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HomeMy WebLinkAbout97-05735 l ~~ ..3.( 'i ~ C ~ ~ ., i '. <:)! " ~ " 5- '" . 'i, / i' n " ! I I '.J _ i I, i .... I . . ~' ,,' d \1, .~ , {,: .- , , L .'; ~ 1L o l() W ~ 00 t- 9 r- C- U) "fj ct ~. ~ '.' ., 1)1 \.: - - M ~ " , ,-. ,. 1- ;..i (,' ~ ! ~ o ~ _;:; ::l! ~ "'_ a~i=~~ ~S~J~'.: .s~~~~~ . Z . a Q = ii... III _ . o . It ~ '" :I: == . .' ,. \. , . . #0 PLEADI~GSII"""~,"jI'l'_t1l(J.IJ.97/~t ., IN RE: JOSEPH RICHARD FRANK, A Minor IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. CTl- 8735 Cu.....SlI€. (('YJ ORDER AND NOW, this~. day of Od"tlbt/' ,1997, after due consideration of the foregoing Petition, IT IS HEREBY ORDERED AND DECREED: 1. The settlement of the personal injury claim of Joseph Richard Frank, a Minor, brought under and by virtue of the injuries he sustained in a dog-bite accident that occurred on July 20, 1996, for the sum of Twenty-Five Thousand Dollars ($25,000.00) is hereby approved as being fair and equitable. 2. The settlement amount of ~wenty-Five Thousand Dollars ($25,000.00) is hereby ordered to be distributed as follows: Joseph Richard Frank, balance of settlement, ".." ,...." ,.',., $18,047.83 Hepford, Swartz & Morgan -- Reimbursement for Costs Advanced: Photocopying charges, ",..., $ Postage charges .',... ",.... $ Telephone charges., ,. ,." ,.. $ Medical Records/Reports ,. ". $ Travel Expenses ,.,.., ",. ." $ Total Costs .. .." ",... $ 56.09 13,13 24.63 315.14 18.00 426.99 Hepford, Swartz & Morgan Attorneys' Fees (25\ of $25,000) .........,......., $6.250,00 .PLIADI N'OS/ !"...l.",".._p.II'/O./ J.fJ7,~l " 3. Upon payment of the aforesaid sums in the manner above described, David Goodyear, Vicki L, Goodyear and Erie Insurance Company shall thereby be fully released from all claims which Joseph Richard Frank, a Minor, had against David Goodyear, Vicki L. Goodyear and Erie Insurance Company by reason of the injuries he received from the dog bite that occurred on July 20, 1996. Petitioners, Richard J. Frank and Brenda Pallante are hereby authorized on behalf of Joseph Richard Frank, a Minor, to execute a Release in favor of. David Goodyear, Vicki L. Goodyear and Erie Insurance Company. /l.4-. J. 3 .P[,EM IN'as I f"",'.Itt,,,.!'IV/O./ :t.rn!,/' IN RE: JOSEPH RICHARD FRANK, A Minor IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY. PENNSYLVANIA NO. Q7. 57,1'50(.(.1.9 7i'rf7l AND NOW, this ORDER day of . 1997. it is hereby ORDERED that a hearing on the petition for Approval of Settlement and Distribution of Proceeds for a Minor shall take place on at in Courtroom # J. 'PU;ADlN(HiI /r'II1L'lIll/"t/J(I '."'97/1~ IN RE: JOSEPH RICHARD FRANK, A Minor IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. q,- S'7~5 G.~J)l€((Yl PETITION POR APPROVAL or SETTLEMENT AND DISTRIBUTION or PROCEEDS rOR A MINOR TO THE HONORABLE, THE JUDGES OF SAID COURT: The Petitioners, Richard J, Frank and Brenda Pallante, parents and natural guardians of Joseph Richard Frank, a Minor, through their counsel, HEPFORD, SWARTZ & MORGAN, petition this Honorable Court for an Order pursuant to 20 Pa.C.S. ~5103 and respectfully represent as follows: 1. petitioner Richard J. Frank is an adult individual who resides at 11880 Crestwood Circle, Waynesboro, Pennsylvania. He is the father and natural guardian of Joseph Richard Frank, a Minor (hereinafter the "Minor"), who sustained personal injuries 'on July 20, 1996, when he was a visitor in the home of Vicki L, Goodyear and was bitten in the face by David Goodyear'S dog in Cumberland County, Pennsylvania. The Minor's date of birth is November 29, 1979, and he is 17 years old. 2. Petitioner Brenda Pallante is an adult individual who resides at 917 Petersburg Road, Carlisle, Pennsylvania, She is the mother and natural guardian of the Minor. 'PLEADINGS/I,.,,,./' '"'" f.t/f(),1.1.rn/Jl 3. On the date of the accident, the Minor resided with Petitioner Brenda Pallante. petitioner Richard J. Frank had a healthcare insurance policy covering the Minor. 