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Home My WebLink About98-00770 tl o ~ q; ~ ~ " .; II) ~ ~ () ,~ I , ,- I i/ t1 '> r " i, i .- 2 '- - -> 0-- 2 <;:( / I I. ( ... .~ i ~ :--- ~ ~ ~ ~ t:--.. I c..., 0-. ~ MAllTSON DEARIlORFf WILI.lAMS & OTTO MQW&:O All.P.R,,~, & !~'~~S1'UOll' AI' I...W WilliAM F. M^"TS()N JOliN II. rOWl.I\lI III l1ANIH. K. DfAIU>OItH: TIIIJMASJ. WnUAMS. lI'IIV.Orl\llll 5"1"1:1'1 WN I.. thoOM GHJltCi~ n. PAI.HRJIl.. TIUIMAS G. ClJl.llNS CM!. C. 1t",,1t II!.N)AMIN 1: WAIlNI'1l TI!N F.....''!' '.IICilI STItH. I' CAIU.lSl.fI, l'fiNN!WI.\'ANIA 17013 T...."'It<lNI! (717) 243,.1341 """"'.III.H (717) 243,1850 INTI1RNRI' www.l11dwu.com -HOARIl CI RlIflrn CIVil. TRIAl. StH'lAll~T April I, 1999 The Honorable Edward E. Guido Cumberland County Courthouso Carlisle, PA 17013 91'- 770 o/v/L RE: Jostine Angelini, by her fathor and logalguardian, Franco Angelini v. Progressive Insuranco Company Our File No. 7837.55 Dear Judge Guido: . You had held a hearing on a Petition for Approval of a Minor's Compromise some lime ago . in this case. At that time, you requested that tho family of Jestine Angelini seek legal coUnsel' regarding undormsured motorist coverage. Dusan Bratic has now written to me and I am. enclosing , a copy of his letter as well as the consent to settle letter from Erie Insurance Group. The matter is now . ripe for a follow up hearing on court approval and we would request that this be scheduled at this tinie. . . . , ',' ," Vory truly yours, MA~N ~RFF WILLIAMS & OTTO " Ge~~~ GBF/las . . Enclosures cc: Dusan Bratic, Esquire Ms. Susan Epler (970598615) F:1J'IUS\DATAFII..ElIPROLTRmS.JO 2 .-', .,' INI'ORMATION 0 ADVICE 0 'ADVOCACY'" "",'11 .t,',," .....' . ~ <:~:~. .,,' .,;\';&!{ . .:,~.:(~ " ....i. .' :.:<;:;.;~ '.. . .:-:' "~;'-{\~'~::';~";:. -<": '- , " ~- ".,,;. l,,'__ r~~ (('" ,!:,,'I,:.; ~--:.>l \S.." @.....5\ ----~ BRATIC Al'in PORTKO AItom~ oJ Low 101 OFFICE CENTER, Surn: A 101 SOUTH U.S. ROUTlll15 DlLUlBURG, PENNSYLVANIA 17010 DUSAH .RATle, ESQ. STltPHEN Ie. PORTKO, ...sQ. (717)4]2-9706 (717) 432-ma FAX (117)432-9220 March 22, 1999 George P. Paller, Jr., Esquire Hartson, lJoaardorff, Willlllm8 " Otto 10 East High Street Carlisle, PA 17013 VIA FAX and MAIL 717-243-1850 REa Jestine Mllelini, by her father and legal guardian, pranco Angelini v_ Progressive Insurance eo.pany Dear GeorgAI Enclosed please find a copy of the letter of consent which we have received from Erie Insurance in the above-referenced claim. please give me a call upon your review of it. I think this matter La ready for schedUling for settlement. Thank you. c euaan Bratic DB ume enclollure CCI Franco Angelini rO'd ~OO'ON SS:vl 66'~~ Jew I! II . 'I ! 'I I, I, II I I I I I , ,/ I, i I II II II I' rl ?= If"lc., II (;:: , , \l__.. . ----. , 'C' ";\ , ~..:.::=) " II , , I ~ ERIE INSURANCE GROUP ST€VEN L METZlER, Ale. A; \I ....liltlnt lilt. P'-IM.'1d Utn:11 CflfN ~. !'""""OHlc.oo 411011.0\1..0, ,P...""'Vn.U.......C.nfOt. PO.l!<l..o'3' M.."Ilnlc1bt.<g.PA 170511-4710 (717) f9$-UOO . follF," ,-eoo..1!Z.l304 . ,.~ I'IF) N'.23UI . I1np"/,........."."'~n.w~.com March 17, 1999 Dusan Brarlc, Esq. Bratic & Panko 101 Office Center, Suite A 101 South US Route l~ DiIlsbura, PA 17019 Re: ERIE Claim ERIE InsUred: Date of Loss: Your Client: #010170410340 Franco Anaelin.l 10/4/91 Jestlne Anaclini Dcar Mr. Bratic: You have rcquested that ERIE supply written consent allowing Jestlne Anllellni to release the tort-fea50r, Franco Angelini. Consent Is requested that Jcstino Angelini can pursue an UnderlllSured Motorists claim wilh ERIE under Policy #QOS-2S0S746. BRIE consents 10 a settlement; however, ERIE reserves all rights afforded under !be policy, and by providing consent 10 sertle, ERIE does not waive, invalIdate, or forfcit any of the rcrms and conditions of said policy. In particular, ERIE does lIOt agree or conflnn that the proposed settlement exhausts aJ/ Liabilil}l Insurance coveraaes available to Franco Angelini. Per our recenl telephone conversalion, r await the medical reports for Jestlne's llCatment. Sincerely. ~.).oo^ x.\ .P~~ Susan G. Philson, AlC, AlS Claims Adjuster P.O. Bolt A Enola. PA 17025 (717) 732. 78~9 . " SGP:eec Th. ERIE Is Above Allin SERviCE.. , Since 11l2!l 637167 ~O'd ~OO'oN ~S:~l 66'?~ Jew '1 ,', ( ( ( '. .- l J \ , I I \ I I I ( ) ~ \ . \~ , , . 1 ! " \, '1 I ~. ......, .~. F 11'I1.l'!NJ.... ,t\! 11.I;'I'M(JncK.'I.\~~.tlll. 1'1;" l'lta/rd OIIH"'IIB"II"'''' Iln"rd O~':J'W n: U I' I'~l 111155 I!AREID'S:J.lliLEASE.AIW.l~DEl\ll'<lIT\' AGllliEl\IEm KNOW ALL BY THESE PRESENTS: Thulthc undcrsigncd, il1llividulllly IInd liS leglll parcnt(s) IInd guardiun(s) of Jcstinc Angclini, u minor (hcreinuficr "Releasors"), for thc sole considcration of FIFTEEN THOUSAND DOLLARS (SI5.000.00), rcceipt or which is hereby acknowlcdgcd, have remised, releascd and forever dischurgcd and covcnllnt to hold harmlcss PROGRESSIVE INSURANCE COMPANY and FRANCO ANGELINI, their hcirs administrators, cxecutors. succcssors, agcnls, cmployces, subsidillrics, affiliutes and assigns (hcreinllficr collcctively refcrrcd to liS "Relcasccs"), from any IInd all claims, demunds, damagcs, costs, expenscs, loss of scrviccs, actions and causes of action, belonging to thc said Releasors arising out of any act or occurrencc up to the present time, and particularly on account of personal injury, disability, property damage, loss or damages of any kind suslaincd or that may hercafier be sustaincd by the said Releasors in consequence of an accident that occurrcd on or about Octobcr 4, 1997, in Boiling Springs, Pennsylvania. To procure the payment of thc stated considcration, the Releasors hcreby dcclare: that no representations about the naturc and extent of the said injurics, disabilities or damages made by any physician, attorney or agent of Relcasee, nor any rcpresentations regarding the nature and extent of legal liability or financial rcsponsibility of any of the parties released, have induced the Releasors to make this Rclease and Indemnity Agreement: that this Release is cntered into in consideration of all known and unknown injuries, disabilities and damages, and also the possibility that the injuries sustained may be pcrmanent and progrcssive and rccovery thcrefrom uncertain and indefinite, so that consequenccs not now anticipatcd may result from the said accident. The paymcnt made to the undersigncd is upon Re1easors warrant that no consideration has been received heretofore from any person, firm or corporation, nor has Releasors released heretofore any person. firm or corporation from any claim or liability for the said accident. Releasors agree to indemnify and hold harmlcss said Releasce from any additional sum of money that Releasee may . hereafier be compellcd to pay on account of the injuries to said minor because of said accident. The Releasors undcrstand that the Rclcasccs admit no liability of any sort by reason of said accident and thaI said paymcnt in compromise is made to terminate further expensc and controversy respecting all claims for damagcs that Relcasors have herctofore asscrted or might personally or through personal reprcscntatives hercafter IIssert bccause of said accident. ~ PETITIONER'S,',; I EXHIBlT\\ If/x ~' rll'll,I:S'UA'Al'II.IN'IUJ!KK:"'l'JS,tlMU l'lat l'lrllm OI/24,Vlll,IJ<HAM Mnhtd (l..t121~W nl U ,., PM 7tJ'SS ~: , , v. IN THE COURT OF COMMON PLEAS or CUMBERLAND COUNTY, I'ENNSYL VANIA CIVIL ACTION-LA W NO. , ,., I. , I' ~ I i: jr, ," I' t rt . i I JESTINE ANGELINI, by hcr fllthcr and Icgal guardian, rRANCO ANGELINI PllIintiffs PROGRESSIVE INSURANCE COMPANY, ORDF.R Defendant AND NOW, this day of April, 1999, the I'ctition for Minor's Compromise is grantcd and Defendanl is ordercd to pay all claims in thc amount of $ I 5,000.00 as sct forth in thc Petition. Said funds shall be dcposited in a fcderally insured account and shall not bc removcd until minor Plaintiffreachcs age 18 or upon furthcr ordcr of this Court. I :e '. BY THE COURT Edward E. Guido, J. j I JESTINE ANGELINI, by her father & legal guardian, FRANCO ANGELINI, Plaintiffs V. PROGRESSIVE INSURANCE CO., Defendant I IN THE COURT OF COMMON PLEAS OF I CUMBERLAND COUNTY, PENNSYLVANIA I I I . . . . : NO. 98-0770 CIVIL TERM . . . . IN REI APPROVAL OF A MINOR'S COMPROMISE , \ ORDER OF COURT AND NOW, this -I ~ tC day of APRIL, 1999, a hearing is scheduled in the above captioned matter for Wednesday, April 21, 1999, at 3:00 p.m. in Courtroom # 5. George B. Faller, Jr., Esquire Dusan Bratic, Esquire :sld By the Court, " . ,/<./~ >C. Edward E. Gu V c.