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HomeMy WebLinkAbout99-03351.h Q?z 9 JW Ci {it i ZM1k: fp ly. Adler & Claraval ATTORNEYS AT LAW P.O. BOX 11933 125 LOCUST STREET HARRISBURG, PA 17108.1933 LOUIS J. ADLER TELEPHONE ROBERT F. CLARAVAL (717) 2334780 WILLIAM L. ADLER FAX (717) 234-1670 CRAIG I. ADLER July 1, 1999 s President Judge George E. Hoffer Cumberland Coun se One C ouse Square = _ C sic, PA 17013 s- Re: Estate of Raymond Harris, late of Cumberland County, PA, Deceased No. 99-3351 Civil Hoffer: KOHN AND ADLER (1943.1960) KOHN, ADLER & ADLER (1960.1981) Enclosed is a copy of Judge Richard A. Lewis' Order of June 30, 1999 approving the settlement in the Petition to Compromise which I filed on behalf of Jessica Carlton. You will recall that you have scheduled a hearing on August 2, 1999 regarding the Petition to Compromise two other minor's claims and to settle the Estate of Raymond Harris. Judge Lewis' Order approving Jessica's settlement is of course contingent on your approval of the overall settlement. cere?ly? ROBERT F.CLARAVAL RFC:diw Enclosure (Order) cc: Carol Carlton Daniel Stem, Esq. IN RE: PETITION FOR THE APPROVAL OF COMPROMISE MINOR SETTLEMENT AND DISTRIBUTION PURSUANT TO PA.R.C.P 2026 et. seq. by JESSICA CATHERINE CARLTON, a minor by her Mother and Natural Guardian CAROL EILEEN CARLTON Petitioner IN TIME COURT OF COMMON PLEAS OF DAUPHIN COUNTY, PENNSYLVANIA : NO. 2281 S 1999 CIVIL ACTION - LAW ORDER OF COURT AND NOW, this ?ty of , 1999, upon presentation, hearing and consideration of the within Petition for the Approval of Compromise Minor Settlement and Distribution of Proceeds, it is hereby ORDERED that: The compromise settlement of the claim of Jessica C. Carlton, a minor, by Carol E. Carlton, her mother, for the sum of Sixty Thousand ($60,000.00) dollars is hereby approved as reasonable. The terms of settlement are as follows: A. A fund in the amount of $27,784.81 to be maintained at Fulton Bank. Attorney Robert F. Claraval is hereby designated as Trustee. The account shall indicate that no withdrawal may occur without prior Order of this Court or until the minor reaches age 18. M' B Attorney's fees of 20% in the amount of $12,000 are to be paid to Robert F. Claraval. C. Litigation costs to date of $215.19 are to be reimbursed to Robert F. Claraval. D. $20,000 to be paid to Physician's Health Plan, Inc as full payment of its subrogation lien. BY THE COURT: I RICHARD A. LEWIS, Judge JUN 3 01999 i,n (ac-ct0ing is a e?,y')j li;e original ..i Y ?IlltM t. o -ICJ Proth notary Adler & Q:laraval ATTORNEYS AT LAW P.O. BOX 11933 125 LOCUST STREET HARRISBURG, PA 17108.1933 LOUIS J. ADLER ROBERT F. CLARAVAL WILLIAM L. ADLER CRAIG I. ADLER TELEPHONE (717) 2334780 FAX (717) 234.1670 June 25, 1999 KOHN AND ADLER (1943.1960) KOHN, ADLER & ADLER (1960.1981) George E. Hoffer, President Judge Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 Re: Estate of Raymond Harris, late of Cumberland County, PA, Deceased No. 99-3351 Civil Dear President Judge Hoffer: By your Order of June 7, 1999 you scheduled a hearing for Monday, August 2, 1999 at 1:30 p.m. in the above matter. I am counsel for Jessica C. Carlton. Jessica was a passenger in the motor vehicle and was involved in the crash which killed Mr. Harris. In the Petition for Leave to Compromise and Settle prepared by Attorney Daniel Stern on behalf of the Harris Estate, Dan correctly sets forth the amounts of insurance coverage available to the injured parties. Dan also correctly sets forth in Paragraph 13 the proposed apportionment agreement reached between Attorney Stern on behalf of Raymond Harris, Correne Harris, Joseph Hams and Catherine Harris and myself on behalf of Jessica Carlton and attorney Bonde Johnson on behalf of Stephen Harris. I have reviewed the proposed distribution and the facts of this case extensively with Carol Carlton, Jessica's mother, and I have made Kevin Carlton, Jessica's father, aware of all of the relevant facts. It is my opinion that based upon all of the circumstances and the insurance coverages available, that the proposed settlement is fair and reasonable and would ask the Court to approve the settlement. I am also able to advise that I have filed a Petition for the Approval of Compromise Minor Settlement. That Petition has been filed in the Court of Common Pleas of Dauphin County as Carol and Jessica now reside in Dauphin County. Judge Richard A. Lewis has scheduled a hearing on June 30, 1999 at 3:30 to determine whether Jessica's proposed settlement is reasonable. George E. Hoffer, President Judge June 25, 1999 Page -2- I am not planning on attending the hearing which you have scheduled for August 2, 1999 and in fact am scheduled to pick a jury that day in Fulton County. Of course, should Your Honor have any questions of me regarding this matter, I would be happy to answer them either via letter or through a telephone call. SinceWFLA 6 BL