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Home My WebLink About99-02954 JENNIFER KLOSE, a minor, by and through her mother and natural guardian, KATHY KLOSE, and KATHY KLOSE, Individually, Plaintiffs VS. TIG INSURANCE COMPANY, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA CIVIL ACTION - LAW NO. 99-2954 Civil PRAECIPE To the Prothonotary of Cumberland County: Please mark the above-captioned action settled, satisfied, and discontinued. ANGINO & ROVNER, P.C. David utz Date: H'i - 6D cc James McCarthy, Esquire I.D. No. 35956 4503 N. Front Street Harrisburg, PA 17110 (717)23&-6791 Attorney for Plaintiffs 206901. NXI M1G i ? tr Li c '??._ , ' O J JENNIFER KLOSE, a minor, by and through her mother and natural guardian, KATHY KLOSE, and KATHY KLOSE, Individually, Plaintiffs VS. TIG INSURANCE COMPANY, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. Clef NOTICE TO DEFEND 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 attorney and filing in writing with the Court your defenses 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 claim 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, Pennsylvania 17013 (717) 249-3116 1-800-990-9108 143B31/LC3 JENNIFER KLOSE, a minor, by and through her mother and natural guardian, KATHY KLOSE, and KATHY KLOSE, Individually, Plaintiffs VS. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. TIG INSURANCE COMPANY, Defendant NOTICIA Le han demandado a usted en la corte. Si usted quiere defenderse de estas demandas expuestas en las paginas sugnuientes, usted tiene viente (20) dias de plazo al partir de la fecha de la demanda y la notificacion. Usted debe presentar una apariencia escrita o en persona o por abogado y archivar en la corte en forma escrita sus defensas o sus objeciones a las demandas en contra de su persona. Sea avisado que si usted no se defiende, la carte tomara medidas y puede entrar una orden contra usted sin previo aviso o notificacion y por cualquier queja o alivio que es pedido en la peticion de demanda. Usted puede perder dinero o sus propiedades o otros derechos importantes para usted. LLEVE ESTA DEMANDA A UN ABOGADO IMMEDIATEMENTE. SI NO TIENE ABOGADO 0 SI NO TIENE EL DINERO SUFICIENTE DE PAGAR TAL SERVICIO, VAYA EN PERSONA 0 LLAME POR TELEFONO A LA OFICINA CUYA DIRECCION SE ENCUENTRA ESCRITA ABAJO PARA AVERIGUAR DONDE SE PUEDE CONSEGUIR ASISTENCIA LEGAL. CUMBERLAND COUNTY BAR ASSOCIATION 2 Liberty Avenue Carlisle, Pennsylvania 17013 (717) 249-3116 1-800-990-9108 JENNIFER KLOSE, a minor, IN THE COURT OF COMMON PLEAS by and through her mother CUMBERLAND COUNTY, PENNSYLVANIA and natural guardian, KATHY KLOSE, and KATHY KLOSE, Individually, CIVIL ACTION - LAW Plaintiffs VS. NO. 9 q. ,2 9 Sel et?,a /z - TIG INSURANCE COMPANY, Defendant COMPLAINT 1. Minor Plaintiff Jennifer Klose, born on January 21, 1984, resides with her mother, Plaintiff Kathy Klose in New Kingston, Cumberland County, Pennsylvania. 2. Defendant TIG Insurance Company is a corporation that has a place of business at 444 North Wells Street, Merchandise Mart Plaza, Chicago, Cook County, Illinois, and regularly conducts business in Cumberland County, Pennsylvania. 3. As a result of a motor vehicle accident that occurred on February 2, 1998, Jennifer Klose sustained injuries including, but not limited to, panic attacks and anxiety disorder. Plaintiff Kathy IClose sustained a foot injury in the subject motor vehicle accident. 4. By reason of the aforesaid automobile accident injuries and medical treatment, Kathy Klose was forced to incur medical expenses in order to seek treatment for accident-related injuries for her daughter and for herself. 1 5. Under the provisions of the Pennsylvania Motor Vehicle Financial Responsibility Law, Defendant TIG Insurance Company is responsible to provide first-party medical benefits to Jennifer and Kathy Klose. 6. Defendant TIG Insurance Company has breached its duty to pay first-party benefits by refusing to pay for all of Kathy Klose and Jennifer Klose's accident-related medical bills. 7. Kathy Klose has been forced to incur liability to pay for Jennifer's accident-related medical bills, including but not limited to medical treatment with Carlisle Pediatric ?I Associates, Carlisle Hospital and Health Services, RWC Emergency Physicians, and Moffitt, Pease, and Lim Associates, and ambulance care from Silver Spring Ambulance. 8. Plaintiff Kathy Klose has incurred medical bills including but not limited to medical treatment with Silver Springs Ambulance, Carlisle Hospital, Carlisle Imaging, prescriptions, and RWC Emergency Physicians for the care of her daughter. 9. Plaintiff Kathy Klose incurred $1,483.00 in accident-related medical expenses as set forth in Paragraph 9. 