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Home My WebLink About99-04876W 1 MICHAEL CHESSEY, a minor, by and through his natural parents and guardians SHANE M. CHESSEY and MARY E. CHESSEY, Petitioners IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA V. GEORGE R. PIERCE, JR., Respondent NO. 99-4876 CIVIL TERM AND NOW, this 16T" day of AUGUST 1999, a hearing on the Petition For Leave To Compromise Minor's Action is scheduled for Monday, August 30, 1999, at 1:30 p.m. in Courtroom # 5 of the Cumberland County Courthouse. Petitioner's Attorney is directed to submit to the Court a detailed accounting of the time expended in the prosecution of this matter. In view of the fact that Petitioners reside in the Pittsburgh area, we will take their testimony by telephone if they so desire. By the David H. Rosenberg, Esquire Edward E. George R. Pierce, Jr. .,8.>Q Ftt_FD OrF?CE OF ! ^"c '` OT ,"NOTARY 99 AUG 11 AN 9' 68 WMWN YLVANA HANDLER, KENNING 6 ROSENBRRG August 27, 1959 Billed through 08/27/99 Bill number 203527-00000-007 DHR MICHAEL CHESSEY 9763 LADY SLIPPER COURT LAUREL, MD 20723 ... ... . __ ..?.. ?•w___. ._ ..-.,ter. • billing timekeeper David It Rosenberg • date of lant bill date of last reminder • last bill through dart- • bill type code 5-4 • action to be taken • 0-hold entire bill 3-0ummary tees and asp • 1-a/r reminder 4-bill tees and exp 2-bill exps, hold fees 5-summary tees/detail e • current .00 • 30 days .00 • 60 days .00 ' 90 days .00 • 120 days .00 billing frequency A-12 • last payment • billing realization 0 1 FOR PROFESSIONAL SERVICES RENDERED 12/02/98 DHR Telephone conference with Mr. Parthmore of Secret Service re: initial contact; Two Telephone calls with Shane Chessey 12/07/96 OUR Initial meeting with clients regarding motor vehicle accident of November 27, 1998 at their home in Maryland 12/09/90 DHR Letter of representation sent to M/M Chessey re: Michael Chesney and review of file 12/09/98 DHR Letter sent to adverse insurance company regarding incident of 11/27198 and letter sent to State Police requesting accident report 12/09/98 DHR Letter sent to State Farm advising of our representation of clients re incident of 11/27/98 12/09/98 DHR Letter sent to Penn State Geisinger Health Group requesting medical records for incident of 11/27/90 12/09/98 DHR Letter sent to Hershey Medical Center requesting all medical records re incident of 11/27/98 12/09/90 OUR Letter sent to state Farm enclosing the Application of Benefits for Michael Chesney 12/09/98 DNR Letter to clients re Application for Benefits 12/09/98 DHR Telephone conference with clients re: vehicle 12/10/98 DHR Telephone conference with clients re: grief counseling 12/14/98 DHR Assignment re contact with State Police and telephone conference with Mr. De Priest re: Marine Corp. Law Enforcement Foundation; Review of file 12/14/98 DHR Telephone conference with clients 12/15/98 DHR Letter sent to Sgt. Kreider re: incident of 11/27/98 • matter 00000 • tmkp date hours rate amount ' DHR 12/02/98 .50 225 112 .50 • DHR 12/07/98 1.00 225 225. 00 • DHR 12/09/98 .40 225 90. 00 ' DHR 12/09/98 .40 225 90. 00 • DHR 12/09/90 .20 225 45. 00 • DHR 12/09/98 .20 225 45. 00 • DHR 12/09/98 .20 225 45. 00 • DHR 12/09/98 .20 225 45. 00 • DHR 12/09/98 .20 225 45. 00 • DHR 12/09/98 .20 225 45. 00 • DHR 12/10/98 .20 225 45. 00 • DHR 12/14/98 ?. 225 112. 50 • DHR 12/14!98 .20 225 45. 00 • DHR 12/15/98 .20 2.25 45. 00 MICHAEL CHESSEr 8111 number 203527-00000-907 DER 12/15/98 DER Telephone conference with clienta 12/15/98 DER Telephone conference with client 12/17/98 DER Telephone cam ere n<e with clients 12/16/98 DER Correspondence to client w/courtesy envelope 12/21/98 DER Letter to Stata Farm forwarding medical hill. an First Party Benefits carrier 01/04/99 DER Telephone conference with client 01/05/99 DER Receipt and review of medical records of Hershey Medical Center 01/07/99 DER Letter to Hershey Medical Center - payment for records 01/08/99 DER Letter to P. Greene at Nationwide Insurance enclosing medical records and information as a result of incident of 11/27/98 01/11/99 DER Telephone conference with I. Miller of Nationwide 01/13/99 DER Telephone conference with I. Miller of Nationwide 01/19/99 DER Telephone conference re medical update - Michael 01/19/99 DER Letter to client - copy of police report 01/19/99 DER Telephone conference with B. Smith of State Farm 01/19/99 DER Telephone conferences with client 01/20/99 DER Letter to State Farm enclosing medical records and/or notes re: incident of 11/27/98 01/21/99 DER Receipt and review of billing information from Hershey Medical Center 01/28/99 DER Telephone conference to West Shore EMS 01/29/99 DER Letter to B. Smith at State Farm enclosing copies of medical records - Michael 02/01/99 DER Review letter received from Nationwide Insurance Co. regarding incident of 11/27/98 02/01/99 DER Letter to Hershey Medical Center - payment for medical records 02/01/99 DER Review correspondence from P. Greene of Nationwide 02/01/99 DER Telephone conference with client cancelling appointment 02/01/99 DER Telephone conference with P. Greene - Nationwide 02/02/99 DER Telephone message from Client 02/DS/99 DER Letter to P. Greene; Draft Affidavit of No Insurance Coverage 02/08/99 DER Letter sent to Mary Chessey 1'e: Michael's medical bill. - reimbursement 02/08/99 DER Telephone conference re medical update On client 02/08/99 DER Reviewed correspondence from B. Smith - State Farm 02/09/99 DHR Letter sent to State Farm submitting medical bills for payment 02/11/99 DER Letter sent to P. Greene 02/11/99 DER Letter sent to client. 