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HomeMy WebLinkAbout03-0490IN RE: CHRISTOPHER TRACE, a minor, by and through his parent and natural guardian LORI TRACE, Petitioner CUMBERLAND COUNTY - CIVIL DIVISION, PENNSYLVANIA Docket No.: PETITION TO APPROVE MINOR'S COMPROMISE AND SETTLEMENT TO THE HONORABLE JUDGES OF SAID COURT: The Petition of Christopher Trace, a minor, by and through his parent and natural guardian, Lori Trace, seeks court approval of a settlement in favor of her minor son, Christopher Trace, in support thereof, provides as follows: 1. Petitioner, Lori Trace, is the legal parent and natural guardian of Christopher Trace, a minor, age 13 (DOB: 09/02/89 and SSN: 198-57-4513) (hereinafter "Minor"). 2. Minor resides with Petitioner Lori Trace and her husband/his father Ronald D. Trace at 20 West Simpson Street, Mechanicsburg, PA 17055. 3. A guardian has not been appointed by the court for the Minor. 4. Petitioner Lori Trace is the primary custodial parent and guardian of Minor. 5. Minor sustained injuries on or about February 14, 2002 as a result of being a pedestrian struck by a single motor vehicle while in the act of crossing the road. Minor was crossing West Simpson Street in Mechanicsburg in front of his residence when he was struck by "a little blue car" The driver of the vehicle at first stopped but then fled the scene. The identity of the driver or of the automobile has never been established. 6. On February 14, 2002, the Petitioner Lori Trace maintained a policy of Private Passenger Automobile Insurance issued by State Farm Automobile Insurance Company ("State Farm"), which is an insurance company licensed to transact business in the Commonwealth of Pennsylvania. The policy of insurance included uninsured motorist coverage. 7. As a result of the above-mentioned accident, Minor sustained injuries consisting of a non-displaced left proximal fibular shaft fracture. The office notes of Dr. Craig W. Fultz, M.D., of Orthopedics Surgeons of Central Pennsylvania, Ltd., from the April 12, 2002 visit is attached and made a part hereof as Exhibit "A". 8. Petitioner has made claim to State Farm under the uninsured motorist coverage provisions of the policy of insurance under which she was insured for injuries sustained by Minor. The limits that were covered during the policy of insurance that issued in this matter are fifty thousand dollars ($50,000). 9. No out-of-pocket expenses have been incurred by Minor or Petitioner with respect to the injuries sustained by Minor. There are presently no outstanding liens or claims on behalf of any medical supplier, Medicare, Department of Welfare, ERISA plan or other entity which may be attached to settlement proceeds in this matter. Furthermore, there is no attorneys fee being charged to the Petitioner or Minor in this matter. 10. Petitioner Lori Trace, has made a careful and diligent inquiry in investigation in asced, ainiag the facts surrounding ~he accident, responsibility [herefore, and [he nature, extent and seriousness of Minor's injuries. 11. In an attempt to maximize the recovery of Minor, State Farm has offered to settle and compromise Minor's claim in the amount of four thousand and 00/100 dollars ($4,000). 12. The entire amount is offered by State Farm representing the payment for damages sustained by Minor exclusively. 13. Petitioner Lori Trace, believes to compromise this offer by State Farm is fair and reasonable and serves the best interest of Minor in this matter. 14. State Farm has requested Petitioner to give a release in the form which is attached hereto as Exhibit "B". WHEREFORE, Petitioner respectfully prays to this Honorable Court that an order be entered approving the Settlement and Compromise of the above action. Dated: L0~i Trac~ inaivi~uall~ and as the parent and natural guardian of Christopher Trace, a Minor, Petitioner Exhibit "A" ORTHOPAEDIC SURGEONS OF CENTRAL PA, LTD. TRACE,CHRISTOPHER R 20 WEST SIMPSON STREET MECHANICSBURG, PA 17055 ACCOUNT # 102654 CHART # 29220 SS # 198705718 April 12, 2002 CAMP HILL OFFICE DOB: 09/02/1989 HISTORY OF PRESENT ILLNESS: Chris is now eight weeks status post left proximal fibular fracture. He notes he is getting some achiness about his leg but it is not localized over the fracture site. He denies any locking, catching or any instability symptoms to his lower leg. He has been working on range of motion exercises. He has not been doing any aggressive strengthening exercises. PHYSICAL EXAMINATION: His physical exam today demonstrates no tenderness over the fracture site. He has a full range of motion of his ankle and knee. He has some mild atrophy in his lower extremity. He is grossly neurovascularly intact. DIAGNOSIS: Left proximal fibular shaft fracture status post pedestrian/motor vehicle accident 2/12/02 - healed PLAN: I've advised the