a4 RFC:d iw cc: Daniel Stern, Esq. Bonde Johnson, Esq. JUN - 4 1990 IN RE: ESTATE OF RAYMOND HARRIS, LATE OF CUMBERLAND COUNTY, PENNSYLVANIA, DECEASED IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. ORDE AND NOW, this If k/ day of , upon consideration of the within Petition for Leave to C promise and Settle Wrongful Death and Survival Claims, and for Approval of Minors' Settlement, it is ordered and directed that Plaintiff/Petitioner, and counsel appear for hearing on the _jAg,4 day of &VIAL..., 1999 at t / 3 b 'clock in ourtroom No. A copy of this Order shall be sent by first class mail, postage prepaid, to the following individuals named in the Petition: Bonde Johnson, Esquire 475 Bridge Street Drawer 929 Groton, CT 06340 Maryellen Sheehan Martin, Esquire PA Department of Revenue Office of Chief Counsel Department 281061 Harrisburg, PA 17128-1061 Timothy Shaffer, SCLA Allstate Market Claims Office 6345 Flank Drive, Suite 1000 Harrisburg, PA 17102 Robert Claraval, Esquire 125 Locust Street Harrisburg, PA 17101 Correne Harris 422 Reno Ave. New Cumberland, PA 17070 Frank Spaziante Allstate Market Claim Office 625 George Washington Hwy. Lincoln, RI 02865 40 'r } ce --' i CV u.t cn r'l ` r r ? 13?y .y cl) o ?? u ._ 1 U l 1 a? w Q v a . IN RE: ESTATE OF RAYMOND HARRIS, LATE OF CUMBERLAND COUNTY, PENNSYLVANIA, DECEASED IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA 6RftbOFS COURT DIVISION NO.: 99.3351 aja T.?,„_., PETITION FOR LEAVE TO COMPROMISE AND SETTLE WRONGFUL DEATH AND SURVIVAL ACTIONS PURSUANT TO Pa.C.S. §3323 AND FOR APPROVAL OF MINORS' SETTLEMENT Respectfully submitted, Date: (u' L Avi Daniel Stem, Esquire 2650 North Third Street Harrisburg, PA 17110 (717) 234-4531 Supreme Court ID# 25989 Attorney for Petitioner Introduction Petitioner, Correne Harris, individually and as the Administratrix of the Estate of Raymond Harris, and as guardian for her two minor children, respectfully moves this Court for an entry of an Order in the form attached as Appendix A approving the compromise and settlement of both a third party tort claim and an underinsured automobile insurance claim. Both claims arise out of a fatal automobile accident which occurred on August 17, 1998 in the state of Rhode Island. Allstate Insurance Company is both the third party liability insurer for the third party Defendant, Joan Medbery, and the underinsurance carrier for Petitioner. In support of this Petition, Petitioner respectfully states the following: The Petitioner, Correne Harris, is the wife of decedent, Raymond Harris, and resides at 422 Reno Avenue, New Cumberland, Pennsylvania 17070. Residing with her are her two minor children, Joseph Raymond Harris born 1/21/90 and Catherine Elizabeth Harris born 9/27/92. 2. On August 17, 1998, Raymond Harris was driving a 1996 Dodge together with five passengers, who were: the Petitioner, Correne Harris; her two children Catherine and Joseph; Mr. Harris' brother, Stephen Harris; and a niece, Jessica Carlton. At that time, a vehicle driven by Joan Medberry crossed the centerline, causing a collision which resulted in the instantaneous death of Raymond Harris and injuries to the five passengers. A copy of the Police Report is attached as Appendix B. 3. Letters of Administration have been granted to Correne Harris on October 23, 1998 by the Cumberland County Registrar of Wills, File No. 1998-00859, who has properly been appointed Administratrix of the Estate. 4. Correne Harris is the only person entitled to maintain a wrongful death action on behalf of Raymond Harris. 2 5. On September 10, 1998, Daniel Stern, was retained as counsel for Correne R. Harris, individually and in her representative capacities as Administratrix and natural guardian for the two minor children. The undersigned then proceeded to investigate the crash, conduct legal research, obtain and review voluminous medical documentation, negotiate with insurance adjusters from Allstate in both its third party and underinsurance carrier capacities. In addition, the undersigned evaluated the law of the State of Rhode Island, and issued notice of a potential claim against it, in the event that the tort feasor, Joan Medbery, was a state employee in the course and scope of her employment at the time of the accident. (This issue is presently unresolved and will be preserved under the proposed order that Petitioner requests herein). 6. Decedent's adult brother, Stephen Harris, is separately represented in this action by Bonde Johnson, Esquire, 475 Bridge Street, P.O. Drawer 929, Groton, CT 06340. His consent to the settlement distribution requested herein is memorialized in an Affidavit dated 4/30/99, which is attached as Appendix C. 7. Minor Plaintiff, Jessica Carlton, is separately represented in this action by Robert F. Claraval, Esquire, 125 Locust Street, Harrisburg, Pennsylvania 17101. He has consented to the proposed distribution and will be present at the hearing scheduled to hear this Petition. 