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Home My WebLink About03-659102HB-00074 LAW OFFICES OF JACOBS & ASSOCIATES 214 SENATE AVENUE, SUITE 503 CAMP HILL, PA 17011 TELEPHONE NUMBER: (717) 731-0988 ATTORNEY FOR PETITIONER IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA Nationwide Mutual Insurance Company, Petitioner vs. Gloria My Le, Respondent 03 - (. 59/ 1. iu't? l `? PETITION TO APPOINT AN ARBITRATION CHAIRMAN FOR AN UNINSURED MOTORIST CLAIM PURSUANT TO 42 PA.C.S.A. §7305 Petitioner, Nationwide Mutual Automobile Insurance Company is an Ohio Corporation licensed to transact insurance business in the Commonwealth of Pennsylvania, with offices at 1000 Nationwide Drive, Harrisburg, Pennsylvania. 2. Respondent, Gloria My Le, is an adult individual residing at 145 Black Walnut Drive, Etters, Cumberland County, Pennsylvania, 17319. At all times relevant hereto, Respondent was an insured under a policy of motor vehicle insurance issued by your Petitioner pursuant to the Motor Vehicle Financial Responsibility Act, policy number: 58 37 C 787 817, that provides uninsured and underinsured motorist bodily injury coverage. (a true and correct copy of the policy is attached hereto as Exhibit "A" and incorporated herein by reference). 4. This Petition arises from the Respondent's claim for entitlement of uninsured motorist coverage under the policy as a result of a motor vehicle accident that occurred on November 7, 1998. The policy provides for arbitration of disputes under the uninsured or underinsured motorist coverage pursuant to the Pennsylvania Arbitration Act of 1927. 6. The policy further provides that after a written demand for arbitration is made, both parties shall select a competent arbitrator who shall select a third. 7. In the instant case, your Petition has appointed Richard H. Wix, Esquire as its arbitrator and the Respondent has appointed Hershel Lock, Esquire as her arbitrator. 8. The policy further provides that if the third arbitrator is not agreed upon within thirty (30) days, either party may request a Court of record to name one. 9. By letter of June 5, 2002, counsel for the Petitioner suggested Daniel Altland, Esquire or James Goldsmith, Esquire as the chairman of the panel. A true and correct copy of the letter of June 5, 2002 is attached hereto as Exhibit "B" and incorporated herein by reference. Neither Respondent, nor her attorney, have agreed to or declined the appointment of either Attorneys Altland or Goldsmith as the arbitration chairman. 10. The policy further provides that the arbitration shall take place in the County and tate where the insured lives. 11. 42 Pa.C.S.A. §7305 gives the Court the power to appoint an arbitrator pursuant to n agreement to arbitrate, where the prescribed method has failed. WHEREFORE, Petitioner, Nationwide Mutual insurance Company respectfully requests your Honorable Court to appoint an arbitration chairman in the above referenced uninsured motorist proceeding. Respectfully submitted, LAW OFFIC OF JAACOOBBS & ASSOCIATES By: G' E. 'ckards, Esquire Identification No. 58867 Attorney for Petitioner Date: December 24, 2003 NATIONWIDE INSURANCE CENTURY II AUTO POLICY • DECLARATIONS p,jw.m. I. o your Sid* Page 1 of 3 These Declarations are a part of the policy named above, and Identified by policy number below. They supersede any Declarations issued earlier. Your policy g4rovldes the coverages and ylimits shown in the schedule of cverages. The otorists' financial rr spo sibility laws to each of your istate only or-vehicles which Properrtly Damages and with ly m injury Liability coverages are provided. Policy Number: Policyholder: 58 37 C 787817 (Named Insured) Issued: NOV 11, 1998 GLORIA MY LE AND DAVID T DUONG 145 BLACK WALNUT DR ETTERS PA 17319.4491 Policy Period From: OCT 12. 1998 to JAN 11 , 1999 but only If the required premium for this period has been paid. and for six month renewal periods N renewal premiums are paid as required. Each period begins and ends at 12:01 A.M. ??.., ..I.t.nee 11 the nnnrvhrJtfar. Jl6llualu uu to aow avv•v++..•••+-°-,-.__ .- IMPORTANT MESSAGES: WER IYO N PYE URRENT C C E C O POLICYTDECLARATlbt1S998 O A C E UR SED S OF INSURED VEHICLE(S) b SCHEDULE OF COVERAGES 1. 1992 SUBA LEGACY L ID •JF/BC632XNK608598 Six Mont h Coverages Limits Of Liability Premium COMPREHENSIVE ACTUAL CASH VALUE LESS $ 50 ACTUAL CASH VALUE LESS $ 500 S S 29. 64. 10 00 COLLISION PROPERTY DAMAGE LIABILITY S 50.000 EACH OCCURRENCE S 46. 10 BODILY INJURY LIABILITY S 50,000 S 100,000 EACH PERSON EACH OCCURRENCE S 52. 90 UNINSURED MOTORISTS-BODILY INJURY S 50.000 ENDORSEMENT 2359 EACH PERSON S 100,000 EACH OCCURRENCE S 8. 40 UNDERINSURED MOTORISTS-BODILY INJURY S 50,000 ENDORSEMENT 2360 EACH PERSON $ 700,000 EACH S 1 0 LOSS OF USE ENDORSEMENT 2310 4. 7 S 15 PER DAY S 300 PER ACCIDENT TOWING AND LABOR S 50 EACH DISABLEMENT S 1 .80 FIRST PARTY BENEFITS OPTION 1-MEDICAL BENEFIT S 5.000 5 77 .50 FULL TORT TOTAL S 239 .80 Auto-7100 FR AMF- .1 1S CENTURY II AUTO POLICY DECLARATIONS 2 1998 GMC JIMMY ID GIGKDT13W4W2527006 Coverages Limits Of Liability COMPREHENSIVE ACTUAL CASH VALUE LESS S 50 COLLISION ACTUAL CASH VALUE LESS S 500 PROPERTY DAMAGE LIABILITY BODILY INJURY LIABILITY UNINSURED MOTORISTS-BODILY INJURY UNDERINSURED MOTORISTS-BODILY INJURY LOSS OF USE TOWING AND LABOR FIRST PARTY BENEFITS OPTION 1-MEDICAL BENEFIT FULL TORT LIENHOLDER-JEFFERSON BANK 3. 1987 CHEV S10 PICK Coverages COMPREHENSIVE COLLISION PROPERTY DAMAGE LIABILITY BODILY INJURY LIABILITY UNINSURED MOTORISTS-BODILY INJURY UNDERINSURED MOTORISTS-BODILY INJURY LOSS OF USE TOWING AND LABOR FIRST PARTY BENEFITS OPTION 1-MEDICAL BENEFIT FULL TORT S 50,000 EACH OCCURRENCE $ `50,000 EACH PERSON S 00,000 EACH OCCURRENCE ENDORSEMENT 2359 S 50.000 EACH PERSON S 100,000 EACH OCCURRENCE 2360 S 50,000 EACH PERSON S 100,000 (?E EACH ENDORSEMENT 2310 15 P ER ACC S 30 0 IDENT P S 50 EACH DISABLEMENT S 5,000 TOTAL LI EN EXPIRES ON DEC 30, 2003 ID IIGCCS14R7H2120576 Limits 01 Liability ACTUAL CASH VALUE LESS S 50 ACTUAL CASH VALUE LESS S 500 $ 50,000 EACH OCCURRENCE S 50.000 EACH PERSON S 100,000 EACH OCCURRENCE ENDORSEMENT 2359 S 50,000 EACH PERSON $ 100.000 EACH RSEMEN T 2360 ENNDO S 50.000 EACH PERSON S 100.000 EACH OCCURRENCE ENDORSEMENT 2310 1 0 PR AY A E S 30 P R CCIDENT $ 50 EACH DISABLEMENT S 5.000 TOTAL VEHICLE CLASSIFICATIONS- Premium Is Based On: 1992 SUBA 1998 GMC 1987 CHEV USE OF VEHICLE PLEASURE KLLY WEE COOMMUTE COMMMUTE WEEKLLY K MI MI RATED DRIVER ADULT ADULT ADULT PRINCIPAL PRINCIPAL PRINCIPAL MARRIED MARRIED MARRIED APPLIED DISCOUNTS PASSIVE RESTRAINT PASSIVE RESTRAINT MULTI CAR MULTI CAR MULTI CAR ANNIVERSARY ANNIVERSARY ANNIVERSARY HOME & CAR HOME & CAR HOME & CAR SPECIAL RATING SAFE DRIVER SAFE DRIVER SAFE DRIVER FULL TORT FULL TORT FULL TORT Page 2 of 3 Six Month Premium S 56.30 S 94.70 S 49.10 S 48.30 S 7.40 S 15.10 S 4.70 S 1.80 S 12.20 S 289.60 Six Month Premium S 13.70 S 37.70 S 46.10 S 52.90 S 8.40 S 15.30 S 4.70 S 1.80 S 21,80 S 202.40 FRAME: K 15 NATIONWIDE INSURANCE Nnionww* is on your aids Policy Number: 58 37 C 787817 Issued: NOV 11, 1998 CENTURY 11 AUTO POLICY DECLARATIONS Page 3 of 3 Policyholder. (Named Insured) GL?RIA MY LE AND Policy Period From: OCT 12, 1998 TO JAN 11, 1999 Policy Form & Endorsements: AUTO 6000D 2264A 2391 Office Use: 49.90 OCT 14, 1998 S Issued By: NATIONWIDE MUTUAL INSURANCE COMPANY 23787 Home Office - Columbus. Ohio Countersigned At: HARRISBURG. PA. By:G. HARNER LOSS PAYABLE CLAUSE ENDORSEMENT This endorsement applies to the Comprehensive and Collision coverages provided by this policy. It protects the lienholder named in the policy Declarations. PayYment for loss will be made according to the Interest of the policyholder and Ilenholder. Payment may be made to Ph jointly. or to either separately. Eilher way, the company will protect the Interests of both. The Iienholder's Interest will be protected, except from fraud or omissions by the policyholder or the policyholder's representative. If the company cancels or refuses to renew the policy, the Ilenhoider will receive notice at least 10 days before protection of its interest will end. The lienholder shall notify the company upon learning any change in ownership of the vehicle. To the extent of payment to the Iienholder, the company will be entitled to the Ilenholder's rights of recovery The endorsement is Issued by the Nationwide Mutual Insurance Company or Nationwide Mutual Fire Insurance Company. whichever has Issued the policy to which it Is attached. NATIONWIDE MUTUAL INSURANCE COMPANY NATIONWIDE MUTUAL FIRE INSURANCE COMPANY Serrv4ry P",idew FRAME: L 15 POLICY MASTER RECORD PRINTOUT 0 05 pAGE 0/0/0 09A-CPNCELLEO RO 5f RRT: A6LNUn lA`f N?MT: k€A56N: H25TbkIt41: ROD = 9074r END" "' "" - - - - - - - - - - - - - - - - - - - - - - - - - 58 37 C 787817 DUONG MRPO TYPE: 01 DIS MRf WT-GRP MRf-LCC (fN021 1056 TOUN DC TAk Cb-TA)-PrrC17(Hk?PRli FIR€-bfS'r ADDRESS ORIGIN - CUSTOMER BIND DATE/TIME 1 EN -- 7720 _GLEX F_ 1Rl+ER ------------------ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ . J ;1 7 561 0547 %CT IVE ZaRE€R _ _ _ _ _ _ _ _ _ FULL-COMM GLORIA MY LE AND ADA INSTALL DATE 08/13/86 UVI_p T DQONQ _ oafVb _ _ _ _ _ _ _ _ _ _ _ _ CVfTDnE R _ NUnBER R i 800553 1 3-3 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 90 GP GREfNUOOb NEW CUMBERLAND. PA MEDIA 00000000 17070-3019 '.'? ; -.-.- :__ i _i-: w -•-? i- POLICY BFSIC bRT_A t• t t t t t a t t t t t t REN-DT NEXT-PEN OSU-EFF GUAR-PEN ANNL-ANNIV CO SPL-GRP TERM TERM-NUM 07111/01 01/11/02 01/11/94 O1/11/02 CPS SA 016 -95[T _ _ _ _ _ _ _ _ _ _TIER _ _FUf= _ JACKET _ _ _ ACTIJ- _ f`ULL-T€RH _ _ _ _ _ _ RISK HCD FRE IDFR CHNG ISS-NUM/SFX TAKEN PREM WRTN-PREM CRE 0 N O1 N 06000 D 449.10 76.40 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ PPC2LIli FAbf0 _ _ _D 6R _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ k OFF/ LAST CHNG PRIOR/CURR VOL FL HRV PRCT 1 I1/171C00 O8/13//01 PRODUCT NON-REN VRESL-MKT OLUNTARY _ _ _ _ _ DEBT3_DaT€'--'"DEG-"------------ --- LICENSE NUr ----PLAN-CD-- "BIkfH 60 €--- _ 03/22/66 23276974 9 DyCS. _Q.6! L5!QI_ Q5i9V9L 12/j 8/A j I/2900 D80.1 O-06L1-6LQO_ L2 W99 Ora./12/94 - - - - - - - - - - - - - - - - - - - - - - - - VEH REV-TYPE/DATE VEH REV-TYPE/DATE VEH REV-TYPE/DATE P GUEST 10/28/02 I __ - MULTf LNb TH DfHETF Tbkf PURCMRS -----_---LIT'€-bfS'LOUNT"--SMI- "" ----------- - ------ DISCO D6510 DISCO FLAG FLAN VP TR AN HE ELIG _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ FEES 0.00 ._ ._. . _. .. . . • . • yILI II'LG_LNE QRngrj QN i ?: a t?_e_? ----------------------- Y aPV /NUMR€R _ _ pAV P6LICr•" _ MIN AMT DUE NEXT _ At CTfON CARk't PLAN OPTION UNPD-BAL DUE DATE DATE PROCESS DATE REG I 0.00 0.00 00/00/00 08/13/01 yELQ - SuS?ENQ - ;S= OC -NU-h - - CI CLING PCi16N fD _ _ _ _ b€BIT/CRE-DTf - - - ACM NT BILLING 0000 00 0 ___________________________________________".Hbf______________________________ - - - - - - - - - - - - - - - - - - - - - - - - - - --- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - POLICY MASTER RECORD PRINTOUT 04/08/02 09A-CANCELLED PAGE 02 OF 05 3f _ FR_ _ NfiMT:__ P ibaL_ n_rFPb naHTH_ END = PC ' 787917 UONG MP TYPE: 01 SS 37 C 78781% DONG MRP TYPE 01 . . . . . . . - t S _ YEMT CLE_ flA5LC_ QAJ 6 s _ a ! s_ t J ! t a f a t i !_ _ _ _ _ _ _ _ _ _ _ _ _ .. _ _ _ _ _ _ _ _ _ _ _ _ _ N- SIFTPG" RCiE- SUS-Pn QDUCT_ O TYPE/OLFR VEH YR MAKE SERIES IDENTIFICATION • /FLG FLAG -AMT GRP MNUL AUTO PICKUP V2 98 GMC JIMMY IGKDT13W4W2527006 4 - - - - - - - - - - - - - - - --- - - - -- --- - - - - POLICY MASTER RECORO PRINTOUT PAGE 02 OF 09A-CANCELLED ________ _ _ - : H?I$TbfFICAL ROD - MOfiTH EN'b _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ RO- - Si WRFC AOLNUM LAST NAME IIfRS6N _ $8 37 C 787817 DUONG nRPO TYPE: 01 . • • • . • t t_•_. t_. YE4ICLE_lLA5LC_QAJ6!_- `-v?fN? STRT 6 RG$_t) '------------------------ SUP - P'ODUCT- - TYPE /OLFR VEH YR HAKE SERIES IDENTIFICATION • /FLG-FLAG -AMT GRP MNUL AUTO PICKUP V2 98 FMC JIMMY 1GKDT13114u2527006 4 _ _ _FIC ___ __________ _____ D SEI 2 LEN N MC - PHETR- RATE-STH T AHENTIFT- REST PASSR- R L K/FL PIRG U OA IO F FRR / ANSk RL SUR NS UR K 00 AS N 0 cbA _ W SP: TnA _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Of _ _ _ _ VEH _RG1 _ _ _ TNSA _ _ _ _ SUSA_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ , RAic-SYn HP COST NF DAMG PF REG TERM COn CODE/DATE DATE 023 020 029 Y 007 ELIG OS%TIR CLEAN CLb AN LOSS L055 ACC HCb$DIP RV UP DATE FLAG RECOUP ALLOC RECOUP ALLOC 00/00/00 .00 .00 .00 .00 0 N 0 ;, Wk l _____________ • -?-? i• t a i F t t t. Y Z`L0 LAS`SI ?I QN R k i t R t t 1-47 R t t R t WORK WKLY- ANNL NNL CAR VRR- VEH USE nCD SUSCL MILES /DAYS COMUT -MI /DISC UOA EXTD POOL RATE Y26L V-----------------9Q- !9Q09------------------'i-------------------------- ......•.• VEHICLE DRIVER CLASSIFICATION R R t R t t t t t t t t VEH' BIRTH MART- OPR- RATE- RES- CLG-STU RATE YRS ADD DRIV RATE PNS NL.in_DFLTE__SEX_ST R T__ SJ P L f qCT_ LyLDtl!9Q P I_ 6 QPL7 DRTY__QAJE__UJI!SLLRLU------------------------ V? 03122766 n n P 1.10 Y O 11/16/00 1 00 '. ...•. t.. t.•.• DRIVER/ACCIDENT DATA R t R R e t R t t t R t t - - - - - - - - - - - - - - - - - - - - - - - DAY YEH-- - -- DLRIK- -peRItlG--DLCVP - Nlln NUn NAnf - - - - - - - - SEX DATE 6PR CODE 1 2 DAVID T DUONG M 03-22-66 P 02 STC_ - CTC aun - - -- D° REIri --- LU --CASE-----qU- N.G --------------------------- DATE STRT NUM CHILD N PA 23276974 01-05-94 Y A/v aiv_ alv__a/v p/v ----AL/V c ?+qG-EX?__EQRylVStl__F UL.T ---------------------------- Aun - TYPE_ CHRG_ PTS OAfE b45 DATE FLAG FLAG YRS CLG-STU MART SC LICENSE _DUY FLOG----ST9T--RC---QRTE------------------------------------------------------- 9 n j------------------------------------------------------------------------------- DRIV VEH BIRTH PRINC OCCUP - 2 1 GLORIA F, LF ------------- F 0 -04-7Y P - Nll ?.= _ L4 QM- _NM E_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ S_ _ ?qTE _ _ _nPJ_t_ _ _ _Ln02_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _____________ POLICY MASTER RECORD PRINTOUT 04/08/02 09A-CANCELLED PAGE 03 OF 05 RO $T PRE AOINUri IASf NanE IF?ASdN: HZ$TbIFI-C?SL YITPD - 110NTH ENb- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 5S 37 C 787817 DUONG MRPO TYPE: 01 Lu - - n?RIw --CIS __cASE --- -= - - - - - - - - - - - - - - - - - - - - - - - - - - ST LfC NUN DAT TRT NUM M CIF uN PA 23392917 01-05-94 Y ' A/V_ Aiv_ - alb= _A/v _,9/V - - - R/_V CNRG- ACV- EKP_ - EQR.OIvEy - _FRUQT- - - - - - - .. POLICY MASTER RECORD PRINTOUT PAGE 04/08/02 09A-CANCELLED _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ RO Sf FRE P6LNuri LASE T41n? ACAS6N: HZST-OkILAL Yf-D - MONTH ENb 5S 37 C 787817 DUONG MRPO TYPE: 01 -LLC --- ----------- Nvp RF.IK --- LID __USE - -----Qq5= - F' -------------------------- ST LfC Um DATE STAf NUM CHILLS HN PA 23392917 01-05-94 Y P/V_ A/V _ AfV A/V--- /V__-PL/V CVPG-- PLY_Er_ QR5IVEN__VVL_T--------------------------- - Run TY 15 CHkG ai5 _?fE_ VT DATE ` LAG FLAG YRS CLG-STU MART SC LICENSE _DRjy FL gG----S-7 eT_ -RC--- QATE ------------------------------------------------------ v n •••••••.