~rf',;..:J' ""''''L<.''c.~.(, ~!I.J/"'1. .>d. P. .f ! JESTINE ANGELINI/ by her father & legal guardian, FRANCO ANGELINI, Plaintiffs I IN THE COURT OF COMMON PLEAS OF CUMBERLAlID COUNTY, PENNSYLVANIA . . V. . . . . PROGRESSIVE INSURANCE CO., Defendant . . : NO. 98-0770 CIVIL TERM . . . . IN RE: APPROVAL OF A MINOR'S COMPROMISE ORDER OF COURT AND NOW, this -l ~ t~ day of APRIL, 1999, a hearing is scheduled in the above captioned matter for Wednesday, April 21, 1999, at 3:00 p.m. in Courtroom # 5. By the Court, George B. Faller, Jr./ Esquire I, ; . Vi..A .' ./ " Edward E. Gu V .' , Dusan Bratic, Esquire :sld Fll EO-O.=nCF. OF 'T'-::: W"fIU,,'''Ji/l.RY 99^Pf1/3 /'n 2: 57 CU..,'O,;;, ','I) l'(',I'''n' 1\ ......."_.., '_ul\ PENNSYLWN~'\ , . \ : i : ~: . . , ) , FP r:O,{)cf!.;E r'F ;i.'''-r>')i''/;';)T/R,y \.' .., ", """"" r;\ 93 flPR ~ I f'i~?::-::5 ('too.,.." . ..., .. "II '-V . }j\':d;~:'ii '..... lA4'l. ':' HJ.Jj\J\t\F~,~'}li\ CMSD0627 /CMSM0627 PAC MAN OPID: SME0004 AGY CLAIM POL COVERAGE INSD: ANGELINI, FRANCO DOL : OCT 04 97 PA-CARLIS-BRN- CLM: 970598615 EFF DT: MAY 31 97 EXPR DT: MAY 31 98 CO* 26 VEHICLE YR: 97 MAKE* HARLE MODEL: FL SERIES LN!COV!LIM COVERAGE DESC 190403 GUEST PASS ..----.... 191003 BI 200102 PD 210108 CaMP 210307 CaLL 291187 PIP DEC 18 97 - 16:18 TERMID: VT690231 POL: 00624170-0 OPEN REP: A GRAS LEY ST* PA VIN: 1HD1BR219V4053200 LIMITS ! COMMENTS ..?_t~/_9_0qEAC!l PERSON-$30,OOO EACH ACCIDENT ......... - -.'- - -.,., .-.-... ".-. '-..--.- $15,000 EACH PERSON-$30,OOO EACH ACCIDENT $10,000 EACH ACCIDENT $500 DEDUCTIBLE $500 DEDUCTIBLE PEDESTRIAN BASIC FIRST PARTY BENEFITS MEDICAL EXPENSE W!O WORKERS COMP - $5,000 DC912747 ONLY PAGE COMMAND: ATCHMT Fl0=CLMPOLI Fll=PRODSEL F13=CLMSUM: * ~. '" F:\FILISIJATAnl.l~.rROI)()('lI11j5.Rn..III.. (',nlnl, ml1""111:U"OAM Rnhnl: IJ.1iH'Vllll:1tlllNAM 1Il1.5.s PARENTS' RELEASE AND INDEMNITY AGREEMENT KNOW ALL BY THESE PRESENTS: That the undersigned, individually and as legal parent(s) and guardlan(s) of Jestine Angelini, a minor (hereinafter "Rcleasors"), for the sole consideration of FIFTEEN THOUSAND DOLLARS ($15,000.00), receipt of which is hereby acknowledged, have remised, released and forever discharged and covenant to hold harmless PROGRESSIVE INSURANCE COMPANY, their heirs administrators, executors, successors, agents, employees, subsidiaries, affiliates and assigns (hereinafter collectively referred to as "Releasees"), from any and all claims, demands, damages, costs, expenses, loss of services, actions and causes of action, belonging to the said Releasors arising out of any act or occurrence up to the present time, and particularly on account of personal injury, disability, property damage, loss or damages of any kind sustained or that may hereafter be sustained by the said Releasors in consequence of an accident that occurred on or about October 4, 1997, in Boiling Springs, Pennsylvania. To procure the payment of the stated consideration, the Releasors hereby declare: that no representations about the nature and extent of the said injuries, disabilities or damages made by any physician, attomey or agent of Releasee, nor any representations regarding the nature and extent of legal liability or financial responsibility of any of the parties released, have induced the Releasors to make this Release and Indemnity Agreement: that this Release is entered into in consideration of all known and unknown injuries, disabilities and damages, and aiso the possibility that the injuries sustained may be permanent and progressive and recovery therefrom uncertain and indefinite, so that consequences not now anticipated may result from the said accident. The payment made to the undersigned is upon Releasors warrant that no consideration has been received heretofore from any person, firm or corporation, nor has Releasors released heretofore any person, firm or corporation from any claim or liability for the said accident. Releasors agree to indemnify and hold harmless said Releasee from any additional sum of money that Releasee may hereafter be compelled to pay on account of the injuries to said minor because of said accident. The Releasors understand that the Releasees admit no liability of any sort by reason of said accident and that said payment in compromise is made to terminate further expense and controversy '. respecting all claims for damages that Rclcasors have heretofore asserted or might personally or through personal rcpresentatives hereafter assert because of said accident. WITNESS: Franco Angelini, Individually and as Parent and Guardian of Jestine Angelini, a minor Jody Angelini, Individually and as Parent and Guardian of Jestine Angelini, a minor COMMONWEALTH OF PENNSYLVANIA ) ): ss. COUNTY OF ) On this, the day of , 1998, before me, the undersigned officer, personally appeared Franco Angelini and Jody Angelini known to me (or satisfactorily proven) to be the persons whose names are subscribed to the within instrument, and acknowledged that they executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. (SEAL) ~tJ(}/)"J YlJea/Jfdoo/j: 71~'IIt'a,m4 &. @'tto 9y- 770 - ^ 1'fl.OIT.\.\ION,\I. COlll'OlU\rtON - WII.I.lAM H MARHON )OIlN 1I.1'0W,-,", III D^NIH K. lJrAltUoRIT 'J"IOMAS). \V,U,IAMS. IvoV.O'l'lu.1f1 SlH'lltN 1..IJr.oo.\l GEORGE n. F^ll.l~R. JR.. MICIIA"). HANFT W. DARRtN POWEll. TflOMAS G. COI.I.lNS CAnt C. RISCII ATIUHNEVS ,\NIl ClllJNSEI.I.OHS AT L\w TEN E,\ST I-IH;/I 5THI'ET C\llI.lSI.E, PENNSYI.VANIA 17013 TnU'IIONi: (717) 24)-))41 FACSIMIU: (717) 24). I HIli March 31, 199R INTrftNJ:T J111Jwo@mdwo,culTl 'UOAIIO CERTlfIEU CIVIL TRI.\L SrECIAlIH VIA "ANI> DELIVERY The Honorable Edward E. Guido Cumberland County Courthouse Carlislc, PA 17013 I I I RE: Jestine Angelini, by her father and legal guardian, Franco Angelini v. Progressive Insurance Company Our File No. 7837.55 Dear Judge Guido: As you know, my partner. Dan Dcardorff, attended the hearing regarding the Petition for Approval of Minor's Compromise in the above referenced matter on March 30. 1998. At that time, you indicated that you would like the Plaintiffs to scck advice from counsel prior to approving the settlemcnt. You had also requested information conceming whethcr Progrcssive would in fact defend Franco Angelini if some type of action were later tilcd by the minor Plaintiff. i I am scnding a copy of this letter to thc Angclinis to notify them that it would not be Progressive's expectation to defend Mr. Angelini. Thc Petition for Court Approval is in fact tiled to contirm that Progrcssive has protected the rights of its insured. who in this case would be Franco Angelini, Plaintiffs fathcr. The manner in which Progressive would protect Mr. Angelini would be to secure a General Release in exchange tor paymcnt of its policy limits. I am enclosing a copy of the General Release which would release Mr. Franco Angelini. as well as Progressive, since the policy limits arc in tact bcing paid. I will be available Monday, April 6, 1998 and will appear before you at that time to discuss any additional concerns which you may have and trust that the Angelinis will also be present and will bring an attorney if they feel it is necessary. GBF/nlm Enclosure cc: Mr. and Mrs. Franco Angelini Ms. Susan Epler (97059R615) 1':\fll.ES"IJ,\TM'II.I:\I'RCiLlK'IHH<1fl1 Very truly yours, M. ^. 