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Home My WebLink About03-2666PAA 09 63 7~ RENEWAL PERSONAL AUTO POLICY DECLARATIONS PENNLAND INSURANCE COMPANY HARLEYSVILLE PA 19q38 A MemberofTheHarleysvillelnsuranceCompanies LARRY L KISE 1325 CHESTNUT ST COLUMBIA PA 17512 ............ 01 TO 01-26-02 PREFERRED ORIGINAL PDLICY DATE 01/83 PAA 09 63 7 DIRECT BIL) INSURED'S COPY JAY H LUTZ & CO INC 20 SOUTH 4TH ST P 0 BOX 550 COLUMBIA PA 17512 71-1372 AGENT TELEPHONE=717-684-2715 CONGRATULATIONS, YOUR POLICY HAS QUALIFIED FOR OUR PREFERRED PROGRAM. YOUR POLICY HAS BEEN DISCOUNTED 10% TO REFLECT YOUR DRIVING RECORD. FOR OTHER DISCOUNTS THAT MAY APPLY TO YOUR POLICY, PLEASE REFER TO THE ADDITIONAL VEHICLE INFORMATION AND DISCOUNTS SECTION OF YOUR DECLARATIONS PAGE REFER TO FORM A1962. ON'R~NTA~ VEHICLE COVERAGE ' ' ***************** BASIC COVERAGES ***************** THE COVERAGES BELOW ARE PROVIDED FOR VEHICLES WHERE A PREMIUM IS CHARGED OR THE WORD INCLUDED IS DISPLAYED. PREMIUMS FOR VEHICLE ---~1 ...... #2--- FULL TORT OPTION SELECTED. NO EXTRAORDINARY MEDICAL EXPENSE BENEFITS COVERAGE SELECTED ........ LIMITS ........ 89 CHEV -COVERAGE- LIABILITY $100,000 EACH ACCIDENT UNINSURED MOTORIST STACKED $100,000 EACH UNDERINSURED MOTORIST STACKED 9100,000 EACH FIRST PARTY BENEFITS-EACH PERSON MEDICAL EXPENSES ~I00,000 NORK LOSS 9 1,O00 EACH MONTH ~ 5,000 TOTAL ACCIDENTAL DEATH NONE FUNERAL ~ 1,500 ACCIDENT ACCIDENT -PP0551 90 CHRY $ 240.00 $ 240.00 ~ 49.00 8 49:00 ~ 65.00 9 65.00 e 89.00 ~ 71.00 INCLUDED INCLUDED INCLUDED INCLUDED INCLUDED INCLUDED -COVERAGE FOR DAMAGE TO YOUR AUTO OTHER THAN COLLISION ACTUAL CASH VALUE * 9.00 ~ 35.00 COLLISION ~ 500 DEDUCTIBLE ~ 59.00 9 123.00 RENTAL REIMBURSEMENT 915 PER DAY/S450 TOTAL INCLUDED INCLUDED PER VEHICLE TOTAL $ 511.00 ~ 583.00 TOTAL POLICY PREMIUM 1094.00 A-?33M1 (Ed. 10-96) ~ ISSUE 12/01/00 G2 YOUR POLICY HAS BEEN DISCOUNTED 10% TO REFLECT YOUR DRIVING RECORD WARNING NOTICE: ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE COMPANY 0R OTHER PERSON FILES AN APPLICATION FOR INSURANCE OR STATEMENT OF CLAIM CONTAINING ANY MATERIALLY FALSE INFORMATION OR CONCEALS FOR THE PURPOSE OF MISLEADING, INFORMATION CONCERNING ANY FACT MATERIAL THERETO COMMITS A FRAUDULENT INSURANCE ACT, WHICH IS A CRIME AND SUBJECTS THE PERSON TO CRIMINAL AND CIVIL PENALTIES. ************** VEHICLE DESCRIPTIONS *************** VEHICLE ~ YR DESCRIPTION VEH ID NUMBER TREE CLASS DR % DR % 1 89 CHEVYPKUP 1GCDC14HTKE277278 PA-O12 88522H 1-100 SYM 05 FACTORS .70 2 90 CHRY SEDAN. ~D --IC3XY66RqLD727355 PA-O12 88522H 1-100 SYM 07 FACTORS .70 DR % DR ~ *** ADDITIONAL VEHICLE INFORMATION AND DISCOUNTS ** ***THE FOLLOWING INFORMATION APPLIES TO INDICATED VEHICLE NUMBERS. #1 PICKUP TRUCK COST NEW:005701 DRIVEN: 3 OR MORE BUT UNDER 10 MILES TO WORK 20000 ANNUAL MILES MULTI-CAR DISCOUNT -25% #2 DRIVEN: 3 OR MORE BUT UNDER 10 MILES TO WORK IO00O ANNUAL MILES MULTI-CAR DISCOUNT -25% PASSIVE RESTRAINT DISCOUNT -20% ON FIRST PARTY BENEFITS DRIVER AIR BAG & SEAT BELTS COVERAGE ***THE FOLLOWING WILL DRIVER 1 LARRY KISE OPERATE VEHICLES STATE ST LICENSE PA 09720637 INFORMATION COVERED BY THIS POLICY. BIRTH MARITAL LIC DATE P/O SEX STATUS DATE 09/06/37 P M M 09/53 A22460296 A19591195. ST71710695. PJOOO6E0895 PR01060694 *** POLICYHOLDER A21940894 IL09100181 A2~110900. A19620990. A17q91284* NOTICES AND POLICY INFORMATION *** A20750692, A20790392 A19820799. Z9090598 PP15011299. Z8871299 POLICY ENDORSEMENTS AND POLICY FORMS ******* PP04230695 PP04190695 PP05510694 PP01510897 PP00010694 ************* END OF POLICY DECLARATIONS ********** PAGE 02 ISSUE 12/01/00 G2 I A-133M2 (Ed. 10-96} IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION- LAW JEANNETTE Y. KISE and LARRY L. KISE, husband and wife, Plaintiffs VS. FRANK E. HOOVER, Defendant FURY TRIAL DEMANDED NOTICE You have been sued in Court. If you wish to defend against the claims set forth in the following pages, you must take action within twenty (20) days after this Complaint and Notice are served by entering a written appearance personally or by an attorney and filing in writing with the Court your defense or objections to the claims set forth against you. You are warned that if you fail to do so, the case may proceed without you and a judgment may be entered against you by the Court without further notice for any money claimed in the Complaint or for any other claims or relief requested by the Plaintiff. You may lose money or property or other rights important to you. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. CUMBERLAND COUNTY BAR ASSOCIATION 2 LIBERTY AVENUE CARLISLE, PA 17013 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW JEANNETTE Y. KISE and LARRY L. KISE, husband and wife, Plaintiffs No. FRANK E. HOOVER, Defendant JURY TRIAL DEMANDED NOTICE TO PLEAD TO: FRANK E. HOOVER, YOU ARE HEREBY NOTIFJED TO PLEAD TO THE WITHIN COMPLAINT WITHIN TWENTY (20) DAYS OF SERVICE UPON YOU OR A DEFAULT JUDGMENT MAY BE ENTERED AGAINST YOU. NIKOLAUS & HOHENADEL, LLP By: t J°~hn P. f-Iohenadei, Esquire For Plaintiffs I.D. #06962 212 North Queen Street Lancaster, PA 17603 (717) 299-3726 1N THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW JEANNETTE Y. KISEand LARRY L. KISE, husband andwife, Plaintiff VS. FRANK E. HOOVER, Defendant JURY TRIAL DEMANDED COMPLAINT 1. One of the Plaintiffs is Jeanette Y. Kise, an adult individual who resides at 1325 Chestnut Street, Columbia, Lancaster County, Pennsylvania, hereinafter "Plaintiff Jeannette". 2. One of the Plaintiffs is Larry L. Kise, an adult individual who resides at 1325 Chestnut Street, Columbia, Lancaster County, Pennsylvania, hereinafter "Plaintiff Larry". 3. The Defendant is Frank E. Hoover, an adult individual who resides at 5 N. Letort Drive, Carlisle, Cumberland County, Pennsylvania, hereinafter "Defendant". 4. On June 8, 2001, the Plaintiff Seannette was the passenger of a motor vehicle, which was being operated by the PlaintiffLarry in an eastbound direction in the right hand lane of travel on State Route 114 in Silver Spring Township, Cumberland County, Pennsylvania. 5. At the said time and place the Defendant was operating a motor vehicle and was operating the said vehicle in a westbound direction on State Route 114 in Silver Spring Township, Cumberland County, Pennsylvania. 6. At the said time and place the Defendant suddenly and without warning attempted to make a left hand mm and or a "LTM turn on State Route 114 causing his vehicle to collide with Kise v. Hoover, Cumberland County CCP Docket No. and strike a second vehicle and then to strike the vehicle the Plaintiff Larry was operating and within which the Plaintiff Jeannette was a passenger. 7. As a result of the collision the Plaintiff Jeannette sustained numerous injuries including, but not limited to; right shoulder rotator cuff tendon tear requiring surgery, right shoulder impingement, right shoulder sprain, strain and contusion; left shoulder sprain and strain; torn meniscus in both knees requiring surgery in both; knee sprain, strain and contusions; left knee buckling and acute pain; myofascial residual pain in the cervical, shoulder girdle and lumbar areas; cervical radicular syndrome; cervical sprain and strain; aggravation of degenerative changes; lumbosacral sprain and strain; and headaches, some or all of which injuries are permanent in nature and for ail of which damages are claimed. 