• a• s a VEHICLE COVERAGES s t s s s s t t t t t s s s a VEHICLE V2 98 GMC JIMMY _C4.V=LD---Coll?----DOLL--- PD ----- BI ----- jou----I1I119l---LQU------------------------- DED-AMT So 500 LIMIT 50 501 100 50/ 100 50/ 100 OPT USTACK USTACK D'T. etlT- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ' - - - - - - RATE-FACT 1.10 1.1-0 1.-10" l.lb' MNUL TERR DR LG------2------Z------2------2------Z------Z------Z---------------------- SUR ? SASE-PREM SUR-PREM UlL?ER.M --- 69,t0---1_;39,SP ---9H_1Q---B2.3Q----B.•IQ---19_.52'-- 4.Zo ---------------------- ROLL-ON SCD LCD ____________________________________________________________________ VECCV-I of COV-ID TL nOCL DED-AMT --LZCP`r----------54 Q09--------------------------------------------------------- OPT-AMT ATE-FACT 1.10 =r'.NRe----------------------------------------------------------------------- ORIG 2 2 SUR`. - - - - - - - - - - - - - - - - - - - - _ _ _ _ _ - - - - - - - - - - - - - - - - - - _ _ _ _ _ _ _ A -_p 3 n ____________________ FULL-TERM 1.80 20.60 __.I.U_______________________________________________________________________ TOTAL PREMIUM 449.10 ENDDQSE nENfS • • s t t t a • • t t t a a '. '; -•- ? 7 -•- 7 _• *7 _• _vEHIGLE VEH V2 2310 2359 2360 ____________________________________________________________________________ ___________________________________"________ibf_____________________________ ----------------------`--- .,------------------------------------------------- POLICY MASTER RECORD PRINTOUT 04/08/02 090-CANCELLED PAGE 04 OF 05 Ru- Sr -PRE r''QLNL?Y LASE NRM_E kEA56N: Hl$iDkfCAL MRPD - MONTH ENS " ""' "" - - - - - - - - - - - - - - - - - - _ - 55 37 C 787817 DUONG MRPO TYPE: 01 .__•_•_• • • INgQ 23RI'L Dgrp_ •_: • ! • I!.ALI!_!!!_____ - 'OEH1 ?TMRDRiY fXPfR. - off L BANK Nun NUM/TYPE DATE FLAG PO BOX 15383 V2 1 LIEN 12/30103 Y RICHMOND,VA --- _ - - - --------------RUZZ-5383.____--________------__ _- POLICY MASTER 04/OS/02 RECORD PRINTOUT 090-CANCE LLED PAGE Rj 9 - ITR'E F60NOM LASf NAMY A&SdN: H19TbkICAI A;FF0 - MONTH END- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 59 37 C 787817 DUONG MRPO TYPE: 01 . H T . . __2 HRDFSTY _._. . . EXPfR .Lr1IgQP?RIY DOT.6 ._• S a • I • ! t! * -------------------- - DEC UEFFirRt(TN SANK vE NUM N UM/TYPE DATE FLAG PO BOX-15383 V2 1 LIEN 1 2/30/ 03 Y RICHMOND.VA 383 23222 - - - - - - - - - - - - - - - - - - - - - - - - _ _ _ _ _ _ _ _ - - 5 -----.-------------------------------- . . . . . . • . . . . . • POLICY ENDORSEMENTS • • t a t • t 4 t t 4 t t • ' 2264 A 2391 ___ ____ *7 . _ . . __ . . HISTISR _ _ _ _ _ _ _ _ _ - - _ _ _ __•_•_t __ . _e_a _____________ Y . . . . • r a • • r r t PROC EFF SRC SYS BUS-REQ ADDITIONAL INFO 09/16/01 08/16/01 CBS CBS IRT 78 42 7878171 0;3[13!Ql Qe1L614L CHS_ GBS_ _9CLOUNI--- -----ZZ4.@S-QR-?4bQ0----Q92F-01--------------------------- _ 09/16/01 08/16/01 CBS CBS CREDIT 148.15 CR 9178 08116/01 08/13/01 PIS POL CPN POL RSN 086 IRT INTERIM TERM 08102/01 08/02/01 CBS CBS ACCOUNT 224.55 08 14600 092201 0310_7!Q1_ Q9IQU QI_ C 85_ C95_ _ ACSDUNI --- ----- j.QO_CR_g69QO- ------------------------------- 0 9 -4- 09'02/Ot 08/02/01 CBs CBS JFEN PAY 3 227.55 OB 8100 08/02101 07/11/01 PP POL 449.10 CR 22100 071101 07/16/01 07/16/01 CBS CBS WARNNOT •449.10 071101 073101 05! 15! Q1 Q71L1121_ PP _ POL_ _ _ - - ___149.L0_p-B_Z21QO ___0-71 LOl__________________________- - - _ 06/t5/01 07/11/01 A0 .4 F5bL 6PL6 PEW 06/15/01 06/15/01 CBS CBS DISCOUNTS HCD •O.OOLTD •46.10AOO •22.80 06/15/01 06/15/01 CBS CBS RENEWAL -449.10 05!Q4!Q1_ 0 Q51Q41Q1_ 4 CB5_ BS EES_ CBS _PREtlttl9PGE ITEFUNO ___ctb2.90-- - --------------------------------- 162 80 ER 95'250 4/01 05/ 05/04/01 /01 05/0 05/02/01 C PP POL CAN ENDOR . V2 2357 05/04/01 05/02/01 PP POL CAN ENDOR V2 2358 05/ o4ZQ1 Q1_ QSIQd AQA_ PUL- -CAN VEH -- - VI R.SN 065. 42Dfl2D_626 LVF --------- -------------------- _ 05/04/01 1 05/02/01 ADA POL CHG CLASS V? nCD Y 05/04/01 05/02/01 ADA POL CHG COV V2 UIMBI UIMBI 50000 100000 ADA OPT 29 05 !04!Q1 C51 Q2!Q 1_ ZA- POL CHb_CDY _ _ _ - - _QMBL _ _ _ 50040 _L09Q09- - - - - - - - - - - - - - - - - - - - - - - - - - VO in8 _ P 29 2 05/04/01 05/02/01 ADA POL CHG DRV BASI RIV-NUM 01 NON-DRIV-I N C D1 D ADA EXCL-DRIV N MART-STAT M ADA - -- -- YR -- BRTy-POTE_66ga2z jj1ggL?[[/1 9_SEX -ML C AOR P itES-CHT ED Y V H-NUM 02 PRI NC-6 ADA OPR YR EXP 0 RTN DOC 5 05/04/01 05/02/01 AOA POL CMG POL BASI C DOB 032266 oy!1?!Q1 _Q41L7141_ C9S- EB - S -ACSO4t+I--- NT A -----YiI,fiS_CR_L4bQ0----032101--------------------------- 00 CR 46000 -3 04/;7/01 04 /17/01 04/17/01 04/17/01 CBS CBS CB CBS CCOU PAYMENT . 434.85 DB 81000 849 03/26/01 03/26/01 CBS CBS WARNNOT •434.85 032301 041501 02/UZQ1 _Q21Z81Q_ CS_CB5 INKAI-L1N I --__43y•.BS_-_- _________________________------- x5 9 $ 01/15/0 01/15/01 CBS CBS REN PAY 565.05 (TB 1 04 0 01/15101 01/15/01 CBS CBS ACCOUNT 130.20 CR 14605 111101 011175/01 01/15/01 CBS CBS ACCOUNT 3.00 CR 46000 01/15!QI _Q1115/Q1_ CBS_QS5 PCtOUNI--- ` -----Y3.1.85_0B-L4.6 Q0----032301----------------------- - - - 12716/00 01 / iI /01 AGN POL ALC PEN C 12/1S/00 12/15/00 CES CBS DISCOUNTS MCD •O.OOLTD •86.80AOD•227.90 12/IS/00 12/Igloo CBS CBS RENEWAL •863.70 2 10 / - CB C L?? 0.NG E a U _ - - -1343 - - - - - - - - - - - - - - - - - - - - - - - - - - - 4 - - - - 1 1 1 C 0 1 t 20/0 0 S BS Y T 000 14165 01 7 1 01 0 f0 fa ' _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ -- K65 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ . _ _ _ _ - _ _ _ - _ - - - _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ] _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - - - - - - _ _ - - - POLICY MASTER RECORD PRINTOUT 04/08/02 09A-CANCELLED PAGE 05 OF 05 Et 01 YCA? ndPD = noNTri ENb _ _ _ _ ____-_-_-- n f- 58 3PO 7 6 C 7R0 797917 87817 OUONG MR UONG NAM1 MRP TYPO TYPE 01 ...•...1 .! ISj QRy _:.}, •t4• !-L?_k2!_!.?!_______________________- fi20L 6F SRC SYt- 901-R-t ADDITZDNAL7A?D II/20100 11/16/00 AOA POL ADD VEH VI RSN 000 99 MAID 626 LX/E II120100 11/16/00 PP POL CAN ENDOR V2 2359 1 1 /ZO/QO_ 1_1116100 PP _POL - _CAN_EPDO.R_ - - !/2_ 230 _ - - - - - - - - - - - - - - - - - - - - - . - - POLICY MASTER RECORD PRINTOUT PAGE 04/08/OZ 09A-CANCELLED PR'E-'PdlN0p LA$f NAME OCASC N: H'1ffT'b9i-cAL MaVa - MONTH EN?D_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 59 37 C 787817 DUONG MRPO TYPE: 01 • . • • .2 • S 1$IQRY_! • •'-2! 3!_Z !_Lt!_t S_______________________ ?ARO? *_€FT'_'-Sac 5r$ 605-aENS ADb?T28NAl IAD II/20/00 11/16/00 ADA POL ADD VEH VI RSN 000 99 MAID 626 LX /E 11/20/00 11/16/00 PP POL CAN ENDOR V2 2359 - 11/tot QO-LII L6J QQ PP _ POL__GAi+_ENDQR--- °2_2359---- -------------------------------------- . 11/120/00 11/16/00 AOA POL CHG CLASS V2 MCD N 11/20/00 11/16/00 ADDA POL CHG COV V2 UIM3BI tIMBI $0000 100000 P OPT 1J LZOl Q0_L11 L614Q QOQ-?OL__ GHt;_GOY---- VOPi?B ?3'7---V'M91---5004Q _L09Q09------------------------ 11/c-0/00 11/16/00 PDA POL CMG DRV BASIC DI DRIV-NUM 01 NON-DRIV-I N POP EXCL-DRIV N MART-STAT M ------------Eon---------------B1R.TyDBLE_6.699322 rRS-DRVN 9-au n.---------------------- AGA VEH-NUM 01 PRT NC-QP P itES-CM"I LD Y AOA OPR YR EXP 09 RTN DOC 5 11/20/00 11/16/00 ADA POL CHG DRV BASIC D2 DRIV-NUM ??11QQ02q NONp-DR,II7V-I N ------- ----POA----------"---"BIRTH DATEN 7308048YVMpfvN 4 SEE -F _________"------------ POP VEH-NUM 01 PRINC-OP P RES-CHILD Y ADA CPR YR EXP 09 RTN DOC 5 {(? g?Oy 73 5. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _, _ _ _ _ _ _ _ _ 1 1 ! -02 Q.0- U J L 6j Q0_ qQA_ POL _ _ CH§ _DB Y SL PLS5 Y2 _ ED F POP RATED ?1(VR E2 CDC--A -tlUa b0 11120100 11/16/00 ADA POL CHG POL BASIC RECVD 092298 ADD-PROC 092398 ADA ADD-EFF 091898 DOB 032266 I1/10(00_110 LL6/Q0 PP _POLCH.G VtM BE`iIL V3--NP d -- 1_/26/00 IJ/26/00C89 CEBS RCCCUNT 19,i.l0 00 142660 IObfOb 10/26/00 10/26/00 CBS CBS ACCOUNT 3.00 CR 46000 10/26/00 10/26/00 CBS CBS PAYMENT 198.30 DB 81000 400 Ict05!QO_!0J 5JQQCBB_05WA NNPI --- t9p,lo---LO92o9---I0a109-----------=-------------- JB/30/00 08/30/00 CBS CBS f1 TALLMENf ;IV .30 OS/30/00 08/30/00 CBS CBS ACCOUNT 195.30 DB 14600 100200 09/30/00 09/30/00 CBS CBS ACCOUNT 195.30 CR 14600 092200 0-9/0? Qo_QSIQZ/4QCH9_CBS__PREaSHPNGF - -----51L'44-- - ------- 09%02/00 09102100 CBS CBS ACC UNT Z46.7o ER f42,60 - --6922 fob- - - 09102100 08/02/00 CBS CBS ACCOUNT 195.30 D8 14600 092200 08/02/00 07/31/00 PGA POL CAN YEW V1 RSN 066 92 SUBA LEGACY L J3 !o2!QO_Q71_1fQo RQA_?GL__GHy _CLASS___12 ?jCD _Y ___ __________________________ 09/02/00 07/31/00 ADA POL CHG CUST N/A G`L21RIA MY LE 4N'6 POP DAVID T<DUONG POP 145 BLACK WALNUT DR PQA- _ __ 21P 17319 _9491 - ----------------------------- 08/02%00 0'%31/00 ADA POl CHG POL BAfIZ HCb Y CNTY 67 T€R4 IS POP FIRE-FORM E 06102/00 07/11/00 PIS POL CDR VEH BASIC V2 VIN-CD 0 I o?413lQ0_Q7JL3JQQ CBS_C,a5__PICHUNi--------243`Z0_"_L4bQO----Q92 too-------------------------- 07/13/00 07/13/00 CBS CBS ACC UN 3.00 CR 46000 107/13/00 07113/00 CBS CBS REN PAY 249.70 DS 81000 807 06/16/00 07/11/00 AGN POL CALC REN Jr!15!Qo_QS/161QQCB3_CB5QI5CQYtlT3 --_-H.CQ-17.24LIQ'42.10PQD 150,10___________________________ 06/16/00 06/16/00 CBS CBS RENEWAL •4_33.40 05/17100 07/11/00 PIS POL CDR VEH BASIC V2 VIN-CD I 05.16/00 07/11/00 PIS POL CHG VEH BASIC V2 VIN-CD 4 CPRS 33 CLRS 32 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 165 _ ______________________ _____________________________________________ __________________________q________-___________________________________.-_-_ Endorsement 2359 f uninsured motorists coverage [is -non-stacked (Pennsylvania) Please attach this impoitant addition to your auto policy. This endorsement replaces the policy's Uninsured Motorists coverage section. Coverage is subject to all terms and conditions of the policy, except as changed by this endorsement. ADDITIONAL DEFINITIONS APPLICABLE TO THIS COVERAGE 1. "ARBITRATION" means a forum for resolving questions subject to arbitration. 2. "ARBITRATOR" means the person conducting the arbitration. 3 An "UNINSURED MOTOR VEHICLE" is: a) one for which there is no bodily injury liability bond or insurance at the time of the accident. b) one for which the insuring company denies coverage or becomes insolvent. c) an unidentified motor vehicle which causes bodily injury to an insured by physical contact with: (1) such insured; or (2) a vehicle the insured is occupying. The driver and the owner of the unidentified vehicle must be unknown. A report must be made to the police and us within 30 days, or as soon as practicable. It must state that the insured has a legal action due to the accident. It must include facts to support the action. If there was no physical contact with the unidentified vehicle, there must be corroborating evidence from a source other than any insured. We may inspect any vehicle the insured was occupying. We will not consider as an uninsured motor vehicle: a) a motor vehicle that is "self-insured" under any law; b) any motor vehicle owned by any government unit or agency; c) any vehicle in use as a residence or premises; d) any equipment or vehicle designed for use mainly off public roads except while on public roads; e) any motor vehicle insured under the Auto Liability coverage of this policy or any other policy; nor t) any motor vehicle furnished for the regular use of you or a relative. COVERAGE AGREEMENT YOU AND A RELATIVE We will pay compensatory damages, including derivative claims, which are due by law to you or a relative from the owner or driver of an uninsured motor vehicle because of bodily injury suffered by you or a relative. Damages must result from an accident arising out of the: 1. ownership; 2. maintenance; or 3. use; of the uninsured motor vehicle. OTHER PERSONS We will also pay compensatory damages, including derivative claims, which are due by law to other persons who: 1. Are not a named insured or an insured household member for similar coverage under another policy; and 2. Suffer bodily injury while occupying: a) your auto. V-2359 (11.93) b) a motor vehicle you do not own, while it is used in place of your auto for a short time. Your auto must be out of use because of. • (1) breakdown; (3) servicing; or (2) repair; (4) loss. c) a four-wheel motor vehicle newly acquired by yqu. This applies only during the first 30 days you own the vehicle, unless it replaces your auto. d) any other motor vehicle while it is being driven by you or a relative. This extension applies only in policies issued to persons (not organizations). However, the vehicle must not be: (1) owned by you or a relative; or (2) furnished to you or a relative for regular use. RECOVERY 1. Before recovery, we and any injured party seeking protection under this coverage must agree on two points: a) whether there is legal right to recover damages from the owner or driver of an uninsured motor vehicle; and if so, b) the amount of such damages. If agreement can't be reached, the matter will go to arbitration. 2. Questions between the injured party and us regarding whether the injured party is an insured under this coverage, or the limits of such coverage, are not subject to arbitration and shall be decided by a court of law. 3. Any judgment against the uninsured will be binding on us only if it has our written consent. 4. Any demand for Uninsured Motorists Coverage benefits must be made within two years after the date of the accident. COVERAGE EXCLUSIONS This coverage does not apply to: 1. Use of any motor vehicle by an insured to carry persons or property for a fee. Motor vehicles used in shared-expense car pools are not considered as carrying persons for a fee. 2. Use of any motor vehicle by an insured without the owner's permission. 3. Punitive or exemplary damages. 4. Directly or indirectly benefit any workers' compensation or disability benefits carrier, or any person or organization qualifying as a "self-insurer" under a workers' compensation, disability benefits, or similar law. 5. Bodily injury suffered while occupying or struck by a motor vehicle owned by you or a relative, but not insured for auto liability coverage under this or any other policy. 6. Bodily injury suffered while occupying a motor vehicle owned by you or a relative but not insured for Uninsured Motorists coverage under this policy; nor to bodily injury from being hit by any such motor vehicle. 