his injaries. thereby incurring various medical expenses for which
medical benefits under the aforesaid policy arc payable. PlaintitT is expected to be obliged to
continue to receive medical care and treatment for the collision-related injures and expend various
sums of money for an indefinite period of time in the future for such treatment for her injuries.
8. Plaintiff sough I treatment by a sp,'Cilllist. Jay J. Cho. M.D,. on or about January 21. 1994, who
performed an examination of plaintiff and diagnosed Plaintiff with low back pain with herniated disc
and radiculopathy; cervical pain with spondylosis and shoulder tendonitis. Therealler. Plaintiff
sought and received further medical treatment from Dr. Cho and Trindle Rehabilitation Center.
9. Trindle Rehabilitation Center was the pr.'Cursor of Rehab Medicine Associates.
10. Aller initially paying for treatment by Dr. Cho and Rehab Medicine Associates. Defendant submiued
the issue of the treatment performed by Dr. Cho and Rehab Medicine Associates to a Peer Review
which was performed in March of 1995. A true and correct copy of said Peer Review Report is
attached hereto as Exhibit" A."
II. It was the reviewer's determination that "the physical therapy serviees at the Trindle Rehabilitation
Center were medically necL'Ssary and were reasonable through 7/31/q4 and that the services of Dr.
Cho were medically reasonable and necL'Ssary through 9/15/Q4." The PRO doctor also opined that
"treatment beyond those dates would not be reasonable or necessary "'r the motor vehicle accident
injuries 01'6/10/93." (See Exhibit "A"),
12. One factor in the PRO determinatiGn was that a lall in July of 1994 during which the PRO report
states that Plaintiff"twisted his lell ankle and developed severe pain along the left side of his low
back." In his "Peer Review Reeommendations" the reviewer cites to an "incident" and a "fall" in
June of 1994 which, in his opinion, aggravated a pre-existing degenerative arthritis condition and
caused bilateral pain, although the reviewer does not cite to a spL"Cific finding in his clinical summary
to support the assertion that PlaintilT was also experiencing right sided pain. (See Exhibit "A").
13. The reviewer thus stated: "Because of the aggravating incident in June [sicl of 1994, it is my opinion
that the additionaltrcatmcnt especially the pelvic traction and therapeutic exercises wcre due to a
separate incident which in all medical probability aggrnvatL'll the pre-existing conditions from the
June of IQ93 accident and also from the underlying degenerative arthritis." (See Exhibit "A").
14, Defendant has refused payment for treatment rendered to Plaintin'by Dr. eho and Rehab Medicine
Associates on the basis that such treatment has not been rcasonable or nccL'Ssary. A true and correct
copy of Defendant's notification that it would not pay further benefits is attached hereto as Exhibit
HB."
15. Plaintiff asserts that his fall in July of 1994 was dirL'Ctly related to the injuries he sustained in the
June, 1993 motor vehicle accident. The injuries he sufTered in the June 1993 motor vehicle accident
were a proximate cause of his lall and thus any treatment for injuries related to the fall arise out of the
motor vehicle accident.
16. As an alternative lu the ahove panlgraph, Ihe f'llI .!i.! nol cause an exacerbaliun a pre-exbling artbrilic
con.!ition. but rather aggraval.-.J the .!isc herniation cause.! by Ihe June 1993 motor vehicle accidenl.
an.! is Ihus relale.!.
17. As such. Plainlitl'conlen.!s Ihal all of his Irealment relaled 10 his low back impairmenls an.!
ra.!iculopalhy which has been provi.!e.! by Dr. Cho an.! Rehab M.-.Jicine Associllles is reasonable and
nec.ossary an.! relate.! to the June 1993 motur vehicle acci.!en\.
18. Ad.!itionally. Plainlitftreats with Dr. Cho an.! Rehab M.>dicine Associates for other injuries sustained
in the June, 1993 aeci.!ent. namely neck an.! sholJI.!er pain. which Defen.!anl was aware of at the time
that it submilled Ihe issue of Dr. Cho's treatment 10 the PRO.
19, PlaintiIT. therefore claims that Defendant improperly invoked the PRO process to deny him benefits
for trealment of injuri.'S which were causally relate.! to the June. 1993 vehicle collision; that said
treatment was an.! conlinues 10 be reasonable an.! ne<:essary. an.! thaI the PRO determination was
done in bad faith and with disregar.! for the contractual and legal rights of PlaintiIT.
20. Under the MVFRL. peer reviews are not 10 be use.! to determine the causal nature of Ire at men\.
21. The PRO at issue conclu.!es that the fall in June or July of 1994; nolthe June, 1993 motor vehicle
acci.!ent is the cause of the pain for which Mr. Nesmith Ireated wilh Rehab Medicine Associates after
7/31/97 and with Dr. Cho after 91:5/94. (See Exhibit "A"). This factual basis. namely causation.
which forms Defendanl's reason for denying payments is an improper determinalion under the PRO
proce.!ures allowed under the MVFRL. E.g.. Neun v. Slale Farm. E.D. no.95-7577 (5/2/96); Pierce
v. Slate Farm Insurance COmDany. CP Lackawanna 10/20/94 (PICS No. 94-2129).