4. petitioners Richard J. Frank and Brenda Pallante, as parents and natural guardians of the Minor, brought a personal injury claim against vicki L. Goodyear. Vicki L. Goodyear had homeowners insurance with Erie Insurance Company on the date of the occurrence. 5. Erie Insurance Company has offered to pay Twenty-Five Thousand Dollars ($25,000,00) for the Minor's claim arising from his injuries in return for a release of the Minor's claim, (A copy of the requested release is attached hereto, marked Exhibit "A" and incorporated herein.) 6, The Petitioners consider the offer of Twenty-Five Thousand Dollars ($25,000.00) to be a fair settlement and they believe that it is in the best interest of the Minor to accept that offer. 7. There were medical expenses arising from the treatment of the injuries sustained by the Minor. All such medical expenses were covered by, and paid for by, Petitioner's health insurance 2 'PLEADINOSI/rou.l.lfti"",V'IO-13.fJ7hl carriers, Pennsylvania Blue Shield and Capital Blue Cross. Petitioners intend to reimburse Pennsylvania Blue Shield and Capital Blue Cross for their respective liens of $258.00 and $108.90 less 25% for attorneys' fees. (See attached letters from Attorney Paul J. Gitnik marked Exhibit "B" and incorporated herein, ) 8. Petitioner Richard J. Frank retained Dennis R. Sheaffer, Esquire, of the law firm of Hepford, Swartz & Morgan, to represent the Minor and he entered into an agreement with said attorney under which said attorney is to be paid 33-1/3% of any settlement for professional services rendered. Dennis R. Sheaffer, Esquire, and HEPFORD, SWARTZ & MORGAN have agreed to reduce their fee to twenty- five percent (25%), or the sum of six Thousand Two Hundred Fifty Dollars ($6,250,00), Additionally, said fee agreement provided for the payment of costs advanced and incurred by the attorney which amount to Four Hundred Twenty-Six Dollars and Ninety-Nine Cents ($426.99), (See HEPFORD, SWARTZ & MORGAN ATTORNEY'S AGREEMENT, attached hereto, marked Exhibit "C" and incorporated herein.) , 9. As a result of the July 20, 1996, accident, the Minor experienced physical trauma and anxiety. The Minor was bitten in the face by a dog in the home of his friend. This was a frightening ordeal for a 16-year-old boy to undergo, and the Minor experienced permanent injuries, 3 ..I 'PLEADINGS/ f,.,,,l.IfII"'I,,VIO.1 J.97/,1. 10. Your petitioners believe, in light of the facts set forth in this Petition, that a fair, just and equitable distribution of the settlement proceeds of Twenty-Five Thousand Dollars ($25,000.00) would be as follows: Joseph Richard Frank, balance of settlement ... ,. ......... ...... $18,047.83 H~pford, Swartz & Morgan -- Reimbursement for Costs Advanced: Photocopying charges .......' $ Postage charges., "" .,..... $ Telephone charges '.., "..... $ Medical Records/Reports, ,... $ Travel Expenses" .,.,.,.,... $ 56.09 13,13 24.63 315,14 18.00 426,99 Total Costs. ,'.' "..... $ Hepford, Swartz & Morgan Attorneys' Fees (25% of $25,000) ...............,.. $6,250,00 Total Attorneys' Fees and Reimbursement for Costs Advanced ....,....,......,..,...,.... $ 6,676.99 Pennsylvania Blue Shield ($258.00 less 25% Attorneys' Fees) Capital Blue Cross ($108.90 less 25\ Attorneys' Fees) $193.50 $ 81.68 Total Blue Cross/ Blue Shield Liens $ 275.18 525.000.00 11. The balance of Eighteen Thousand Forty-Seven Dollars and Eighty-Three Cents ($18,047.83) payable to the Minor, shall be 4 GENERAL RELEASE For the consideration of Twenty Five Thousand Dollars ($25,000,00). receipt of which is hereby acknowledged, I/we release and discharge. and for myself/ourselves my/our heirs, repres(;lnlatives, executors. adminislralors, successors and assigns, do hereby remise, release and forever discharge David Goodyear and Vicki L. Goodyear hereinafter referred 10 as Ihe releasee(s). his/her/lheir/its heirs. execulors. administrators. insurers, successors and assigns, and any and all olher persons. firms. corporalions. associations, of and from any and all causes of aclion. suils. judgments, claims and demands of whalsoever kind, in law or in equily, known and unknown, which