7. Noneconomic loss of any insured who has elected "Limited Tort" in accordance with the Pennsylvania Motor Vehicle Financial Responsibility Law. 8. Bodily injury of any insured if the insured settles, without our written consent, with a liable party. INSURED PERSONS' DUTIES 1. The insured must: a) submit written proof of the claim to us. It must be under oath, if required. It must include details of: (1) the nature and extent of injuries; (2) treatment; and (3) any other facts which could affect the amount of payment. b) provide all facts of the accident and the name of all witnesses. c) submit to oral examination under oath as often as we require. d) be examined by doctors, including doctors examining the insured for rehabilitation purposes, chosen by us as often as we require. At our request, the injAred person must promptly authorize us to: (1) speak with any doctor who has treated him; (2) read all medical history and reports of the injury; (3) obtain copies of wage and medical reports and records; and (4) obtain copies of all medical bills as they are incurred. 2. We require the insured to file suit against any and all liable parties to preserve and protect our subrogation rights. Failure to do so precludes recovery under this coverage. 3. The insured must obtain our written consent to: a) settle any legal action brought against any liable party; or b) release any party. ARBITRATION If we and the insured disagree about the right to recover damages from the owner or driver of an uninsured motor vehicle or the amount of such damages: 1. After written demand for arbitration by either party, each will select a competent arbitrator. The two so selected will select a third competent arbitrator. Unless the insured and we agree otherwise, arbitration will take place in the county and state where the insured lived at the time of the accident. 2. If the third arbitrator is not selected within 30 days, the insured or we may request a judge of a court of record to name one. The court must be in the county and state in which arbitration is pending. 3. Each party will pay its chosen arbitrator. Each will pay half of the neutral arbitrator's expenses. Fees to lawyers and expert witnesses are to be paid by the party hiring them. 4. Arbitration shall be conducted in accordance with the provisions of the Pennsylvania Arbitration Act of 1927. OUR RIGHT TO RECOVERY This applies to the extent of any payment we make under this coverage. We will have first right to any amount the insured receives from any liable party. The insured will: 1. Hold in trust for us his right to recover against any such party; and 2. Furnish us all papers in any suit the insured files. Our payment of a claim may result from the insolvency of an insurer. If so, we have the right to recover from the insurer, but not its insured. LIMITS OF PAYMENT AMOUNTS PAYABLE FOR UNINSURED MOTORISTS LOSSES We agree to pay losses up to the limits stated in the policy Declarations. The following applies to these limits: 1. The Uninsured Motorists bodily injury limit shown for any one person is for all legal damages, including all derivative claims, claimed by anyone due to bodily injury to one person as a result of one occurrence. The per-person limit is the total amount available when one person sustains bodily injury, including death, as a result of one occurrence. No separate limits are available to anyone for derivative claims, statutory claims, or any other claims made by anyone arising out of bodily injury, including death, to one person as a result of one occurrence. The total limit of our liability shown for each occurrence is the total amount available when two or more persons sustain bodily injury, including death, as a result of one occurrence. In no event shall any one person recover more than the per-person limit shown. 2. Coverage applies as stated in the Declarations. The insuring of more than one person or vehicle under this policy does not increase our Uninsured Motorists payment limits. In no event will any Insured be entitled to more than the highest per person limit applicable to any one motor vehicle under this policy or any other policy issued by us. 3. Damages payable under this coverage shall be reduced by any amount paid by or for any liable parties. 4. The insured may recover for bodily Injury under the Auto Liability coverage or the Uninsured Motorists coverage of this policy, but not under both coverages. OTHERINSURANCE If there is other insurance: 1. For bodily injury suffered by an insured while dccopying a motor vehicle you do not own, we will pay the insured loss not covered by other insurance. . 2. Except as stated above, if there is other insurance similar to this coverage under any other policy, we will be liable for only our share of the loss. Our share is our proportion of the total insurance limits for the loss. 3. In any event, if more than one policy applies, total limits applicable will be considered not to exceed the highest limits amount of any one of them. DUPLICATE PAYMENT We will make no duplicate payment to or for any insured for the same element of loss. ASSIGNABILITY No interest in this coverage can be transferred without our written consent. However, if the policyholder dies, this coverage will continue in force for the rest of the policy period. It will apply to the following having proper custody of your auto: 1. your relatives; 2. your heirs; 3. an appointed legal representative; or 4. anyone else using your auto with the express permission of the legal representative. This endorsement applies as stated in the policy Declarations. This endorsement is issued by the company shown in the Declarations as the issuing company. This endorsement supersedes any prior endorsement numbered 2249. NATIONWIDE INSURANCE COMPANIES Home Office: Columbus, Ohio 43215-2220 Endorsement 2360 t)s und6rinsured -non-stacked motorists (Pennsylvania) Please attach this important addition to your auto po. This endorsement replaces the policy's Underinsured Motorists coverage section. Cos and conditions of the policy, except as changed by this endorsement. ADDITIONAL DEFINITIONS APPLICABLE TO THIS COVERAGE 1. "ARBITRATION" means a forum for resoling questions subject to arbitratio 2. "ARBITRATOR" means the person conducting the arbitration. 3 An "UNDERINSURED MOTOR VEHICLE" is a motor vehicle for which bodi bonds or insurance are in effect. However, their total amount is insufficient to pay th-utitled to recover. We will pay damages that exceed such total amount. We will not consider as an underinsured motor vehicle: a) a motor vehicle that is "self-insured" under any law; b) any motor vehicle owned by any government unit or agency; c) any vehicle in use as a residence or premises; d) any equipment or vehicle designed for use mainly off public roads except v e) any motor vehicle insured under the Auto Liability coverage of this policy; f) any motor vehicle furnished for the regular use of you or a relative. COVERAGE AGREEMENT YOU AND A RELATIVE We w ll pay compensatory damages, including derivative claims, which are due by law tibe owner or driver of an underinsured motor vehicle because of bodily injury suffered by you burst result from an accident arising out of the: 1. ownership; 2. maintenance; or 3. use; of the underinsured motor vehicle. OTHER PERSONS We will also pay compensatory damages, including derivative claims, which are duens who: 1. Are not a named insured or an insured household member for similar coverag?; and 2. Suffer bodily injury while occupying: a) your auto. b) a motor vehicle you do not own, while it is used in place of your auto for Ao must be out of use because of: (1) breakdown; (3) servicing; or (2) repair; (4) loss. c) a four-wheel motor vehicle newly acquired by you. This applies only duryou own the vehicle, unless it replaces your auto. d) any other motor vehicle while it is being driven by you or a relative. Thisly in policies issued to persons (not organizations). However, the vehicle must not be: (1) owned by you or a relative; or (2) furnished to-you or a relative for regular use. V-2360 (11.93) RECOVERY h' ? ra^^ Host aurec on hvo points: 1. Before recovery, we and any in urcd party seeking protection under t ?s co?c r a) whether there is legal right to recover damlges from the owner or driver of an underinsured motor vehicle; and if so, b) the amount of such damages. if agreement can't be reached, the matter will`go to arbitration. 2. Questions between the injured party and us regarding whether the injured party is an insured under this coverage, or the limits of such coverage, are not subject to arbitration and shall be decided by a court of law. 3. Any judgment against the underinsured will be binding on us only if it has our written consent. 4. Any demand for Underinsured Motorists Coverage benefits must be made within Mo years after the date of the accident. COVERAGE EXCLUSIONS This coverage does not apply to: 1. Use of any motor vehicle by an insured to carry persons or property for a fee. Motor vehicles used in shared-expense car pools are not considered as carrying persons for a fee. 2. Use of any motor vehicle by an insured without the owner's permission. 3. Punitive or exemplary damages. 4. Directly or indirectly benefit any workers' compensation or disability benefits carrier, or any person or organization qualifying as a "self-insurer" under a workers' compensation, disability benefits, or similar law. 5. Bodily injury suffered while occupying or struck by a motor vehicle owned by you or a relative, but not insured for auto liability coverage under this or any other policy. 6. Bodily injury suffered while occupying a motor vehicle owned by you or a relative but not insured for Underinsured Motorists coverage under this policy; nor to bodily injuy from being hit by any such motor vehicle. 7. Noneconomic loss of any insurer] who has elected "Limited Tort" in accordance with the Pennsylvania Motor Vehicle Financial Responsibility Law. 8. Bodily injury of any insured if the insured settles, without our written consent, with a liable party. INSURED PERSONS' DUTIES 1. The insured must: a) submit written proof of the claim to us. It must be under oath, if required. It must include details of: (1) the nature and extent of injuries; (2) treatment; and (3) any other facts which could affect the amount of payment. b) provi de all facts of the accident and the name of all witnesses. c) submit to oral examination under oath as often as rve require. d) be examined by doctors, including doctors examining the insured for rehabilitation purposes, chosen by us as often as we require. At our request, the injured person must promptly authorize us to: (1) speak with any doctor who has treated him; (2) read all medical history and reports of the injury; (3) obtain copies of wage and medical reports and records; and (4) obtain copies of all medical bills as they are incurred. 2. We require the insured to Me suit against any and all liable parties to present and protect our subrogation rights. Failure to do so precludes recovery under this coverage. 3. The insured must obtain our written consent to: a) settle any legal action brought against any liable party; or b) release any party. 2 ARBITRATION I(we and the insured disagree about the right to recover damages from the owner or driver of an underinsure motor vehicle or the amount Of such damages: 1. After written demand for arbitration by either party, each will select a competent arbitrator. The two so selected will select a third competent arbitrator. Unless the insured and we agree otherwise, arbitration w ill take place in the county and state where the insured lived attYthe time of the accident. 2 If the third is mnot ust selected within 30 the county ahd sthe tate cin aon is ured or we may request pe dinege of a court of record court 3, Each party will pay its chosen arbitrator. Each will pay half of the neutral arbitrator's expenses. Fees to lawyers and expert witnesses are to be paid by the party hiring them. 4. Arbitration shall be conducted in accordance with the provisions of the Pennsylvania Arbitration Act of 1927. OUR RIGHT TO RECOVERY payment we make under this coverage. This applies to the extent of any insured receives from any liable party. The insured will: and 1. Hold in trust for us his right to recover against any party; 2. Furnish us all papers in any suit the insured riles. Our payment of a claim may result from the insolvency of an insurer. insurer, but not its insured. We will have rust right to any amount the if so, we have the right to recover from the LIMITS OF PAYMENT A:110UNTS PAYABLE FOR UNDERINSURED bIOTORISTS LOSSES We agree to pay losses up to the limits stated in the policy'Declarations. The following applies to these limits: to none n person as a result of onao damages, z including all jur Emit ueyto bodily shown for 1. The derivative Motor sts anyone boily in. d p,rson rson s ric re The sult r-one o limit ice.be t Lal unoulit at ills available to anyone forderivati e claims, tatutloryl claims[ or any of No sep Lim are including claims made by anyone arising out of bodily injury, death, to one person as a result of one one two occurrence. r each occurrence is The total limit of our babildi n sdoown fats a result of one occurhe cet?In no event shall available over more amount sustain bodily injury, g than the per-person limit shown. g of more than on, applies as stated 2 rage dove not increase our Underinsured the ?Declar t ions. paThe insuric yment t mits. In no event willll`an% insured be entitled to more than the highest per person limit applicable to any one motor vehicle under this policy or any other policy issued by us. e shall be reduced by any amount paid by or for any liable parties. . Damages payable under this coverag 3 4. The insured may recover for bodily injury under the Auto Liability coverage or the Underinsured ;Motorists coverage of this policy, but not under both coverages. 