8. On March 17, 1999, Frank Spaziante, Staff Claim Analyst for Allstate in connection with its third party liability coverage, extended an offer to settle the third party claim on behalf of Joan Medbery by paying its policy limit of $50,000.00 per person and $100,000.00 per accident. 9. Allstate, through its underinsurance claims representative, Timothy Shaffer, has consented to the third party settlement and has tendered the underinsurance policy limit of $300,000.00 (for three vehicles insured by Petitioner and Decedent, each with coverage of $50,000.00 per person/ $100,000.00 per accident, stacked). 10. Counsel for Petitioner believes that it is in the best interest of the Estate, Correnc I-larris individually, and the two minor children, to accept the offer of settlement. 1 l . Acceptance of the settlement of the third party and underinsurance claims will preserve the remaining potential claim against the state of Rhode Island. 12. On May 21, 1999, the Department of Revenue, through its counsel, Maryellen Sheehan Martin, Esq., approved the proposed distribution of the proposed settlement. A copy of her letter is attached as Appendix D. 13. All parties to this action are represented. Counsel for the parties, following consultation with their respective clients, have agreed that the settlement proceeds should be allocated as follows: a. Out of the third party settlement: i. $50,000.00 to the Estate of Raymond Harris (the maximum amount recoverable under the third party policy); ii. $20,000.00 to Correne Harris; iii. $20,000.00 to Jessica Carlton; iv. $10,000.00 to Stephen Harris. b. Out of the underinsurance settlement: (Plaintiffs Stephen Harris and Jessica Carlton, as nonresidents of the Harris household, do not get the benefits of stacked coverage; Stephen Harris has agreed to waive any claim to any portion of the underinsurance coverage.) i. iv. V. To the Estate of Raymond Harris - $150,000.00; To Correne Harris - $50,000.00; To Joseph Harris - $30,000.00; To Catherine Harris - $30,000.00; To Jessica Carlton - $40,000.00. 4 14. As of this date Petitioner's counsel has incurred litigation costs in the amount of $160.69. to obtain medical and other records necessary to fully evaluate and prepare the case. An itemization is attached as Appendix E. 15. The letter of representation signed by Petitioner with the undersigned counsel provides for fees to be payable as follows: attorney's fee equal to 10% out of the third party recovery; and fees of 25% of the underinsurance recovery. WHEREFORE, Petitioner respectfully requests that this Court approve the settlement as set forth herein, and that Petitioner be permitted to sign Releases prepared by Allstate with respect to both the third party and underinsurance claims and approved by Petitioner's counsel. Further, Petitioner moves this Honorable Court for an Order which distributes the proceeds as set forth in the preceding paragraphs, and as summarized on Appendix F. Date: - Respectfully submitted, Dko? JUAAe--- Daniel Stern, Esquire 2650 North Third Street Harrisburg, PA 17110 (717) 234-4531 Supreme Court ID# 25989 Attorney for Petitioner IN RE: ESTATE OF RAYMOND HARRIS, LATE OF CUMBERLAND COUNTY, PENNSYLVANIA, DECEASED IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ORPHAN'S COURT DIVISION NO.: ORDER AND NOW, this day of , 1999 upon consideration of the Petition for Leave to Compromise and Settle and wrongful death and survival claims, it is hereby ordered as follows: I. The Administratrix is authorized to execute a release with Allstate Insurance Company in exchange for the policy limit of $50,000.00 per person/ $100,000.00 per accident. 2. The Administratrix is further authorized to execute a release with Allstate in its capacity as underinsurance motorist carrier, for the maximum amounts recoverable under said coverage, i.e. $50,000.00 per person, $100,000.00 per accident, for three vehicles, stacked, for a total of $300,000.00. 3. Apportionment of the settlement funds, to the Estate of Raymond Harris, is 90% for wrongfu: death, and 10% for the survival action, in accordance with the letter from the Pennsylvania Department of Revenue (Appendix D). 