22. The amount of unpaid bills known to PllIintitl' as of June of 1997 was $982.00. Moreover, PlaintiIT
has undertaken to make payments for such Ireatment on his own. or through other insurance coverage
available 10 him. The amount of bills paid by sources other Ihan Nationwide for trealment rendered
after 7/31/94 by Dr. Cho an.! Rehab M.>dicine associates is approximately $889.00. Copies of
account statements concerning Plaintill"s care arc attached hereto as Exhibit "C."
23. The care which Dr. Cho and Rehab Medicine Assnciatc'S have provided has been reasonahle and
necessary and is related to the injuric'S sustained in the June 10, 1993 collision.
24, It is anticipated that Plaintil1' will require continuing care and treatment and surgery is contemplated
to attempt to alleviate Plaintiff's painful back condition.
25. Defendant's refusal to pay lor the reasonable and necessary care of Plaintiffs injuries and its
submission of Dr. Cho and Rehab Medicine Associates' billings to a PRO violate both the applicable
insurance policy and the MVFRL.
26. Defendant's refusal to pay for the reasonable and nc"Cessary treatment of Plaintil1's injuries on the
basis of a PRO determination that certain treatments after 7/31194 and 915/94 were not casually
related to the June 10, 1993 motor vehicle collision is outside of the scope of Act 6. Denials for
payments lor further treatments have thus been frivolous and unfounded in violation of 42 Pa.C,S.A,
~8371 ,
WHEREFORE, PlaintilT claims damages in the amount of:
a) any unpaid bills by Defendant lor Dr. Cho and Rehab Medicine Associates;
b) reimbursement for payments made by Plaintil1' and/or any third parties for treatment rendered
by Dr. Cho and Rehab Medicine Associates;
c) as well as interest in the amount of the prime rate plus 3%;
d) attorney fees;
e) costs of suit;
l) punitive damages;
g) and an order requiring Defcndantto either payor challenge all future bills for treatment
related to the June 10, 1993 motor vehicle collision in accordance with the MVFRL,
h) and any other remedy the court deems appropriate.
i) The value of this action is not in cxeess of $25,000,
By:
.
ennili:r . Deite inan
Pa. ID #72779
McGRAW, f1AIT &
DEITCflMAN
4 Liberty A venue
Carlisle, P A 17013
Phone: (717)249-4500
Fax: (717)249-4500
HOME OFFICE
6618 BLACK HORSE PIKE' CARDIFF. NJ 081Jl
'609'641'UOO
r A REGIONAL OFFICE
110 8ETHLEHEM PIKE, r,o, UOX ~t.I" COI.MAR. PA 18915.0566
11151 997.8413
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March 2, 1995
Ms. Debra Davis
Nationwide Insurance company
P.O. Box 2655
Harrisburg, PA 17105
Re: Joseph Nesmith
Claim I: 5837C 311026 06109301FPB
IMC I: 2869PA
Dear Ms. Davis:
At the request of Independent Medical Consultants, I
reviewed certain medical records which were submitted to
me on the above named individual. These records included
the following:
1. Reports from the Carlisle Hospital Emergency
Room, dated 6/10/93.
2. X-ray report of 6/10/93 of the thoracolumbar
spine.
3. Reports from the office of Dr. Kipp from 6/11/93
through 6/28/93.
4. Reports from the office of Dr. Thomas J. Green,
M.D. from 7/15/93 through 12/29/93.
5. Reports from the offices of the Rehabilitation
Medicine Associates and Dr. Cho from 1/21/94
through 12/2?/94.
6. Reports from the Alexander spring Rehabilitation
Center of Carlisle pennsylvania from 7/22/93
through 8/24/93.
7. Records from the East Shore Rehabilitation
Center from 10/7/93 through 1/27/94.
8. Records from the Trindle Rehabilitation Medicine
Center from 1/24/94 through 12/14/94.
9. Records from the seidle Memorial Hospital of
Mechanicsburg, Pennsylvania for a
hospitalization from 5/9/94 through 5/24/94.
10. Copies of diagnostic studies which included the
following: CT Scan of the lumbosacral spine,
dated 6/24/93; MRI Scan of the Lumbosacral
Spine, dated 8/10/93; EMG, dated 8/13/93; MRI
Scan of the Lumbosacral Spine, dated 1/21/94;
X-ray of the cervical and lumbosacral spine,
dated 1/24/94; x-ray of the left shoulder and
EXHIBIT
I
A
Centers IocBlfld IhlOuoh<lU' Now Jorsey, Peflllsylvanld ,nd Mdntlarr.tn
Nesmith, Joseph
Page 2
cervical spine, dated 5/10/94; EMG report of 1/25/94; MRI
Scan of the Left Shoulder, dated 5/12/94; Chem Profile,
dated 617/94 and EMG Report, dated 9/6/94.
11. copies of prescriptions for medication, diagnostic studies
and therapy.
CLINICAL SUMMARY
According to the records, the claimant was reportedly involved in
a motor vehicle accident which occurred on 6/10/93. He was fifty-
eight years old at the time of the accident and was a restrained
driver of a vehicle that was rear ended by another vehicle. He
went to the Emergency Room at the Carlisle Hospital with complaints
of neck pain. X-rays of the cervical and thoracic spine in the
Emergency Room revealed degenerative arthritis of the cervical
spine without any evidence of acute abnormalities. The claimant
was diagnosed with neck and back strain, given prescriptions for
anti-infl~mmatory medications and recommendations to apply moist
heat and follow up with his Family Physician. It should be noted
that the records indicate thnt the claimant's past medical history
was significant for a ruptured disc from the 1970's, stomach ulcer,
degenerative joint disease and past nasal surgery.