'RTSO~, DOC'.;R. DORFF, WILLIAMS & OTTO C) t" L # . '. 'Ii ' " /'(~.. C, George B. Faller, JIi INI'ORMATION . ADVICE. ADVOCACY'" ....... F;\Fltf.S\OATAFlLEIIROOQCtN'.REL.I\I.. Crated: Om4l9111JUoAM IhYiMd: o1l.U191 D1;24:59'M '1)'.55 PARENTS' RELEASE AND INDEMNITY AGREEMENT KNOW ALL BY THESE PRESENTS: That the undcrsigned, individually and as legal parcnt(s) and guardian(s) of Jestine Angelini, a minor (hereinafter "Releasors"), for the sole consideration of FIFfEEN THOUSAND DOLLARS ($15,000.00), receipt of which is hereby acknowledged, have remised, released and forever discharged and covenant to hold hannless PROGRESSIVE INSURANCE COMPANY and FRANCO ANGELINI their heirs administrators, executors, successors, agents, employees, subsidiaries, affiliates and assigns (hereinafter collectively referred to as "Releasees"), from any and all claims, demands, dwnages, costs, expenses, loss of services, aciions and causes of action, belonging to the said Releasors arising out of any act or occurrence up to the present time, and particularly on account of personal injwy, disability, property dwnage, loss or damages of any kind sustained or that may hereafter be sustained by the said Releasors in consequence of an accident that occurred on or about October 4, 1997, in Boiling Springs, Pennsylvania. To procure the payment of the stated consideration, the Re1easors hereby declare: that no representations about the nature and extent of the said injuries, disabilities or dwnages made by any physician, attorney or agent of Releasee, nor any representations regarding the nature and extent of legal liability or fmancial responsibility of any of the parties released, have induced the Releasors to make this Release and Indemnity Agreement: that this Release is entered into in consideration of all known and unknown injuries, disabilities and damages, and also the possibility that the injuries sustained may be permanent and progressive and recovery therefrom uncertain and indefinite, so that consequences not now anticipated may result from the said accident. The payment made to the undersigned is upon Releasors warrant that no consideration has been received heretofore from any person, fmn or corporation, nor has Releasors released heretofore any person, firm or corporation from any claim or liability for the said accident. Releasors agree to indemnify and hold hann1ess said Releasee from any additional sum of money that Relcasee may hereafter be compelled to pay on account of the injuries to said minor because of said accident. The Releasors understand that the Releasces admit no liability of any sort by reason of said accident and that said payment in compromise is made to terminate further expense and controversy respecting all claims for damages that Releasors have heretofore asserted or might personally or through personal representatives hereafter assert because of said accident. WITNESS: Franco Angelini, Individually and as Parent and Guardian of ]estine Angelini, a minor Jody Angelini, Individually and as Parent and Guardian of ]estine Angelini, a minor COMMONWEALTH OF PENNSYL VANIA ) ): ss. COUNTY OF ) . On this, the day of , 1998, before me, the undersigned officer, personally appeared Franco Angelini and ]ody Angelini known to me (or satisfactorily proven) to be the persons whose names are subscribed to the within instrument, and acknowledged that they executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. (SEAL) ~. q)e<Mtk/t 1f/iIIuvnu &- (7/W ^ rROFF.MIONAL CORrORATION WILLIAM F. MARTSON JOliN B. FOWLER, 1II DANIEL K. DEAROORFF TIIOMAs}. WILLIAMS' Ivo V. Onn, 1II STErllEN L. BLOOM GEORGE B. FALLER, JR.' MICHAEL J. HANFT W. DAAAEN POWEIJ. THOMAs G. COLLINS CARL C. RJsCII ArrORNEYS AND COUNSEI.LOns AT lAw TEN EAST HIGH STItF.E'J' CAIlI.ISLE, PENNSYLVANIA 17013 ~ o () TELErJfONE (717) 243-3341 FACSIMILE (717) 243,1850 April IS, 1998 INTERNET mdwo@mdwo,com -8mAO ClAnmo CIVIL TIIlI"L SN:CIAUST Dusan Bratic, Esquire BRA TIC & PORTKO 101 Office Center, Suite A 101 South U.S. Route IS Dillsburg, PA 17019 k/ t:.. : 93'- 77tJ c,'v/L RE: Jestine Angelini, by her father and legal guardian, Franco Angelini v. Progressive Insurance Company Our File No. 7837.55 Dear Dusan: This will confirm our telephone conversation of April 1, 1998. At that time, you indicated that you had represented Franco Angelini in the past and had discussed the issue of the minor's compromise regarding Jestine Angelini with the family. You indicated that you would like to have them into your office and speak with them in detail regarding the potential of an underinsured motorist claim and whether they are desirous of pursuing that at this time. I advised you that Judge Guido had scheduled a hearing for Monday, April 6, 1998 to reconsider the issue of the Petition for Minor's Compromise but you felt that you would not be able to meet and discuss the issues with the Angelinis by that time. Therefore, I called the Judge's chambers and advised that this could be taken offClfthe Judge's calendar for Monday, April 6, 1998 and we would recontact him once you have had an opportunity to meet and discuss the issue with the Angelinis. Thank you for your assistance, and I am enclosing a copy of the Petition for Minor's Compromise which was filed, as well as a copy of the Geneml Release which we were proposing be executed in favor of Franco Angelini and the insurer, Progressive Insurance. Very truly yours, MARTS ON, DEARDORFF, WILLIAMS & OlTO George B. Faller, Jr. GBF/nlm Enclosures cc: v The Honorable Edward E. Guido Ms. Susan Epler (970598615) F;\fILES'DATAFllEWtClLTR9IUS.OD.1 INFORMATION. ADVICE. ADVOCACY'" . ..-. J;..." ,/ ---r.~=:",,";:,,""I.l"""'J4' .......,.J '1" <l ../ I '.IJ1LF..1\l)A T AnLE\J'ROI)UC'~lM ~.Pr.r.1 WIll Onltd OlfOQ....O'tnlllAM R""",, O~MO'f))4\AM 11111." JESTINE ANGELINI. by her father and legal guardian, FRANCO ANGELINI PlaintilTs v. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION-LAW .- NO, q Y.770 ~ I~_ PROGRESSIVE INSURANCE COMPANY, Defendant ORDER fA ,/ AND NOW this / r day of 1-L6 /LtlA({" Y ,1998, a hearing is hereby set to consider the Petition to consider the Petition for approval of the Minor's Compromise. The hearing will be held before the Honorable -Edt.vAtul bu.,'cltJ on .3 - gtJ _ .1998, @. 9;.2~ fJ. m. BY THE COURT ~ J. JESTINE ANGELINI. by her father and legal guardian. FRANCO ANGELINI Plaintiffs IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,.PENNSYLVANIA v. CIVIL ACTION-LAW NO. Cj'~- 170 ~ lJ.... PROGRESSIVE INSURANCE COMPANY. Defendant PETITION FOR MINOR'S COMPROMISE I. Petitioner Franco Angelini is the parent and natural legal guardian of the minor Petitioner, Jestine Angelini, whose date of birth is March 25, 1990, 2. The Respondent Progressive Insurance Company is an insurance company licensed to do business in Pennsylvania with an address at 801 East Park Drive, Suite 105, Harrisburg, Pennsylvania 17 I 11-2808. 3, On or about October 4, 1997, the minor Plaintiff, Jestine Angelini, was a passenger on a motorcycle being operated by Franco Angelini. 