4. Disbursements shall be made as shown on the Summary marked as "Appendix E" to the Petition, which is incorporated by r:ference into, and made part of, this Order. By the court: J. Knoae 1Sid IU Ot.OLte roiice, Technical Accident Reconstruction Unit Date: Time: Location: Vehicles Involved: August 17, 1998 11:20 AM RI Route 138 Richmond, Rhode Island 1997 Saturn, Four Door VIN: 1G8ZK5278VZ353012 Rhode Island Passenger: YQ-372 (Hereinafter referred to as.the Saturn) 1996 Dodge, Four Door VIN: 1 B3EJ46C6TN163059 Pennsyl: snia Pazz-,nger: BAK-1647 (Hereinafter referred to as the Dodge) Abstract: The Saturn was traveling west on Route 138 in the Town of Richmond, / when at a point east of White Tail Trail, the Saturn travels left of center and strikes the Dodge, which was traveling east on Route 138. RI Slate Police Hope valley Barracks Accident #277 ' Results: Both vehicles totaled. Fatal injury sustained to both operators. Injury to five (5) passengers of the Dodge. Case No TAR L980801 Date November 5 1998 Page 1 of 7 Pa es Technical Accident Reconstruction Unit SYNOPSIS On August 17, 1998 at approximately 11:20 AM, a 1997 Saturn, occupied by Its operator, was traveling west on Route 138 in the Town of Richmond. At the same time, a a 1996 Dodge, occupied by its operator and five (5) passengers, was traveling east on Route 138 in the Town of Richmond. Investigation revealed from evidence gathered at the scene and witness statements, th.-t.flic pcr; t, o! b!s^. Sksct -at sn;n e point lost ,?:ontrol of her vehicle, traveled left of tenter lsto the eastt;-und lano, and struck the Dodge. As a result of the accident, both the Saturn and Dodge sustained heavy damage and were deemed totaled. The operators of both the Saturn and Dodge sustained fatal injury at the .scene. The five (5) passengers of the Dodge were seriously injured and were transported to area hospitals by Hope Valley rescue vehicles. Case' No. TAR 980801 Date November 5, 1998 Page 2 of 7 Pages a%aauuc atiiaaau uLCLL ruaa(:c, Technical Accident Reconstruction Unit 1444) HIGHWAY INFORMATION Route 138 is a two-lane state highway that runs East and West through the Town of Richmond. It consists of one (1) lane running east and one (1) lane running west. At the location where the accident occurred, the eastbound and westbound lanes are divided by a double yellow line. Both travel lanes average twelve (12) feet in width. The lateral Rupport, or shoulder of the highway, is made of asphalt. All roadway markings, such as the double yellow center lines and the fig 'lines are clearly marked. There exists a slight cure to the right running from easV_. west on the highway in the vicinity of"thy arciden*:. Points of possible perception along with sight distances for operators traveling east to west on Route 138 in the area where the accident occurred are good. It was raining at the time when this accident occurred and the roadway ws wet. No roadway defects or deficiencies were located which could have contributed to this accident. The posted speed limit is forty miles per hour (40 mph) on Route 138 where the accident occurred. _ _.... _.._ Case No TAR 980801 Date November 5 1998 Page 3 of 7 Pages Technical Accident Reconstruction Unit THE ACCIDENT At approximately 11:20 AM, the Dodge, occupied by its operator and five (5) passengers, was traveling in the eastbound lane of Route 138 in the Town of Richmond. At the same time, the operator of the Saturn, traveling in the westbound lane of Route 138, lost control of her vehicle, traveled left of center, and thereby struck the Dodge. The Saturn, prior to impacting the Dodge, was sliding / rotating in a clock::i a direction,- The vehicles camo to a point of maximum engagement when the left drivers side of the Saturn struck the left drivers side of the Dodge. The two vehicles then disengaged. The force of the impact caused the Saturn to flip over in ?- northwesterly direct!,:;--., Thp Saturn ultimately stopped and came to a position of uncemtrol'icd rest on its wheels facing southwest' the :kesti;aund lane. The Dodge, upon disengagement from the Saturn, rotated in a clockwise direction while moving forward before coming to a position of uncontrolled rest facing southwest in the grass along the edge of the eastbound lane. I Case No TAR 980801 Date November 5 1998 Page 4 of 7 Pages Technical Accident Reconstruction Unit VEHICLE DAMAGE EXAMINATION On September 10, 1998 at 10:20 AM, Corporal Rohan and Trooper Wall of the RI State Police Accident Reconstruction Unit, along with John Stowik, a Division of Motor Vehicles Investigator, responded to Edward's Garage located on Main Street in Hope Valley, RI, to inspect both the Saturn and Dodge for any evidence relative to the accident and to inspect the damage the vehicle incurred as a result of the collision. Both the Saturn ate; :he I) %d1ge sustained heavy left front end and left side damage as a result of this collision. Contact damage was observed to both vehicle's left front fender, left front door, front grill, and front bumper. Induced damage was also incurred on both h!