8. As a further result of the said collision, the Plaintiff Jeannette has sustained great pain, suffering, inconvenience and loss of life's pleasures and has been advised and therefore avers that she may sustain pain, suffering, inconvenience and loss of life's pleasures in the future, some or all of which may be permanent in nature, and for all of which damages are claimed. 9. As a further result of the said collision and the resulting injuries to the Plaintiff Jeannette, the Plaintiffs have sustained various medical expenses and have been informed and therefore aver that the Plaintiffs may sustain medical expenses in the future, for all of which damages are claimed. 10. On June 8, 2001, the Plaintiffs were protected by a policy of automobile insurance issued by Harleysville Insurance Company containing the full tort option. A true and correct copy of the Declarations Page of such coverage is attached as Exhibit "A". Kise v. Hoover, Cumberland County CCP Docket No. COUNT I ,.,JEANNETTE y. KISE V. FRANK E. HOOVEI~ NEGLIGENCE 11. Paragraphs 1 through 10 are incorporated into this Count by reference thereto. 12. The injuries sustained by the Plaintiff Jeannette were caused solely by the negligence, recklessness and carelessness &the Defendant as follows: a. In failing to have his vehicle under proper and adequate control; b. In operating his vehicle in a reckless manner so as to create a dangerous situation for others such as the Plaintiff Jeannette; c. In failing to observe the vehicle within which the Plaintiff Jeannette was a passenger on the roadway; d In causing his vehicle to collide with and strike the vehicle within which the Plaintiff Jeannette was a passenger; e. In failing to yield the right of way to the vehicle within which the Plaintiff Jeannette was a passenger; £ In attempting to enter Interstate Route 81 when such a maneuver could not be done in safety; g In attempting to make a "If' turn when such a maneuver could not be done in safety; and h. In violating the Motor Vehicle Code of the Commonwealth of Pennsylvania, specifically, Vehicle Turning Left, 75 Pa. CS.A. § 3322. 3 Kise v. Hoover, Cumberland County CCP Docket No. 13. The negligence of the Defendant as set forth in paragraph 12 (h) constitutes negligence per se. WHEREFORE, the Plaintiff Jeannette demands judgment in favor of the Plaintiff Jeannette and against the Defendant in an amount in excess of the jurisdictional amount for arbitration referral in Cumberland County, Pennsylvania plus interest, court costs and or damages for delay as allowed by law. COUNT Il LARRY L. KISE V. FRANK E. HOOVER LOSS OF CONSORTIUM 13. Paragraphs 1 through 12 are incorporated into this Count by reference thereto. 