4. The motorcycle was insured through Progressive Insurance and had guest passenger liability coverage in the amount of$15,OOO.00 per person, 5, See policy claim coverage limits hereby attached as Exhibit "An. 6. On or about October 4. 1997, the motorcycle operated by Franco Angelini, was proceeding eastbound on State Rt. 174 when a vehicle stopped in front of him. 7. Mr. Angelini was not able to stop and struck the vehicle in front of him, ejecting him and the minor Petitioner. Jestine Angelini. 8. As a result of the accident, the minor Plaintiff, Jestine Angelini sustained a displaced fracture of the femoral shaft of her ieft leg requiring closed reduction and internal fixation. 9, The Respondent has agreed to pay its policy limits of $15,000,00 to the minor Plaintiff and seeks court approval in exchange for a General Release. 10, The Petitioner, Franco Angelini has reviewed this Petition as evidence by the attached verification, -" ~'Ulll"., '~"'",.", '.',111 ~'" 1'1" ~.t;"'-Illl @ '~ Exhibit A .1 :'~\--_''''''''.ll.',,;; ;.'.<. ,... :', '; ~ ' "to .CMSD0627 ICMSM0627 PAC MAN OPID: SME0004 AGY CLAIM POL COVERAGE INSD: ANGELINI, FRANCO DOL : OCT 04 97 PA-CARLIS-BRN- eLM: '970598615 EFP 111': MAY 31 97 BXPR 111': MAY 31 98 CO* 26 VBHICLE YR: 97 MAKB* HARLE MODEL: FL SERIES IM/COV/LDIJ. COVERAGB DESt 190403 ~ iAi&, ' . 191003 BI 200102 PD 210108 COMP 210307 COLL 291187 PIP DEC 18 97 - 16:18 TBRMID: VT690231 POL: 00624170-0 OPEN REP: A GRAS LEY ST* PA VIN: 1HD1BR219V4053200 LIMITS I COMMBN'l'S jQ5,000 EACH PERSON-$30,000 EACH ACCIDENT ..'- $15,000 EACH PERSON-$30,000 EACH ACCIDENT $10,000 EACH ACCIDENT $500 DEDUCTIBLE $500 DEDUCTIBLE PEDESTRIAN BASIC FIRST PARTY BENEFITS MEDICAL EXPENSE W/O WORKERS COMP - $5,000 DC912747 ONLY PAGE COIIIIAHD: ATCHMT PIO=CLMPOLI Pll=PRODSBL P13=CLMSUM Exhibit "A" * .....' o.r: T/PlfQ-Q'rICE: ' """""""'n ,t,..,VllllTy Q9r'I.'" .. - 111~:J PN II"',? ,I.. G'/J.... U/lit,I"~""" .\" "'1)1 t,,!U (' ", PtiV/VSjll:'lIV~ihVTY 0... 0- " " ~:i... '1 J ~ I . JESTINE T. ANGELINI, A Minor, : By FRANCO ANGELINI her Parent and Naturnl Gunrdlnn Plnlntlffs, IN TilE COMMON PLEAS COURT 011 CUMBERLAND COUNTY,I'ENNSYLVANIA v. CIVIL ACTION NO. q 8 - 71~ ERIE INSURANCE EXCHANGE Defendant. ORDER OF COURT AND NOW THIS I J~ day of ~3, upon prescntalion ofthe within Petition For Leave to Settle and Distribution of Procccds For A Minor and due consideration thercof, the Court being satisficd of thc propriety of selllcment and that it is in the best intcrest of the partics, it is hercby ORDERED AND DECREED as follows: 1. That thc selllcment on bchalf of JESTINE T. ANGELINI, a minor by and through FRANCO ANGELINI, her Father and Natural Guardian in a total amount of $75,000.00 is hercby approvcd and distribution of the total selllement of$75,000.00 is hercby directed as fcilows: A. To Jestinc T. Angelini, a minor, by and through Fnmco Angclini, her Fathcr And Natural Guardian, to be placed in a rcstrictcd fcdcrally insured account or a certificate of deposit to be marked: (Not to bc withdrawn any earlicr than March 25, 2008) in the amount of $ 12,085.17 B. To Bratic & Portko, Allomcys At Law for counscl fces and scrviccs rendered $ 22,500.00 C. To Bratic & Portko, Allomeys At Law for reimbursement of costs s; 414 R1 TOTAL SETTLEMENT $75,000.00 a D. A structurcd sclllclllcut wilh u tolal prcsenl dny valuc or $40,000 to be puid us set Ibrth inlhe uCColll(1l1uying Exhibils. 2. Thut u(1on (1l1ymcnt of ulbrcsuid sum or $75,000.00 as sct forth hcrein ubove und pnymcnt of thc rccord costs by the Defcndunt, i r uny, the Pctitioncr is authorlzcd und dircctcd to cxcculc a rclcase and sclllelllent us agrccmcnt us to the Defcndanl, ERIE INSURANCE, and thc Dcfcndunt shallthercby be rully rclellscd rromuny IInd allliubllily by rellson orthc facts set rorth in thc foregoing Pctition us rurthcr defincd in the Rclcusc cxccutcd by the Plaintiff, n copy or which is IIttachcd hereto und made a part hercor. q It >!b-:> Dated' J. ~ ~X5 o9~J:<-63 ,,' 2 (-'{) -u rI:~'i: C'~: ' ... ""In" ,/, . . .';;'.11 03 .C:FP 1(.' il,',! II: n! Ci" "J" . ,. '\"V . .'/;' ~ "-' '.J' \~..' '.., ,-. <.Ji I I I"ChI,v.v; 1'1~1\1,\ 1,;;,'1 ....,.... 1\., (, . JESTINE T. ANGEUNI, A Minor, : Dy IIRANCO ANm;UNI hcr l'lIrcnt lInd Natural Guardhlll Plaintiffs, IN THE COMMON I'LEAS COURT 011 CUMDEIU,AND COUNTY, P~;NNSYLV ANIA CIVIL ACTION NO. v. ERIE INSURANCE EXCHANGE Defendant. PRTITION FOR I,RA VR TO SRTTI,R ANn mSTRIRJJTION OF PROCRRns FOR A MINOR COMES NOW, the Plaintiff, JESTINE T. ANGELINI, a Minor, by her fathcr and Natural Guardian, FRANCO ANGELINI, and Pctitions this Honorable Court for leave to settle the claims ofthe Plaintiff in the above captioned mattcr and statcs: 1. JESTlNE T. ANGELINI is a minor, and the Plaintiff in the abovc referenccd action who residcs at 5 I 3 Park Drive, Boiling Springs, P A 17007. Shc was bom on March 25, 1990. 2. The Plaintiff, FRANCO ANGELINI, is an adult individual who resides at 513 Park Drivc, Boiling Springs, PA 17007. The Plaintiff FRANCO ANGELINI is the Fathcr and Natural Guardian of JESTlNE T. ANGELINI and has had physical custody of said minor since 1990. 3. On or about October 4, 1997 JESTINE T. ANGELINI was a passengcr on a motorcycle drivcn by hcr father, FRANCO ANGELINI on SR 174, Boiling Springs Road, Boiling Springs, PA. FRANCO ANGELINI struck the rear ofvchicle in front of him, which was allached to a receivcr hitch and an accident occurrcd in which JESTlNE T. ANGELINI was injurcd. 4. At thc time of the accident, the motorcyclc opcratcd by the father FRANCO ANGELINI and was insured through Progressive Insurancc with Third Party Liability Limits of $15,000. 5. The Third Party case was scttled for $ I 5,000 and said settlement was approved by Judgc Edward E. Guido on the 26th day of April 1999 and Docketcd to Cumberland County Civil Action No. 98-770. At that time Dusan Bratic waivcd any allorney fees. 3 6. The PlainlilT, JESTINE T. ANGELINI, a minor sullcrcd the following injurics as a result of Ihc accidcnl: (II) LlIccrations amI contusions (b) Displaccd fructurc of lcn femoral shan with closcd rcduclion IInd intemal fixlItion with Rush Rod (c) Rcvision ofhypcrtrophic scar by Dr. John P. Stratis on 5/4/98. (d) Rcmoval ofintemlcduleary Rod that was symplomalic from Icfi fcmur. JESTINE T. ANGELINI has mllde II good rccovcry cxcept that the skcloid changes hllve returncd to thc area of surgcry. Shc will nccd to wait until shc has fully grown and dcvclopcd bcfore attempting further revisions to the scar. Scc attach cd letter from Dr. Mark S. Boland datcd May 7, 2001. 7. The Plaintiff, FRANCO ANGELINI. carricd an automobile insurance policy No. Q05 2505746 H through Eric Insurance Exchange with liability policy limits for bodily injury comblncd policy limit 01'$100,000. 8. The Dcfcndant is the undcrinsurcd carricr; Eric Insurance Exchange has not paid any liability claims to the Plaintillarising from this accidcnt. 9. There arc no unpaid mcdical or other bills in this matter. 10. In light of the injurics and mcdical expcnses incurred to date, Eric Insurancc Exchange has ollered to pay the sum of $75,000 in complcte scttlcment of the underinsured damages under coverage's which the mothcr and natural guardian has agreed to arc being fair and reasonable. 11. Your Petitioners propose that a portion of said funds for the minor be deposited in a certificate of deposit in the name of the minor. in a bank. which is Federally insured and to be administercd by hcr Father and Natural Guardian, FRANCO ANGELINI, undcr the provisions of the attachcd Ordcr which will indicate that no withdrawals shall be made /Tom any such account until JESTINE T. ANGELINI, a minor, attains 18 years of age, which will occur on March 25, 2008, cxccpt for payments towllrds a collegc education, i I' she so elccts to maturate prior to her 18th birthday, or as authorized by prior Ordcr of Court pursuant to Pa. R.C.P. 2039 (b) (2). 