IIwe now have or may hereafter have, and/or which Ihe minor Joseph R Frank now has or may hereafter have, from the claimed legal liability of releasee(s), which Iiabilily releasee(s) expressly deny(ies), arising from or by reason of any and all bodily or personal injury and/or property damage known and unknown, foreseen and unforeseen which herelofore has/have been or which hereafter may be sustained by me/us or the minor aforementioned arising out of the accident on or about July 20, 1996. at or near Mount Holly Sprinlls, in Ihe County of Cumberland, in Ihe Slale of Pennsylvania, in which the minor aforementioned sustained personal Injuries and/or property damage. This is not a release of any claim to or entitlement to benefits from any policy of health insurance under which the undersigned or Joseph R Frank is an insured. INoIe agree that the consideration set forth above is specifically applicable to and paid to me/us wilh respect to any and all damage 10 any property, eilher real or personal, of mine/ours or the minor aforementioned, and wilh respect to any and all personal or bodily injury of mine/ours or the minor aforementioned, whelher presently known or unknown, foreseen or unforeseen or which may subsequently develop and the consequences Ihereof, all as arising from Ihe aforementioned accident. INoIe further agree that the consideration set forth above is specifically applicable to and paid to me/us wilh respecl to any right of contribution that IIwe or the minor aforementioned may have against the releasee(s), his/her/lheir/its heirs, executors, adminislrators, insurers, successors and assigns relative to claims of other than thai may be brought against me/us or the minor aforementioned by reason of said accident. INoIe further agree that the consideration sel forth above is specifically applicable to my/our agreement that IIwe or Ihe minor aforementioned will not join nor attempt to join the releasee(s), his/her/lheir/its executors, administrators, insurers, successors and assigns in any capacity, in any action that may be brought againsl me/us or the minor aforementioned arising out of said accident. In consideration of the aforesaid payment, IIwe for myself/ourselves and my/our heirs, representatives, executors, administrators, successors, and assigns do hereby: (1) agree to indemnify and hold forever harmless the releasee(s) and his/herlitsltheir represenlatives, adminislralors, or assigns, against loss from any and all further claims, demands or aclions Ihat may hereafter be mads at any lime or broughl against the releasee(s) by me/us or Ihe minor aforementioned, or by anyone in our behalf for the purpose of enforcing a further claim, for which Ihis release is given; warrant that IIwe have received no money or other valuable consideralion from any olher person or persons by reason of any causes of action, suils, covenants, agreements, Judgments, claims and demands of whalsoever kind, which IIwe now have or may hereafter have, for injuries 10 person or property arising out of the aforementioned accident or for the other matters for which this release is given, (2) Intending to be legally bound thereby, WITNESS my/our hand(s) and seal(s) this ,1997. day of WITNESS: Richard J. Frank, Father Brenda Pallanle, Molher (Seal) (Seal) EXHIBIT "A" PAUL J. GITNIK & ASSOCIATES ATTOItNEVS AT LAW "aul J. Gllnlk Centre UOI UrouKhton Ruad I'lll.hUfKh,l'ennlylvanla IS2J6-J469 Telephone: (4U) 6SJ-8702 (800) 426,OSSS E-mail: aJJodate'@Kllnlk.eom Faellmlle: (4U) 6SS.872\ Employer Identlne.llon No. :ZSo\661182 October 7, 1997 DeMls ShealTer, Esquire Hepford Swartz 8l. Morgan III North Front Street 1'0 Box 889 Harrisburg, PA 17108 Re: Capllal Blue Cross Patient: Frank, Jo,eph Contract No.: 17J404197H Date orlnjury: JullO, \996 Dear Mr. SbealTer: As you are aware, this law firm has been retained as legal coun,elto Capital Blue Cross ("CBC") with regard to the above-referenced subrogation case. Enclosed please lind a copy of the preliminary Record of Claim Payments prepared by CBC which indicates that CBC's subrogation lien amount is SI08.90, paid as of October 7. 