+ncls. &lvers core: t=rents 3!?d roofs of the Saturn and the Dodge % which w:.,^ evident by those vehicle Fade parts buckling inward. All the windows on the left side of both vehicles were smashed I broken to include both windshields. Both front airbags were deployed on both the Saturn and the Dodge as a result of the collision. Inspector Stowik found that there were no obvious safety defects on either vehicle at the time of the inspection. Case No. TAR 980801 Date November 5, 1998 Pa e 5 of 7 Pages Technical Accident Reconstruction Unit WITNESS STATEMENTS 1.) Tanya C. Zbrozek 36 Deerfield Drive Berlin, CT 06037 DOB: 11-29-73 (860)-828-0224 2.) John Laurenzo 40 Tabor Avenue (?b;i?iclet5ee, h: u290-i DOB: 4-22-69 (401)-354-4385 Case No. 7AR 980801 Date November 5, 1998 Pa e 6 of 7 Pa es tttluuu x?ACUiu ..??aLC ru11c;C, •? Technical Accident Reconstruction Unit FINDINGS/CONCLUSIONS Investigation of this collision revealed that the Saturn crossed over the center line while traveling in a westerly direction and struck the Dodge in the eastbound lane while the Dodge was traveling in an easterly direction. PROBABLE CAUSE The Rhode Island State Police Technical Accident Reconstruction Unit determines the probable ! : ?se for this collision :o be the loss Of'co:?trol aiii: 4russing of t::e Ceni:'r line :1iiU tht: ?Jc7th r the Dodge due to the inattention 1 distraction on the part of the operator of the Saturn. No evidence 1 information has been developed to date that would determine an actual cause or reason for the loss of control on the part of the Saturn. Submitted: November 5, 1998 Rohert S. Wall Troop.:?r No. TAR 980801 I Date November 5 1998 j Pale of 7 Pages N 3e 8 ?r _f ?I a Y 9 s 9 C v a? s ? i •a ! d to a e I I I ? I I el N?o f mr . , ecw x? S d 4 t. y_ , w I m C m ? - ? e ti m a- I i - 44n i o n s t I s a d a:? v ` m t n 4 ? a 7 n ? 1 ts?ta N ? w N ca W co M r 7 O I Dale of Accident: 8117/98 ? Sun 0 Man OTues ® Public Property ®Investignted et scene Posted speed: Time: 11:20 ®AM ? PM ?Wed ? Thu ? Fri ? Sal ? Private Property ? Walk In ?Other 40 MPf1/KM Location: Street/Highway: Cily/rown: Intersection with: ROUTE 138 RICHMOND Exact Location if not at Intersection: Nearest Intersection Street: WHITE TAIL TRAIL O North ? South ® East ? West Mile Marker: I Name of Operator: Juan Medbe Dale of Birth: 7/20/40 M F Social Security Number (Optional) Stre- Mailing Address: City/ Town: Stale: Zit) Code: 02898 152 Arcadia Rd Hope Valley RI License-No: 5704945 State: RI, ® Operator O Chauffeur ?Permit 539-7690 Restriction: NIA Transporting Placardable HM OY ® N ? Motorcycle Telephone (Optional) O CDL/Re ? Yes ? No Charges (IfAppUcabfe) Statue N Vehfclc Direction Citation k (1) (2) (3) NO SO BO W Registration o.: Q-372 Plate Type: Year: 1997 Make: Saturn V.I.N. Number. State: RI Passenger ColodModel Green/4dr IGBZK5278VZ353012 Registered Owner's Name: Street/Mailing Address: Cityfrown: Hope Valley Zip: 02898 Ed and Joan Medbery 152 Arcadia Rd Stale: RI Company: Ravmond F. Harris Street/Mailing Address: 422 Reno Ave License No: 21118522 State: PA Restriction: NIA Transporting Placardable HM OY ® N 03/18 New Cumberland ?A $D Operator ? Chauffeur ?Penn t (1) (2) (3) Telephone (Optional) Vehicle Direction NO SO E® W? Vc/11C1e NL Registration No.: B State: PA Registered Owner's DA(I'M 3 6 9 2 5 8 1 4 7 OcamarrrQniurt. Irtfnnnnfinnt /Plate r&t Annrnninb Cndi .e .Penn Al..... Aee1. VI V Nance of Occupant: Joan Medbery ? M F Date of Birth: Street/Mailing Address: 152 Arcadia Rd. 7/20/40 Ci rrown: Hope Valley tale RI Zi 02898 Vehicle r Seat Seal Bell Eject Injury code Pedes/Bicy. Helment Transported Refuse Treatment Own Dactar Loc. 1 1 NO NO D N/A YES N/A NIA Name of Occupant: Raymond F. Harris M F Date of Birth: Street/Mailing Address: 422 Reno Ave 12/8/65 Ci t•/Town: New Cumberland Stale PA Zip 17070 VehicleN Sett Seat Bell Eject Injury code Pedes/Bicy. Helment Transported Refuse Treatment Oscn Doctor I Lac. 2' 1 UNK NO D N/A YES N/A N/A Name of Occupant: Steven Harris M F Date of Birth: Street/Mailing Address: 631 Shennecsso Rd. 7/15164 Cit frown: Groton State: CT Zi : Vehicle # Seat Seat Bell Eject Injury code Pedea/Biay. Helment Transported Refuse Treatment Own Doctor Loc. 2 3 YES NO C N/A YES NO NO Street/Maifing: 6037 Street/Mailing: Damage by vehicle N: Citvfrotvn: Stale Zip RaaA Cmrdirinner ®Y ?N 7. 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Helment T,n Nrlted ment ;Rcfuse : Own Doctor 2 5 YES IVO A NIA YES NO NO Name of Occupant: Catherine Harris Street/Mailing Address: 422 Reno Ave F Date of Birth i /Town: New Cumberland Stale: PA Zi :17070 P hicle k Seat Seat Belt Eject Loc. injury code Pedes43icy, Heimerd Transported 7Rcfuse aUnerd Own Uoctw 2 r G YES NO A N/A YES NO H rtn65 I It/Dr7r 10A'on: Street/Mailing: 40 Tabor Ave Street/Mailing: I Damage by vehicle l City?own: State Zin ?Y®N a ;T,ylpoFtroaaA z3'r... ?X, :'?? ?,sTriilBeK x•?.CeSG JL s:., j?Road ',E ac2,. :aC ?: ;AOid .t?riiiltlod < X ;; =uoruher ;' ° A? ,. 'UlrC; '=a?,Cmd.?:''?? X TtirlBr: _ = rn ? Ex resswat• Q Stop Sin ? Concrete ? Dry ? Clear ? Daylight ? Li ht Q Residential Q Divided ht ? Traffic Sill. ? Asphalt ? wet ? Rain ? Dawn/Dusk Q Medium Q Rural ? Exit Ram Q officer Q GravcVD'ut Q Snow/Ice ? Snow ? Darkness ? Heavy Comrt?Induri Q 2 Lanes ? R/R Signal Q Sand Cover Q Construction Q Sleet ? Li hied. n 7 Lana Q No controls ? ? 