The claimant did undergo an evaluation by his Family Physician, at
which time he was having complaints of cervical and lower back
pain. These evaluations and treatment from his Family Physician
took place throughout June of 1993 at which time the claimant was
diagnosed with degenerative disease, cervical and back strain. It
was in June of 1993 that the claimant underwent a CT Scan of the
lumbosacral sprain which showed some slight disc bulging at L4-L5
along with advanced degenerative disc disease at the lumbosacral
level and evidence of a degenerative disc herniation at the L4-L5
level.
The claimant was referred to an Orthopedic Specialist who felt that
the claimant had sustained a low back strain from the motor vehicle
accident and was left with a residual sacroiliac syndrome. The
claimant was subsequently referred to the Alexander Spring
Rehabilitation Facility for a course of outpatient physical therapy
treatments from July through August of 1993. These treatments
consisted of moist heat, ultrasound, massage and therapeutic
exercises.
The claimant underwent an MRI Scan of the Lumbar Spine on 8/10/93
which revealed a disc herniation at L5-S1 and some compression on
the SI nerve root. An EMG study in August of 1993 was interpreted
as being within normal limits.
The claimant was subsequently referred by Dr. Green to the East
Shore Rehabilitation Center for further physical medicine
Nesmith, Joseph
Page J
evaluations and treatment. This treatment took place from October
of 1993 through January of 1994. Despite these treatments, however
the claimant continued to experience primarily neck and lower back
pain. He was referred to the Rehabilitation Hedicine Associates in
January of 1994. Dr. cho evaluated the claimant and Lelt that he
had a radiculitis and a herniated disc of the lumbar spine. There
was some history in Dr. Cho's notes of the claimant having one
episode of bladder and bowel incontinence. This happened in
January of 1994. The claimant was referred to the Trindle
Rehabilitation Center for additional physical therapy modalities.
Another EHG study was obtained in January of 1994 which was
consistent with a left Sl radiculopathy and another HRI Scan
revealed a herniated disc at L5-S1. The claimant was placed on
corticosteroid therapy along with the physical therapy treatments.
He also underwent an epidural steroid injection in Harch of 1994
and received anti-inflammatory medication. He was followed on a
regular basis by Dr. cho who noted by April of 1994 that the
claimant had undergone a series of epidural steroid injections. By
that time, the claimant's radicular pain in the left leg had
subsided but he was still having complaints of lower back pain,
neck pain and left shoulder pain. It was recommended that he
continue with physical therapy treatments, anti-inflammatory
medication and Darvocet. Despite this treatment, the claimant
continued to have persistent complaints of pain and he was
eventually admitted into a hospital for approximately two and a
halL weeks for additional treatment including intravenous Decadron.
It was also LeI t that the claimant possibly had a rotator cuff
injury of the left shoulder and an HRI Scan was obtained in Hay of
1994 which was noted to be within normal limits. By early June of
1994, it was felt that the claimant was doing better. His only
complaint at that time was fatigue and blurry vision. It was felt
that the claimant's radiculopathy of the left Sl and left C5 nerve
roots had improved. It was also felt that the cervical spondylosis
had improved. In July of 1994, another progress note referred to
another injury which occurred in front of a restaurant in which the
claimant twisted his left ankle and developed severe pain along the
left side of his lower back. Prior to that the claimant was
receiving therapeutic exercises to the cervical and lumbar region
as well as work simulation treatments in physical therapy.
Following the incident in July of 1994, further outpatient physical
therapy was recommended.
The claimant continued to undergo regular evaluations by Dr. Cho
from July of 1994 through January of 1995. Another EHG study was
obtained in September of 1995 which showed an acute L5
radiculopathy along with a chronic Sl radiculopathy. The claimant
was switched to Daypro and Relafen and continued with stretching
activities and therapeutic exercises. It should be noted that the
claimant was placed on bed rest in August of 1994 because of an
aggravation of his symptoms and findings of muscle spasms in the
lower back.
",
Nesmith, Joseph
Page 4
In October of 1994, the claimant was referred for another epidural
injection at which time it was felt that if the symptoms did not
improve that he might need a surgical opinion. The claimant was
taking Relafen at that time and continued to primarily have
complaints of lower back pain. Because of those symptoms in
october he was started with a course of pelvic traction, which
improved his symptoms. This was continued twice a week for a
period of eight weeks along with the Relafen and exercises. The
claimant was again evaluated in December of 1994 at which time he
was still having complaints of lower back pain and this was
associated with some weakness in his lower extremities. The
claimant was recommended to continue taking anti-inflammatory
medication and pelvic traction.