5. No payment will be made until the limits of all other auto liability insurance and bonds that apply have been exhausted by payments. . An insuredwho recovers damages [or an uninsured motorists claim cannot recover damages for an underinsured 6 motorists claims for the same accident. OTHERINSURANCE If there is other insurance: 1. For bodily injury suffered by an insured while occupying a motor vehicle you do ?et own, we w ll pay the insure loss not covered by other insurance. to this coverage under 2 Except stated above, the these is other insurance is our proportion n of the total insurancevlimits for the loss be liable other for only our share 3 3. In any event, if more than one policy applies, total limits applicable will be cons:-'.,red not to exceed the highest limits amount of any one of them. DUPLICATE PAYMENT We will make no duplicate payment to or for any insured for the same element of loss. ASSIGNABILITY No interest in this coverage can be transferred without our written consent. However, if the policyholder dies, this coverage will continue in force for the rest of the policy period. It will apply to the following hating proper custody of your auto: 1. your relatives; 2. your heirs; 3. an appointed legal representative; or 4. anyone else using your auto with the express permission of the legal representative. This endorsement applies as stated in the policy Declarations. This endorsement is issued by the company shown in the Declarations as the issuing company. This endorsement supersedes any prior endorsement numbered 2249. NATIONWIDE INSURANCE COMPANIES Home Office: Columbus, Ohio 43215-2220 4 Endorsement 2310 f loss of use ® comprehensive -or collision coverages (auto rental expenses) Please attach this important addition to your auto policy. Loss of Use coverage is subject to the provisions of the policy that apply to the Comprehensive and/or Collision coverages. This coverage applies only if this endorsement was in effect at the time of a covered Comprehensive or Collision loss. We will repay you for auto rental expense incurred by you or a relative if unable to use your auto because of a covered Comprehensive or Collision loss. Auto rental expense is the cost of renting one vehicle from a rental agency or garage. Subject to the coverage limit, reimbursement is limited to a maximum daily payment. The coverage limit and daily payment amounts are shown in the Declarations. This expense must be incurred within a certain time period. It begins when your auto cannot run due to a covered loss; or if your auto can run, when left at a shop for agreed repairs. It continues: a) for 30 consecutive days; or b) until your auto is repaired; or c) until a total settlement is agreed to; whichever comes first. Any expense payable under this coverage shall be reduced to the extent it is payable under the Comprehensive or Collision coverages of the policy. This endorsement applies as stated in the policy Declarations. This endorsement is issued by the company shown in the Declarations as the issuing company. NATIONWIDE INSURANCE COMPANIES Home Office: Columbus, Ohio 43215-2220 V-2310 (5-95) Endorsement 2391 -lmend,,(Ory enciorsemEn'i- uninsured/underinsured molorisis (Pennsylvania) Please attach this important addition to your auto policy. This endorsement amends any Uninsured/Underinsured iviotorists Coverage er.:=:semeas attached to the policy. RECOVERY Item 4. of Recovery is replaced to read: 4. The injured party shall provide notice of an uninsured/underinsured motors:; clai= within two years after the date of the accident. If the injured party fails to provide s_ch nonce, and this ubrogate against liable parties, coverage r- ay be denied as failure precludes our ability to s provided in Insured Persons' Duties No. 2 below. INSURED PERSONS' DUTIES Items 1. c) and 1. d) are replaced to read: 1. The insured must: c) submit to oral examination under oath as often as we require with good reason. d) be examined by doctors, including doctors examining the insured for rehabilitation purposes, chosen by us as often as we require with good reason. At our request, the injured person must promptly authorize us to: (1) speak with any doctor who has treated him; (2) read all medical history and reports of the injury; (3) obtain copies of wage and medical reports and records; and (4) obtain copies of all medical bills as they are incurred. This endorsement applies as stated in the policy Declarations. This endorsement is issued by the company shown in the Declarations as the isss_ir._ coq?any. NATIONWIDE INSURANCE COMPANIES Home Office: Columbus, Ohio 43215-2220 V-2391 ® Endorsement 2264A amendatory endorsement (Pennsylvania) Please attach this Important addition to your auto policy. It is agreed that the policy is amended as follows: DEFINITIONS Definitions 7 and 9 are replaced to read: 7. "PRIVATE PASSENGER AUTO" means a four-wheel: a) private passenger auto; b) van; or c) pickup truck. 9. "RELATIVE" means one who regularly lives in your household and who is related to you by blood, marriage or adoption (including a ward or foster child). A relative may live temporarily outside your household. PHYSICAL DAMAGE COVERAGE AGREEMENT COMPREHENSIVE COVERAGE The following is added to item 1. b) (2): For damage to your windshield, we may offer to have it repaired in lieu of replacement. We will not apply a deductible for the repair of the windshield. However, if the repair is not satisfactory, we will replace the windshield subject to your deductible. COLLISION COVERAGE Item 1. is amended to read: 1. We will pay for loss to your auto caused by collision or upset. We will pay for the loss less your deductible. We will not subtract the deductible amount for broken glass if you have full (no deductible) Comprehensive coverage in force. COVERAGE EXTENSIONS USE OF OTHER MOTOR VEHICLES Item 2. is amended to-read-.- 2. A four-wheel motor vehicle newly acquired by you. You must report the acquisition of the vehicle to us during the first 30 days you own the vehicle. Also, if the newly acquired vehicle does not replace your auto, all household vehicles owned by you must be insured by us or an affiliate for this extension of coverage to apply. We provide this coverage only if you do not have other collectible insurance. You must pay any added premium resulting from this coverage extension. COVERAGE EXCLUSIONS Exclusions 1., 2., 3., and 8. are replaced to read: We will not pay for loss: 1. To more than one: a) recording tape; b) compact disc; or c) other recording media. 2. To a container to be used for storing or carrying: a) recording tapes; V-2261-A (6-97) Page 1 of 6 b) compact discs; or c) other recording media. 3. To any device which is a: a) tape player; ` b) compact disc player; c) citizens band radio; d) two-way mobile radio; e) telephone; or f) any other device which records, emits, receives and/or transmits sound. This exclusion (3.) does not apply if the device is a permanent part of your auto. Permanent part means installed in a location used by an auto maker for such a device. If the device is not covered, its antenna and other parts are not covered. 8. To scanning monitor receivers used for radar detection, or any other device designed to detect the monitoring of speed. LIMITS OF PAYMENT ACTUAL CASH VALUE The Actual Cash Value provisions are replaced to read: The limit of our coverage is the cash value of your auto or its damaged parts at the time of loss. To , determine cash value, we will consider: 1. fair market value; 2. age; and 3. condition of the property; at the time of loss. In addition to our payment of the loss, necessary and reasonable towing and storage will be paid to protect the auto from further damage. The following provisions apply under the heading Loss Settlement: LOSS SETTLEMENT At our option, we may: 1. pay you directly for a loss; 2. repair or replace your auto or its damaged parts with parts furnished either by original equipment manufacturers or non-original equipment manufacturers; 3. return stolen property at our expense and pay for any damage. COVERAGE CONDITIONS The following Condition is added: CONTROLLING STORAGE COSTS When an insured is involved in a Collision or Comprehensive loss, we have the right to move the vehicle from any impound lot, storage site, towing yard or any other facility to control storage costs, towing costs or other fees. The insured will be promptly notified whenever any such action is undertaken. AUTO LIABILITY COVERAGE AGREEMENT PROPERTY DAMAGE AND BODILY INJURY LIABILITY COVERAGE Item 3. c) is replaced to read: 3. c) pay premiums: (1) of not more than $250 per insured for bail bonds required because of an accident or traffic violation. Page 2 of 6 V-2264-A (6-97) (2) for appeal bonds in defended suits 4nd for bonds to release attached property. The amount of such bonds shall not be more than the limits of liability shown in the Declarations. Although paying such premiums, we are liot required to apply for or furnish such bonds. COVERAGE EXTENSIONS ` USE OF OTHER MOTOR VEHICLES Item 2. is amended to read: 2. A four-wheel motor vehicle newly acquired by you. This coverage applies only during the first 30 days you own the vehicle unless it replaces your auto. If the newly acquired vehicle does not replace your auto, all household vehicles owned by you must be insured by us or an affiliate for this extension of coverage to apply. We provide this coverage only if you do not have other insurance. You must pay any added premium resulting from this coverage extension. COVERAGE EXCLUSIONS Exclusions 1., 4., 5., and 7. are replaced to read: 1. Property damage or bodily Injury caused by an act intending to cause any harm done by or at the direction of any insured. 4. Property damage caused by any insured: a) to a motor vehicle that is owned or operated by, or in the custody of, that Insured; or b) to any other property that is owned by or in the custody of any Insured or anyone occupying your auto. This exclusion does not apply to a: (1) rented home; or (2) rented private garage. 5. Bodily injury to any person eligible to receive any benefits required to be provided or voluntarily . provided by any Insured under a: a) workers' compensation; b) unemployment compensation; c) non-occupational or occupational disease; d) disability benefits; or any similar law. 7. The United States of Atgerica or any of its agencies. It also does not apply to any employee of . the United States of America or any of its agencies while such person is acting within the scope of his or her office or employment and the provisions of the Federal Tort Claims Act apply. The LIMITS OF PAYMENT section is replaced in its entirety to read: LIMITS OF PAYMENT AMOUNTS PAYABLE FOR LIABILITY LOSSES Our obligation to pay Property Damage or Bodily Injury Liability losses is limited to the amounts per person and per occurrence stated in the Declarations. The following conditions apply to these limits: 1. The limit shown: a) for Property Damage Liability is for all property damage in one occurrence. b) for Bodily Injury Liability for any one person is for all legal damages, including all derivative claims, claimed by anyone arising out of and due to bodily Injury to one person as a result of one occurrence. The per-person limit is the total amount available when one person sustains bodily injury, including death, as a result of one occurrence. No separate limits are available to anyone for derivative claims, statutory claims, or any other claims made by anyone arising out of bodily injury, including death, to one person as a result of one occurrence. V-2264-A (6-97) Page 3 of 6 C) for Bodily Injury Liability for each occurrence is the total limit of our liability for all legal damages when two or more persons sustain bodily Injury, including death, as a result of one occurrence. No separate limits are available to anyone for derivative claims, statutory claims, or any other claims arising out of bodily injury, including death, to two or more persons as a result of one occurrence. '!this total limit is subject to the limit for any one person. 2. Liability limits apply as stated in the Declarations. The insuring of more than one person or vehicle under this policy does not increase our liability limits. 3. In any loss covered under items 2. and 3. of "USE OF OTHER MOTOR VEHICLES," the highest liability limit applicable to any one vehicle on this policy will apply. 4. A motor vehicle and attached trailer are considered one vehicle for Auto Liability coverage. OTHERINSURANCE In any losses involving the use of your auto or any other motor vehicle covered under this policy, we .. will be liable for only our share of the loss if there is other collectible liability insurance available to you or an insured. Our share is our proportion of the total insurance policies applicable to you or . . any insured for the loss. You may have more than one Nationwide policy; we will pay only up to the i highest limit of any one of them., FIRST PARTY BENEFITS OPTIONS OPTION 3 -ACCIDENTAL DEATH BENEFIT The following sentence is added: In the alternative, payment will be made to the surviving spouse. OPTION 5-COMBINED LOSS BENEFITS The second paragraph is replaced to read: Option 5 is subject to the following conditions: a) Within 18 months after the date of the accident, it must be determined with reasonable medical probability that future medical expenses will be incurred as a result of the injury. b) In no event will benefits be paid beyond three years from the date of the accident. c) There is no monthly dollar maximum for Income Loss Benefits. d) The maximum Accidental Death Benefit payable is $25,000. e) The maximum Funeral Benefit payable is $2,500. f) Benefits under d) and e) are only payable if death occurs within two years of the date of the accident. INSURED PERSONS' DUTIES The following paragraph is added: The injured person must submit to examination under oath as often as reasonably requested by us. GENERAL POLICY CONDITIONS 1. INSURED PERSONS' DUTIES Item h) is added to read: h) provide all records and documents we reasonably request and permit us to make copies. 3. HOW YOUR POLICY MAYBE CHANGED Items c) and d) are replaced and item e) is added to read: c) no other changes may be made in the terms of this policy except by endorsement or policy revision. d) the premium for each coverage is based on information in our possession. Any change or correction in this information will allow us to make an adjustment of the premium as of the date the change is effective. Page 4 of 6 V-2264-A (6-97) e) the policyholder has a duty to notify usgas soon as possible of any change which may affect the premium or the risk under this policy. This includes, but is not limited to, changes in: (1) the principal garaging address of the insured vehicle(s), which must be reported to us within 30 days of the date the addretss change becomes effective; (2) drivers; `, (3) use of the insured vehicle(s); or (4) desired coverages, deductibles, or limits. 5. SUBROGATION Items d) and e) are added to read: d) Uninsured Motorists; and e) Underinsured Motorists; General Policy Condition 7 is replaced to read: CANCELLATION DURING POLICY PERIOD The olicybolder may cancel this policy or any of its coverages by mailing notice to us of the ' p future date of cancellation desired. Premium refund, if any due, will be made as soon as practicable after the date of cancellation. Based on our "short-rate table," we will retain . premium for the days covered, plus a percentage-figured charge for cancelling at the policyholder's request during the policy,period. If this policy or any coverage has been in effect less than 60 days, we have unlimited right of . cancellation. We may cancel. by mailing notice to the policyholder 15 days in advance of termination. After any coverage of this policy has been in force 60 days, our right to cancel such coverage during the policy period is limited. We may cancel during an annual policy period: a) if premiums or premium installment payments are not paid when due, whether payable directly to us or through any premium finance plan. b) if the driver's license or motor vehicle registration of any named insured has been suspended or revoked during the policy term. c) if it is determined that any insured has concealed a material fact, has made a material allegation contrary to fact, or has made a misrepresentation of a material fact and that such concealment, allegation or misrepresentation was material to the acceptance of the risk by us. We must mail notice to the policyholder: a) 15 days in advance of termination for nonpayment of premium. b) 15 days in advance of termination for loss of license or of motor vehicle registration. c) 60 days in advance of termination for concealment or misrepresentation. In any case of cancellation by us, our mailing of notice to the policyholder's last known address or delivery of it to the policyholder will constitute proof of notice. We will retain premium for days covered during the policy period. Premium refund, if any due, will be made as soon as practicable. Mailing or delivery of our check will constitute tender of refund. Conditions 11., 12., and 13. are added to read: 11. DIVIDENDS The policyholder is entitled to any dividends which are declared by the Board of Directors and are applicable to coverages in this policy. 