patient on.advancing his activities to bicycling and walking program. He can do straight leg raises, heel and toe walking. He can do some light jogging if he · wishes. No contact sports. No jumping activities. We will keep him out of gym class until we reevaluate him in a few more weeks. If he is having difficulty in advancing his activities we will get him started on some physical therapy. If he is doing well at his next appointment we will consider ~ischarge and dropping his restrictions. Craig W. Fultz, M.D. CWF/dlh DD: 04/12/02 DT: 05/05/02 ORTHOPAEDIC SURGEONS OF CENTRAL PA, LTD. TRACE,CHRISTOPHER R 20 WEST SIMPSON STREET MECHANICSBURG, PA 17055 ACCOUNT # 102654 CHART # 29220 SS # 198705718 April 12, 2002 CAMP HILL OFFICE X-RAYS: Left tibia and fibular, 2V X-rays today demonstrates a moderate amount of callous and bone formation about the proximal fibular fracture. No other fractures are identified. Craig W. Fultz, M.D. CWF/dlh DD: 04/12/02 DT: 05/05/02 Exhibit "B" VERIFICATION I, Lori Trace, the Petitioner in this action hereby verify that the statements made in the foregoing Petition to Settle or Compromise Minor's Action are true and correct to the best of my information, knowledge and belief. I understand that the statements in said Petition are made subject to the penalties of 18 Pa.C.S. §4904, relating to unsworn falsification to authorities. Lon Trace, as the parent and natural guardian of Christopher Trace, a Minor, Petitioner IN RE: CHRISTOPHER TRACE, a minor, by and through his parent and natural guardian LORI TRACE, Petitioner CUMBERLAND COUNTY- CIVIL DIVISION, PENNSYLVANIA ENTRY OF APPEARANCE Please enter my appearance in the above-captioned action. Respectfully submitted, McKissock & Hoffman, P.C. By:. B. Craig Black, Esquire Attorney I.D. No. 36818 Robert A. McDermott Attorney I.D. No. 66724 2040 Linglestown Road Suite 302 Harrisburg, PA 17110 (717) 540-3400 Date: IN RE: CHRISTOPHER : TRACE, a Minor, by and : through his parent and : natural guardian, LORI : TRACE, : Petitioner : IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 03-490 CIVIL TERM IN RE: PETITION TO APPROVE MINOR'S COMPROMISE AND SETTLEMENT ORDER OF COURT AND NOW, this l0th day of February, 2003, upon consideration of the Petition To Approve Minor's Compromise and Settlement, a hearing is scheduled for Tuesday, March 11, 2003, at 3:30 p.m., in Courtroom No. 1, Cumberland County Courthouse, Carlisle, Pennsylvania. BY THE COURT, Jff94esley Ole~r-J~., ~ J. Robert A. McDermott, Esq. 2040 Linglestown Road Suite 302 Harrisburg, PA 17110 vt Lori Trace 20 West Simpson Street Mechanicsburg, PA 17055 Petitioner :rc IN RE: CHRISTOPHER TRACE, a minor, by and through his parent and natural guardian LORI TRACE, Petitioner CUMBERLAND COUNTY- CIVIL DIVISION, PENNSYLVANIA Docket No.: AMENDED ENTRY OF APPEARANCF Please 6nter my appearance in the above-captioned action on behalf of State Farm Insurance Co., the Uninsured Motorist Insurance Carrier for this claim. Respectfully submitted, McKissock & Hoffman, P.C. Date: B. Craig Black, Esquire Attorney I.D. No. 36818 Robert A. McDermott Attorney I.D. No. 66724 2040 Linglestown Road Suite 302 Harrisburg, PA 17110 (717) 540-3400 IN RE~ CHRISTOPHER TRACE, a minor, by and through his parent and natural guardian LORI TRACE, Petitioner CUMBERLAND COUNTY - CIVIL DIVISION, PENNSYLVANIA Docket No.: 03-490 CIVIL TERM PRAECIPE Please accept the attached document showing the identification of the account and financial institution where the settlement proceeds of this matter were deposited in compliance with the order entered by the Honorable Wesley Oler on March 11,2003. Respectfully submitted, legal g er Trace Ronald D. Trace, as the parent and !ega! guardian of the minor, Christopher Trace M bersl-' I~'EDEI~tL C~EDrI' UN'ION I::' R :[ I,t T S C R Iii: E N P.O. Box 40 · Mechanicsburg, PA 17055-0040 (717) 697-1161 TOLL FREE (800) 283-2328 www.members lst.org MA :1: I... I::' A C I L I T Y INVAI...ID ID 229721 TRACE/CHRISTOPNER R I...ORI A '[F~A[;E:: 20 W ,SIMPSON S'l" MECHANICSBLJI~G PA 1 7055..-6324 CI:;: 1:;5I' :: O FL. AGS: 05/05/03 BR: 80wn:P BI): 09/02/1989 Ref: Dept: BOOI4...'F( I='R: .00 Passwo'rd: SSN: 198-'70-5718 A f f i n .t t y C od e: f"l..l: ( 717 ) 766 - 2430 Household: 0 WK: (000) 000-0000 Iqumber Date Memo 000001002 05/05/03 MINOR ACCT -ONLY JOINT MAY WITHDRAWL JAW 000001003 05/05/03 MINOR REACNIES AGE OF MATURITY 9/2/08 JAW Slx Demo Dt Open Balance Avail Rate YTD Div Lst Act 00 RSA 050503 25.00 0 .0000 .00 050503 40 4YR 050503 4000.00 4000 3. 0600 .00 050~]03 Total Shares Pledged: 25.00 MEMBERS 1ST FEI)ERAL. ~'¥ UNION ID: I.' ] TRAN CODIE: I: ] PARAMETIEI'TS: I.'.' Flails 22 DATE:J05/05/03] ..,, ~ , '~ST MemDers FI~ERAL CRI~IT UNION P.O. Box 40 · Mechanicsburg, PA i'~7055-0040 (717) 697-1161 TOLL FREE (800) 283-2328 wWW.membersl st.org · .