02/11/99 DER Letter to P. Greene 02/11/99 DER Letter to clients 02/16/99 DER Telephone conference with Shane re: son':: Counseling 02/22/99 DER Meeting with District Attorney Gabig and clients 02/26/99 DER Telephone conference with client PAGE CONTINUED DER 12/15/96 .ni 225 67.50 • DER 12/15/9B .20 225 45.00 • DER 12/17/98 .20 225 45.00 DER 12/16/98 .20 225 45.00 DEP. 12/21/96 .20 225 45.00 DER U1/04/99 .30 225 67.50 DEP. 01/05/99 .35 225 78.75 DER 01/07/99 .20 225 45.00 DER 01/09/99 .50 225 112.50 DER 01/11/99 .20 225 45.00 • DER 01/13/99 .20 225 45.00 • DER 01/19/99 .20 225 45.00 • DER 01/19/99 .20 225 45.00 DER 01/19/99 .20 225 45.00 DER 01/19/99 ,70 225 157.50 DER 01/20/99 .20 225 45.00 DER 01/21/99 .20 225 45.00 • DER 01/26/99 .1e 225 22.50 • DER 01/29/99 .20 225 45.00 DER 02/01/99 .20 225 45.00 • DER 02/01/99 .20 225 45.00 DER 02/01/99 .20 225 45.00 • DER 02/01/99 .20 225 45.00 • DER 02/01/99 2.00 225 450.00 • DER 02/02/99 .20 225 45.00 • DER 02/05/99 .50 225 112.50 • DER 02/0B/99 .30 225 67.50 DER 02/08/99 .30 225 67.50 • DER 02/08/99 .20 225 45.00 DER 02/09/99 .20 225 45.00 DER 02/11/99 .20 225 45.00 DER 02/11/99 .20 225 45.00 OUR 02/11/99 .2-' 225 45.00 OUR 02/11/99 ._. 225 45.00 DER 02/16/99 .20 225 45.00 DER 02/22/99 3.00 225 675.00 • OUR 02/26/99 .30 225 67.50 MICHAEL CHESSEY Bill number 203527-00000-UU7 DER 03103/99 DER Review correspondence from Nationwide InsurancD Co. re: incident of 11/27/98 and settlement 03/03/99 DER Letter Dent to P. Greene 03/03/99 DER Telephone conference with P. Greene 03/03/99 DER Letter to clients 03/03/99 DER Telephone conference with P. Greene 03/04/99 DER Letter to Hari. Hammill, M.D. requesting medical information re: Michael 03/04/99 DER Letter to clients is settlement 03/04/99 DER Telephone conference with J. Garvin of State Farm D3/09/99 DER Letter to P. Greene at Nationwide 03/09/99 DER Review correspondence from P. Greene at Nationwide 03/10/99 DER Review note from Mrs. Chessey re: additional medical bile from child psychiartrist 03/12/99 DER Telephone conterence with D. Brown 03/23/99 DER Letter to P. Greene re: psychological records of client 03/25/99 DER Review facsimile from Nationwide Ins. regarding the declaration page for Respondent 03/25/99 DER Review facsimile from Nationwide Ins, regarding the declaration page for Respondent 03/26/99 DER Review facsimile from FES re proposed structured settlement offers 03/26/99 DER Reviewed letter from P. Greene 03/31/99 DER Reviewed letter from P. Greene 04/01/99 DER Review Affidavit of Insurance Coverage regarding Respondent 04/01/99 DER Correspondence to client with settlement offers 04/05/99 DER Telephone conference with clients 04/05/99 DER Telephone conference with Client 04/07/99 DER Follow-up letter sent to Dr. Hammill re: medical record of Michael 04/12/99 DER Telephone conference with client 04/18/99 DER Letter to P. Greene at Nationwide Ins. 04/19/99 DER Letter to P. Greene at Nationwide enclosing psychiatric evaluation and treatment summary of Michael 04/19/99 DER Letter to B. Smith at State Farm submitting medical bills as first party benefits carrier 04/19/99 DER Letter to P. Genre at Nationwide enclosing copies of medical records - Michael 04/19/99 DER Letter to P. Greene at Nationwide 04/20/99 DER Letter sent to clients regarding payment of medical bills for Michael 04/20/99 DER Letter to B. Smith at State Farm 04/20/99 DER Letter to clients re accident of 11/27/98 04/27/99 DER Letter to Clients regarding status report 04/30/99 DER Telephone conference with cl_euts 05/04/99 DER Telephone conference with P. Greene 05/11/99 DHR Telephone conference wit hP. Greene 05/12/99 DER Telephone conference with client 05/14/99 DER Letter to J. Garvin at State Farm re coverage 05/14/99 DER Telephone conference with P. Greene PAGE 3 CONTINUED DER 03/03/99 .2n 225 45,00 DER 03/03/99 .20 225 45.00 DER 03/03/99 .30 225 67.50 • DER 03/03/99 .20 225 45.00 DER 03/03/99 .20 225 45.00 • DER 03/04/99 .20 225 45.00 • DER 03/04/99 .20 225 45.00 • DER 03/04/99 .30 225 67.50 DER 03/09/99 .20 225 45.00 DER 03/09/99 .30 225 67.50 DER 03/10/99 .20 225 45.00 DER 03/12/99 .20 225 45.00 DER 03/23/99 .20 225 45.00 DER 03/25/99 .30 225 67.50 • DER 03/25/99 .30 225 67.50 DER 03/26/99 .20 225 45.00 DHR 03/26/99 .20 225 45.00 DER 03/31/99 .20 225 45.00 DER 04/01/99 .20 225 45.00 DER 04/01/99 .20 225 45.00 DER 04/05/99 .30 225 67.S0 • DER 04/05/99 .30 225 67.50 DHR. 04/07/99 .20 225 45.00 DER 04/12/99 .30 225 67.50 DER 04/18/99 .20 225 45.00 DER 04/19/99 .20 225 45.00 DHR 04/19/99 .20 225 45.00 SAAR 04/19/99 .20 225 45.00 DER 04/19/99 .20 225 45.00 DER 04/20/99 .20 225 45.00 DER 04/20/99 .20 225 45.00 DER 04/20/99 .20 225 45.00 DER 04/27/99 .30 225 67.50 DHR 04/30/99 225 67.50 DHR. 05/04/99 2G 225 45.00 • DER 05/11/99 fn 225 67.50 DHR 05/12/99 .30 225 67.50 DER 05/14/99 .30 225 67.50 DHR 05/14/99 .20 225 45.00 MICHAEL CHESSF.Y Bill number 203527-00000-007 DHR PAGE 4 CONTINUED , 05/19/99 DHR Letter sent to B. Smith at State Farm r0 medical bills as fleet party benefice carrier DHR , 05/19/99 20 225 4S.00 05/19/99 DHR Letter sent to S. Smith at State Farm a medical bills as first party benefits carrier ONE , 05/19/99 .20 225 45.00 05/25/99 DHR Review correspondence from B. Smith of State Farm 06/01/99 DER Letter to P. Greene at Nationwide Inn. tie Michael's ongoing treatment DHR DHR , 05/25/99 06/01/99 .20 20 225 225 45.00 45.00 06/01/99 DHR Letter to P. Greene at Nationwide enclo:nng copies of medical records - Michael DIIR 06/01/99 .