12. NON-SUFFICIENT FUNDS CHARGE The company reserves the right to impose a fee for any premium payment that is unable to be processed due to non-sufficient funds, or if there are non-sufficient funds in an account that is being utilized for electronic funds transfer (EFT) payments. This is under the terms and conditions approved where required by the Department of Insurance. V-2264-A (6-97) Page 5 of 6 13. FRAUD a) this policy does not cover any loss to or by any insured if any element of fraud or fraudulent action is engaged in by that Insured in connection with the loss. b) this policy does not provide Physical Da?age coverage if you or a relative, either before or after a loss has: (1) intentionally concealed or misrepresented any material fact or circumstance; or (2) committed any fraud or made false statements relating to such loss. Mutual Policy Conditions are replaced to read: Mutual Policy Conditions (Applicable only to policies issued by Nationwide Mutual Insurance Company-Nationwide Mutual Fire Insurance Company.) If this policy is issued by Nationwide Mutual Insurance Company or Nationwide Mutual Fire Insurance Company, the policyholder is a member of the company issuing the policy while this, or any other policy issued by one of these companies is in force. While a member, the policyholder is entitled to one vote only-regardless of the number of policies issued to the policyholder-either in person or by proxy at meetings of members of said company. The annual meeting of members of the Nationwide Mutual Insurance Company will be held at the Home Office at Columbus, Ohio, at 10 a.m. on the first Thursday of April. The annual meeting of members of the Nationwide Mutual Fire Insurance Company will be held at the Home Office at Columbus, Ohio, at 9:30 a.m. on the first Thursday of April. If the Board of Directors of either of the above companies should elect to change the time or place of meeting, that company will mall notice of the change to the policyholder at the address last known to it. The company will mail this notice at least 10 days in advance of the meeting date. This policy is non-assessable, meaning that the policyholder is not subject to any assessment beyond the premiums the above companies require for each policy term. This endorsement applies as stated in the policy Declarations. This endorsement is issued by the company shown in the Declarations as the issuing company. This endorsement supersedes any prior endorsement numbered 2264. . NATIONWIDE INSURANCE COMPANIES Home Office: Columbus, Ohio 43215-2220 Page 6 of 6 V-2264-A (6-97) NATIONWIDE INSURANCE Nationwide s on your side RENTED AUTO NOTICE IF THE DECLARATIONS AT- TACHED TO THIS POLICY SHOW THAT COLLISION COVERAGE APPLIES TO YOUR AUTO, THERE IS ALSO COLLISION COVERAGE FOR DAMAGE TO A RENTED AUTO. COVERAGE IS SUBJECT TO CONDITIONS AND LIMITA- TIONS LISTED ON PAGE 5 AND ELSEWHERE IN THE POLICY OR ATTACHED ENDORSEMENTS. Nationwide's Century II Auto Policy Auto insurance protection you can count on in a policy you can understand This is a different kind of insurance policy-one that's readable, understandable, straightforward. We believe you have purchased the best auto insurance protection-backed by the best in policyholder service. We intend to keep it that way. Please take a few minutes to read and see what's inside your new Century II Policy. Should you have an accident or loss-and we hope you don't-just call us at once. Our claims service starts then. The telephone number to call is listed on your Nationwide identification card, or you may get in touch with any local claims office. If you have any questions about this policy, or any part of your insurance program, your sales representative will welcome your call any time. Thank you for relying on Nationwide. YOUR GUIDE TO PROTECTION DEFINITIONS 2 . Key Policy Words .................................... .................. TERRITORY 3 Where Your Protection Applies ........................ ................... COVERAGES 3 ..... Comprehensive ....................................... 4 .............. ....... Collision ........................................... 4 ............. Towing and Labor ................................... .................... 6 ... Auto Liability ....................................... 9 ................. First Party Benefits .................................. .................... 13 .. Uninsured Motorists ................................. .................. 17 . Underinsured Motorists .............................. ................... GENERAL CONDITIONS 20 Your Duties After an Accident or Loss .................................••• 21 Use of Other Motor Vehicles ..........................................••. 21 How Your Policy May Be Changed ...................................... Our Right to Recover from Others (Subrogation) ............................ 2 21 Policy Renewal/Nonrenewal .............................................. 22 Your Right and Our Right to Cancel ...................................... 23 Our Installment Premium Plan ............................................ MUTUAL POLICY CONDITIONS-Nationwide Mutual Insurance Company- 23 Nationwide Mutual Fire Insurance Company.... Nationwide Mutual Insurance Company • Nationwide Mutual Fire Insurance Company • Nationwide Property and Casually Insurance Company/Home Office: Columbus, Ohio 43215-2220 Auto 6000-D (4-98) (Attach Declarations and Endorsements Here) definitions 12. is the named insu ed under this epolicy first person named in the and does not include the pot cy'holder's spoluse. If (continued) the first named insured 's an organization, that organization is the policyholder. 13. "NONECONOMIC L09S" means pain and suffering and other nonmonetary detriment. Other words are also defined. All defined words are in bold print. physical damage coverages (damage to your auto) TERRITORY All coverages in this policy apply only to occurrences while the policy is in force. All coverages apply in Canada, the United States of America and its territories or possessions, or between their ports. All coverages except Uninsured Motorists and Underinsured Motorists apply to occurrences in Mexico, if within 50 miles of the United States boundary. We will base the amount of any Comprehensive or Collision loss in Mexico on cost at the nearest United States point. NOTE: You will need to buy auto insurance from a Mexican insurance company-regardless of coverage provided by this policy-before driving in Mexico. Otherwise, you may be subject to jail detention, auto impoundment, and other legal complications in case of an accident. Additional Definitions Applicable to These Coverages 1. "LOSS" means direct and accidental loss or damage to your auto. Your auto includes its equipment. 2. "EQUIPMENT" means anything usual and incidental to the use of a motor vehicle as a motor vehicle. A trailer is not equipment. COVERAGE AGREEMENT COMPREHENSIVE COVERAGE 1. We will pay for loss to your auto not caused by collision or upset. We will pay for the loss less your deductible. Coverage is included for: a) damage from contact with: (1) animals; or --k2)failing or flying objects; b) broken glass: (I)even if caused by collision or upset; and (2) if you do not have Collision coverage. If Your Comprehensive and Collision coverages have different deductibles, the smaller deductible will apply to broken glass. Also, if your auto has a loss under this coverage we will: a) pay for resulting damage to your clothing and luggage or that of any relative. ivlaximun payment is $200. We will pay for stolen clothing or luggage only if your auto is stolen b) repay your travel costs after your auto is stolen. Maximum payment is $ 15 per day-no to exceed $450 per occurrence. These costs must be incurred within a certain time. I starts 48 hours after you report the theft to us and the police. It ends when your aut is returned to you or we pay for its loss. c) repay you for the cost of travel from where your auto was disabled to where you war going. Maximum payment is SIO. physical damage (2)involving a private passenger auto owned by an employer of an insured. (continued) (3)involving a privatejpassenger auto furnished to you or a relative for regular use. (4)to any rented motor vehicle. 4. a rented private passenger auto, including its loss of income. a) This applies only: (1) while such auto is- rented by you or a relative; (2)to policies issued to persons (not organizations); (3)if such auto is rented from a rental company for less than 28 days; and (4) for loss of income that is: (a) verifiable by us; and (b) owed to a rental company because: (I) the rental company had a customer willing to rent a private passenger auto; and (2) there was no other vehicle available for rental in place of the damaged rented auto. b) We will not pay for loss involving a private passenger auto rented or leased by anyone for or on behalf of the employer of an insured. COVERAGE EXCLUSIONS We will not pay for loss: 1. to more than one: a) stereo tape; b) cassette; or c) cartridge. 2. to a container to be used for storing or carrying: a) stereo tapes; b) cassettes; or c) cartridges. 3. to any: a) citizens band radio; b) two-way mobile radio; c) telephone; or d) other device which receives and transmits sound. This exclusion (3) does not apply if the device is a permanent part of your auto. Permanen part means installed in a location planned by the auto maker for a radio. If the device i not covered, its antenna and other parts are not covered. 4. to a camper or living quarters unit which can be mounted on or attached to a vehicle. NN' will pay the loss if: a) the unit is reported to us; and b) the required premium is paid; before the loss. 5. due to: a) wear and tear; b) freezing; c) mechanical or electrical breakdown or failure. This exclusion (5) does not apply to damage which is the result of other loss covered t this policy. This exclusion does not apply to Towing and Labor coverage. 5 auto liability 3. We will pay such liability losses up to the limits stated in the Declarations. In addition to (continued) these limits and as to ?y covered damages, we will: a) defend at our expense, with attorneys of our choice, any suit against the insured. We may settle or defend any claim or suit as we think proper. b) pay: (1) all expense incu?red by us; and (2) all costs levied 'against the insured; in any such suit. c) pay: (1) all premiums on appeal bonds in defended suits. (2) a premium of not more than $250 for bail bond required because of an accident or traffic violation. Although paying such premiums, we are not required to apply for or furnish such bonds. (3) all premiums on bonds to release attached property. d) pay post-judgment interest on all damages awarded. We will not pay interest that accrues after such time as we have: (1) paid; (2) formally offered; or (3) deposited in court the amount for which we are liable under this policy. e) pay expenses incurred by an insured for emergency medical aid to others at the time o accident. f) pay all reasonable expenses incurred by an insured at our request, but not more that $50 per day for loss of earnings. 4. After the limits of this coverage have been paid, we will not defend any suit or pay an; claim or judgment. COVERAGE EXTENSIONS USE OF TRAILERS 1. This coverage applies to the use of a trailer by: a) you; b) a relative; or c) someone else with your permission. -2. The trailer must be: a) designed for use with a private passenger auto; and b) used with a vehicle that is insured under this coverage. 3. The trailer must not be used for business purposes with a vehicle that's not a private passeng auto. USE OF OTHER MOTOR VEHICLES This insurance also applies to certain other motor vehicles as follows: 1. a motor vehicle you do not own, while it is used in place of your auto for a short tim Your auto must be out of use because of: a) breakdown; c) servicing; or b) repair; d) loss. 2. a four-wheel motor vehicle newly acquired by you. It applies only: a) during the first 30 days you own the vehicle unless it replaces your auto; and b) if you do not have other insurance. You must pay any premiums resulting from t coverage. 7 auto liability 9. noneconomic loss of or for any person who has elected "Limited Tort" in accordance with (continued) the Pennsylvania MotorlVehicle Financial Responsibility Law. first party benefits Our obligation to pay Liability losses is limited to the amount per occurrence sta e Declarations. The following conditions apply to this limit: 1. This limit will first be applied to provide the separate bodily injury and property damage limits required to satisfy the financial responsibility law. Any amount remaining within the total limit will then be used as needed. 2. Limits apply as stated in the Declarations. Insuring more than one person or vehicle under this policy does not increase our limits. 3. In any loss covered under items (2) and (3) of "USE OF OTHER MOTOR VEHICLES," the highest liability limit applicable to any one vehicle in this policy will apply. 