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R S.nr A7 .... h,,)- I'm Name of Occupant: Correne R. Harris M F Date of Birth: Street/Mailing Address: 422 Reno Ave 4112/66 Ci /Town: New Cumberland State PA Zip 17070 VehicleN Seat Lac. Seat Bell Eject Injury code Pedes/Bicy. Helment Traruported Refuse Treatment Own Doctor 2 6 YES NO A N/A YES NO NO Name of Occupant: M F Date of Birth: Street/Mailing Address: City/Town: Slate Zip Vehicle q Seat Loc. §eat Belt Eject Injury code Pedes/Biey. Helment Tramported Refuse Treatment Own Doctor Name-of Occupant: M F Date of Birth Street/Mailing Address: , Ci frown: Stale: Zi : Vehicle N Seat Seat Belt Eject Injury code Pedes/Bicy. Helmerd Transported Refuse Treatment Own Doctor Loc. Name of Witne Street/Mailing: StreetiMailing: ?Y ON Damage by vehicle k: t ? Tyna Y? i2 s'33sb a r„r,: ,.c, Expressway Xx 57? Q ': Taamc' °' )x c.t nsiL < Ste Si x g Q Ao tt ' i? StRf.ttk Concrete X. k ? Z > RoNd . Gb1tID?1?? Dry X ? "Womlter n a?£ t £ ?.i,.: ,f. Cleu x s .•5 ? YJ hL. ' IiCF R .? Cnad. <.:; Daylight i r ? ?'r?Irl!' Cb6d.:. x Li g ht x a ? Y :2 T)pt .: atlorz'' Residential Q Divided h /y Traffic Sig. Q Asphalt ? Wet ? Rain D Dawn/Dusk D Medium ? Rural Q Exit Ram ? Officer ? Gravel/Dirt ? Snow/Ice Q Snow ? Darkness Q Heavy ? Comm/Indust ? 2lanez D R/R Signal ? Sand Cover ? Construction ? Slcet ? Lighted ? D 3 Lanes ? No Controls ? ? Repair Q Fo Mist ? Not Lichted ? 4 Lanes ? 01 1 ? _ _ ? One wa ? Un•Paved !'nlicimJd trnhnl lnrnnrurlimr V.hirf. rlnrrefnrtl r)nrralnrn a tfmnerof cewridn' . x eoll)"t tictl, , ;mtyenadlopa;: afrtotttlLesa 1 S ;Pdr x PhyalsatroFdmaei nro or .> r Y prd+, x Akoba• „Dd; D Angle D Barrier D ? Straight ? ? ? ? Had Been Drinking ? ? D ? Tu iy n Merging ? u Guard Rail ? ? ? Changing lanes Q ? Obvious) Impaired 0 1 0 0 C) Refused Q Sideswipe Same Dir. Curb ? ? D hakin R Tum D D [3 Physical landica Q 1 _Q_ ? Breath O Sideswipe Opp. Dv D ? ? ? Makin L) Tum ? ? Q ? View Obstructed ? D D ? Blom O Head -On Q Bridge Rail ? ? ? Makin UTurn Q ? ? ? Slec (ried e Urin ? Rear • End ? Sign Post D O D slowing/sloping D ? ? Fell Asleep D ? Not A Q Broadside D Pole ? ? ? start in Tsalre ? ? ? ? Impairment U/H Rollover D Tice ? O D wek;n O D ? Ran Of Road O O D 0 Parked 0 0 ? STATE OF RHODE ISLAND UNIFORM Briefly Describe Damage to Vehicle LAMM oy Acelacnuu.crvwug v.ma ...---o-• - - -- - Briefly Describe Specific Vehicle Damage which Pre- Existed the Accident/ including Glass Breakage, if Known: UNK Briefly Describe Damage to Contents of Vehicles -Caused by Accident, If Any: UNK Briefly Describe Damage to vehicle causea Dy Acc?ucnumc uuu,g ?.?aa ?• a-• • - - Briefly Describe Specific Vehicle Damagc which Pre- Existed the Accident/ Including Glass Breakage, if Known: UNK Briefly Describe Damage to Contents of Vehicles - Caused by Accident, If Any: UNK to Vehicle 01 was traveling westbound on Route 1381n the Town of Richmond and when at a point approximately 120 feet east of White Tall Trail, vehicle f/1 crossed the center line of the roadway and struck vehicle 92 which was traveling eastbound on Route 138. A Copy of this Report Must Be Forward to: The Department of Administration Safety Responsibility Section 345 Harris Avenue Providence, Rhode Island 02909-0345 (Within 15 Days - Per: Rhode Island General Law 9 31-26-9) DMV/9 TIME: 1:00 PM DATE: 08-17-98 LOCATION: Rhode Island State Police Hope Valley Barracks INTERVIEW OF: Tanya C. Zbrozek INTERVIEW BY: Trooper Michael McGlynn Q. What is-your name, date of birth, address and telephone number? A. Tanya G. Zbrozek, 11-29-73, 06037, (860) 828-0224. 36 Deerfield Drive, Berlin, CT Q. Why are you at the Rhode Island State Police Hope Valley Barracks? A. I witnessed a motor vehicle accident on Route 138 in the Town of Richmond. Q. Where was your vehicle when you saw the accident? A. My vehicle was traveling on Route 138 east, directly behind a light blue car. Q. What did you observe? A. I saw a black car in the other lane coming west on Route 138. Q. What drew your attention to the vehicle? A. I noticed the headlights cross over the double yellow line. I had not noticed the vehicle prior to it crossing over the lines. Q. What happened next? A. The black vehicle crossed the lines and collided head on with the blue vehicle. The accident occurred in the eastbound lane. I recall the blue vehicle did not, step or. the brakes because the brake lights did not come on. I didn't have much time to slow down. The blue vehicle then bounced into the grass on the eastbound side. The black vehicle bounced back into the westbound lane. I drove between both vehicles. Q. what happened to the blue vehicle after it was struck? A. I don't know I think the blue vehicle rolled over. The black vehicle definitely rolled over. I don't remember anything other than the debris in the air. That's all I remember. Q. Do you recall how fast were you traveling? A. I would have to say 45 miles per hour. Q. Do you recall if you were traveling faster or slower than the