-i. 225 45.00 06/01/99 DHR Receipt and review of medical record. and billing information from Maria Hammill, M.D. DHR 06/01/99 5U 225 112.50 06/02/99 DHR 06/10/99 DHR Letter to clients re: incident of 11/27/98 Review correspondence from clients re: 11/29/98 incident DHR CUR 06/02/99 06/10/99 60 .20 225 225 135.00 45.00 06/10/99 DHR Letter to Dr. Hammill - payment for medical records DHR 06/10/99 .20 225 45.00 06/14/99 DHR 06/17/99 DHR 06/28/99 DHR Letter to P. Greene at Nationwide Letter to B. Smith at State Farm Review facsimile re: ratings of Nationwide Ins. Co. regarding Settlement for Michael DHR DER DHR 06/14/99 06/17/99 06/26/99 .20 .20 .50 225 225 225 45.00 45.00 112.50 06/28/99 DHR 06/28/99 DHR 06/28/99 DHR 06/28/99 DER 06/29/99 DER Review correspondence from A. ShellswicY. Draft Petition - Minor's Compromise Action Telephone conference with client Telephone conference with P. Greene Letter to M/M Chesney regarding proposed DHR DHR DHR SHE • DHR 06/28/99 06/20/99 06/28/99 06/28/99 06/29/99 .20 2.00 .30 .20 2U 225 225 225 225 225 45.00 450.00 67.50 45.00 45.00 structured settlement for Michael 07/12/99 DHR Letter to clients regarding settlement/annuity information for Michael OHR , 07/12/99 .20 225 45.00 07/12/99 DHR 07/29/99 DHR 07/29/99 DHR Review Petition - Minor's Compromise Review facsimile from FSS Review facsimile from FSS re: structured DHR DHR • DHR 07/12/99 07/29/99 07/29/99 1.00 .50 5o 225 225 225 225.00 112.50 112.50 settlement for Michael , 09/30/99 DHR Letter sent to FSS re: proposed structured settlement for Michael DHR , 07/30/99 .10 225 67.50 08103199 DHR Letter to M/M Chesney regarding the proposed Petition for Leave of Compromise Minor's Action DER 06/03/99 .20 225 45.00 06/11/99 DHR Letter to Prothonotary to file Petition for Leave DHR 08/11/99 .20 225 45.00 to Compromise Minor's Action 08/16/99 DHR 08/18/99 DHR Review Order from Judge Guido Letter to clients re: hearing DER DHR 06/16/99 08/18/99 .30 .26 225 225 67.50 45.00 Total fees for this matter G 81336.25 37.05 8336.25 DISBURSEMENTS 01/06/99 01/27/99 08/10/99 08/27/99 08/27/99 08/27/99 00/29/99 08/27/99 Recordex Services Inc Hershey Medical Center Froth of Cumberland County Document Reproduction Document Reproduction Postage Costs Postage Costs Long Distance Telephone Chaigs0 21.78 15.00 45.50 6.40 42.00 4.21 3.95 1.R1 5424 5242 1CUM COPY [SI POS POST TELE 01/06/99 01/27/99 06/10/99 summary summary summary summary nummary 21.78 15.OD 45.50 6.40 42.00 4.23 3.95 1.81 Total disbursements for this matter $ 190.69 • 190.69 MICHAEL CHESSEY Bill numb,, 203527-00000.007 ONE BILLING SUMMARY Total Fee, Total Disbursement, TOTAL CHARGES FOR THIS BILL PAGE 5 CONTINUED • PUP 37.05 225 8336.25 S. 336.25 37.05 8336.25 ICUM 45.50 • 5242 15.00 • 5.424 21.78 COPT 6.40 ISI 42.00 POS 4.23 POST 3.95 TELE 1.81 140,67 140.67 8,476.92 8476.92 ,N v I ? ? Q O P _y J Q , n - ^ 00 8 N M M Q xCp6M Y O M N ? w b2 F em. ve U Q = u.. UL 1 3 lyn. ,l , MICHAEL CHESSEY, a minor, by and through his natural parents and guardians SHANE M. CHESSEY & MARY E. CHESSEY, Petitioners V. GEORGE R. PIERCE, JR. Respondent : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA NO. MINOR'S COMPROMISE CIVIL, ACTION - LAW ORDER AND NOW, this 36 day of ? 1999, upon consideration of the foregoing Petition, e--1w?t's Cat : G-x 1? IT IS HEREBY ORDERED that the disbursement of funds, as well as counsel fees and expenses, are approved as set forth in said Petition and shall be disbursed in accordance with the terms and conditions of the settlement agreement as follows: A. attorney's fees and $113.41, for reimbursement of costs; B. Direct payment of the balance of$1,971.00 to be placed in an account investing only in securities guaranteed by the United States government or a Federal governmental agency managed by responsible financial institutions, bearing the name ofPetitioner, Michael Chessey, that is marked "Not to be withdrawn until minor reaches the age of 18 or without the Order of a Court of Competent jurisdiction." Proof of Deposit to be filed with the Court. C. Direct payment of$16,667.00 into a Structured Settlement for the benefit ofMchael Chessey, wherein $7,280.00 is to be paid per year beginning on August 14, 2007 for 4 years through and including August 14, 2010. Direct payment of $6,250.00 to David HRosenberg, Esquire, representing reasonable BY THE COU : MICHAEL CHESSEY, a minor, by and through his natural parents and guardians SHANE M. CHESSEY & MARY E. CHESSEY, Petitioners : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA :NO. ? f- 11576 id TL,.. v. MINOR'S COMPROMISE GEORGE R. PIERCE, JR. Respondent : CIVIL ACTION - LAW PETITION FOR LEAVE TO COMPROMISE MINOR' A ON Pursuant to Pennsylvania Rule of Civil Procedure No. 2039, Shane M. Chessey and MaryE. Chessey, the natural parents and legal guardians of minor, Michael Chessey, by their attorney, David HRosenberg, Esquire, ofHANDLER, HENNING& ROSENBERG, petition this Honorable Court to enter an Order permitting settlement and compromise of this action, and, in support avers: 1. Michael Chessey was born on August 14, 1989, and is, therefore, nine (9) years old and a minor, and was, at the time ofthis collision, residing at 9763 Lady Slipper Court, Apt. B-1 Ground, Laurel, Howard County, Maryland 20723. 2. Petitioners, Shane M. Chessey and Mary E. Chessey, adult individuals, are said minor's natural parents and legal guardians, and currently resides with their son at 6 Fieldstone Court, Pittsburgh, Pennsylvania 15239. I it 7 T 3. Respondent, George R. Pierce, Jr., is an adult individual residing at 310 Market Street, P.O. Box 717, Dauphin, Dauphin County, Pennsylvania 17018. 4. On or about November 27,1998, Petitioner, Michael Chessey, was a passenger in a vehicle operated by Mary E. Chessey. The vehicle was stopped in the southbound lane of Williams Grove Road in Monroe Township, Cumberland County, Pennsylvania, when Respondent, George R. Pierce, Jr., failed to observe the stopped Chessey vehicle and collided with the rear end of the Chessey vehicle. 