14. As a result of the collision, which collision was caused by the negligence of the Defendant, as a result of the injuries to the Plaintiff Jeannette, Plaintiff Larry suffered a loss of the companionship, services and assistance of his wife, Plaintiff Jeannette, and has been advised and therefore avers that he will continue to suffer such damages in the future, for all of which damages are claimed. WHEREFORE, the Plaintiff Larry demands judgment in favor of the Plaintiff Larry and against the Defendant in an amount in excess of the jurisdictional amount for arbitration referral in Cumberland County, Pennsylvania plus interest, court costs and or damages for delay as allowed by law. 4 Kise_v. Hoover, Cumberland County CCP Docket No. Date: NIKOLAUS & HOHENADEL, LLP Attorney for Plaintiffs 212 North Queen Street Lancaster, PA 17603 (717) 299-3726 I.D. #06962 5 PAA RENEWAL 09 63 7~ PERSONAL AUTO POLICY DECLARATIONS PENNLAND INSURANCE COMPANY HARLEYSVILLE PA 19458 A MemberofTheHarleysvillelnsuranceCompanies ~ KISE 1325 CHESTNUT ST COLUMBIA PA 17512 -01 TO 01-26-02 ORIGINAL POLICY DATE 01/8~ PREFERRED PAA 09 65 7 DIRECT BIL INSURED'S COPY JAY H LUTZ & CO INC 20 SOUTH 4TH ST P 0 BOX 55O COLUMBIA PA 17512 71-1372 AGENT TELEPHONE:717-684-2715 CONGRATULATIONS, YOUR POLICY HAS QUALIFIED FOR OUR PREFERRED PROGRAM. YOUR POLICY HAS BEEN DISCOUNTED 10% TO REFLECT YOUR DRIVING RECORD. FOR OTHER DISCOUNTS THAT MAY APPLY TO YOUR POLICY, PLEASE REFER TO THE ADDITIONAL VEHICLE INFORMATION AND DISCOUNTS SECTION OF YOUR DECLARATIONS PAGE REFER TO FORM A1962 ON'~£NTA~ vEHIcLE-coVERAGE · *~*~*~**~*~*~*~ BASIC COVERAGES **************~ THE COVERAGES BELOW ARE PROVIDED FOR VEHICLES WHERE A PREMIUM IS CHARGED OR THE WORD INCLUDED IS DISPLAYED. PREMIUMS FOR VEHICLE FULL TORT OPTION SELECTED. ---~1 ...... #2--- NO EXTRAORDINARY MEDICAL EXPENSE BENEFITS COVERAGE SELECTED -COVERAGE- - ....... LIMITS ...... ~- 89 CHEV 90 CHRy LIABILITY $100,000 EACH ACCIDENT $ 240 O0 $ 240 O0 UNINSURED MOTORIST · · STACKED $100,000 EACH ACCIDENT ~ 49.00 $ 49~00 UNDERINSURED MOTORIST STACKED 8100,000 EACH ACCIDENT ~ 65.00 $ 65.00 FIRST PARTY BENEFITS-EACH PERSON -PP0551 $ 89.00 t 71.00 MEDICAL EXPENSES $100~000 INCLUDED INCLUDED WORK LOSS $ 1,000 EACH MONTH $ 5~000 TOTAL INCLUDED INCLUDED ACCIDENTAL DEATH NONE FUNERAL ~ 1,500 INCLUDED INCLUDED -COVERAGE FOR DAMAGE OTHER THAN COLLISION COLLISION RENTAL REIMBURSEMENT TO YOUR AUTO ACTUAL CASH VALUE 9 9.00 $ 55.00 $ 500 DEDUCTIBLE $ 59.00 $ 123.00 415 PER DAY/S450 TOTAL INCLUDED INCLUDED PER VEHICLE TOTAL $ 511.00 $ 583.00 TOTAL POLICY PREMIUM $ 1094.00 A ISSUE A-lg3M1 (Ed, /O-g$) 12/01/00 G2 I YOUR POLICY HAS BEEN DISCOUNTED 10% TO REFLECT YOUR DRIVING RECORD WARNING NOTICE: ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE COMPANY OR OTHER PERSON FILES AN APPLICATION FOR INSURANCE OR STATEMENT OF CLAIM CONTAINING ANY MATERIALLY FALSE INFORMATION OR CONCEALS FOR THE PURPOSE OF MISLEADING, INFORMATION CONCERNING ANY FACT MATERIAL THERETO COMMITS A FRAUDULENT INSURANCE ACT, WHICH IS A CRIME AND SUBJECTS THE PERSON TO CRIMINAL AND CIVIL PENALTIES. VEHICLE ~ YR DESCRIPTION VEH ID NUMBER TERR CLASS DR % 1 89 CHEVYPKUP IGCDClqH7KE277278 PA-OI2 88522H 1-10O SYM 05 FACTORS .70 2 90 CHRY SEDAN. 40 _ 1C3XY66RqLD727355 PA-OI2 88522H 1-1OO SYM 07 FACTORS .70 ************** VEHICLE DESCRIPTIONS ***~,~,~, DR % *** ADDITIONAL VEHICLE INFORMATION AND DISCOUNTS ** ***THE FOLLOWING INFORMATION APPLIES TO INDICATED VENICLE NUMBERS. #1 PICKUP TRUCK COST NEW:00$70i DRIVEN: 3 OR MORE BUT UNDER i0 MILES TO WORK 20000 ANNUAL #2 MULTI-CAR DISCOUNT DRIVEN: $ OR MORE BUT UNDER MULTI-CAR DISCOUNT PASSIVE RESTRAINT DISCOUNT DRIVER AIR BAG & SEAT BELTS lO DR % DR MILES -25% MILES TO WORK 10000 ANNUAL MILES -25% -20% ON FIRST PARTY BENEFITS COVERAGE ***THE FOLLOWING WILL DRIVER 1 LARRY KISE DRIVER INFORMATION OPERATE VEHICLES COVERED BY THIS POLICY. STATE BIRTH MARITAL LIC ST LICENSE # DATE P/O SEX STATUS DATE PA 09720637 09/06/37 p M M 09/53 A22460296 A19391195. ST71710695. PJ0006E0895 