4. A motor vehicle and attached trailer are considered one vehicle for Auto Liability coverage. LIMITS OF PAYMENT AMOUNTS PAYABLE FOR LIABILITY LOSSES t d in the OTHERINSURANCE In any loss involving the use of your auto, we will be liable for only our share of the loss if there is other collectible liability insurance. Our share is our proportion of the total insurance limits for the loss. For losses involving the use of other motor vehicles, we will pay the insured loss not covered by other insurance. You may have more than one Nationwide policy; we will pay only up to the highest limit of any one of them. ASSIGNABILITY No interest in this coverage can be transferred without our written consent. However, if the policyholder dies, the Liability coverage will continue in force for the rest of the policy period for: 1. Anyone having proper temporary custody of your auto until a legal representative is appointed; and 2. The appointed legal representative. COVERAGE AGREEMENT This coverage provides First Party Benefit options in accordance with the Pennsylvania Moto Vehicle Financial Responsibility Law. The options and limits which the policyholder has selecte, are shown on the Declarations. We will pay First Party Benefits for bodily injury of an insured as a result of an accident th, arises out of the maintenance or use of a motor vehicle as a motor vehicle. We will pay thes benefits regardless of who is at fault in the accident. Additional Definitions Applicable to This Coverage For purposes of this coverage: 1. "RELATIVE" means the following residents of the policyholder's household: a) spouse; b) anyone related to the policyholder or spouse by blood, marriage or adoption; and first party OrTION 3-ACCIDENTAL. D17ATII BENEFIT benefits if this option is selected by Ayment of premium, we will pay the Accidental Death Benefit for (continued) the policyholder or a relative who suffers accidental bodily injury causing death from a covered accident. We will pay the Accidental Death Benefit limit shown on the Declarations. We will increase this limit $10,000 for an insured using an approved motor vehicle seat belt or child he time1?of the accident. Death must occur within two years of, and as a restraint system at the' direct result of, the accident. -Payment will be made to the executor or administrator of the estate. OPTION 4-FUNERAL BENEFIT ium, we will pay reasonable expenses directly related If this option is selected by payment of prem to the funeral, burial, cremation, or other form of disposition of the remains of a deceased insured. These expenses must be the direct result of death from a covered accident within two years of the date of the accident. Payment will be made to any person presenting bills for qualified expenses incurred. We will pay such expenses up to the limit shown on the Declarations. OPTION 5-COMBINED LOSS BENEFITS If this option is selected by payment of premium, we will pay the benefits described in Options 1, 2, 3 and 4 above. However, total benefits payable under this option are limited to: a) the aggregate limit shown on the Declarations for this option; or b) three years from the date of the accident; whichever occurs first. Option 5 is subject to the following conditions: a) Except for the 18 month determination of further expenses to be paid under the Medical Benefit, the "no time limitation" provision does not apply. b) There is no monthly dollar maximum for Income Loss Benefits. c) The maximum Accidental Death Benefit payable is $25,000. d) The maximum Funeral Benefit payable is $2,500. e) Benefits under c) and d) are payable if death occurs within two years of the date of the accident. OPTION 6-EXCESS MEDICAL BENEFITS If this option is selected by payment of premim, we will pay Excess Medical Benefits for ai insured who suffers accidental bodily injury from a covered accident. Excess Medical Benefit are all reasonable expenses for necessary medical treatment and rehabilitative services. We wil pay such expenses in excess of $100,000 but not to exceed one million dollars. We will not pa: Excess Medical Benefits to an insured who is not eligible for option I-Medical Benefits uncle this policy. Our liability to one person in one accident is $50,000 per year. Subject to this limit for any on person in any one year, our aggregate limit for any one person is one million dollars for an one accident. During the first 18 months of eligibility, we shall approve payments for an insure without regard to the $50,000 per year limit. For purposes of this option, the first 18 mono of eligibility begins when the insured has incurred $100,000 of eligible necessary medical treatme and rehabilitative services expenses. If the insured is covered Option 5-Combined Medical Benefit limits greateorrtha similar auto benefi an $100 000 in sue package with another insurer), applicable package shall be excess over any sums paid or payable under Excess Medical Benefits. 11 first party FIRST - For a named insured on any policy, the policy on which that person is the named benefits insured. (continued) SECOND - For a relative, the policy covering the relative as an insured. THIRD - For the occupants of an insured motor vehicle, the policy on that motor vehicle. FOURTH - For a person who is not the occupant of a motor vehicle, the policy on any motor vehicle involvyd in the accident. NO DUPLICATION OF BENEFITS; OTHER INSURANCE In any occurrence where other similar auto insurance or self-insurance of equal priority to that provided in this coverage is available and the claim is first presented to us, we will process and pay the claim as if wholly responsible up to the limits of our policy. The total limits available from all such insurance will be considered not to exceed the highest limits available from any one source of coverage. In no instance may an insured or legal representative recover duplicate benefits from the same elements of loss under this and other similar auto insurance or self-insurance. WORKERS' COMPENSATION REDUCTION We will reduce any amount payable to anyone under this coverage by any benefits received or available under workers' compensation. No reduction will be made if such benefits have not been paid by the time benefits under this coverage are due. However, we will be entitled to reimbursement from whomever is obligated to pay the benefits, or from anyone who ultimately receives them. INSURED PERSONS' DUTIES The insured, or someone on the insured's behalf, will report any accident to us in writing as soon as practicable. This report will identify the injured and give reasonably obtainable information about the time, place and circumstances of the accident. As soon as practicable, the insured or someone on the insured's behalf will submit written proof of claim to us, under oath if required. This proof will include detailed information about the nature and extent of bodily injury, treatment and rehabilitation received and contemplated, and anything else that may help us determine what benefits are payable in what amounts. The injured person must grant us authorization, if we request it, to obtain copies of medical, income and income tax reports and records. Injured persons must submit to examinations by company-selected physicians as often as the company reasonably requires. uninsured Additional Definitions Applicable To This Coverage ¢ "Arbitration" means resolving questions in dispute. yy? I,olons s "Arbitrator" means the party conducting the arbitra (for bodily injury caused by "Uninsured motor vehicle"-See definition in "CO uninsured motorists) COVERAGE AGREEMENT YOU AND A RELATIVE We will pay compensatory damages as a result of b and due by law from the owner or driver of an unins from an accident arising out of the: 1. ownership; 2. maintenance; or 3. use; of the uninsured motor vehicle. 13 lion. VERAGE AGREEMENT" section. odily injury suffered by you or a relative ured motor vehicle. Damages must result uninsured c) any motor vehicle insured under the liability coverage of this or any other policy; nor motorists f) any motor vehicle furnithed for the regular use of you or a relative. (continued) COVERAGE EXCLUSIONS This coverage does not apply`to' 1. Use of any motor vehicle by) an insured to carry persons or property for a fee. Shared-expense car pools are not considered carrying persons for a fee. 2. Use of any motor vehicle by an insured without the owner's permission. 3. Bodily injury of any insured if the insured settles, without our written consent, with a liable party. 4. Bodily injury suffered while occupying a motor vehicle owned by you or a relative but not insured for Uninsured Motorists coverage under this policy; nor to bodily injury from being hit by any such motor vehicle. 5. Punitive or exemplary damages. 6. Noneconomic loss of any insured who has elected ' `Limited Tor[" in accordance with the Pennsylvania Motor Vehicle Financial Responsibility Law. 7. Directly or indirectly benefit any workers' compensation carrier or any person qualified as a self-insurer under any workers' compensation law. INSURED PERSONS' DUTIES 1. The insured must: a) submit written proof of the claim to us. It must be under oath, if required. It must include: (1) the nature and extent of injuries; (2) treatment; and (3) any other details which could affect the amount of payment. b) provide all facts of the accident and the name of all witnesses. c) answer questions under oath as often as we require with good reason. d) be examined by doctors chosen by us as often as we require with good reason. At our request, the injured person must promptly authorize us to: (1) speak with any doctor who has treated him; (2) read all medical history and reports of the injury; (3) obtain copies of wage and medical reports and records; and (4) obtain copies of all medical bills as they are incurred. 2. After notice of claim, we require the insured to take legal action against any liable party. 3. An insured may bring legal action against the other party for bodily injury. A copy of any paper served in this action must be sent to us at once. 4. The insured must: a) obtain our written consent to: (1) settle any legal action brought against any liable party; or (2) release any liable party. b) preserve and protect our right to subrogate against any liable party. ARBITRATION If we and the insured disagree about the right to recover damages, or the amount of such damages: 1. After written demand for arbitration by either party, each %N ill select a competent arbitrator. The two so selected will select a third. 15 > if you have other insurance similar to this coverage under another statevc willd be above, liable forpnly our share of the loss. Our share is our proportion of the ,surance limits for the loss. ty event, if more than one policy applies to an insured other than you or a relative, al limits applicable will be considered not to exceed the highest limits of any one of them. LICATE PAYMENT i(ra(ion will make no duplicate payment to or for any insured for the same element o loss. itten consent. SSIGNABILITY do interest in this coverage can be transferred without our %%rittzn consent. Hoeriod It w hll policyholder dies, this coverage will custody continue in f auorce to for the rest of the policy p 3nce are in apply to anyone having prop I is entitled Additional Definitions Applicable To This Coverage "Arbitration" means resolving questions in dispute. a "Arbitrator" means the party conducting the arbitration. E AGREEMENT" section. 'Public 'nse )le is ed by orlsls) "Underinsured motor vehicle"-See definition in "COVERAG COVERAGE AGREEMENT YOU AND A RELATIVE We will pay compensatory damages as a result of bodily injury' suffered by you or a relative and due by law from the owner or driver of an underinsured motor vehicle. Damages must result from an accident arising out of the: 1. ownership; 2. maintenance; or 3, use; of the underinsured motor vehicle. OTHER PERSONS Anyone else is protected who suffers bodily injury while occupying: 1. Your auto. 2. A motor vehicle you do not own, while it is used in place of your auto for a short time. _Your auto must be out of use because of: a) breakdown; b) repair; c) servicing; or d) loss. , A four-wheel motor vehicle newly acquired by you. This applies only during the first 30 3 days you own the vehicle, unless it replaces your auto. lies 4. Any other motor vehicle while it is being driven by You or a relative. This extension app only in policies issued to persons (not organizations). However, the vehicle must not be: a) owned by you or a relative; or b) furnished to you or a relative for regular use. DERIVATIVE CLAIMS This coverage also protects others for compensatory damages due them, as a derivative claim, by law because of bodily injury to you or a relative. A derivative claim is included within the limit payable per person and per occurrence as described in the Limits of Payment section. 17 '%read all medical history and reports of the injury; no eve veh/ete ) obtain copies of wageiand medical reports and records; and 17Y ooeent Wi// (4)obtain copies of all medical bills as they are incurred. s to motor 0ecya?a onsot fter notice of claim, we require the insured to take legal action against any liable party. An insured may bring legal kction against the other party for bodily injury. A copy of any or for any paper served in this action must be sent to us at once. fdama ,. The insured must: spoy/c6'es a) obtain our written consent to: tat app/y (I) settle any legal action brought against any liable party; or (2) release any liable party. am ages b) preserve and protect our right to subrogate against any liable party. ARBITRATION If we and the insured disagree about the right to recover damages, or the amount of such damages: 1. After written demand for arbitration by either party, each will select a competent arbitrator. ,wn The two so selected will select a third. 2. If the third arbitrator is not agreed upon within 30 days, the insured or we may request ier a judge of a court of record to name one. The court must be in the county and state where he arbitration is pending. 3. Each party will pay its chosen arbitrator. Each will pay half of all other expenses. 4. Arbitration shall be conducted in accordance with the provisions of the Pennsylvania Arbitration Act of 1927. 5. Unless the insured and we agree otherwise, arbitration will take place in the county and state where the insured lives. The insured will submit to examination under oath as often as reasonably requested by us. The insured must grant us authority, at our request, to obtain copies of wage and medical records. The arbitrators will resolve the issues. Questions in dispute will be decided when two arbitrators agree. 6. Any demand for arbitration must be made within two years after the date of the accident. TRUST AGREEMENT This applies to the extent of any payment we make under this coverage. We will have first right to any amount the insured receives from any liable party. The insured will: Hold in trust for us his right to recover against any such party; and 2. Furnish us all papers in any suit the insured files. Our payment of a claim may result from the insolvency of an insurer. If so, we have the right to recover from the insurer, but not its insured. LIMITS OF PAYMENT AMOUNTS PAYABLE FOR UNDERINSURED MOTORISTS LOSSES We agree to pay losses up to the limits stated in the attached Declarations. Any change to those limits must be requested by the policyholder in writing. The following applies to these limits: I. Bodily injury limits shown for any one person are for all legal damages, including all derivative claims, claimed by anyone for bodily injury to one person as a result of one occurrence. Subject to this limit for any one person, the total limit of our liability shown for each occurrence is for all damages, including all derivative claims, due to bodily injury to two or more persons in any one occurrence. 