4 , 12. Your Pctitioner proposes to IIcccpt $40,000 of thc settlcmcnt us u structure undcr u proposul submittcd by thc IIttuched liS Exhibit A, a finn spcciulizing in lhe same, which is cxpcctcd to yield IIpproxin1Utcly 4'X" tllx-rrce und to provide for grudualcd payments us follows: BENEFIT COST GUARANTEED YIELD Immcdiate ClIsh und Attorney Fccs $ 35,000 $ 35,000 Guarantecd Lump Sums Tax-Frce paymcnls: $10,750 on 3/25/08 (lIgc 18) $11,610 on 3/25/09 (age 19) $12,539 on 3/25/10 (age 20) $13,725 on 3/25/1 I (age 21) $ 9,302 $ 10,750 $ 9,730 $ 11,610 $ 10,178 $ 12,539 'l: 10,7lJO 'l: 11 7?~ $ 75,000 $ 83,624 13. Thc structurcd portion of thc scttlemcnt will providc thc Minor with an additional $8,624 oftax-rree benefits and provide a fund for collcge irshe so chooses. 14. Thc said Dusan Brutic hilS consulted his brother, Alexander Bralic formerly Dcputy Insurance Commissioncr ror the Commonwcalth of Pcnnsylvania and chairman of Mutual Fire and an expert on insurance company cvaluations, having served for a number or years as a rehabilitator in thc Dcpartmcnt or Insurance in the Commonwcalth of Pennsylvania. His opinion is that Eric Insurance is a sound insurance company and that this rcprcsents a prudent investment. This information was supplicd to the minor's guardian along with A.M. Bcst Company rating as cxccllcnt. Sce attachcd Exhibits. 5 ': WHEREFORE, the said I'clitioncrs pray your Honorablc Court to approve such sclllcment liS sel forth in this pctitionand to dircct the distributionthcrcof liS follows: (11) To JESTINE T. ANGELINI by FRANCO ANGELINI, Mothcr and NlItural GUllrdilln, bc depositcd in a Fcdcrally insurcd institution in thc amount of......... $ 12,085.17 (b) To Dusan Bratic, Esquire for rcimburscment of costs............... $ 414.83 (c) To Dusan Bratic, Esquirc for Legal fccs......................... $ 22,500.00 (d) Structured scttlemcnt with Eric Insurance as sct forth In Exhibit A with a prcsent day value of....................... $ 40,000.00 TOTAL SETTLEMENT $ 75,000.00 And further to authorizc your Pctitioncrs on payment of said sums by thc Defcndants, to mark said action scttlcd and discontinued insofar as it relates to ERIE INSURANCE EXCHANGE. DlItcd f/v~ us an Bratic Supcrior Court 1.0. No. 19249 101 Officc Ccnter, Suite A 101 U.S. Route 15 South Dillsburg, PA 17019 (717) 432-9706 Allomey for Plaintiffs 6 , ) JES'I'INE T. ANm:L1NI, A Minor, : By FRANCO ANGELINI her Pnrent nnd Natural Guardlnn Plnlntlffs, IN TilE COMMON I'LEAS COURT OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION NO. ( .\,; II CONSRNT OF PI,.\INTIFF AN NATIJRAI, GITARnJAN v. ERIE INSURANCE EXCHANGE Defendnnt. . THE UNDERSIGNED, FRANCO ANGELINI, Plaintiff in thc abovc captioned action and Father and Natural Guardian of JESTINE T. ANGELINI, a minor has read the forcgoing Petition for Minor's Compromisc and has reviewed the terms of said Petition and settlement with our attomey and hereby consent to the Pctition and agree to said settlement. ~ C~(~~ C-- Franco Angelini I 7 JESTINE T. ANGELINI, A Minor,: By FRANCO ANGELINI her Parent and Natural Guardian Plaintiffs, IN THE COMMON PLEAS COURT OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION NO. v. ERIE INSURANCE EXCHANGE Defendant. CF.RTIFICATF. OF SF.RVICF. I HEREBY CERTIFY that a true and correct copy ofthc foregoing Plaintifrs Petition for Leavc to Settle for Jestine T. Angelini was fumishcd by U.S. Mail, first class, postage prcpaid on this ~ day of~t2003, to: Franco Angelini 513 Park Drivc Boiling Springs, P A 17007 Daten' f /'14.. D san Bratic Superior Court I.D. No. 19249 101 Officc Center, Suite A 101 U.S. Routc 15 South DilIsburg, PA 17019 (717) 432-9706 Attomey for Plainti ITs 8 to'd 11:UOl .... PUSAN BRAnc, ESQ. STEPDI'I K, PORTKO, ESQ. BRA TIC AND PORTKO A"""'IyJ .t LIIW 101 OFFICE CENtER, SlJTTEA 101 SOUTH U.S. ROUTe IS DILL.SBlJRlj, PfiNNSVLVANIA 17019 FAX COVER SHEET (7J7) m-9706 (717) "32-2$38 FAX (717) 432-9220 DATE: AugUSl19,2003 RE: Structured Settlement TO: Alr.x Dralic FHA Holding Company lZO E. Uwc.b11Ul Avenue, Suite 101 Exton, PA 19341 (610) 524....700 Ext,264 or 1-800-583-8049 FAX NO.: I,'AX: (610) 524--0900 NO. OF PAGES: 3 FROM: DUSla Bratic NOTE: If you do not receive all the pages of this facsimile transmission, or if any page is nOllegible, please call (717) 432-9706 immediately. r have a client who wants to struoture $40.000 of a settJcment. Erie will only l!WIranlee with their own comDan V. Here are the financials and ratinl!s. Is this safe with this comDanv? It would be writtco thouRh Erie Familv Life and P.1Iaranteed bv Erie Insurance Group ~.s~ NOTICE: The inConnanon cOIImiDed in lIUs facsimile \l'UlJmilSiDn is attorney privili:ged and conlidtlltial infoltMtion inlCJ1ded only for lhc U6e ofthc .bove'lloled Iddressec. If the ~adcr is not the intended recipiOll~ you ;are hereby uotified that tJ1JY diucminltiDll, distnbudon or copy of1liis flc,imi1e is slrictly prohibited. If you bave lteeiwd this ttansmis.ion in c:rror, please notify lU immediatcly by =Iephonc lJId r= the original mesnge to Il9 althe adcln:s.! noted althe lOp oCthispage. YOlll'eoopennan il appredl[ed. E fQ..\ e l.5 0... S +- ./l.-0tJ ~b{~ ~ UIWf)1:JN1 -.skc)~ '7~ v( t (5 rJt- k ~ to/tO'd OO~PPcSOt9t ~~3 nu~ 15 n~ 04. 15p .John W. Cnmp,..nn '11'I'Ii!1I15[J;! p. I .. RINGLER ASSOCIATES, INC. ~ .... I I 1,1 ill ,t r . ( I: - - FACSIMILE TRANSMITTAL SHEET TO: DUSAN llRATIC. ESQ. FROM: JOHN W, CAMERON COMPANY: DATE: 8-15-2003 FAX NUMRF.R: 717.432.9220 TOTAL NO. OF PAGES INCLUDING COVER: /5'" RE: mSTINJ> ANGELINI CC: DON IlOTTIINI FAX PIIONE: 717-795-2315 CLAIMS NUMllER: 010/70410340 o URGF.NT 0 FOR RIlVIF.W 0 PI.IlASIl COMMENT 0 PJ,IlASE REPI.Y 0 I'I,RASE RRCYCI.1l NOTES/COMMENTS: Dear Mr. Bratic: I am wilh Ringler Associatcs of Harrisburg, P A, a stmcturcd scttlemenllirm, and am writing regarding your client, Jestine Angelini. Don Bottini, from Erie Insurance Group, referred me this case. This will confinn our conversation on August 15,2003. Please find attached the structured settlement proposal wc discussed. Erie Family Lifc was uSI,d to preparc this proposal. Also, attachcd is financial infonnalion on Erie Family Life and Eric InSurdllce Group. Please advise if this proposal is acceptable to YOll and your client. The enclosed ligures are for illustrative purposes only and should not bc construed as a contract. All ligurcs arc subject to approval by Ihe life insurance carrier prior to contract issuance. [fyou have any questions regarding this proposal, please call so we can discllss them. .Tohn W. Cameron ~~~ 49112 CARLISLE I'IKE . I'M II 395 . MECIIANICSBUnG, I'A 170511 1'1I0N~;: 717-728-1500 . ~ 717-728-1502 t5 03 John W. Camer-on 7177201502 p.e! " 00 o RINGLER ASSOCIATES John W. Cameron jCilmcron@rin9'cr~ssocl~lcs.com 717) 728.1500 (800) 515.5033 F~x (717) 728-1502 August 15,2003 ,I I , i Immediate Cash and Attorney Fees $35,000 $35,000 Individually Designed Seltlomenl Josline Angelini 0/0/8 3/25/90 BENEFIT COST GUARANTEED YIELD Guaranteed Lump Sums Tax-free payments: $ 10,750 on 03/25/08 (age 18) $ 11,610 on 03/25/09 (age 19) $ 12,539 on 03/25/10 (age 20) $ 13,725 on 03/25/11 (age 21) 9,302 9,730 10,178 10,790 \ , I 10,750 11,610 12,539 13,725 j , $75,000 $83,624 I ( t': , ,', , '," 'r I" ll' I! ":~'., \)..', '" I: :,') ~902 CARLISLE PIKE, PMB 395, MECHANICSBURG, PA 17050-3079 www.ringlermidam.com Au~ 15 03 04:IGp .Jnhn W. CAmernn 71'1'721Jt502 p. :1 ,\ Life Insurer Financial Profile Comptmv Eric Family , A (3) Api (6) /Ratings/Rank* A,M, Best Company (Best's Rating. 