PR0106069q POLICYHOLDER A21940894 IL09100181 A24110900. A19620990. A17491284. NOTICES AND POLICY INFORMATION *** A20750692, A20790592 A19820799~ Z9090598 PP13011299, Z8871299 ****** POLICY ENDORSEMENTS AND POLICY FORMS ******* PP0fi230695 PP04190695 PP0551069fi PP01510897 PP00010694 ************* END OF POLICY DECLARATIONS ********** A-t33M2(Ed. IO.96} PAGE 02 ISSUE 12/01/00 G2 I VERIFICA'lION I, JEANNETTE y. KISE, verify that the facts set forth in the foregoing Complaint are true and correct to the best of my knowledge, information and belie£ I acknowledge that had I knowingly made false statements in this document, I would be subject to the penalties of a misdemeanor of the third class pursuant to 18 Pa C.S.A. § 4904 regarding unswom falsification to authorities. .4~4~'N~Ti'E V. KiSE VERIFICATION I, LARRY L. KISE, verify that the facts set forth in the foregoing Complaint are true and correct to the best of my knowledge, information and belief, I acknowledge that had I knowingly made false statements in this document, I would be subject to the penalties ora misdemeanor of the third class pursuant to 18 Pa C.S.A. § 4904 regarding unsworn falsification to authorities. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW JEANNETTE y. KISE and LARRY L. KISE, husband and wife, Plaintiffs FRANK E. HOOVER, Defendant No. JURY TRIAL DEMANDED PRAECIPE FOR ENTRY OF APPEARANCE TO THE PROTHONOTARY: Please enter the appearance ofNIKOLAUS & HOHENADEL, LLP by John P. Hohenadel for the Plaintiffs in the above action. NIKOLA~ & HOHENADEL, LLP for Plaintiffs I.D. #06962 212 North Queen Street Lancaster, PA 17603 (717) 299-3726 SHERIFF'S RETURN - CASE NO: 2003-02666 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND KISE JEANNETTE Y ET AL VS HOOVER FP~ANK E REGULAR DAWN KELL Cumberland County, Pennsylvania, says, the within COMPLAINT & NOTICE HOOVER FR3tNK E DEFENDANT , at 1420:00 HOURS, at 5 NORTH LETORT DRIVE CARLISLE, PA 17013 NENITA HOOVER, WIFE a true and attested copy of COMPLAINT & NOTICE INTERROGATORIES AND REQUEST FOR PRODUCTION OF DOCUMENTS and at the Sheriff or Deputy Sheriff of who being duly sworn according to law, was served upon on the 9th day of June by handing to the , 2003 together with same time directing Her attention to the contents thereof. Sheriff's Costs: Docketing 18.00 Service 3.45 Affidavit .00 Surcharge 10.00 .00 31.45 Sworn and Subscribed to before me this ~?~ ~ day of So Answers: R. Thomas Kline 06/10/2003 NIKOLAUS & HOHENADEL Deputy Sheriff 1N THE COURT OF COMMON PLEAS FOR CUMBERLAND COUNTY, PENNSYVANIA CIVIL DIVISION PRAECIPE TO DISCONTINUE AND END JEANNETTE Y. KISE and LARRY L. KISE, husband and wife, Plaintiffs No. 03-2666 V. : FRANK E.HOOVER, Defendant JURY TRIAL DEMANDED TO: CLERK OF COURTS - CIVIL DIVISION PLEASE MARK THIS ACTION AS DIRECTED BELOW: X This suit is settled, discontinued, ended and costs paid. This suit is se'ctled, discontinued, ended with prejudice and costs paid. This suit is settled, discontinued, ended without prejudice with costs paid. Satisfaction of the award in the within suit is acknowledged. Satisfaction of the judgment, with interest and costs in the within matter is acknowledged. Other. ~IGlqATURE OF PLAINTIFFS ATTORNEY John P. Hohenadel, I.D. #06962 212 North Queen Street, Lancaster, PA 17603 SIGNATURE OF DEFENDANT'S ATTORNEY DISCONTINUANCE CERTH~ICATE AND NOW,~ SUIT HAS BEEN MARKED AS ABOVE IRECTED. PI~OTHONOTARY NOTE: SIGNATURE OF DEFENDANT'S COUNSEL NEEDED ONLY IF CASE HAS AN ADDITIONAL DEFENDANT OR COUNTERCLAIM.