5. As a direct and proximate result of the collision, Petitioner, Michael Chessey, suffered from post traumatic stress disorder and bereavement, due to the death of his younger brother resulting from the collision. He was taken from the scene via ambulance to the Hershey Medical Center. 6. The minor child continues to receive psychological counseling. (See, attached as Exhibit "A", the Psychiatric Evaluation and Treatment Summary.) 7. To date, Petitioner's first-party insurance carrier, State Farm Insurance Company, has paid for all of Petitioner's medical bills. 8. Respondent's vehicle was insured under a policy of motor vehicle insurance issued by Nationwide Insurance Company. Said policy was in effect at the time of the collision. 9. Nationwide Insurance Company has offered to settle said minor's claim for twenty-five thousand dollars ($25,000.00). 10. The settlement provides payment of $6,250.00 up front for attorney's fees and expenses and other disbursements with the balance to be placed in a trust for the minor's benefit. The settlement further provides that $16,667.00 be placed into a structured settlement which provides 2 periodic payments to be available for the minor and to be distributed according to the following schedule: Seven Thousand Two Hundred Eighty Dollars ($7,280) on or about August 14, 2007. Seven Thousand Two Hundred Eighty Dollars ($7,280) on or about August 14, 2008. Seven Thousand Two Hundred Eighty Dollars ($7,280) on or about August 14, 2009. Seven Thousand Two Hundred Eighty Dollars ($7,280) on or about August 14, 2010. 11. Petitioners believe said settlement is in the best interest of the minor and propose to accept said settlement offer of $25,000.00 from Nationwide Insurance Company, thereby releasing Respondent from any and all claims, suits, and/or actions in the future. (See, attached as Exhibit "B", the proposed settlement release.) 12. David HRosenberg, Esquire, of HANDLER, HENNING & ROSENBERG, has been the attorney for the minor in this action and he requests reasonable counsel fees of (25%) $6,250.00 for services rendered plus costs and expenses of $113.41 pursuant to a Contingent Fee Agreement signed by Petitioners. The 25% represents a reduction from the 33-1/3% fee agreement signed by the Petitioners for Mchael Chessey. Thus, the total amount requested for attorney's fees and costs is $6,363.41. (See, attached as Exhibit "C", a true copy of the billing summary.) 13. Petitioners further request this Honorable Court to order a payment of the balance of $1,971.00 to be placed in an account investing only in securities guaranteed by the United States government or a Federal governmental agency managed by responsible financial institutions, bearing the name of Petitioner, Mchael Chessey, that is marked "Not to be withdrawn until minor reaches the age of 18 or without the Order of a Court of Competent jurisdiction." 14. Petitioners, Shane M. Chessey and Mary E. Chessey, believe that this Compromise is in the best interest of their minor son, Michael Chessey. WHEREFORE, Petitioners request this Honorable Court to: a. Approve the Compromise above-stated; b. Authorize the payment of fees above-stated from funds due the minor; and c. Direct payment of the net funds due, in accordance with the Compromise above-stated. Respectfully submitted, DATE: Y / / 9 c! j6hainor's comp(chemey.m HANDLER, HENNING & ROSENBERG BY: IA- David H R senberg, Esquire I.D. No. 210569 319 Market Street P.O. Box 1177 Harrisburg, PA 17108 (717) 238-2000 Attorney for Petitioners ?1. VERIFICATION We, Shane M. Chessey and Mary E. Chessey, verify that the statements contained in the foregoing document are true and correct to the best of our knowledge, information and belief. We understand that false statements contained therein are made subject to the penalties of 18 Pa. C. S. §4904 relating to unsworn falsification to authorities. Dated: Dated: F/- /0 Shane M. Chessey Mary E. essay Exhibit "A" ADAM M. ROTH, M.D. FAMILY AND CHILD CENTERS JOSEPHIVI'ATeDEN.) iAL Board Certified Adult & Child Psychiatrists AMID TREATMENT SUMMARY Patient: Michael Chessey Date of Birth: 8-14-89 Dates of Evaluation: 2-5-99, 2-23-99, and 3-12-99 Referral Source: Dr. Dan Glazer Informants: Michael and his parents, Shane and Mary Chessey Home Address: 9763 Lady Slipper Court, #1B Laurel, Maryland 20703 SSN: 216-25-1545 Identifying and Reason for Referral: Michael is a 9 year old boy who was accompanied by his parents for psychiatric evaluation because of excessive fear of elevators and storms and being in the car. This is his first psychiatric evaluation. Historyof the Present illness: Michael and his 19 month old baby brother, Colby, and his parents, were visiting relatives in Harrisburg, Pennsylvania during the 1998 Thanksgiving Holiday when they were involved in a motor vehicle accident which resulted in the death of Colby. Michaels father sustained shoulder and pectoral muscle injuries and Michaelis mother had a fracture of her knee. They were treated at the hospital in Pennsylvania and this happened the day after Thanksgiving of 1998. Although Michael was previously diagnosed with Attention Deficit Hyperactivity Disorder in kindergarten and has been treated with Dexedrine for the last two years his parents did not report that he had excessive fears or anxiety about a lot of things prior to the car accident. He has always been an A/B student in school. Since November of 1998 he has been afraid of playing outside when it is raining and he is afraid of elevators and storms. When he is riding in the car he gets extremely anxious and wants everybody to be careful and needs frequent reassurance. He is afraid that a natural disaster might hit their house such as a tree falling on the house. He denies fears of fire trucks or ambulances and he does not have any nightmares. He always tells his parents to be careful when they are in the car. The family bought a truck since the accident and Michael wants to be reassured that the car is safe. He has no problems with sleep and appetite. 