1997, We reserve the right to provide you with and shall expect you to request an updated CBC Record of Claim Payments prior to the final settlement andlor resolullon of this subrogation case with this firm. As you are aware, CBC's subrogation lien is separate and distinct from that of Medicare. PeMsylvania Blue Shield andlor any oilier Blue Cross andlor Blue Shield Plan(s), When appropriate, please ensure thai the draft is made payable to Paul J. Gllnlk & Assoclales, AlIorney. for CBe, If you should have any questions regarding this matter, please feel free to call me. Very truly yours, PAUL 1. GITNIK 8l. ASSOCIATES Q ~p ~,,~~~-" Paul 1. Gitnik P JG/aka Enclosure EXHIBIT "B" ~ rar'1oo SUBDWII EXPLANATION OF 8LUE CROSS BENEFITS , . This IS a benelll slalement for Ihe pal lent noled, It you have any quesllons. please conlact your nearest Blue Cross office. Locations are noled on the reverse side, 1.0.11111.1..1.1,11..1..1.1,1...,11...11.1.1..1,.1.11.1101..11 RICHARD FRAKK 11880 CRESTWOOD CIR WAYKESBORO PA 17268-9339 09.110.196 PIII."I JOSEPH 173404197 651993000 FRAKK & HECKIIAK PC Clllm 0564593 Pro.lder CARLISLE HOSPITAL TypootlOrvlc. OUTPATIEKT Service 01"(1) 07.120.196 DATE RECEIVED 08.102.196 DATE PAID 08.114.1' Cont'lcl Group No. Group Nam. Servicts Provided Provider Chorgll Blue Cra.. Benl1lflts Non.Covered Chlrge. R.markS Cod. PHARIIACY SUPPLIES EIIERGEKCY ,00 ------------------- 49.00 49.00 ------------------- 36,00 36,00 ROOII ------------- 157,00 157.00 TOT A L S 242,00 242,00 IF YOU HAVE AKY QUESTIOKS ABOUT THIS EXPLAKATIOK OF BEKEFITS. PLEASE CALL 1-800-958-5558 BETWEEK THE HOURS OF 8100 A.II. AKD 6'00 P.II. ,00 ,00 .00 ;kid U PJ-,fI/tJJ-.Jo : :.:::-- ~..'; ':"1; "(O\J " Pennsylvania 81ueShJeld An IncHlpend.nILc...... oIlht 8u. 00.. and BIuI ShIeld "'~11l1on Camp HID, PA 17089 October 21, 1996 OH17340U97 P.tlent Subecrlber Contract 10 Group Number . D.te Accident. B.S. Cont.ct I Attorney I Joeeph Fr.nk Richard Frank H173404197 651993000 July 20, 1996 SUB E. IAXA P.ul J. Gltnlk, <~ 8 ,~ =I '..:". j J Eeq. Penneylv.nl. Blue Shield Tot.l....$258.00 CLAIM INFORMATION PROVIDER DATE SERVICE PROVIDER CHARGE AMOllN'l' PAID DATE PAID RWC Corp Emg 07/20/96 Anee , Recon Sur 07/21/96 $66.00 $700.00 $60.00 $198.00 08/16/96 08/07/96 I , SIZ/pas , , EXHIBIT .Cn LA W OFFICES HEPFORD, SWARTZ '" MORGAN ATTORNEY'S AGREEMENT THIS AGREEMENT, entered inlo this ~ay of ;:r;; l. 'I , 19 '1~by and between HI':PFORD. SW TZ & M08.GAN, Attorneys-at-Law, (hereinafter "Allorney"), and ,'- ItfLO ,f-/l.4rJl<! (hereinafter "Client"). WITNESSETH: That Allomey, for the cons erat on ere na er st,f,u ate, as un ert en and does hereby undertake and agree with Client to act as legal eou.nsel in negotiatinta sell en;r:; and if the same is not effected, in bringing, conducting and rosecuting action lIllalnSt V"',..~, Ayo" oo'ft:l"1- to recover damages for I ~,.; ~JCf'H L, (:.(J1l -+ DDfr 81T E which occurred on or about "U>, 19 b . ATTORNEY FEE: In consideration for services so rendereu by Allomey, it is hereby agreed by and between the parties hereto that Allomey shall be compensated as foliows: (a) Thirty-Three and One-Third (33-1/3%) 'percent of gross recovery if the case is sellled before jury selection in a jury trial case, before commencement of trIal in a non-jury trial case, or before the commencement of the hearing In a mailer first heard by arbitrators; or (b) Forty (40%) percent of the gross recovery if the case is sell led any time after it proceeds to jury selection at trial or If a gross recovery is obtained in any other manner at or after the selection of the jury in a jury trial case, after commencement of the trial in a non-jury trial case or after the eommencement of the hearing in a mailer first heard by arbitrators. The Allomey's fee as set forth above covers only the Allomey's services through and including the trial of the Client's case and any posttrial proceeding before the trial court. If the case is appealed to a conrt beyond the trial court, then the Client must