vehicle in front of you? A. We were traveling at the same speed, approximately 45 miles per hour. Q. What was the distance from your vehicle to the blue vehicle? A. Approximately one and a half car lengths behind the vehicle. Q. What were the traffic conditions? A. Traffic was light. Q. What were the weather conditions and visibility? A. Poor visibility and rain. Q. Would you like to add anything to this statement at this time? A. No. Is the above statement true to the best of your knowledge? U-S Y s s, it is true. Tanya C. Zb oze c T o r di.chae AFFIDAVIT OF ATTORNEY BONDE E. JOHNSON I, the undersigned, BONDE E. JOHNSON, being duly sworn, depose and say: 1. I am over 18 years of age and believe in the obligations of an oath. 2. I am an attorney licensed to practice law in the State of Connecticut. 3. 1 represent STEPHEN J. HARRIS in regard to personal injuries he sustained in an automobile accident on August 17, 1998. 4. The tortfeasor's liability carrier in this case, has tendered the policy limits in this case to be divided amongst the injured parties. 5. I have consulted with my client Stephen J. Harris and he is agreeable to settle this case against the tortfeasor for the divided portion of $10,000. 5. I believe that $10,000 is a fair and equitable settlement for the injuries he received in proportion to the amounts received by the other injured parties from the tortfeasor. Subscribed to and sworn to before me, this ), r`day of 1999. Notary Public My Commission Expires: ANN a. RO-1UnTAtr A .' /': l ::: r 1. !l , J (. MY C;in1nigSlUn : rmEa ,J..t ,J, 10U < t An E:VOHNSON LAW OFFICES • O'BRIEN, SNAFNCa. STUART, KELLY B MORRIS, P.C. P,O ORAWCR 929 , GROTON. CONNECTICUT' 06340 • 06O AAS4162 • FAIL 860.445.1529 • JURIS NUMBER 43695 el OFFICE OF CHIEF COUNSEL COMMONWEALTH OF PENNSYLVANIA DEPT. 251081 DEPARTMENT OF REVENUE HARRISBURG, PA 17125.1061 May 21, 1999 Daniel Stern, Esq. NAY ?41,9gg 2650 North Third Street Harrisburg, PA 17110 Re: Estate of Raymond Harris, Deceased Cumberland County Allocation of Proceeds Dear Mr. Stern: PHONE: 717.757.1352 FAX: 717.772.1455 This letter is in response to your letter of May 13, 1999, and the Petition for Leave to Compromise and Settle Wrongful Death and Survival Actions Pursuant to Pa.C.S. §3323. Please be advised that the Department's agreement to the above settlement allocation applies only to the facts in this case is no indication as to the position the Department may take in future factual situations. Pursuant to the Petition, the thirty-two (32) year old decedent died instantly as the result of fatal injuries he suffered in two-vehicle accident on August 17, 1998. Decedent, a furniture and drapery installer and warehouse manager, is survived by a wife and two minor children. Allstate Insurance is the insurer for the defendant as well as the underinsurance insurer. They have offered $200,000 in settlement of both claims. A potential claim against the State of Rhode Island still exists. This claim is limited by statute to $100,000. Please be advised that the Department has no objection to the allocation of 10% of the proceeds to the survival action and 908 of the proceeds to the wrongful death action. The survival action portion must be reported on a Pennsylvania inheritance tax return and the appropriate tax must be paid. Attorney's fees and costs can be allocated between the actions but they must be prorated by the above-cited percentages. Please be advised that the Department's agreement to the above settlement allocation applies only to the facts in this i t Daniel Stern, Esq. May 21, 1999 Page Two case is no indication as to the position the Department may take in future factual situations. I trust that this letter is sufficient representation of the Department's position on this matter. Please do not hesitate to contact me if you have any questions or require additional information from this office. I can be reached by telephone at (717) 787-1382, extension 3061. Sincerely, le Marye len Sheehan Martin Assistant Counsel MSM:mh ESTATE OF RAYMOND HARRIS LITIGATION COSTS DATE PROVIDER AMOUNT 9/17/98 Rhode Island State Police (Police Report) $5.00 10/2/98 Kent County Memorial Hospital (Med. Rec.)