PEER REVIEW RECOMMENDATIONS
Based on a review of the records, it is my opiniolJ that it was
medically reasonable and necessary for this claimant to undergo
evaluations and treatment recommended by Dr. Jay cho for the
alleged motor vehicle accident injuries of 6/10/93. Although the
claimant did have a pre-existing history of degenerative disc
disease, at least three diagnostic studies did reveal evidence of
a herniated disc at L5-S1 and this was associated with EHG findings
of an L5-S1 radiculopathy. The records indicate that the claimant
made satisfactory progress with various forms of treatment
including physical therapy, steroid treatments and epidural steroid
blocks through June of 1994. In late June the claimant sustained
another injury which aggravated his lower back pain primarily on
the left side. He did, however go on to experience the pain not
only on the left side, but also on the right side as well. Because
of this second incident, the claimant continued to require various
forms of physical therapy treatments, pelvic traction, medication
and office evaluations. with respect to the injuries that could be
considered motor vehicle accident injuries of June of 1993, it is
my opinion that the evaluations by Dr. cho through 8/23/94 were
reasonable and necessary. It is my opinion that the symptoms and
treatment beyond that date cannot be considered injuries f.om the
motor vehicle accident, but were very likely due to his pre-
existing degenerative arthritis and the aggravation that occurred
following the fall in June of 1994. It is my opinion that the
second EMG study by Dr. cho was clinically appropriate.
with respect to the physical therapy services at the Trindle
Rehabilitation Center, it is my opinion that with respect to the
June of 1993 motor vehicle accident injuries the services provided
were medically necessary and reasonable through 7/31/94. Because
of the aggravating incident in June of 1994, it is my opinion that
the additional treatment especially the pelvic traction and
therapeutic exercises were due to a separate incident which in all
medical probability aggravated the pre-existing conditions from the
Nesmith, Joseph
Page 5
June of 1993 accident and also from the underlying degenerative
arthritis.
with respect to Haximum Therapeutic Benefit of treatment, it is my
opinion that the physical therapy services at the Trindle
Rehabilitation Center were medically necessary and reasonable
through 7/31/94 and that the services by Dr. Cho were medically
reasonable and necessary through 9/15/94. For the reasons noted
above, it is my opinion that treatment beyond these dates would not
be reasonable or necessary for the motor vehicle accident injuries
of 6/10/93.
If I can be of any further assistance to you with respect to this
file or if you have any questions regarding my report, please
contact me at your convenience.
Sincerely yours,
^ 1 e.....l. U e-:-c...-t~, AA.~][..6
/M~ A. H~~~ico, M.D.
Independent Medical Consultants, Inc.
DICT:klw
.'
BILLING OFFICE
51Zq E Irindle Road
Mechdnlcsburg PA 1/0&&
Phone": 117-79&-7935
fIN" :3 ,~107032
TO: JOE NESMITH JR
q;:q FAIRGROUND AVE
CARLISLE,PA 17013
I ACCOUNl IAMOUNT DUEIClOSE DAlEIPAGE
1------------------------------------
Inesmjo-011 36&.00 I 06/16/97 I 01
-------------------------------------
Please Make Check Payable 10.
fRINDlE REHAB MEDICINE CENIER
rhls account l~ now due. Pled&e send payment today. If this claIm has
been submitted to your In~urance carrier, please contact them.
DATE IDR.IPArIENTIPROC CDEI
DESCRIPllON
I DIAG 1 AMOUNT
---------------------------------------------------------------~._------------
02/14/96Ipt
0<./14/961 pt
02/14/96 pt
02/14/96 pt
02/14/96 pt
02/14/96 pt
02/14/96 pt
02/1&/96 pt
02/1&/96 pt
02/1&/96 pt
02/19/96 pt
0<:/19/96 pt
02/19/96 pt
02/19/96 pt
02/19/96 pt
02/21/96 pt
0l/21/96 pt
02/21/96 pt
02/21/96 pt
0;:/21/96 pt
112/21/96IPt
02/22/96Ipt
02/22/961pt
0~/22/96Ipt
Joe
Joe
Joe
Joe
,Joe
Joe
Joe
Joe
Joe
Joe
Joe
Joe
Joe
Joe
Joe
Joe
Joe
Joe
Joe
Joe
Joe
Joe
Joe
Joe
Ne w971&
Ne W97<:0
Ne Q0103
Ne Q0104
Ne 97032
Ne 99070
Ne 97010
Ne 97032
Ne 97124
Ne 97010
Ne w971&
Ne W9720
Ne 97032
Ne 97124
Ne 97010
Ne u9710
Ne W9720
Nel97110
Ne 197032
Ne1971;:4
Nel97010
Nel97110
Ne 197032
Nel97010
IPhyslcal Therapy 2+ More Modal7242
lEach Additiona 1& Min To W97117242
IPI Eval. Medi~are,W/C,Auto - ~7242
IPT Eval. Medicare,W/C,Auto - 17242
IpI Eiectric Stlm,manuai Each 1/242
IElectrodes- Disposable \7242
PI Hot/Cold Packs 17242
PT Electric Stim,manual Each 17242
PT Massage 17242
PT Hot/Coid Pack~ 17242
Physical rher~py 2+ More Modal7242
Each Additlona 1& Mln To W9711724<:
Pl Electric Stim,manual E~ch 17242
PT Ma"sage 17242
PI Hot/Cold Packs 17242
PhYGical Therapy 2+ More Modal7242
Each Additiona 1& Min Fo W97117242
Phy<.ical Therapy, InitIal {117242
PI Electric Stim,manuai Each 1/242
PT Massage 17242
PT flot/Cold Packs 17242
Phy<.ical Therapy, Initial (1\7242
PF Electric Stim,m~nudl Each 1/242
IPT Hot/Cold Packe 172q2
60.00
90.00
60.00
30.00
46.00
26.00
20.00
4&.00
3&.00
20.00
60.00
30.00
46.00
36.00
20.00
60.00
60.00
3&.00
4&.00
36.00
20.00
3&.0Il
45.00
20.00
..------. -------------------------------------------------------------------
ACCOUNT NOICURRENI I 31-60 I 61-90 1 91-120 lOVER 1201
___________________ ---------------------------------------1
ne~rnjo-01 I 0,001 0.001 0.001 0.001 365.001
I I I I I I
..---.------------------
EXHIBIT
--------------------------- I
ICONTINUED
I
c
BIllING OFFICE
~12q E Irindle Road
Mechanlcsburg rA 1/0&&
Phone~. 717-79&-7D3~
ElN~ 23-2107032
TO. JOE NESMIIH JR
q;:q FAIRGROUND AVE
CARLISLE,PA 17013
I ACCOuNT IAMOUNI UU~ICL05E DAfElpAGE
1------------------------------------
Inesmjo-011 365.00 1 06/16/97 1 02
Please Make Check Payable To:
TRINDLE REHAB MEDICINE CENTER
This account is no~ due. Pledse send payment today. If thIs ciaim hds
been submitted to your insurance carrier, pledse cont~ct them.