15 ratings)" Standard & Poor's (Financial Strength. 20 ratings) Moody's (Financial Stren9th, 21 ralings) Weiss Ratings (Salely Ralln9. 16 ratings) Comdex (percenllle In Rated Companies) B+ (4) 79 . These rallngs reflect Ihe opinions ur the r.111n9 olgcncln and art! not Implied war,anlfes of the company's abllltv to meet its contractu.,r obligatIon.... All ratings shown arc current as of August 0'.2003. .. Relative financial sr((!ngth and operating performance in comparison with Industry norms. !Assets & Liabilities Total Admitted Assets Tota' lIabllllles Separate Accounts TOlal Surplu, & AVR As % 01 General Account Assets /Invested Asset Distribution & Yield Total Invested Assets Bonds (%) Stocks (~ Mongages (%) Real Estale (6) Policy Loans 0.') Cash & Short-Term (!16) Olher Invested Assets (5i:) Net Yield on Mean Invested Assets 2002 (Industry Average 6.42%) S Year Average (Industry Average 7.0S%) Non-Performing Assets as 0/0 of Surplus & AVR Bonds In or Near Default Problem Mortgages Real Estate Acquired by Foreclosure Total Non-Performing Assels As a Percent 01 Invested Assels IBond Qualitv Total Value 01 Bonds Class 1-2: Highest QualilY Class 3-5: Lower Quality Class 6: In or Near Delaull Weighted Bond Class IIncome & Earnings Total Income Net Premiums Written Earnings Before Dividends and Taxes Net Operating Earnings I 1,225.589 I, J 32,270 o 94,598 7.7% I 1,183.171 B2.2% 6,3% 0.6% 0.1% 0,8% 8.5% 1.4% 6,64% 6.95% 4,5% 0.0% 0,0% 4,5% 0.4% I J ,034,995 95.5% 4.1% 0.4% 1.5 .--J 302,8J I 224,325 JO.906 5,479 03ta ror Year-Fnd 2Q02 (rom the lire insurance companies' U.ltUtory annual statements. All doUelt amounts atc In thousands. Page 1 01 I ;/ ., I, ii !; f , ,. j .: Rue: 15 03 04: tGp .Jnhn W. Cnmr.rnn 7177201502 p.5 , r I' .. I " List of Possible Ratings i i' !\ , Standard & [, A.M. Best Poor's MoodV's Weiss i 1. A++ AM Aaa At r Superior Extemelv Strong (xceptional (.cellent f: 2. A+ M+ Aal A Superior Very Strong Excellent Excellent 3. A M Aa2 A- I Excellent Very Strong Excellent Excellent II 4. A- M- Aal B+ ;1 Excellent Very Strong Excellent Good I 5. B++ A+ At B Very Good Strong Good Good 6, B+ A A2 B- Good Strong Good Good 7. B A- Al C+ Fair Strong Good Fair 8. B- BBB+ Baal C Fair Good Adequate Fair 9. C++ BBB Baa2 C- Marginal Good Adequate Fair 10. C+ BBB- Baal 0+ Marginal Good Adequate Weak 11. C BB+ Bal 0 Weak Margl nal Questionable Weak 12. C- BR Ba2 0- Weak Marginal Questionable Weak 13. 0 BB- Bal E+ Poor Marginal Questionable Very Weak 14. E B+ Bl ( Under State Supervision Weak Poor Very Weak 15. F B B2 E- In liquidation Weak Poor Very Weak 16, B- Bl F Weak Poor Failed 17. CCC+ Caal Very Weak Very Poor 18. CCC Caa2 Very Weak Very Poor 19. CCC- Caal Very Weak Very Poor 20. CC Ca Extremely Weak E.tremely Poor 21. C lowest 22. 23. 24. Page 2 of 2 ..:._.,.:.....~. ,I P. Stratu, HID. FrO~1 C.rlls1e HOIDlt.l . 5-4-98 915b," D. l Dr 1 . ANGELI NI, JEST I NE T. 1 1 MRn 286580 oPS DATE OF OPERATION: SURGEON: ASSISTANT SURGEON: ANESTHESIA: 05/04/98 Dr. John P. Stratia General PREOPERATIVE DIAGNOSIS: Hypertrophic scar of the left thigh. POSTOPERATIVE DIAGNOSIS: Hypertrophic scar of the left thigh. OPERATION: Excision of hypertrophic scar and layered closure. INDICATIONS: This 8-year-old white female is having a rush rod removed today by Dr. Mira and the parents wish to have scar revi- sion performed. The procedure including risk of recurrent poor scarring was explained to the patient. PROCEDURE IS AS FOLLOWS: After appropriate general endotracheal anesthesia had been administered, the patient was placed in the right lateral dscubitus position and the left hip was prepped and draped in the normal sterile fashion using Betadine solution. The scar was excised completely under 4.5 power Loupe magnifica- tion using a #15 blade. The rod was then removed by Or. Mira. The flaps in the subcutaneous tissue were made to overly in re- duced tension on the skin and these were closed with 3-0 Monccryl suture. Subcutaneous tissues were also closed with 3-0 Monocryl and 4-0 Monocryl suture. The skin was closed with subcuticular 4-0 Monocryl suture runnin~ and Steri-Strips. This was all done under 4.5 power Loupe magn~fication_ The patient tolerated the procedure well, wes dressed with 4 x 4 and Tegaderm. She went to the recovery room postoperatively. JPS/bjw 0: 05104/1998 - 08:35 am T: 05/04/1998 cc Or. John P. Stratis John P. Stratis, M.D. ANGELINI, JESTINE T. OPS MR# 286580 05/04/1998 03/25/1990 Stratis, John P. M.D. Page 1 of 1 CARLISLE HOSPITAL OPERATIVE REPORT 22:D7 RECEIVED FROM: P.DI c.,' ') ~ielia me!l. ~ lIge'!i of Central Pennsylvania, p.c. ,-:J William p, Graham. III, M.D, John P. StraUs. M.D. Lawrence K. Thompson. III. M,D. 818 Belvedere Strael Cartlsle. PA 17013 (717) 249.0100 Fax (717) 249.8889 Kaye M, Riolo, M,O, Oonald R, Mackay, M,O, Peter Glassweln. M,D. 850 N, Twelfth Slraet Lemoyne, PA 17043 (717) 783.9766 Fax (717) 783-7710 4700 Union Deposll Road. Sulle 240 Harrisburg. PA 17111 (717) 541-4303 Fax (717) 541-4446 March 3, 1998 '. Allan Mira, M.D. Medical Arts Building 220 Wilson St. Carlisle, Pa. 17013 RE: Jestine Angelini Dear Al: I ! I saw Jestine Angelini in the office today in consultation for hypertrophic scar of the left hip. It is my understanding that she was involved in a motorcycle accident ,with her father and sustained this hypertrophic scar. I also understand that you plan removing a rod and at that time we would perform a scar revision. I went over the risks of recurrence with this patient and her family, but also indicated that there are some things we can do in the healing process to improve the scar. My office will be coordinating this with your office. If you have any questions, please let me know. Sincerely, , I j J~tratis, r M.D. " JPS!klf ~ PlasllclCosmellc Surgery' Breasl Proeedurss . Micro Surgery' Laser Capabllllles . Hand Surgery Birth Detects. Endoscopic Plasllc Surgery' Blomedlc Skin Cars Program Slate Weensed Surgical Facility On-Slle c. . ~ .. " ~.' .,..... , ,'. , " ,', ., -. . .. t,.' . ' ",. I ".;' j' ," .~'. . ,I, ';1"1' . ..': 't . "," .' ': I ~ ,,' ,/ .' ,',. .", '.t':' I; . ...,.!. . ...,.......' :.. .',,, '. ", . . ..' . , William P. Graham, III, M.D. , John P. Stratls, M.D. Lawrence K. Thompson, III, M,O. 010 Balvedare SlIIat Ca~llla. PA 17013 ... (717)249.0100 FIX (717) 249-0889 " . o(Central Pennsylvania, P.C. Kaya M. Riolo, M,D. Donald R. Macluly, M.D. Palar Glassweln, M.O. 4700 Union Dapollt Road, Sulta 240 Harrlabur;. PA 17"1 (717) 54 1-4303 Fax (717) 541-4448.. , ....~ . . 650 N, TwaIIh Strut Lamoyna. PJ\ 17043 (717) 763-9766 Fax (717) 783-nl0 " . June 23, 1998 " '.' ". . " '. " " " " ~ " .... Allan Mira, M.D. Medical Arts Building 220 Wilson St. . . Carlisle, Pa. 17013 RE: Jestine T. Angelini ...... . . Dear Al: ". ." . ,.,." :~.' 0' I saw Jestine Angelini in the office today. Her scar is trying to become hypertrophic again. As euch I'm starting her on silicone gel sheeting and hopefully will nip this in the bud. She is going to return to see me in a month." . ','" " "', , '. . 'J'", . ..: . ..,. - . . ",t I'll keep you abreast of her progress. please let me know. ., ,...'. ':.7'" If, you have " :,.:.", " any 'qu~stions; ',:. ;"i, . .' . " ',_ . .! '.' ..~.:..', ~. I .~.:: .... . .:' .i' .... . :::..~.'.~ '. . ..... . .... . Sincerely, ., '.\ '. JC~~~iS;' .. ',' .. : . ~. ," . . ~ .', : M.D. .: . " " JPS/klf ,. .. ". .. ' ,',','; " ._,.... ". . PlasUclCosmaUc Surgary . Breaat Procedures' MI= Surgary . Lasar CaPabWtJas . Hand Surgary Birth Dal_ . Endoscopic Pla.Uc Surgery' Blomedlc Sldn Care Program Slate Ucensad Surgical Facility On-Slla ". .. , ) .J l \ , I , , , I i I I , 'i 1 i , \.; ., . fi !' \, 1'1 ; I..'