10. Based on Defendant TIG Insurance Company's violation of 75 Pa.C.S.A. 1797 and its failure to pay Jennifer Klose's accident- related medical bills in violation of 75 Pa.C.S.A. 1712, Defendant TIG Insurance Company has breached its duties as set forth under the Pennsylvania Motor Vehicle Financial Responsibility Law. 2 11. Plaintiff Kathy Klose has also been forced to incur liability to pay accident related medical bills in the amount of $451.75 for the care and treatment she received as a direct result of the subject February 2, 1998 motor vehicle accident. 12. Plaintiffs have submitted their accident-related medical expenses to Defendant TIG Insurance Company for payment under the Pennsylvania Motor Vehicle Financial Responsibility Law. 13. To date, Defendant TIG Insurance Company has failed to pay the medical bills in accordance with Act 6 of the Pennsylvania Motor Vehicle Financial Responsibility Law. 14. Based on Defendant TIG Insurance Company's violation of 75 Pa.C.S.A. 1797 and its failure to pay Plaintiff Jennifer Klose and Plaintiff Kathy Klose's accident-related medical bills, Defendant TIG Insurance Company has breached its duties as set forth under the Pennsylvania Motor Vehicle Responsibility Law. WHEREFORE, Kathy Klose, as mother and natural guardian of Jennifer Klose, and Kathy Klose, individually, demand judgment against Defendant TIG Insurance Company in the amount of $1,483.00 on behalf of Jennifer's accident-related medical bills, and $451.75 3 on behalf of Plaintiff Kathy Klose's medical bills, together with costs, interest, and attorney's fees. Date: ANGINO r ROVNER, P.C. J . n Davia L: mutz I.D. #359 6 4503 N. Front Street Harrisburg, PA 17110 (717) 238-6791 Counsel for Plaintiffs 4 VERIFICATION I, Kathy Klose, Plaintiff, have read the foregoing COMPLAINT and do hereby swear or affirm that the facts set forth in the foregoing are true and correct to the best of my knowledge, information and belief. I understand that this Verification is made subject to the penalties of 18 Pa.C.S.A. Section 4904, relating to unsworn falsification to authorities. WITNE S: j Kathy ,t o e Dated: :, . ' v - 16 V w O aw? ? N N W m w z z U ? z0 z n0 0,a m LL Ic i O N a 0 O O m n Z z m - C7 "? Z ° a Q ° _ JENNIFER KLOSE, a minor, by and through her mother and natural. guardian, KATHY KLOSE, and KATHY KLOSE, Individually, Plaintiffs . IN THE COURT OF COMMON PLEAS . CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW VS. NO. 99-2954 Civil TIG INSURANCE COMPANY, Defendant AFFIDAVIT OF SERVICE This is to certify that on the 19th day of May, 1999, a true and correct copy of a Complaint was mailed to the Defendant, TIG Insurance Company, via certified mail, return receipt requested, at 444 N-Wells Street, P.O. Box 3575, Chicago, IL 60654-0575. A copy of the certified mail receipt No. Z,_318 811 078 is attached hereto. David L. Lutz RETURN OF SERVICE This is to certify that on the 25th day of May, 1999, a Complaint was served upon Defendant, TIG Insurance Company, via certified mail, return receipt requested, at the above-noted address. A copy of the signed return receipt No. Z 318 811 078 is attached hereto. v Sworn to and subscribed before me this _12Lh day of Qx 1999. SEAL ?YVIS C1 C 4? • ` { x ?C .1 MEGAN AREk1?ARD Hoary r Notary Public Safto"# Iwo, &7dw County, 140A My commission expires: MyCommiWwEapimMay7 9001 152794/MTG Z 318 81-30-[-'-1+8 N OI m o? G m M ! LL U) US Postal Service Receipt for Certified Mail No Insurance Coverage Provided. Do not use for International Mail [Fen rnvwsnl Stroot & Number Post Office, Slate, 8 ZIP Code E Postage Certified Fee Special Delivery Fee Restricted Delivery Fee Rerun Receipt Slowing to Wham d Dale Delivered Return Reeepl ShowYq to when, Dale, 6lddru 's Mdess TOTAL Postage d Fees $ Postmark or Dote Pt) 5e v tZG S-_ ?4 -4 q ................_•--.???..-..,?.?......?....?..?.-.......?...... w ..?T'n.•x. •.? ?.?..... .-m..... .r.rnv.n,M«ra+-+?t.m+.e....a».?.+w m'Pmrx..i.^[.'Vi4 1 J SENDER: a Complete items t an3nar 2 for additional esMOn, • Complete item 3, N, and 4b. ¦ Prim your tern and address on the reverse of this torn so VW we can ratan this 1 card to you ,I a pApaab?Ih4 form to the front of the msOphecs, or on 1M beck a spare does not a Wrxa 'Rerun Reoelp RspuesfWart the mellplero below the ueda number. ¦ The Return Pe iPt wa show to whom tea amcta w deltvemd and ma tlWe delivered. 3. ANcle Addressed to: 4a. Article I '?=6SwrancQ C@ <D. Service ?R tip bolD SZ} _ ?? to of 5. Received e . Print Name) a. dre en r 6. $I atu : (Addressee cifAgent I .2 Ps Form 31311, Dumber 1994 a -0as ( I also wleh to receive the following services (for an extra fee): 1. ? Addressee's Address 2. ? Restricted Delivery ' Consult postmaster for fee. H' for 8 1 r In I u P E3 COD `g. FrWu-as Fed- CERT, IFICATE OF SERVICE I, Mary T. Geraets, an employee of the law firm of Angino & Rovner, P.C., do hereby certify that I am this day serving a true and correct copy of the AFFIDAVIT/RETURN OF SERVICE upon defense counsel via postage prepaid first class United States mail addressed as follows: Reena E. Parambath, Esquire The Widener Bldg. One South Penn Square Philadelphia, PA 19107 Attorney for Defendant Dated: I , (1 -Vk i ' T. / eraets LJ? 4 CO . ) ° ` i.2. q2 „ 0 (J rn to j U