DATE IDR.lpA1 IEN11PROC CDE
02/26/96Ipt IJoe
02/26/961 pt 1J0e
02/26/96Ipt IJoe
02/27/96Ipt IJoe
02/27/96Ipt IJoe
02/27/96Ipt IJoe
02/28/96Ipt IJoe
02/28/96Ipt 1J0e
02/28:96Ipt 1J0e
02/29/96\pt IJoe
02/29/96Ipt IJoe
02/29/96Ipt IJoe
03/04/96Ipt 1J0e
03/04/961 pt 1J0e
03/04/96Ipt IJoe
03/04/96\pt IJoe
03/04/96Ipt IJoe
03/06/961 pt 1J0e
03/06/961 pt 1 Joe
03/06/96Ipt 1J0e
03/06/96Ipt IJoe
03/06/96lpt IJoe
1l3/12/96lpt IJoe
03/12/96lpt 1J0e
Ne19/110
Nel97032
Ne 97010
Ne 97110
Ne 97032
Ne 97010
Ne 97110
Ne 97032
Ne 97010
Ne 97110
Ne 97032
Ne 97010
Ne ~9715
Ne W9720
Ne 97110
Ne 97032
Ne 97010
Ne ~9715
NelW9720
Nel971lil
Nel97032
Ne 197010
Ne 197110
Nel97032
DESCRIPTION
I DIAG 1 AMOUNT
Physical Therapy, Initial (1/7242
PT Electric Stlm,manual Each 172q2
pr Hot/Cold Packs 72q2
Physical Therapy, Initial (1 7242
Pf Electric Stim,manual Eac~ 7242
PT Hot/Cold Packs 7242
Physical Therapy, Initial (1 72q2
PT Electric Stim,manual Each 7242
P1 Hot/Cold Packs 72q2
Physicdl Therdpy, Initial (1 72q2
PT Electric Stim,manual Each 72q2
PT Hot/Cold Packs 7242
Physical Therapy 2+ More Moda 7242
Each Additiona 15 Min To W971 72q2
Physical Therapy, Initial (1 7242
PT Electric Stlm,manual Each 72q2
P r Hot/Cold Packs 7242
Physical Therapy 2+ More Modal72q2
Each Addltlona 15 Mln To W971'17242
Physical Therapy, Initial (1/72q2
P1 Electric Stirn,mdnudl Each 172q2
PT Hot/Cold Packs 17242
Physical rherdpy, InItIal (11/2q2
PT Electric Stim,mdnual Each 172q2
35.00
45.00
20.00
70.00
45.00
20.00
70.00
45.00
20.00
70.00
45.00
20.00
60.00
30.00
35.00
45.00
20.00
60.00
30.00
35.00
45.00
20.00
70.00
45.00
-----------------------------------------------------------------------------
1 CONTINUED
1
ACCOUNt NOlcur-RENT 1 31-60 I 61-90 1 91-120 lOVER 1201
- ---------------------------------------------------------I
n..mjo-01 1 0.001 0.001 0.001 0.001 365.001
1 I 1 I I I
BILLING OFFICE
5124 E Trlndle Road
Mechanlc.burg rA 110&&
rhone~: 111-19&-191&
I ACCOUNT IAMOUNT DUEICLOSE OATEIPAOE
1------------------------------------
Inesmjo-011 36S.00 I 06/16/91 I 03
ElN~ 23-210703<:
TO: JOE NESMIIH JR
424 FAIRGROUNO AVE
Please Make Check PaYdble To,
CARLISLE,PA 17013
[RINDLE REHAB MEDICINE CENTER
This dccount Is now due. rlease send payment today. If this claim has
been &ubmittcd to your in~urarlce carrier. pleaco cuntd~t them.