.~.. " .'. .e.,... ':'''.,' ',' '!\iC..~~"iflj~r":~~~;~~fIj''''<iJ'lo'',,:~,\~:;, "~;~""~~:':":: '::. I'" i.,. ;"ifIif.' ,... '1<'.' ..' ,I~ :~,F.'\' '" I. ,.h',' ,::r'"," .!... 1114'.' '.',11. 'J.l t .t~,., ".......1'. . ".' ~ . e.:"" . ,l'fil /.,-.. ~".' ..~.. '-J.il- ~ ..:~.,'~ ,,' . ...." .lld:,..,....t.. <"~i;''; '.;~lJ .. '-::;:\:.... ,~.~ ';';i:~ r~~"r',;rt'{I.t:.t:';'''I;I': ,.t'ol W1J~ '/'''~k1''' JlI~ ~"fe. ..i, 1'.;J,...-,..)l~::l " '.. .,.'1.'....': . ,,~1. 'f.:r'J '" , iJ . If( '\..~ !J\"r-~,,!t; 'f .j .' 'V'~\ .' r,. ) ~l':' "LtC." : ..... ,', . :" " . '-:'~~lt:'I\ll'''''f'r.';\~I~~~,.. ll~,"'?l~':"l..;:~...~-=t,.;:!;,:~~\~~(t,.. , '(C I ",' , .~~,,~r;.1 " l' ...'J":r",.. .~.' .'!' ~iJ '~,\, "', ',..0 entr(/ Pennsyll'a/lla, p.c. ,.,11,(/",;1, ,,~.,' :i':"':I~.'t';.. ;: ,..i.... ~.:':';I'T...,.:>;,. '. ~ ", ' "'., . ,",.. _ .., '.. "~ ' ..\ "\"(,-,,,', i..' ....,. "t. ';'"I~tJ r t~'. Kaya M RIolo '" o' .. ': :...,. ,''' :~'I\l",' ' . '. 'i~:'; ,.,,: '. -':....~....'i. ,', ..~, ,; .; ;".' I ". . . .", " . :;'.' .;~I.'" ~" " .:. :'~',~:,'" ~.".. ~\; I.., ,: ,~;,./~l Donald R. Mackay, M.D.. : .':: ...~,l.,r...... r,l~ ' ..'~..t\'r-.*\ I, ........1.. PeterGI...weln MD ..;-. .' ,.... I.".' . I, . I .. .. ; ,., ~ ,;'." r. _ . '..:' " '. l" I.. ~ '. ~.' ..'. ~ :...,';' 850 N. Twelfth SlnIet ." ": ,,,:.:::.;, p :~.\~.4700,~rlon Depollt Road, Sui'. 249 ,~' , Lemoyne, PA 17043 ". .:'... ~,,:,",,:..l,;.~.. ,"',;, . ,..,: Harrilburv, PA 17111 .. '(717)763.9766 ..';~'., ,<...,I:i~~)~'~'l~'t""'.!:i, ,(717)541-4303 . , 1':.";0.. . . I .1"1 .. '/i.""'. ,":".1" ,,' , . '.: "". .,': FIX (717) 763-nl0 I,' , :; .:' '.':"~ ~"I''i\~'~''';'~~' ,;'... , '" Fex (717) 541-4446 :, .. .'" I .' . ,. I . '. ';f .lj',~, I' ,.~. . I 1''''hJ' ...., . ", .,' Ji.....28 1998 " '.;,v,/."r.~,: ,,'r;'" -' .. , " '''( .:o.~lt! f',' ..'::'.; ..,. .;, U.1 '. :~l'.~:.~t"~~~~~ 11.t{#o.... ,.-:' ." ..l~A;-~,if.~~, .~:. I" ,...,n:.....' :':"I,j<l..!'ii\'1,,,~'Io;tl,,,,~'..ut>. ... ,f, ..~j~~!,~,. ." . . :" \ :.,,\f'o"< I ~ . . .... .' ,f" .. . "~""(""-'!,'" '.,' ,.,'101'. i,''''&.~~J.~,~u....'' '. V.I' ,,'..,.. :t..,.".' . ,1.:..:: :.J,..... .... ,.', ".L.;,"l.";.:\::~",'.,,,.)~'.... '. ...~.':,,~~.\i;,'~ . ',.';, ,. ....~.;r\...it,/.W.:::.;:'i''{!.. ll.~_"';'.!~~ ~'. '. r." .. . '. .... "~'. ~It'\"'~.. '.' '..,,1. JoJ.:] . .! . . . ,'. . .... ,.. C,'" .., ' ,..... . .. ..... ...r~ . . ,,~ t.. ~ ;" . " J,' ., .... '.. ..... '. "'" .,.'" '. ~. I','" . p"'''''' ..~..... /,":, ."~:<<~'.~~'/:::'.': .':'t'I~';~.~~:f/~~~~I/:3;~.1.:~::": '" . . .....\;.;~.;~;~t>:: RE: Jestine T. Angelini .. , /;':"'~'; . '. ,....:.......... ..:;,,~~i.~.i,i-i.~. II,.. : .' .I..-.;..~...,J;r.~ . ." ...."t.".... .....:I.~...._.."......:.~.'I..~,....~~.',.;.......... ,.......:~:..:.,~,~'.~:~. :'.;::-', ''''~''''..." ' "~J. Ilru..OT"~"j'\'l." ''',' '. .'. I...., "~I'":. . . . .~.:.:.:,:,,{.'::.t...::..::?r:~.:,:. )'. ". .' ...., :J;t...i'''.....''Ir.... o;t. ;~- .... , I.' '.t'-~'.. ...".."..... .. ':!'~'. "'. . . .. : ~.o:' ::..';):;: ~~..:' ~'.~~:~~~-, ':~1l~V4i~,~~'~:0i;!I:::Y :...:;'. .... . ...: ..~):~~;i~~:~..:. .. ..':....._.'.;,\:::j... . . ,.! . ............ .' .......', ,tltt~"lr""'~ .. ~I,...... .,' . . 'I'~' ~..~,.., '. .., . " . "1" ,.....~.'to'r-,. . .......&1'1('........... ;1$;;"~ ~: " - ....:c.n.';-:.. " :: ' '. .:"".-..' :~. ',.'. . .:.~-......J-~':....._~ ....:.:,..."~I"... ,:'. :~~.t'.i."'.;.I,~J.-1~';'~r..I.." ".f'~\'" '!. " .. 'i:~vt"::':':'~ . I saw ]estine Angelini today. Unfortunafe1y, her hypertrophic sCarring luiS' iiimoSt ',~':r^ " :":_~~:~;;,:,~..".. '" completely~. She ~_ nOt abl.e to use silicOne ~ ~~ ~a,..;e.~,fth~,.~,tha!1 '_ ..iI~1Ji:~ she gets, aro~d It. She does not.WI~ to have a~ero!i1 mJ!lCIion.. "!'~ ~~ust gomg to., . :'~:';'-:"j"'; leave this as IS and have her address it when she gets past puberty if she WIshes to have :,;"",r,' anythin d .th't' ,....';... ..... \.: '1..-...I:...\~.. ':":'.:';:":'C~"1.~',,,<.1' ';\'.:'~ .--;.~..'.~Ji.:" g aneW! 1. " j.' ..... .,"\......,..... '......'~.f'./I:;'.:.n.".JV,...'-I.,... ':";'.','" ,.J...~_. '. . " ','l .... '~"';'CI':;.I""'!.I'v .' ...'t~.~":;:~..:~:".' .'. ;~F~\r-:~l!,""~r.";,;, ..~ ~ '.::.w!:!"'-: '. . . .r.... :.~..J.' .."I.'....1~;;.;..)i.4: 4 '.,~i..~\.~!,;:..;~... ...!..-.l....~.,..z.i';:'(.ft..1...11~.: '.', .. -.~-:..;....',.. . .' . . .,. ~" ..;. . " I ,'.' '. .... .o' :..~.,....:.:..~. .'lor; ::..' .:.:,.~....{;";\~l~.~.r...\:1.!.,l,,; ~ ....... . .~.:.,\.~-'~:.- ." .Thank you for mvolvmg us m the care of this patient. ,'.'."., .",~ . <,.;'.~'tl,Fo,::1\.l."k.I,-io.';_ : ' . ' . ":':';:' ..t............ .;.:.... I<"fl1~v3.......i- .. 1; . .; I"....:.".'.(.'i".\ ",..:n::-i"~'~""'l~~~h!-"'I.,... t .,. .~;I~'AJt:..:'" ::'.::,;:.:~: . ~ ~ .:" '\.' ''''r ~'~""~"~1(",~"":::~:\:" : ,j' ::':;-....Pl~.1i~.. ...~~~~~:~~.....:..:tf~,~i;~i;t1...':'..\:~fll . .~'.~.:...:~:;:~~......:. .:'. :~~~~.t,:: .. ..f ~...' .;..... :;!!~~';':';l~.;~.:?.:.. "r. ". SincerelY:"~:.~~~'~::1.;.:~~.~::.. ~r,:ij;:~~:t;'7i~;":,;J :.?t~.., '., .... ::':.)ff~:;"-;''1 !.'7'~:. .........r:~.?>:.,.:~'.:.~... !::.' .... ........ '~', .... .~': ,.:" ::""..(i..f:.~tr~"..~~~'it.~. .~,"".!.'.: '.. .";'-':.~..1'.?1;':: : .....c..!..., ..../.. ,I.r\..' ......1, " t'.. ..,.,I'.~.'l'-'1i~,t,.."'l"'''f/...} ~ ....;,.:.;. ;~\~.o' :.... '''';\; ." r..' ~ ... '.,\ .. ....: ).. ..~~'L.~J,('.'r" .._1... 'j ..... "':. .....:'1-.., '.. '.: '. I' .... t.. ........~.. ..~.., " ..1..... .. .!.1 .:o'I.....!tI.~.;..~;:I;. '" ...h~""" ........,.,.:"....:...,.. .' ' .. ":'::;:'~~'''~::'l'~:':'' . ._~I;;'-;< :':'\"~if\;~~;~~0~iH',j'; ,:\::::: ' ,.' Jf;' .'. ,',;:: ,I' hnP Stratis MD ;.~-~V"\"rf.'.'.:.,.I~~-:""~;i';:~;" '. r' ..~.~.'. '", .'-\'." ..... . .,.' ...,..:\..,J..,'\:;\...t,';",.~llP""''''''l'~-' I..... I~.;:.. ..~~;:'. ........: ':~', ": t,'.' "':-.{:~ ' '.~'~;.:? ~;~\~(~~.,.~;'~~!~,".'.~.,,' /~~~.~..;'. .~:-" "r~~"~~~: .... "'," ,;t.:.>;....,.... ....~..i.:,i..f~l.I~J!;'~i";~......'.~. -' :....\....~.;.~~.'...: . .. _ . ':\.. . (~,. \ . . ,"" . ...... . h' . ~'''l''''' .>:..:.~:;,::~::h':,::7- .;,':}~::;:':'~: .':i~;:..7lP:4'1t:' r..I.:~-';:..,.,: -:"", ,:; ;',,;:--.'. ":;,/i':t .. ;f:)"}'.:~i;it~~~f~J, ,;" · .;~~, ," ''''d'''.. .....=J.,". ci~::_:.}:t~.?,,:,. ...'" ". .:':.~~r ':t,_ ::......... . .:.. .;.; "::. :;. ~~.~',:!~ .... ,,' ,;' . .'. " "r:~${}"" . .; "b~~.?~'~.:.,.,~ : ;;""1' ....1. _"'.' .........,~.;~ .:;':~:'.~'.:::-'\~'~;'"'::'~":' ,~-....:.,~.'~, ',~ ; . . ~'. :.: ~,~.r. ",~...,~>~,,: ..:.t:.;'i.:'i:..~;~;~~~~:"~. . .. ...... ," ,.. '}'.1:"" ;J' ~'.".. .f... .'l.~ ".~;' ~:~::l::. Plastic/Cosmetic Surgery' BllllISt Procedures' Micro Surgery' Laler Capablltlll . 'Hand Survery Birth Defecta. Endoacoplc~l..tic Surgery' Blomedlc Skin Care Progrem ,'. ... , Stale Ucenled Surgical Faclllty ?n-Slle , ",.. . , . ..... .,.:.... .:::t';;.. ..,-:...... " ...,....,'. Wllllem P. Graham, III, M.D. John P. StreUI, M.D. Lawrence K, Thomplon, III, M,O. '. 616 Belvedere Strest Cerlllle, PA 17013 (717) 24g.o100 'F,!" (717) 249-6669 ..~ . ,:"". .; " Alan Mira, MD. 220 Wilson Street Carlisle, PA 1701~ , , ..'........ '.', ''';' (' 'r: '. ," ..., ,Dear Al: '-'" ......;., '. .' . ~ . . IPS/ph Carlisle ., " "'.r. '. ,'f" ., '.',." " , ," "t. ...{. .... .. .,;. ':"'~}'. '.- '. , .~ J;i .' ; '-- .;....~;.. ~.:.. .~.: ' -.... . ,A .~' _.. Ita' -' If . - . . . I ANGELINI, JESTINE T. 303.A MRt# 288580 DATE DISCHARGED: 10/10/1997 FINAL DIAGNOSIS: r;JI.o I Displaced fracture of left femoral shaft IF g'1t7-?