700 OLD LINE CENTRE 7474 GREENWAY CENTER DRIVE 10403 HOSPITAL DRIVE SUITE 308 SUITE 730 SUITE G-06 WALDORF, MD 20602 GREENBELT, MD 20770 CLINTON, MD 20735 301-870-5003 301-982.3437 301.856-6000 200 HOSPITAL DRIVE SUITE 115 GLEN BURNIE, MD 21061 410.768-8286 Psychological Evaluation and Treatment Summary n Michael Chessey ,?lfC??', Page 2 Pacer pgy_h;arri at=: He has never been hospitalized for psychiatric reasons. He was treated by his pediatrician for ADHD and was initially tried on Ritalin but this was discontinued as it made him be like a "zombie." For the last two years he has been on Dexedrine 15mg in the morning and 10mg at noon. He does not always need the 10mg at noon depending on the amount of work that he needs to do. and -o Ial H+s ory: His parents have been married for over 10 years. His only sibling was Colby who he was extremely fond of. Michaels mother stayed home to take care of the children. Michaels father works for the U.S. Secret Service. There is no reported physical or sexual abuse and the family environment is reportedly stable. He has been a good student and he is currently in the 4th grade at Forest Ridge Elementary School where he is an A/B student. The family medical history is significant for anxiety attacks, ADHD, and depression. Medical History: He has no known drug allergies. His developmental milestones were on time. He has no history of any surgery, head trauma, loss of consciousness, or seizures. His pediatrician is Dr. Dan Glaser. He is allergic to cats. He was hospitalized once for pneumonia. He has no known heart disease and no bowl or bladder problems reported at this time. Birth and Devel jamtal H's orv: He was born prematurely by c-section with a birth weight of 6 pounds 2 ounces with slight breathing problems. He spoke his first words at 11 months and walked independently at 10 months. He was toilet trained by 3-1/2 years. He had Hyaline Membrane Disease at birth due to prematurity. t al Status NEXaMIMALUM: Michael is a thin, well developed, sad, tearful and scared 9 year old who wanted both his parents in the room during the initial interview. He was clinging to his parents and was avoiding eye contact. He look extremely depressed and anxious with normal rate, tone, and volume of speech. His affect was full range and he was crying throughout the initial interview. He was alert and oriented times three. He expressed fear of airplanes, elevators, bugs and storms. His thoughts were generally logical. Pa chol r?!17/ y,. Y ogical Evaluation and Treatment Summary ^,+ Michael Chesaey •? Page 3 + He expressed grief over his brotherIs death and was reporting that he and his parents miss him very much. He denied any thoughts of harming himself or others and there was no evidence of a formal thought disorder. He denies any delusions or hallucinations. His insight and his judgment was good. M a nr rm,rae: The patient was seen for follow-up on 2-23-99 and 3-12-99. They missed their appointment on March 29, 1999 because he was sick and another time because of conflict in their schedule. Michael was initially started in outpatient individual and family therapy. He was expressing a lot of grief and bereavement issues over his brother's death and the accident. During the subsequent visits he was more relaxed although he was still reluctant to use the elevators although he agreed to take it either going up or going down. He was excited about the snow and that would allow him to stay home. He likes to talk about other things other than the tragic accident. He was allowed to pursue any topic of conversation that he prefers. He talks about gymnastics and that he is keeping up with his school work. He claims that he is dealing with his fear of bugs by buying a bug carnival kit which he can put bugs in and play with them in a controlled setting. He was generally well groomed and he was more confident and not as tearful in the subsequent visits. He reported being nervous of elevators and that recently on the news he heard about a tree falling in the street during an ice storm and that he worries about it still. He still thinks about Colby a lot but sometimes he believes he is in a good place now. His father reports that he has ongoing defiant behavior in doing his homework and keeping up with his house chores. He is feeling more confident about riding in the van. He described the van to me in great detail stating that there is a rail in the front that protects them and that it is a 4-wheel drive so it is safe during bad weather. He said that since his dad is home a lot more he feels better because his dad makes him feel safe. He is excited about the possibility of their moving to Pennsylvania when he completes school this June. He says that he will be close to his cousins and other relatives and that will be able to play with them. He also reports how he wrote a letter to the Tooth Fairy asking how his brother Colby is doing and he received a letter saying that an angel saw Colby and that Colby is happy where he is and that he has a lot of toys and that made Michael feel good. Psychological Evaluation and Treatment Summary Michael Chessey Page 4 He reports not feeling as anxious or as worried as before even with the recent onset of bad weather. He was looking forward to Colby's birthday on April 3rd in which the family is planning to have a little celebration with relatives. He said he still cries easily but not as often as before. Axis I: Acute Stress Disorder vs. Post-Traumatic Stress Disorder. Attention Deficit Hyperactivity Disorder. Generalized Anxiety Disorder. Grief and Bereavement. Axis II: Deferred. Axis IV: Problems with primary support, social environment problems, and educational problems referring to occasional refusal to go to school. Axis V: Present 50; Past Over 70 Recommendations: 1. Review his medical and school records 2. Individual therapy to help deal with the loss of a brother and address his excessive fears and phobias as well as help with his attention and school difficulties. 