DATE IDR.IPATIEN1IPROC CDEI
DESCRIPTION
---------------..---- --------------------------.------------------------------
I DIAG I AMOUNT
03/12/96Ipt
04/26/96 pt
04/26/96 pt
04/26/96 pt
04/26/96 pt
04/26/96 pt
07/29/96
07/29/96
08/01/96
08/01/96
08/08/96 pt
08/08/96 pt
08/08/96 pt
00/08/96 pt
08/08/96 pt
00/0!l/96 pt
0B/08/96 pt
08/08/96
08/08/96
08/08/90
08/08/961
06/08/961
08/08/961
06/09/961
Joe
Joe
Joe
Joe
Joe
Joe
Joe
Joe
Joe
Joe
Joe
Joe
Joe
Ne 97010
Ne
Ne
Ne
Ne
Ne
IPT Hot/Cold Packs
\Adjustment
I Adjustment
IAdjustment
IAdjustment
IAdjustment
IAdj,PA Biue Shield
IPlan Payment'2355742
IAdj:P~ Blue Shield
IPlan Payment:236048S
IAdjustment
IAdjustment
IAdjustment
IAdjustment
IAdjustment
IAdjustment
IAdjustment
IAdjustment
\Adj,PA Blue Shield
IPlan Payment:2367851
IAdj:PA Blue ShIeld
IAdjustment
IPlan Payment:23678b2
IPlan Payment:2369270
17242
I
I
I
I
I
Blue Shi\
I
Blue Shil
I
I
I
I
I
I
I
\
Blue Shil
Blue Shil
I
Blue Shi\
Blue Shil
I
I
20.00
150.00-
90.00-
120.00-
90.00-
90.00-
766.90-
196.00-
130.00-
66.00-
90.00
90.00
120.00
90.00
90.00
230.011
5.00
0.00
140.00-
32.00-
140.00-
0.00
12B.00-
12B.00-
Ne
Ne
Ne
Nel
Nel
Nel
Nel
I
I
I
I
I
I
I
CON1INUEO
ACCOUNT NO!CURRENT I 31-60 I 61-90 I 91-120 lOVER 1201
-----------------------------------------------------------1
ne5mjo-01 I 0.001 0.001 0.001 0,001 365.001
I I I I I I
-------------------------------------------------------------------------------
BILLING OHICC
5124 Elrindle Road
Mnchanicsburg PA 1/055
Pho"e": 717-795-7935
E IN" 23-2107032
TO: JOE NESMITH JR
4~4 FAIRGROUND AVE
CARLISLE,PA 17013
1 ACCOUNI IAMOUNI DUEICLOSE DAIEIPAGE
1------------------------------------
Inesmjo-011 365.00 1 06/16/91 I 04
-------------------------------------
Plea~e Make Check Payable To:
TRINDLE REHAB MEDICINE CENTER
ThIs account is now due. Please send payment today. ,If tills claIm h.H
been submItted to your insurance carrier, please contact thom.
DATE IDR.IPATIENTIPROC CDEI
DESCRIPTION
1 DIAG I AMOUNT
------------------------------------------------------------------------------
0B/09/961
04/25/97Ipt
1
I
11/16/94Ipt
11/16/94Ipt
11/16/94 pt
11/16/94 pt
11/22/94 pt
11/22/94 pt
11/22/94 pt
11/22/94 pt
11/23/94 pt
11/23/94 pt
11/23/94 pt
11/23/94 pt
12/05/94 pt
12/05/94 pt
12/07/94 pt
12/07/94 pt
12/12/94 pt
12/12/94 pt
12/14/94 pt
12/14/94 pt
Joe
Joe
Joe
Joe
Joe
Joe
Joe
Joe
Joe
Joe
Joe
Joe
Joe
Joe
Joe
Joe
Joe
Joe
Joe
Joe
Joe
1
Nel
1
I
Ne197110
Ne197032
Ne 97124
Ne 97010
Ne 97110
Ne 97032
Ne 97124
Ne 97010
Ne 97110
Ne 97032
Ne 97124
Ne 97010
Ne 97110
Ne 97012
Ne 97110
Ne 97012
Ne 97110
Ne 97012
Ne 97110
Ne 97012
Blue Shil
I
1
1
Physical Therapy, Initial (117242
PT ElectrIc Stim,manual Each 17242
Pl Massage 17242
PT Hot/Cold Packs 17242
Physical Therapy, InItial (117242
PT TherapeutIc Exercise \7242
Pl Massage 17242
PT Hot/Cold Packs 17242
Physical Therapy, InitIal (117242
PT Therapeutic Exercise \7242
PT Massage 17242
PT Hot/Cold Packs 17242
PhysIcal Therapy, Initial (111242
PT TractIon, Mechanical 17242
Physical rherapy, Initial (1'1/242
PT Traction, Mechanical \7242
Physicai Iherapy, Initial (111242
PT r raction, Mechanicai 17242
Physical Therapy, Initiai (11'242
PT Traction, Mecha"ical 1/242
Adjustment
Adjustment
deductable
vv At Carrier
vv
141'-00-
611.00
111.1111
45.00
3S.1I11
20.00
711.1111
45.110
3S.1I11
211.110
711.1111
45.00
3S.1I11
211.1111
711.110
35.110
70.00
35.110
7'L00
3S.00
70.00
35.00
---------------------------------------------------.--------------------------
ACCOUNT NOICUHRENI 1 31-60
pesmjo-Ol 1
1
0.001
I
0.001
I
61-90 I 91-120 lOVER 1201
----------------------------1
0.001 0.001 365.001
I 1 1
ICONTINUED
1
-------------------------------------------------------------------------------
BILLING OFFICE
b124 E Trindie Road
Mech~nicsbur9 PA 1/055
Phone.: 717-795-7935
UN. 23-2107032
TO I JOE NESMITH JR
424 FAIRGROUND AVE
CARLISLE,PA 17013
1 ACCOUNT IAMOUNT DUEICLOSE DATEIPAGE
1------------------------------------
Inesmjo-0LI 305,00 I 06/L6/97 I 05
-------------------------------------
Please M~ke Check Payable To:
TRINDLE REHAB MEDICINE CENTER
This account is now due, Please send payment today. If this ciaim has
been submitted to your insurance carrier, please contact them.