> r:etJP~ OIIY" 7 9 - 3 5 PROCEDURE: reduction/Internal fixation of left femur with Rush pin, DATE: 10/04/9 SURGEON: Dr. Allan J. Mira HOSPITAL COURSE: The patient was Involved In motorcycle accident and sustained the above Injury, She was brought to the hospital and her condition was stable, She was taken to surgery where the ebove nemed procedure was done because of considerable displacement of this transverse frac- ture, We talked about the option of traction and spica casting and the parents elected to perform the operation, Her postoperative course was very satisfactory. The wound healed nicely. She was quite comfortable and reasonably stable with this, She did require some careful hendllng of her leg with movement but everyday she improved. X-ray looked satisfactory, Hemoglobin remained stable, Vital signs were stable. She wes afebrile and eble to trensfer with very good strength and capabillly with the help of her mother and the staff at the hospital and she did very well, She was discharged to home on 10/10 to retum to the office on 10/21 at which time she will get en x-ray of the femur on arrival and Instructions are to be toe touch welghl bearing with a walker, She has a knee exerciser and a hospital bed at home to use 3 x a day and she is taking Tylenol for pain. They are to call if they have any questions. She will get home bound Instruction for school work for approximately four weeks, CONDITION ON DISCHARGE: Satisfaclory, stable, and improving. V Allan J. Mira. M.D, AJM/bjw 0: 10/10/1997.01:44 pm T: 10/12/1997 cc Dr. Allan J. Mira Dr. William J, Phelan ANGELINI, JESTINE T. 303-A MR# 286580 10/04/1997 03/25/1990 Mira, Allan J, M.D. Page 1 of 1 ORIGINAL CARLISLE HOSPITAL DISCHARGE SUMMARY Ir-- [I .:...,AGENT .: . AA7507 RONALD L SHINER ~. 1--- i , I ! . ITEM 1. NAMED INSURED AND ADDRESS '",1,1",1111"1'",'",11,'",1,1,1",.1",'",1,,,11,1'",' FRANCO ANGELINI & JODY ANGELINI 513 PARK DR BOILING SPRINGS PA 17007-9507 . ITEM 2. POLICY,~PERIOD,rn'.':'1<:ll i.POLlCY NUMBER.: OS/25/97 TO OS/25/98 QO~ 2505746 H .:.lTEM 3. OTHER INTEREST AS LISTED BELOW AGENT - RONALD L SHINER ***** I AGENT P~ONE - (717) 766-1200 ******************************************************************* * FIRST ACCIDENT FORGIVENESS APPLIES. THE FIRST SURCHARGE FOR A * * FUTURE AT-FAULT ACCIDENT WILL BE WAIVED. * ******************************************************************* 1001 S. MARKET STREET SUITE C MECHANICSBURG PA 17055 ITEM 4. AUTOS COVERED AUTO YR MAKE VIN ST TER SYM RATING CLASS DDP 1 95 FORD PROBE GT 1ZVLT22B8S5101594 PA 27 J A3B-MULTI 2 94 CHEVE ASTRO VAN 1GBDM19U3RB200048 PA 27 L A1AL-MULTI ITEM 5. ~S~g~~~~~ I~O~~~X~g~~ ~~~f~SAA~SE~&M~ALO~R~~r&MsIxR~H~~NFb~~o~~~ #1 #2 *****GOOD DRIVER RATES APPLY***** --- THE FULL TORT OPTION APPLIES TO ALL PRIVATE PASSENGER VEHICLES. ___ LIABILITY PROTECTION- BODILY INJURY S100M!PERSON $300M/ACC 110 90 PROPERTY DAMAGE S100M/ACC 66 54 FIRST PARTY BENEFITS- MEDICAL EXPENSE ~100M 46 38 INCOMB LOSS SlM/MONTH, $15M MAXIMUM 9 8 ACCIDENTAL DEATH S5M 1 1 FUNERAL BENEFIT S2.5M 1 1 UNINSURED MOTORISTS COVERAGE- BOD INJ ~100M2PERSON ~300M/ACC-STACKED 21 21 UNDEP.INSUR~D MO,ORISTS ~OVER~GE- BOD INJ S100M7PERSON S300M/ACC-STACKED 70 70 PHYSICAL DAMAGE COVERAGES- COMPREHENSIVE - $50 DED 132 III COLLISION - S500 DED 211 173 OPTIONAL COVERAGES- ROAD SERVICE 4 4 TOTAL ANNUAL PREMIUM FOR EACH AUTO 671 571 TOTAL ANNUAL POLICY PREMIUM $ 1,242 ITEM 6. APPLICABLm POLICY~ ENDORSEMENTS~ EXCEPTIONS TO DECLARATIONS ITEMS ALL AUTOS - FA~' 04~97*, AF~N01 04/97*, Ar'PA03 04/97*. AUTO 1 - AFPU01 04/.97*. AUTO 2 - AFPU01 04/97*. MULTI POLICY DISCOUNT APPLIES - AMOUNT OF DISCOUNT IS $ 31 PASSIVE RESTRAINT DISCOUNT APPLIES - AIRBAGS AUTO 1 PASSIVE RESTRAINT DISCOUNT APPLIES - AIRBAG AUTO 2 ANTI-LOCK BRAKE DISCOUNT APPLIED AUTO 1 ANTI-LOCK ERAKE DISCOUNT APPLIED AUTO 2 AUTO 2 - RATED AS CUSTOMIZED VEHICLE '::XPLANATION OF ADUL'!' &/OR '~OUTHFUL DRIVER RATING CLASS AUTO l-':~O l"OR)~ 21-:,0 '.'ilL!;:S Ofm WAY ,,,"UTO :2-!'LEASUl1E as;:;, 8. 50::, an HOrlP. -~LGES M1NUALLY . ,'1238 . . . ISEE REVERS!' SIOF.\ . . . YD AGTBG -. " 04/19/97 ~~/~O/~~~~ !b:U~ I! I~LI.:I!tsU I MUWU ,~' PAGE 02/07 - . JESTINE ANGELINI, by her father nnd legal guardian, FRANCO ANGELINI Plaintiffs IN TIm COURT OF COMMON PLEAS OF CUMBERLAND COUNTY"PENNSYL VANIA v. CIVIL ACItON.LAW NO. c;f(. ~7o ~ fP-o. ~ ~ ~ c.. -n :.1 "'1')~IJ r"Tl .''':n m. ~": (;0 , ',- :<:'::l zc: I -i'J I-:J.,;: ..0 ~~ ;"''1 -!&, :::!, :oJ .... \"/:tJII :!J 'i.c'" :::: 9c) ~r') i':'-rn ';"'c:: - ~ -,- ~ 1. Petitioner Franco Angelini is the parent and natural legal guardian oI:.Q1e @tor:5!. Petitioner, Jestine Angelini, whose date of birth is March 25, 1990. 2. The Respondent Progressive Insurance Company is an insurance company licensed to do business in Pennsylvania with an address at 801 East Park Drive, Suite 105, Hnnisburg, Pennsylvania 17111-2808. 3. On or about October 4, 1997, the minor Plaintiff; Jestine Angelini, was a passenger on a motorcycle being operated by Franco Angelini. 4. The motorcycle was insured through Progressive Insurance and had guest passenger liability coverage in the amount of$15,000.00 per person. 5. See policy claim coverage limits hereby attached as Exhibit "A H. 6. On or about October 4, 1997, the motorcycle operated by Franco Angelini, was proceeding eastbound on State Rt. 174 when a vehicle stopped in front ofhim. 7. Mr. Angelini was not able to stop and struck the vehicle in front of him, ejecting him and the minor Petitioner, Jestine Angelini, 8. As a result of the accident, the minor Plaintiff; Iestine Angelini sustained a displaced fracture of the femoral shaft of her left leg requiring closed reduction and internal fixation. 9. The Respondent has agreed to pay its policy limits of $lS~OOO.OO to the minor Plaintiff and seeks court approval in exchange for a General Release. 10. The Petitioner, Franco Angelini has reviewed this Petition as evidence by the attached verification. PROGRESSIVE INSURANCE COMPANY, Defi:ndant PETInON FOR MINOR'S COMPROMISE , . . WHEREFORE, Defundant requests that this Court approve the aforementioned minor's settlement, 'I MARTSON, DEARDORFF, WILLIAMS & OTTO ~ ! I! I By' George B. Fal ,Jr.. Esquire 1.0. Number 498J3 Ten East High Street Carlisle, PA 17013-3093 (717) 243.3341 .- , Attorneys for Defendant Date: E1lbc1my 9. .lS98 \ 'j /c, rt,. ~;" :'.l:. 1 K~.': .. ;:y t':) .,,~ lJ~nb/~UU~ !b: lJ~ I !I"~~!~'J I MUWU '.U"~lJ4.JU~' I ~1~t.&UVh' &0 .. - - .. -.. OI?ID: SME0004 AGY CloAIH POL COVERAGE "lNSri:' ANlELOO, FRANCO 'DOL : ocr 04 97 PA-CARLIS-BRN-. CLH: 970598615 BFP DT: IlAY 31 97 BX.PR M: MAY 31 98 CO* 26 VBHICLE lR: 97 DXB* HARLE HODEL: FL SERIES TE:RHIDi VT690231 POL: 00624170-0 OPEN REP: A GRASLEY ST* PA VIN: 1HD1BR219V4053200 rB/ctJV/LJlI COVBMGB DESt 190403 GJl'RctlJ!. ,Ill! ..'" '.-' 191003 BI 200102 PD . 210108 COHP 210307 COLL 291187 PIP LIKl'J.'S I tDIIIBR'l'S ~5,OOO EACH PERSON-$30,000 EACH ACCIDENT -...-- $15,000 EACH PBRSON-$30,000 EACH ACCIDENT $10,000 EACH ACCIDENT $500 DEDUCTIBLE $500 DEDUCTIBLE PEDESTRIAN BASIC FIRST PARTY BENEFITS MEDICAL EXPENSE WIO WORKERS com> - $5,000 DC912747 CRI.Y PAGE COIIIIARD: ATCFIMT F1D::CLMPOLI Pll=PPOJ\SRl'. p13=CLHSm1 Exnibit "A" UBI ~bl ~UfJ~ Ib:U~ 111~4.:1! ~I:J I . . . . . . rnRTIFlCATE OF SFRvrCE I hereby certify that a copy of the foregoing Petitioner for Minor's Compromise was served this date by depositing same in the Post Office at Carlisle, PA, first class mail, postage prepaid, addressed ns follows: Mr. Franco Angelini 513 Park Drive . Boiling Springs, PA17007 MARTSON, DEARDORFF, WILLIAMS & OTTO By J(,[iYJ-U ~. m(fJlQ~ Nichole L. Myers Ten East High Street Carlisle, PA 170]3 (717) 243-3341 Dated: February 9, 1998 . . .. , 0 -! ~~.; ..~: ! " ,- , , J , ~.' iO .. , ,,:,.1 , ..\ .-, " "_.J " '1 r-~ '""j , ! :;.r:",:,.- L- " " ;~ , .'-' ,- ~ ~u -.J -<