3. Family therapy to help the family deal with the tragic incident and cope with ongoing medical problems. 4. Continue with Dexedrine 15mg in the morning, 10mg at noon. This is prescribed by Dr. Glaser, his pediatrician. Psychological Evaluation and Treatment Summary Michael Chessey Page 5 5. Closely monitor for significant changes in mood and behavior and ongoing monitoring for medication such as antidepressants or antiaxiety agents. Maria C. Hasmnill, M.D. Exhibit "B" RELEASE AND SETTLEMENT AGREEMENT This Release and Settlement Agreement ("Agreement") is made and entered into among Michael Chessey, a minor, by his parents and natural guardians, Shane Chessey and Mary Chessey; George Pierce, Sr. and Patricia Pierce, individually and as husband and wife and George Pierce, Jr.; and Nationwide Mutual Insurance Company ("the Parties"). The "Claimant" shall collectively mean Michael Chessey, a minor, by his parents and natural guardians, Shane Chessey, their respective heirs, executors, administrators, personal representatives, successors and assigns; the "Insured" shall collectively mean George Pierce, Sr. and Patricia Pierce, individually and as husband and wife and George Pierce, Jr.; and the "Insurance Company" shall mean Nationwide Mutual Insurance Company. 1. RECITALS A. On or about November 27, 1998, at or near the intersection of Williams Grove Road and Fisher Road, Monroe Township, Cumberland County, Pennsylvania, Michael Chessey claims to have sustained physical injuries as a result of the alleged conduct of the Insured (the "Incident"). In connection with the Incident, the Claimant has asserted a claim against the Insured based upon tort or tort type claims. B. The Insurance Company and the Insured have entered into a liability insurance contract which provides that the Insurance Company shall defend the Insured against any claim or suit for damages arising from the Incident, has authority to settle any such claim or suit on behalf of and as agent for the Insured, and shall insure the Insured for such liability subject to the limits set forth in the contract. C. The Parties desire to enter into this Agreement to provide, among other things, for considerations in full settlement and discharge of all claims and actions of the Claimant for damages which allegedly arose out of or due to the Incident, on the terms and conditions set forth in this Agreement. NOW, THEREFORE, it is agreed as follows: II. RELEASE A. Release and Discharge. In consideration of the cash payment(s) referred to in Paragraph III.A. and the promise to make the periodic payments referred to in Paragraph III.B. ("Periodic Payments"), the Claimant hereby completely releases and forever discharges the Insured, the Insurance Company, and any and all other persons, firms, or corporations from any and all past, present, or future claims, demands, actions, damages, costs, expenses, loss of services, and causes of action of any kind or character, whether based on tort, contract, or other theory of recovery, whether known or unknown, which have arisen in the past or which may arise in the future, whether directly or indirectly, caused by, connected with or resulting from the Incident. This release and discharge shall be a fully binding and complete settlement among all Parties to this Agreement, and their heirs, assigns, and successors. 2 The Claimant acknowledges and agrees that this release and discharge is a general release. The Claimant expressly waives and assumes the risk of any and all claims for damages and expenses which exist as of this date, but of which the Claimant does not know or suspect to exist, whether through ignorance, oversight, error, negligence, or otherwise, and which, if known, would materially affect the Claimant's decision to enter into this Agreement. The Claimant further agrees that the Claimant has accepted the considerations set forth in Paragraphs III. A. and B. as a complete compromise of matters involving disputed issues of law and fact. The Claimant assumes the risk that the facts or law may be other than the Claimant believes. It is understood and agreed to by the Parties that this settlement is a compromise of a doubtful and disputed claim, and the payments are not to be construed as an admission of liability on the part of the Insured, by whom liability is expressly denied. B. Injuries Known and Unknown. The Claimant fully understands that the Claimant may have suffered personal injuries that are unknown to the Claimant at present and that unknown complications of present known injuries may arise, develop or be discovered in the future, including, but not limited to, subsequent death or disability. The Claimant acknowledges that the consideration received under this Agreement is intended to and does release and discharge the Insured and the Insurance Company from any claims for, or consequences arising from, the injuries which