DATE IDR.IPAIIENIIPROC CDEI
DESCRIPTION
I DIAG 1 Arl0UNT
-------------------------.-----------------------------------------.-----------
L2/19/94Ipt IJoe
12/19/941 pt lJoe
12/2B/94Ipt IJoe
12/2B/94Ipt 1J0e
12/2B/94Ipt IJoe
12/29/94 pt IJoe
12/29/94 pt IJoe
12/29/94 pt IJoe
12/29/94 pt lJoe
01/04/95 pt IJoe
01/04/96 pt lJoe
01/05/9& pt 1J0e
01/06/96 pt lJoe
1
1
1
I
I
I
1
1
1
1
I
1
I
1
1
1
1
I
1
I
1
I
1
1
1
1
1
1
1
I
1
I
1
1
1
-----------------------------------------------------------
PAY THIS AMOUNT --) 1 166.00
I
Ne 197110
Ne197012
Ne197110
Ne197110
Nelg7012
He197110
He 197110
Ne197010
Hel97012
He 97110
He 97012
He 97110
He 97012
Physical Therapy, Initial (117242
PT rraction, Mechanical 17242
Physical Therapy, InItial (117242
Physical Therapy 1 Area Each 17242
PT Traction, Mechanical 17242
Physical Therapy, InitIal (1\7242
Physical Therapy 1 Area Each 17242
PT Hot/Cold Packs 17242
PT TractIon, Mechanical 17242
Physical Therapy, Initial (117242
PT TractIon, Mechanical 17242
Phy~lcal Therapy, InitIal (117242
PT Traction, Mechanical 17242
1
I
I
I
.1
1
1
1
1
1
1
ACCOUNT HolcURREHI 1 31-60 1 61-90 1 91-L20 lOVER 1201
--------------------------------------------------.---------1
nesmjo-0L 1 0.001 0.001 0.001 0.001 365.001
I I I 1 1 1
70.00
36.00
70.00
60.00
36.00
70.00
60.00
20.00
36.00
36.00
36.00
3&.00
36.00
---.---------------.-.-----------.---------------------.-.----------------------------
6ILLING OFfICE
b124 East Irindle Road
M~chdnlG5burg PA 11055
f' h 0 n c" : 7 17- 7 95 -793!>
L IN" 23-2107032
TO: JOE NESMITH JR
424 FAIRGROUND AVE
CAHLlSLE,PA 17013
I ACCOUNf IAMOUNT DUEICLOSE DAIEIPAGE
1------------ -----------------------
Ine6mjo-001 617,00 I 06/16/91 I 01
----------- --------------------------
Plea6e Make Check Payabie 101
REHAB MEDICINE ASSOC,MECHBRG
We flIed d ciaim to your In6urance carrier oyer 90 daY6 ago and to date
haye not receiyed payment. As the insured, you dre responsIble for seeing
this biil is paid. Piea6e pay this balance in full. Thank you.
DATE IDR.IPATlEN1IPROC CDEI
DESCRIPTION
I DIAG I AMOUNT
-----------------------------------------------------------------------------
09/27/94Icho
11/30/94Icho
12/29/94Icho
01/17/951 cho
02/08/96Icho
03/08/9510ho
01/24/96Icho
02/07/96Icho
02/09/96 cho
02/29/96 cho
04/09/96 01'00
04/30/96 cho
05/14/96 oho
06/06/96 cho
07/05/96 cho
06/06/96 cho
06/06/96
08/06/96
08/1'0/96
00/21/96
08/21/96
09/11/96
09/11/96
Joe
Joe
Joe
Joe
Joe
Joa
Joe
Joe
Joe
Joa
Joe
Joe
Joe
Joa
Joe
Joe
I
cholJoe
I
I
I
I
Your
99213
99213
99213
99213
99214
99214
99214
99214
Ne
Ne
Ne
Ne
Ne
Ne
Ne
Ne
Ne
Ne 99214
Ne 99214
Na 99213
Ne 99213
Nel99213
Nel99213
Ne199213
I
I
Nel09102
I
I
I
I
insurance
lev L2, Subsequent 17244
IOV L2, Sub6equent 17244
IOV L2, Subsequent 1'244
IDV L2, subsequvnt 17244
lev L3, Subsequent 17244
lev L3, Subsequent 17244
IOV L3, Subsequent 17242
IOV L3, Subsequent 1723.4
IAdjustment I
IOV L3, Subsequent 17242
lev L3, Subsequent 17244
lev L2, Subsequent 17244
IOV L2, Subsequent 17244
lov L2, Subsequent 17244
IOV L2, Subsequent 17244
lev L2, Subsaquent 17242
IAdj:PA Blue Shieid Biue erol
IPlan Payment:2364887 I
IMedicaI Records (initial chg)17242
IAdj:PA Blue Shield Blue eral
Iplan Paymcnt:2383457 I
IPlan Payment:2405355 I
IAdj:PA Blue Shield Blue ~hil
company applied this balance to your
I
I
I
I
I
I
I
I
1
I
I
I
1
I
I
I
1
I
1
I
I
1
1 55.1'11'1-
DEDUCTIBLE.