$18.00 10/28/98 HCC (Medical Records) $28.39 10/28/98 CMI (Medical Records) $17.28 12/9/98 CMI (Medical Records) 92.02 TOTAL: $160.69 IF, SUMMARY: SETTLEMENT PROCEEDS TOTAL. AVAILABLE FOR DISTRIBUTION TO ALL, CLAIMANTS: $400,000.00 (100,000. total 3`d party liability, 300,000. total UIM) PROPOSED DISTRIBUTION, GROSS AMOUN TS 3RD PARTY UIM Estate of Raymond Harris $200,000.00 50,000 150,000 Correne Harris $70,000.00 0 70,000 Joseph Harris $30,000.00 10,000 20,000 Catherine Harris $30,000.00 10,000 20,000 Jessica Carlton $60,000.00 20,000 40,000 Stephen Harris $10.000.00 10,000 0 TOTAL $400,000.00 100,000 300,000. Counsel fees & costs to Daniel Stern, Esq.: 10% of 3rd Party Settlement Proceeds $7,000.00 of $70,000.00 allocated to Harris family: 25% of UIM benefit proceeds of $260,000.00 allocated to Harris family $65,000.00 Costs Advanced $160.69 (See Account Statement for breakdown of costs and name of party for whom incurred) VERIFI_CATION I verify that the statements made in the foregoing Petition for Leave to Compromise and Settle Wrongful Death and Survival Actions Pursuant to Pa.C.S. §3323 are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. Section 4904 relating to unsworn falsification to authorities. Date:??q S Correne Harris Y f. 1 1 1 CERTIFICATE OF SERVICE I, Queena J. Stremmel, hereby certify that a true and correct copy of the foregoing Petition for Leave to Compromise and Settle Wrongful Death and Survival Actions Pursuant to Pa.C.S. §3323 was served upon the following person by first class mail, postage prepaid: Bonde Johnson, Esquire 475 Bridge Street Drawer 929 Groton, CT 06340 Maryellen Sheehan Martin, Esquire PA Department of Revenue Office of Chief Counsel Department 281061 Harrisburg, PA 17128-1061 Timothy Shaffer, SCLA Allstate Market Claims Office 6345 Flank Drive. Suite 1000 Harrisburg, PA 17102 Date: _ tp a Robert Claraval, Esquire 125 Locust Street Harrisburg, PA 17101 Correne Harris 422 Reno Ave. New Cumberland, PA 17070 Frank Spaziante Allstate Market Claim Office 625 George Washington Hwy. Lincoln, RI 02865 ^Iw1 eena J. emmel, Paralegal to Daniel Stem, Esquire i f i I. I j I I' I .: i i "i IN RE: ESTATE OF RAYMOND HARRIS, LATE OF CUMBERLAND COUNTY, PENNSYLVANIA, DECEASED IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO.: 99-3351 CIVIL ORDER AND NOW, this 7--day of consideration of the Petition for Leave to Com romis d Settle andlwrongful death and survival claims, it is hereby ordered as follows: 1 • The Administratrix is authorized to execute a release with Allstate Insurance Company in exchange for the policy limit of $50,000.00 per person/ $100,000.00 per accident. 2. The Administratrix is further authorized to execute a release with Allstate in its capacity as underinsurance motorist carrier, for the maximum amounts recoverable under said coverage, i.e. $50,000.00 per person, $100,000.00 per accident, for three vehicles, stacked, for a total of $300,000.00. 3. Apportionment of the settlement funds, to the Estate of Raymond Harris, is 90% for wrongful death, and 10% for the survival action, in accordance with the letter from the Pennsylvania Department of Revenue (Appendix D). 4. Disbursements shall be made as shown on the Summary marked as "Appendix F" to the Petition, which is incorporated by reference into, and made part of, this Order. 5. All funds disbursed for the benef it of a minor Plaintiffs shall be deposk'ted on behalf of the minor in a bank or other institution whose deposits are insured by a Federal government agency, or in one or more accounts investing in only securities guaranteed by the United States or a Federal Government agency managed by responsible financial institutions. No withdrawals can be made from any such account until the minor attains majority, except as authorized by prior order of the court. Proof of the deposit shall be promptly filed of record. COP i S, Mare ??c? d`cXt! ??2Sr.?JJ?(? ?iCfF? I b1/a /;f ;i By the court: 1 SUMMARY: SETTLEMENT PROCEEDS TOTAL AVAILABLE FOR DISTRIBUTION TO ALL CLAIMAN TS: $400,000.00 (100,000, total 3rd party liability, 300,000, total UIM) PROPOSED DISTRIBUTION, GROSS AMOUNTS 3R° PARTY UIM Estate of Raymond Harris $200,000.00 50 000 Correne Harris $70,000.00 , 0 150,000 Joseph Harris $30,000.00 10 000 70,000 Catherine Harris $30,000.00 , 10 000 20,000 Jessica Carlton $60,000.00 , 20 000 20,000 Stephen Harris $10.000.00 , 000 10 40,000 - TOTAL $400,000.00 , 100,000 n C 300,000. Counsel fees & costs to Daniel Stern, Esq.: I, 10% of 3rd Party Settlement Proceeds $7,000.00 of $70,000.00 allocated to Harris family: I.. 25% of UIM benefit proceeds of $260,000.00 allocated to Harris family $65,000.00 Costs Advanced (See Account Statement for breakdown of costs $160.69 and name of party for whom incurred) I. 99- 3,3x1 ?,v?c lfit r'' Certificate of Deposit NON-NEGOTIABLE yd 1 wl 800-053917 Accountholder(s): 800-0$3917 rr NOT TRANSFERABLE CATHERINE E HARRIS (COST/UTMA) CORRENE R HARRIS Date of Opening Alinimum Initial Renewal Annual • Rate of Frequency of Issuance Balance Balance maturity hrm Percentage Earnings Compounding Required Date Yield per Annum 09/11/1999 22,500.00 10000.00 0811!/2001 23MO 6.00 05.8400 MONTHLY RM 3220 (M Certificate of Deposit NON-NEGOTIABLE \?? V1 sr ? 800-053916 ,??l?y Accountholder(s): 80©-053910(? NO7 TRANSFERABLE JOSEPH R HARRIS (CUST/UTMA) CORRENE R HARRIS Date of Opening Alinimum Initial Renewal Annual Rate of Frequency of Issuance Balance Balance Maturity Term Percentage Farnings Compounding Required Date Yield per Annum 09/11/1999 22,500.00 10000.00 .08/11/2001 23MO 6.00 05.8400 MONTHLY RM 3220 ?s ' h? 1 a. i1? CU CL C