allegedly arose from the Incident; and the Claimant hereby waives any rights to assert in the future any claims not now known or suspected even though, if such claims were known, such knowledge would materially affect the terms of this Agreement. C. Parties Released. This release and discharge shall also apply to the Insured's and the Insurance Company's past, present, and future officers, directors, stockholders, attorneys, 3 agents, servants, representatives, employees, subsidiaries, affiliates, reinsurers, partners, predecessors and successors in interest, heirs, executors, personal representatives, and assigns and all other persons, firms or corporations with whom any of the former have been, are now, or may hereafter be affiliated. III. PAYMENTS TO CLAIMANT PAYEE AND/OR BENEFICIARY A. Payment at Settlement (and Amounts Previously Paid). The Insurance Company and the Insured have paid Eight Thousand Three Hundred Thirty Three Dollars ($8,333) to the Claimant, and Claimant's counsel, David Rosenberg, receipt of which is acknowledged. This includes, but is not limited to, all out of pocket expenses, attorney fees, all medical liens, all rights of recovery, all medical subrogation claims, all worker compensation subrogation claims, known and unknown, and claims for general damages. B. Periodic Payments. The Insurance Company, on behalf of the Insured, agrees to pay or cause to be paid the following Periodic Payments: (1) To Michael Chessey ("Payee"), the following guaranteed lump sum payments: Seven Thousand Two Hundred Eighty Dollars ($7,280) on or about August 14, 2007. Seven Thousand Two Hundred Eighty Dollars ($7,280) on or about August 14, 2008. Seven Thousand Two Hundred Eighty Dollars ($7,280) on or about August 14, 2009. Seven Thousand Two Hundred Eighty Dollars ($7,280) on or about August 14, 2010. 4 (2) Should Michael Chessey die before August 14, 2010, then any remaining guaranteed Periodic Payments set forth in Subparagraph I11.B.(1) shall instead be paid, subject to the provisions of Subparagraph III.B.(3) below, as they become due, to the estate of Michael Chessey ('Beneficiary"), with the last payment to be made on or about August 14, 2010. (3) The Payee shall have the right, after reaching the age of majority, to submit a request to change the Beneficiary by filing a written request with the owner of the Annuity Contract. The change will be effective when approved by both the owner of the Annuity Contract and the Annuity Issuer. Any change in the Beneficiary shall not in any way affect or alter any of the provisions of this Agreement. IV. RESPONSIBILITY AND FUNDING FOR FUTURE PERIODIC PAYMENTS A. Responsibility for Payments. The Parties understand and agree that the Insurance Company will be directly and solely responsible for making all future Periodic Payments set forth in Paragraph III.B. of this Agreement. B. Annuity Funding. The Parties understand and agree that the Insurance Company may fund its obligation to make the Periodic Payments by purchasing an annuity contract (the "Annuity Contract") from Nationwide Life Insurance Company (the "Annuity Issuer"). If such Annuity Contract is purchased, the Insurance Company shall be the owner of the Annuity Contract and shall have and retain all rights of ownership in the Annuity Contract. 5 For its own convenience, the Insurance Company may direct the Annuity Issuer to make all the Periodic Payments directly to the respective Payees and/or Beneficiaries designated in Paragraph III. B. Each Payee and Beneficiary designated in Paragraph III.B. shall be responsible for maintaining his current mailing address with the Annuity Issuer. The obligation to make each Periodic Payment shall be fully discharged upon the mailing of a valid check or electronic funds transfer in the amount of such payment on or before the due date to the last address on record for the Payee or Beneficiary with the Annuity Issuer. If the Payee or Beneficiary notifies the Insurance Company that any check or electronic funds transfer was not received, the Insurance Company shall direct the Annuity Issuer to initiate a stop payment action and, upon confirmation that such check was not previously negotiated or electronic funds transfer deposited, shall have the Annuity Issuer process a replacement payment. C. Status of Claimant. Payees, and Beneficiaries. The Claimant, each Payee and each Beneficiary, as applicable, shall, at all times, remain a general creditor of the Insurance Company and shall have no rights in the Annuity Contract nor in any other assets of the Insurance Company. The Insurance Company shall not be required to set aside sufficient assets or secure its obligation to the Claimant, each Payee, or each Beneficiary, in any manner whatsoever. V. NO CHANGES IN PERIODIC PAYMENTS The Claimant acknowledges and agrees that all, some, or any part of the Periodic Payments cannot be accelerated, commuted, transferred, deferred, increased or decreased by the 6 Claimant or by any Payee or Beneficiary and that the Claimant or any Payee or Beneficiary shall not have the power to sell, mortgage, encumber, or otherwise anticipate all, some, or any part i i of the Periodic Payments by assignment or otherwise. VI. ENTIRE AGREEMENT This Agreement contains the entire agreement between the Claimant, the Insured, and the Insurance Company with regard to the matters set forth in it. There are no other understandings or agreements, verbal or otherwise, in relation to the Agreement, between the Parties except as expressly set forth in it. This Agreement is intended to conform with the requirements of Internal Revenue Code Sections 104(a)(2). All provisions of this Agreement should be construed in a manner so as to effectuate that intent. VII. READING OF AGREEMENT In entering into this Agreement, the Claimant represents that the Claimant has completely read all of its terms and that such terms are fully understood and voluntarily accepted by the Claimant. The Claimant has been represented by counsel of the Claimant's choice. 