40.00
40.00
40.00
40.00
60.00
60.00
80.00
80.0~
36.00-
80.00
B0.00
60.00
60.00
50.00
50.00
50.00
35.1'11'1-
36.1'11'1-
45.00
31'1.1'11'1-
96.1'11'1-
11'11'1.1'11'1-
--------------------------------------------------------------------------------
ACCOUNI NoleUHRENI I 31-60 I 61-90 I 91-120 lOVER 1201
__________________________________.___________________------1
'nesmjo-00 I 1'1.001 24.1'101 45.001 40.001 508.001
1 1 I 1 I I
leONTINUED
I
-------------------------------------------------------------------------------
BILLING OFFICE
5124 East lrindie Road
Mechdnicsburg PA 1/055
Phone~: 717-795-7935
ElN~ 23-2107032
TO, JOE NESMITH JR
424 FAIRGROUND AVE
CARLISLE.PA 17~13
I ACCOUNr IAMOUNT OUEICLOSE OAIEIPAGE
1------------------------------------
Inesmjo-001 61/.00 I 06/16/97 I 02
-------------------------------------
Piedse Mdke Check Pdyabie To,
REHAB MEOICINE ASSOC,MECHBRG
We flied a cia{m to your insurance cdrrier over 90 ddYS ago and to ddte
have not received pdyment. As Lhe inr.ured. you are recporlsible for seeing
this bill is paid. Please PdY this baldnce in full. !hank you.
DATE IDR.IPATlENrlPROC CDEI
DESCRIPTION
I OIAG I AMOUNT
-----------------------------------------------------------------------------
02/11/97
~3/13/97
~3/25/97
04/16/97
~4/16/97
~&/01/97
~&/01/97
~9/17/96
1~/IB/96
10/1B/96
1~/IB/96
11/21/96
11/21/96
12/03/96
12/17/96
12/17/9b
05/14/97
OS/22/97
06/10/91
~b/l~/97
cholJoe Nel99213
1 I
Your lnr.urdnce comp
cholJoe Nel99214
Your insurdnce comp
cholJoe Nel99213
I I
I I
1 1
1 1
cholJoe Nel99213
cholJoe Ne\99213
I
I
1
1
cholJoe Ne 99213
I
I
cholJoe Ne 99213
cholJoe Ne 09102
I
I
I
OV L2. Subsequent 11242 50.00
Adj:PA Blue Shield I I 10.11-
ny dpplied Lhis bdlance to your DEOUCTIBLE.
OV L3. Subsequent 17231 I B0.00
ny applied this balance to your DEDUCTIBLE.
OV L2. Subsequent 17210 1 50.00
Adjustment I I 35.11-
Plan Payment:2725055 1 I 16.11-
Adj :Write-off Blue Shi 1 I 10.li-
vv At Carrier vv I 1
OV L2. Subsequent 17222 I
OV L2. Subsequent 17244 1
AdJ :PA Blue Shield Blue Crol I
Pldn Payment:2456236 1 I
Adj:PA Blue Shield Blue Crol
Plan Payment:2504441 1
OV L2. Subsequent 17242
Plan Payment:253Bl91 I
Adjustment Blue Shil
OV L2. Subsequent 17242
Medical Records (initial Chgll1242
req by atty Jennifer deit~~m II
Pldn Payment: 27B1535,dAatiL Q4;
Adj :~Jri te-off Blue.,hi 1
50.00
50.00
11.11-
32.11-
11.11-
32.11-
&0.00
32.11-
10.11-
&0.00
200.00
32.11-
11.11-
---------------------------------------------------------------.---- ---------
PAY fillS AMOUNl --) 617.00
I\CCOUNI NolCURRENT I 31-60 1 61-90 I 91-UO lOVER UOI
______________________________________________________-----1
ne';lIIjo-OO 1 0.001 24.001 4&.001 40.001 &08,001
1 1 I I 1 I
------------------ -------------------------------------.--------------------------
() ,,") (')
~..~ ::.41 >"1
::;"". ,;",)
-r, \.~ ",., -j j=!J
fili, ::lJ
:-::" tt.> ,n,
It?
I'>, ..::> .) I
eLf ',C)
:r.~ ":.fl
:'::c., ~ :"1
.:(")
, . ~ , " :)fll
'. ~.
~., ,'..- I
,. .:"
:.--! ~...l
,::> "'
MdJRAW, IIAH olllHTCIIMAN
.. l.ibaty Avenue
Carti~.. fA .,Oll
1717l2~9-1300
1^"ornC)'s fur PlalnlilTl
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY. PENNSYLVANIA
JOSEPH NESMITH. aIkIa JOE
NESMITH. JR..
Plaintiff
: Civil Action - Law
: No,: 97-5491
vs,
: PRAECIPE TO SATISFY
: JUDGEMENT
NATIONWIDE MUTUAL INSURANCE
COMPANY.
Defendant
TO: Prothonotary
Please mark the default judgment in the above-captioned matter fully satisfied.
and costs paid.
Respectfully Submitted.
McGRAW. HAlT & DEITCHMAN
By:
ennifer C. Deitchman
Pa, ID II 72719
4 Liberty Avenue
Carlisle. PA 17013
(717) 249-4500
Date: 11125/98