19 general policy conditions (continued) 2. UNAUTHORIZED USE OF OTHER MOTOR VEHICLES Protection in this policy doV not apply to any motor vehicle any insured: a) uses without a reasonable belief that the insured is entitled to do so. b) has stolen. c) knows to have been stall n. 3. HOW YOUR POLICY MAY BE CHANGED a) Any terms of this policy which may be in conflict with statutes of the state in which the policy is issued are hereby amended to conform. b) Any insured will automatically have the benefit of any extension or broadening of coverage in this policy, as of the effective date of the change, provided it does not require more premium. c) No other changes may be made in the terms of this policy except by policy endorsement. d) The premium for each coverage is based on information in our possession. Any change(s) in this information will allow us to make an adjustment of the premium on a pro rata basis. 4. IF YOU BECOME BANKRUPT Bankruptcy or insolvency of any insured will not relieve us of any obligation under the terms of this policy. 5. SUBROGATION We have the right of subrogation under the: a) Physical Damage; b) Auto Liability; and c) Medical Payments; coverages in this policy. This means that after paying a loss to you or others under this policy, we will have the insured's right to sue for or otherwise recover such loss from anyone else who may be liable. Also, we may require reimbursement from the insured out of any settlement or judgment that duplicates our payments. 6. RENEWAL /NON RENEWAL This policy is written for a six-month policy period. We will renew it for successive policy periods, subject to the following conditions: a) renewal will be in accordance with policy forms, rules, rates and rating plans in use by us at the time. b) prior to the expiration date of a policy term for which premium has been paid, we will mail a notice to the policyholder for the premium required to renew or mainitain the policy in effect. We will mail this notice to the address last known to us. c) all premiums or premium installment payments must be paid when due, whether payable directly to us or through any premium finance plan. d) at the end of each 12-month period after the first effective date of the policy or any coverage, we will have the right to refuse to renew any coverage or the entire policy. If we elect not to renew, we will mail notice to the policyholder 60 days in advance of the date when coverage will terminate. Such mailing to the last known address will be considered proof of notice. 21 general policy conditions 10. OPTIONAL PAYMENT OF PREMIUM IN INSTALLMENTS The policyholder may pay4hc premium for this policy in installments, under terms and conditions approved where required by the Department of Insurance. For each separate installment payment there is an installment service charge. Your agent can provide more information about installment payment. Mutual Policy Conditions (Applicable only to policies issued b} Nationwide Mutual Insurance Company-Nationwide Mutual Fire Insurance Company.) If this policy is issued by Nationwide Mutual Insurance Company or Nationwide Mutual Fire Insurance Company, the policyholder is a member of the company issuing the policy while this, or any other policy issued by one of these companies is in force. While a member, the policyholder is entitled to one vote only-regardless of the number of policies issued to the policyholder- either in person or by proxy at meetings of members, of said company. The policyholder is entitled to any dividends which are declared by the Board of Directors and are applicable to coverages in this policy. The annual meeting of members of the Nationwide Mutual Insurance Company will be held at the Home Office at Columbus, Ohio, at 10 a.m. on the first Thursday of April. The annual meeting of members of the Nationwide Mutual Fire Insurance Company will be held at the Home Office at Columbus, Ohio, at 9:30 a.m. on the first Thursday of April. If the Board of Directors of either of the above companies should elect to change the time or place of meeting, that company will mail notice at least 10 days in advance of the meeting date. This policy is non-assessable,'meaning that the policyholder is not subject to any assessment beyond the premiums the above companies require for each policy term. IN WITNESS WHEREOF: Nationwide Mutual Insurance Company, Nationwide Mutual Fire Insurance Company or Nationwide Property and Casualty Insurance Company, whichever is the issuing company as shown in the Declarations, has caused this policy to be signed by its President and Secretary at Columbus, Ohio, and countersigned as may be required by a duly authorized representative of the company. Prexiden! 3rrretnrp 1.5 O NATIONWIDE Nationwide Mutual insurance Company • Naliomnl?e Mutual Fire Insurance Go.-..Pa--Y INSURANCE Nationwide Properly and Casualty Insurance Campely/Home Office: Columbus, Onic 43215-222 23 (continued) DONALD R. DoRER CIRARD E. RICKARDS* ATTORNEYS *CERTIFIED CIVIL TRIAL ADVOCATE NATIONAL BOARD of TRIAL ADVocAcy REFER To: 021113-00074 JACOBS.& SABA (NOT A PARTNERSIIIP) 214 SENATE AVENUE SUITE 503 CAMP Htct, PA 17011 (717)7 1.0988 June 5, 2002 David W. Knauer, Esquire Knauer & Associates 411A East Main Street Mechanicsburg, PA 17055 FAx:(717)731-0987 TDD (800) 622-2421 DENISE E. 1CAUFF\L1N? PARALECAL Re: Gloria My Le Duong vs. Nationwide Mutual Insurance Company Cumberland County: BIW Arbitration Dear Mr. Knauer, As you are aware, I had been retained to defend Nationwide Mutual Insurance Company in your claim for uninsured motorist benefits on behalf of your client, Gloria My Le Duong. I see that you have selected Herschel Lock, Esquire as your arbitrator. Please be advised that Nationwide appoints Richard H. Wix, Esquire as its arbitrator. Allow me to suggest Daniel Altland, Esquire or James Goldsmith, Esquire as the chairman of the panel. r. Before any hearing is scheduled, I anticipate exercising some of Nationwide's rights under its policy. Specifically, I would like to obtain copies of your client's family physician records and employment files. I will also want to take a statement under oath and perhaps have an independent medical examination performed. Based on our earlier discussion, I understand that you really have no idea whether the tortfeasor has any insurance or not. It seems to me that you are somewhat premature in calling this an uninsured motorist case. Please allow me to also address your records subpoena. The subpoena is captioned in a matter where one of the Defendants has been dismissed and you have failed to serve the other Defendant. The Pennsylvania Rules of Civil Procedure specifically outline the procedures for obtaining records by subpoena. Leaving aside the impropriety of your obtaining discovery in a Page 2 Iti 0211B-00074 lawsuit where you have no Defendant in the case, the rules provide that you must serve notice to the opposing parties at least twenty (20) days in advance of your records subpoena. You are also required to provide a certification to the subpoena recipient, indicating that you have followed those procedures. Over the telephone, we discussed that there are several options in dealing with this. One. is that you could attempt to enforce your subpoena by moving for sanctions. The other option is for me to file a Motion to Quash the Subpoena. The third, and the one that we seemed to be leaning towards, is for Nationwide to produce its subrogation file to you. I am enclosing a copy of the remaining documents from Nationwide's subrogation attorney file. The documents include correspondence between the attorneys and its client, Nationwide. Although these documents are attorney/client privilege, I am enclosing them for you in any event. Nationwide has agreed to release this information to you in spite of the attorney/client privilege. I have requested the claim logs for the subrogation file and I anticipate that I will provide them to you in the near future. By doing so, I am not agreeing that your subpoena is in any way proper, nor that you have any right to receive these documents under the terms of the policy through discovery. I am simply providing these documents in an effort to move matters to a conclusion more quickly. You still have a lawsuit in the Court of Common Pleas of Philadelphia County against your alleged uninsured driver, Brett L. Masie. Please provide me with copies of all documents that would indicate your efforts in trying to serve Mr. Masie. As you are quite aware, you can only toll the statute of limitations against him for as long as you can make reasonable efforts at service. If you have not made reasonable efforts at service then you have certainly prejudiced Nationwide's subrogation rights against Mr. Masie. I look forward to receiving those documents, together with authorizations for the release of Mrs. My Le Duong's employment and family physician's files. Feel free to contact me if you have any questions. Ve cvly y rs irar ckards GER:Isw -Camp 02HB-00074 LAW OFFICES OF JACOBS & ASSOCIATES 214 SENATE AVENUE, SUITE 503 CAMP HILL, PA 17011 TELEPHONE NUMBER: (717) 731-0988 ATTORNEY FOR PETITIONER IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA Nationwide Mutual Insurance Company, Petitioner vs. Gloria My Le, Respondent VERIFICATION I, Barbara Noce verify that the statements made in the foregoing _Petition to Appoint an Arbitration Chairman for an Uninsured Motorist Claim Pursuant to 42 Pa.C.S.A. 7305 are true and correct to the best of my knowledge, information and belief. I understand that false statements herein are made subject to the penalties of Pa.C.S.A. §4904, relating to unsworn falsification to authorities. Dated: X0z 'em //Lst //.flC( Barbara Noce 02HB-00074 LAW OFFICES OF JACOBS & ASSOCIATES 214 SENATE AVENUE, SUITE 503 CAMP HILL, PA 17011 TELEPHONE NUMBER: (717) 731-0988 ATTORNEY FOR PETITIONER IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA Nationwide Mutual Insurance Company, Petitioner VS. Gloria My Le, Respondent CERTIFICATE OF SERVICE Girard E. Rickards, Esquire, hereby certifies that he is the attorney for the Petitioner herein, and that he caused a true and correct copy of petition to Appoint an Arbitration Chairman for an Uninsured Motorist Claim Pursuant to 42 N.C.N.A. 7305 to be served by regular first class mail upon: David W. Knauer, Esquire Knauer & Associates 411A East Main Street Mechanicsburg, PA 17055 )ated: December 24, 2003 Girard E. 'ckards, Esquire Attorney for Petitioner l ? f iQ v( 0 F n l N O_ ('7 tTt C7 r .? G? s- W T -{? Rl 7 =i 2•. LZ> )2HB-00074 LAW OFFICES OF JACOBS & ASSOCIATES 214 SENATE AVENUE, SUITE 503 CAMP HILL, PA 17011 TELEPHONE NUMBER: (717) 731-0988 ATTORNEY FOR PETITIONER IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA Nationwide Mutual Insurance Company, Petitioner V3. Gloria My Le, Respondent n-3 -1 L-ST I'mo' ORDER AND NOW, this 7009 day of 1?-, 2004, upon consideration of Nationwide's Petition to Appoint an uninsured motorist arbitrator, said Petition is hereby granted. ime aniel Altland, Esquire is hereby appointed as the arbitration chairman by the Court. The costs of this Petition are to be paid by the Respondent. BY THE COURT: . -e le, 6 oa r u?.n,?0n?;v?nn €s ?z ?a z- tatir aooa 1,EVLONOHIOW 3H130 03a0-43113 02HB-00074 LAW OFFICES OF JACOBS & ASSOCIATES 214 SENATE AVENUE, SUITE 503 CAMP HILL, PA 17011 TELEPHONE NUMBER: (717) 731-0988 ATTORNEY FOR PETITIONER IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA Nationwide Mutual Insurance Company, Petitioner vs. Gloria My Le, Respondent PETITION TO COMPFT, ITN 03-6591 Civil Term THE ALTERNATIVE TO ENTER JUDGMENT IN FAVOR OF NATIONWIDE MUTUAL INSURANCE COMPANY Petitioner, Nationwide Mutual Insurance Company, is an Ohio Corporation with offices at 1000 Nationwide Drive, Harrisburg, Pennsylvania. 2. Respondent, Gloria My Le is an adult individual residing at 145 Black Walnut Drive, Etters, Cumberland County, Pennsylvania, who has at all times relevant hereto been represented by David W. Knauer, Esquire of Mechanicsburg, Pennsylvania. This Petition arises from the Respondent's claim for entitlement of uninsured motorist coverage as a result of the motor vehicle accident that occurred on November 7, 1998. The policy provides for arbitration of disputes under the uninsured motorist coverage pursuant to the Pennsylvania Arbitration Act of 1927. 4. On December 26, 2003, Nationwide Mutual Insurance Company filed a Petition to Appoint an arbitration chairman for this uninsured motorist claim in the Cumberland County Court of Common Pleas. 5. By Order of January 2, 2004, the Honorable George E. Hoffer, P.J. appointed Daniel Altland, Esquire as the arbitration chairman. 6. Prior to the Defendant's Petition to Appoint an Arbitrator, the Respondent had selected Hershel Lock, Esquire as her arbitrator and your Petitioner appointed Richard H. Wix, Esquire as its arbitrator. An uninsured motorist hearing was scheduled on this matter for March 24, 2004 at 9:00 a.m. by the arbitrators and notice was given to the parties. 8. On March 12, 2004, counsel for the Respondent wrote to the arbitrators indicating that his client was withdrawing her claim for uninsured motorist benefits. A true and correct copy of the letter of March 12, 2004 is attached hereto as Exhibit "A" and incorporated herein by reference. 9. On at least two occasions, the Respondent's attorney has advised Nationwide that the withdrawal of the uninsured motorist claim is intended to be without prejudice and he reserves the right to pursue an uninsured motorist claim as a result of the motor vehicle accident of November 17, 1998 at another time. 10. As a result of the letter of March 12, 2004, the Arbitration Panel decided not to hold a hearing because the Plaintiff had withdrawn her claim for uninsured motorist benefits. 11. Counsel for Nationwide opposed the cancellation of the hearing on the basis of the representation of the Respondent's counsel that the matter was being withdrawn with the intention of refilling at some point in the future. A true and correct copy of the letter of March 16, 2004 is attached hereto as Exhibit "B" and incorporated herein by reference. 12. The Uniform Arbitration Act provides that a Court may order parties to proceed with arbitration upon application made by a party. 42 Pa.C.S.A. §7304(a); 42 Pa.C.S.A. §7307(a)(3). The Act also provides that a Court may confirm the arbitrators award or enter judgment or decree upon said award. 42 Pa.C.S.A. §7313; 42 Pa.C.S.A. §7316. 