7 VIII. FUTURE COOPERATION All Parties agree to cooperate fully, to execute any and all supplementary documents, and to take all additional actions that may be necessary or appropriate to give full force and effect to the terms and intent of this Agreement which are not inconsistent with its terms. IX. DRAFTING OF DOCUMENT AND RELIANCE BY CLAIMANT This Agreement has been negotiated by the respective Parties through counsel. The Parties to this Agreement contemplate and intend that all payments set forth in Section III constitute damages received on account of personal injuries or sickness, arising from the Incident, within the meaning of Section 104(a)(2) of the Internal Revenue Code of 1986, as amended. However, the Claimant warrants, represents, and agrees that the Claimant is not relying on the advice of the Insured, the Insurance Company, anyone associated with them, including their attorneys and the insurance broker placing the Annuity Contract, as to the legal and income tax or other consequences of any kind arising out of this Agreement. Accordingly, the Claimant hereby releases and holds harmless the Insured, the Insurance Company, and any and all counsel or consultants for the Insured and the Insurance Company from any claim, cause of action, or other rights of any kind which the Claimant may assert because the legal, income tax or other consequences of this Agreement are other than those anticipated by the Claimant. The Parties signing this Agreement, and each of them, warrant and represent that no promise, inducement or agreement not expressed in this Agreement has been made to them and 8 that this Agreement constitutes the entire agreement between the Parties and that the terms of this Agreement are contractual and not mere recitals. The Claimant represents and agrees that the Claimant has read the Agreement and fully understands it, and has been advised by counsel of the Claimant's own choosing as to the propriety and legal effect of executing it, and neither the Agreement nor the compromise and settlement recited in it were induced by fraud, coercion, compulsion or mistake, nor is this Agreement nor the compromise and settlement made in reliance upon any statement or representation of any of the Parties released by this Agreement, or their representatives, agents or attorneys. X. WARRANTY OF CAPACITY TO EXECUTE AGREEMENT The Claimant represents and warrants that, with the exception of contingency fee contracts and any agreements which may exist between the Claimant and the Claimant's counsel relative to the reimbursement of litigation expenses, no other person or entity has, or has had, any interest in the claims, demands, obligations, or causes of action referred to in this Agreement, and that the Claimant has the sole right and exclusive authority to execute this Agreement and receive the sums specified in it and that the Claimant has not sold, assigned, transferred, conveyed or otherwise disposed of any of the claims, demands, obligations or causes of action referred to in this Agreement. 9 ,. . XI. COURT APPROVAL The Parties agree that the Claimant will file petitions for all necessary court approvals, that all such petitions and orders shall be in a form satisfactory to all Parties, and that this Agreement will not be effective until such approvals have been obtained. XII. CONTROLLING LAW This Agreement shall be construed and interpreted in accordance with the laws of the Commonwealth of Pennsylvania. Dated: Dated: Dated: Approved as to Form and Content: Dated: Shane Chessey, as parent and natural guardian of Michael Chessey, a minor, Claimant Mary Chessey, as parent and natural guardian of Michael Chessey, a minor, Claimant Duly Authorized Representative for Nationwide Mutual Insurance Company David Rosenberg, Counsel for Claimant APPLICABLE TO PENNS17LVANIA ONLY: For your protection, Pennsylvania requires the following to appear on this form: 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 such person to criminal and civil penalties. 10 I I • II Exhibit "C" HANDLER, HENNING 6 ROSENBERG August 11, 1999 Billed through 08/11/99 Bill number 203527-00000-005 DHR MICHAEL CHESSEY 9763 LADY SLIPPER COURT LAUREL, MD 20723 • billing timekeeper Onvid H Rosenberg • date of last bill date of last reminder • last bill through date • bill type code S-4 • action to be taken 0-hold entire bill 3-summary fees and axp 1•a/r reminder 4-bill tees and exp 2-bill exps, hold tree 5-summary fees/detail a • current .00 • 30 tlays .00 • 60 day. .00 • 90 days .00 • 120 day. ,00 • billing frequency A-12 • last payment billing realization 0 t • matter 00000 DISBURSEMENTS 01/06/99 Recordex Services Inc 21 .78 5424 01/06/99 21 .78 01/27/99 Hershey Medical Center 15 .00 5242 01/27/99 15 .00 08/10/99 Proth of Cumberland County 45 .50 1CUM 08/10/99 45 .50 08/11/99 Document Reproduction 6 .40 COPY summary 6 .40 08/11/99 Document Reproduction 18 .60 ISI summary 18 .60 08/11/99 Postage Costs 3 .57 POS summary 3 .57 08/11/99 Postage Costs .75 rOST summary .75 08111199 Long Distance Telephone Charges 1 .81 TELE summary 1 .81 Total disbursements for this matter S 113 .41 113 .41 BILLING SUMMARY • 1CUM 45 .50 • 5242 15 .00 • 5424 21 .78 COPY 6 .40 ISI 18 .60 POS 3 .57 POST .75 TELE 1 .81 Total Disbursements 113. 41 113 .41 TOTAL CHARGES FOR THIS BILL + 113. 41 113 .41