enter a new agreement with the Allomey or make additional arrangements for the Allomey's fee for services for representing the Client in the appeal. "Gross recovery" shall mean the full amount of selllement proceeds or the full amount of verdict, including any pre-judgment Interest, without reduction for expenses or costs advanced or incurred. Allomey shall have a lien on any sum or sums recovered, whether by selllement or judgment, for services rendered, costs advanced and expenses incurred under this Agreement. If for any reason the services of the Allomey are terminated, either by the Allorney or by the Client, Allomey shall have a right to be compensated for the reasonable value of the services provided to Client. The reasonable value of the Allomey's servi.es shall be the greater of the amounts determined as follows: (a) by applying the hourly rates ordinarily charged by the Allorney during the time of Allorney's represenlation to the time expended by Allomey in this mailer; or (b) Thirty-Three and One-Third (33-1/3%) percent of the highest offer to sellle Client's case received prior to termination. The right of Allomey to receive any such compensation will be contingent upon Client obtaining a recovery in this case by selllement, verdict or olherwise. Additionally, the Client will then also become responsible for the payments ofallthe expenses and costs incurred by HEPFORD, SWARTZ & MORGAN on the Client's case. Said expenses and costs will become immediately due and owing to IIEPFORD, SWARTZ'" MORGAN. EXPENSES OF LITIGATION: Any necessary and reasonable costs advanced by Allomey in the preparation and preGCntation of Client's claim, and all expenses allendant thereto. shall be the responsibility of the Client to pay upon the Client's obtaining a recovery in the case. Allorney retains the right to request that the Client advance said expenses and costs. Allomey may apply any funds held in escrow on behalf of Client to the costs and expenses of Iiugation. SETTLEMENT PROVISIONS: All olTers to sell Ie, adjust or compromise the above claim shall be reviewed between Client and Allomey before any such offer is either accepted or rejected. Client further agrees to consider seriously any recommendation for selllement made by Allorney and not to unreasonably withhold consent to such selllement recommendation. EXHIBIT "e" DISCHARGE OR WITHDRAWAL: In the event that Allorney subsequently determines thaI the claim or suit lacks merit, or Client unreasonably withholds consent to any bona fide selllement recommendalion made by Allomey, or Client refuses or fails to cooperate with AlIomey, or Client cnnceals or misrepresents facts regarding tho above elaim, or Client commits a breach of this Agreement, AlIorney shall have the righlto terminate his services upon giving reasonable notice to Client. MISCELLANEOUS: Client understands, acknowledges and agrees that AlIorney docs not guarantee the outcome or eventual result of the above claim. 'lbis a~reement contains the final and entire agreement between the parties hereto and expresses the embodiment of all negotiations and agreements prior to its execulion. The parties hereto shall not be bound by any terms, statements, conditions or representations, oral or wrillen, expressed or implied, not specifically set forth in this agreement. IN WITNESS WIIEREOF, the parties hereto, iatending to be legally bound, have hereunto set their hands and seals to this Agreement, in execution thereof, the day and year first above wrillen. WITNESSES: HEPFORD. SWARTZ & MORGAN '~ (SEAL) (SEAL) ADDENDUM Authorization 10 Distribute AlIornev Fees: Client understands that has a right for services rendered to receive part of the AlIorney Fee payable to Allorney in this case. Client hereby authorius Allorney to distribute a part of the Allorney Fee in this case to . It is understood by Client thaI said payment to docs not increase the AlIorney Fee for which ellent is liable to Allorney for the services rendered in this case. WITNESSES: IIEPFORD. SWARTZ & MORGAN By: (SEAL) (SEAL) FORHS/1tiP1FBB.AGR 2