13. Your Petitioner requests this Honorable Court to either compel an arbitration hearing, or to enter a judgment or decree declaring that the uninsured motorist claim is withdrawn with prejudice. 14. Permitting the Respondent to withdraw the claim without prejudice may subject your Petitioner to an arbitration hearing at some date in the future after evidence and/or witnesses are lost and may prejudice the Respondent's ability to produce evidence at said hearing. WHEREFORE, Petitioner, Nationwide Mutual Insurance Company respectfully requests your Honorable Court to enter an Order deeming the Respondent's claim for uninsured motorist benefits denied with prejudice, or in the alternative, to compel the appointed arbitrators to proceed with an arbitration hearing and determine the merits of the Respondent's claim for uninsured motorist benefits. Respectfully submitted, LAW OFFICES ? JACOBS & ASSOCIATES By: irard E. Rickards, Esquire Identification No. 58867 Attorney for Petitioner Date: March 25, 2004 03/17/2004 14:46 7176526990 WIX WENGER! WEIDNER PAGE 01 Knauer & Associates, LSC Attorneys-at-Law 411A. East Mairi Street, Mechahiesburg, PA 17055 Telephone: (717) 795.7790 Fax: (717) 795.7793 David W. Knauer Email: knanfrl)..rh, March 12, 2004 Daniel P. Altland, Esquire 3401 North Front Street Harrisburg, PA 17110 RE: Gloria Le v. Belfiore Dear Mr. Altland: 2004This confirms the telephone message on left on your voice mail on March 11, . My clients have withdrawn their uninsured motorist claim. I so informed Mr. Rickards. By copy of this letter; I am also informing'the other zrbitrators; Richard Wix, Esquire and Herschel Lock, Esquire. Consequently, there will be no arbitration and your services will not be needed. Thank you for your willingness to be an arbitrator. very truly yours, David W. Knauer DWK: bm CC: Gloria Le Richard Wix, Esq. Herschel Lock, Esq. Company\Le\03-12.04\ltr LAW OFFICES JACOBS & ASSOCIATES DONALD R. DORER GIRARD E. RICKARDS- JOANNE E. KINZEL Employees of Nationwide Mutual Imurance Company® Not a Partnership PARALEGALS DENISE E. KAUFFMAN LISA S. WOLFGANG Refer To: 02HB-00074 214 SENATE AVENUE, SUITE 503 CAMP HILL, PA 17011 (717) 731-0988 (FAX) (717) 731-0987 March 16, 2004 FACSIMILE TRANSMISSION Fax Number: (717) 236-1816 P. Daniel Altland, Esquire Mette, Evans & Woodside 3401 North Front Street Harrisburg, PA 17110 Re: Gloria My Le Duong vs. Nationwide Mutual Insurance Company Cumberland County: Uninsured Motorist Arbitration Dear Dan, As you are aware, an uninsured motorist hearing is scheduled for Wednesday, March 24, 2004 at 9:00 a.m. in your office. I recently received a call from Attorney Knauer indicating that his client wished to withdraw her claim for uninsured motorist benefits at this time, reserving the right to file a later claim for benefits. I am requesting that either the hearing go forward for a decision on the merits, or that the arbitrators enter a decision in favor of Nationwide dismissing the uninsured claim with prejudice. This case arises from a 1998 motor vehicle accident in which Ms. Le claims to have been injured. I have witnesses under subpoena and ready to testify at the upcoming hearing. Mr. Knauer named his arbitrator by letter of March 11, 2002. The file was assigned to me and I appointed Nationwide's arbitrator on June 5, 2002. In that letter, I suggested arbitration chairmen and never received a response from Attorney Knauer as to the selection of an arbitration chairman. On December 26, 2003, Nationwide filed a Petition to Appoint Arbitration Chairman pursuant to 42 Pa.C.S.A. §7305. On January 2, 2004, Judge Hoffer signed an Order appointing you as the arbitration chairman. The Uniform Arbitration Act provides that the arbitrators are to appoint a time and place for the hearing and serve notice of the hearing to the parties. The Statute specifically provides that the arbitrators may hear and determine the controversy upon evidence produced at the hearing notwithstanding the failure of a duly notified party to appear. 42 Pa.C.S.A. §7307. That is what I am requesting the arbitrators to do. Nationwide desires a prompt resolution of this uninsured •Ccrdrlcd Civil Trial Advocate by National Board of Trial Advocacy, A Pennsylvania Supreme Court Accredited Agency Bethlehem • Conshohocken • Doylestown • Greensburg • Harrisburg • Philadelphia • Pittsburgh • Wilkes. Barre Page 2 02HB-00074 motorist claim. To permit the Plaintiff to withdraw her claim now and bring it at a later date may result in the loss of documents and/or witnesses that are available and scheduled to appear at the arbitration hearing. Your consideration is greatly appreciated. Very truly yours, Girard E. Rickards GER:dek David W. Knauer, Esquire Richard Wix, Esquire Hershel Lock, Esquire 'Certified Civil Trial A&ocak by National Board of Trial 02HB-00074 LAW OFFICES OF JACOBS & ASSOCIATES 214 SENATE AVENUE, SUITE 503 CAMP HILL, PA 17011 TELEPHONE NUMBER: (717) 731-0988 ATTORNEY FOR PETITIONER IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA Nationwide Mutual Insurance Company, Petitioner vs. Gloria My Le, Respondent 03-6591 Civil Term VERIFICATION I, Barbara Noce verify that the statements made in the foregoing Petition to Compel Insurance Company are true and correct to the best of my knowledge, information and belief. I understand that false statements herein are made subject to the penalties of Pa.C.S.A. §4904, relating unswom falsification to authorities. Dated: ,s )10'r Barbara Noce 02HB-00074 LAW OFFICES OF JACOBS & ASSOCIATES 214 SENATE AVENUE, SUITE 503 CAMP HILL, PA 17011 TELEPHONE NUMBER: (717) 731-0988 ATTORNEY FOR PETITIONER IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA Nationwide Mutual Insurance Company, Petitioner vs. Gloria My Le, Respondent 03-6591 Civil Term CERTIFICATE OF SERVICE Girard E. Rickards, Esquire, hereby certifies that he is the attorney for the Petitioner herein, and that he caused a true and correct copy of Petition to Compel Uninsured Motorist Arbitration or in the Alternative to Enter Judment in Favor of Nationwide Mutual Insurance Company to be served by regular first class mail upon: David W. Knauer, Esquire Knauer & Associates 411A East Main Street Mechanicsburg, PA 17055 Dated:_ March 25, 2004 Girard E. ?ckards, E quire Attorney for Petitioner s rn ?rYy .^O ? r i ?? Tt3 y n c.n i '? w 02HB-00074 LAW OFFICES OF JACOBS & ASSOCIATES 214 SENATE AVENUE, SUITE 503 CAMP HILL, PA 17011 TELEPHONE NUMBER: (717) 731-0988 ATTORNEY FOR PETITIONER IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY. PENNSYLVANIA Nationwide Mutual Insurance Company, Petitioner VS. Gloria My Le, Respondent No. 03-6591 Civil Term ORDER AND NOW, this day o*bi 2004, upon consideration of Nationwide's Petition to Compel Unins-'?'ureedd???MMootorist i on or in the Alternative to deem the Uninsured Motorist Claims withdrawn with prejudice, said Petition is hereby granted. The Arbitration Panel is to proceed promptly with the hearing and determination of the uninsured motorist claim. BY THE COURT: L4* f. I - G? - N N r 02HB-00074 LAW OFFICES OF JACOBS & ASSOCIATES 214 SENATE AVENUE, SUITE 503 CAMP HILL, PA 17011 TELEPHONE NUMBER: (717) 731-0988 ATTORNEY FOR PETITIONER IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA Nationwide Mutual Insurance Company, Petitioner VS. Gloria My Le, Respondent No. 03-6591 Civil Tenn PETITION TO COMPEL UNINSURED MOTORIST ARBITRATION OR IN THE ALTERNATIVE, TO ENTER JUDGMENT IN FAVOR OF NATIONWIDE MUTUAL INSURANCE COMPANY Petitioner, Nationwide Mutual Insurance Company, is an Ohio Corporation with offices at 1000 Nationwide Drive, Harrisburg, Pennsylvania. 2. Respondent, Gloria My Le is an adult individual residing at 145 Black Walnut Drive, Etters, Cumberland County, Pennsylvania, who has at all times relevant hereto been represented by David W. Knauer, Esquire of Mechanicsburg, Pennsylvania. 3. This Petition arises from the Respondent's claim for entitlement of uninsured motorist coverage as a result of the motor vehicle accident that occurred on November 7, 1998. The policy provides for arbitration of disputes under the uninsured motorist coverage pursuant to the Pennsylvania Arbitration Act of 1927. 4. On December 26, 2003, Nationwide Mutual Insurance Company filed a Petition to Appoint an arbitration chairman for this uninsured motorist claim in the Cumberland County Court of Common Pleas. By Order of January 2, 2004, the Honorable George E. Hoffer, P.J. appointed Daniel Altland, Esquire as the arbitration chairman. 6. Prior to the Defendant's Petition to Appoint an Arbitrator, the Respondent had selected Hershel Lock, Esquire as her arbitrator and your Petitioner appointed Richard H. Wix, Esquire as its arbitrator. 7. An uninsured motorist hearing was scheduled on this matter for March 24, 2004 at 9:00 a.m. by the arbitrators and notice was given to the parties. On March 12, 2004, counsel for the Respondent wrote to the arbitrators indicating that his client was withdrawing her claim for uninsured motorist benefits. A true and correct copy of the letter of March 12, 2004 is attached hereto as Exhibit "A" and incorporated herein by reference. 9. On at least two occasions, the Respondent's attorney has advised Nationwide that the withdrawal of the uninsured motorist claim is intended to be without prejudice and he reserves the right to pursue an uninsured motorist claim as a result of the motor vehicle accident of November 17, 1998 at another time. 10. As a result of the letter of March 12, 2004, the Arbitration Panel decided not to hold a hearing because the Plaintiff had withdrawn her claim for uninsured motorist benefits. 11. Counsel for Nationwide opposed the cancellation of the hearing on the basis of the representation of the Respondent's counsel that the matter was being withdrawn with the intention of refilling at some point in the future. A true and correct copy of the letter of March 16, 2004 is attached hereto as Exhibit "B" and incorporated herein by reference. 11 The Uniform Arbitration Act provides that a Court may order parties to proceed with arbitration upon application made by a party. 42 Pa.C.S.A. §7304(a); 42 Pa.C.S.A. §7307(a)(3). The Act also provides that a Court may confirm the arbitrators award or enter judgment or decree upon said award. 42 Pa.C.S.A. §7313; 42 Pa.C.S.A. §7316. 13. Your Petitioner requests this Honorable Court to either compel an arbitration hearing, or to enter a judgment or decree declaring that the uninsured motorist claim is withdrawn with prejudice. 14. Permitting the Respondent to withdraw the claim without prejudice may subject your Petitioner to an arbitration hearing at some date in the future after evidence and/or witnesses are lost and may prejudice the Respondent's ability to produce evidence at said hearing. WHEREFORE, Petitioner, Nationwide Mutual Insurance Company respectfully requests your Honorable Court to enter an Order deeming the Respondent's claim for uninsured motorist benefits denied with prejudice, or in the alternative, to compel the appointed arbitrators to proceed with an arbitration hearing and determine the merits of the Respondent's claim for uninsured motorist benefits. Respectfully submitted, LAW OFFICES QF JACOBS & ASSOCIATES By: .tii4E.ickards, Esquire Identification No. 58867 Attorney for Petitioner Date: March 25, 2004 WIX WENGER WEIDNER PAGE 01 03/17J2004 14:46 7176526790 Knauer &. Associates, LSC Attorneys-at-Law 411A. East Main Street, Mec6hiosburg, FA 17055 Telephone: (717) 795.7790 David W. Knauer Fax: (717) 795-7793 Email: knaucrC4?earlv.com www.knauerlaw.eom March 12, 2004 Daniel P. Altland, Esquire 3401 North Front Street Harrisburg, PA I II 10 RE: Gloria Le v. Belfiore Dear Mr. Altland: This confirms the telephone message on left on your voice mail on March 11, 2004. My clients have withdrawn their uninsured motorist claim. I so informed Mr. Rickards. By copy of this letter; I am also informing the other arbitrators; Richard Wix, Esquire and Herschel Lock, Esquire. Consequently, there will be no arbitration and your services will not be needed. Thank you for your willingness to be an arbitrator. Very truly yours, David W. Knauer DWK: bm CC: Gloria Le Richard Wix, Esq. Herschel Lock, Esq, Company\Le\03-12-04Vtr LAW OFFICES JACOBS & ASSOCIATES DONALD R. DORER GIRARD E. RICKARDS* JOANNE E. KINZEL Employees of Nationwide Mutual Insurance Company® Not a Partnership PARALEGALS DENISE E. KAUFFMAN LISA S. WOLFGANG 214 SENATE AVENUE, SUITE 503 CAMP HILL, PA 17011 (717) 731-0988 (FAX) (717) 731-0987 Refer To: 02HB-00074 March 16, 2004 FACSIMILE TRANSMISSION Fax Number: (717) 236-1816 P. Daniel Altland, Esquire Mette, Evans & Woodside 3401 North Front Street Harrisburg, PA 17110 Re: Gloria My Le Duong vs. Nationwide Mutual Insurance Company Cumberland County: Uninsured Motorist Arbitration Dear Dan, As you are aware, an uninsured motorist hearing is scheduled for Wednesday, March 24, 2004 at 9:00 a.m. in your office. I recently received a call from Attorney Knauer indicating that his client wished to withdraw her claim for uninsured motorist benefits at this time, reserving the right to file a later claim for benefits. I am requesting that either the hearing go forward for a decision on the merits, or that the arbitrators enter a decision in favor of Nationwide dismissing the uninsured claim with prejudice. This case arises from a 1998 motor vehicle accident in which Ms. Le claims to have been injured. I have witnesses under subpoena and ready to testify at the upcoming hearing. Mr. Knauer named his arbitrator by letter of March 11, 2002. The file was assigned to me and I appointed Nationwide's arbitrator on June 5, 2002. In that letter, I suggested arbitration chairmen and never received a response from Attorney Knauer as to the selection of an arbitration chairman. On December 26, 2003, Nationwide filed a Petition to Appoint Arbitration Chairman pursuant to 42 Pa.C.S.A. §7305. On January 2, 2004, Judge Hoffer signed an Order appointing you as the arbitration chairman. The Uniform Arbitration Act provides that the arbitrators are to appoint a time and place for the hearing and serve notice of the hearing to the parties. The Statute specifically provides that the arbitrators may hear and determine the controversy upon evidence produced at the hearing notwithstanding the failure of a duly notified party to appear. 42 Pa.C.S.A. §7307. That is what I am requesting the arbitrators to do. Nationwide desires a prompt resolution of this uninsured •Certirted Civil Trial Advocate by National Board of Trial Advocacy, A Pennsylvania Supreme Court Accredited Agency Bethlehem • Conshohocken • Doylestown - Greensburg • Harrisburg • Philadelphia - Pittsburgh • Wilkes-Barre Page 2 P. Daniel Altland, Esquire 02HB-00074 March 16, 2004 motorist claim. To permit the Plaintiff to withdraw her claim now and bring it at a later date may result in the loss of documents and/or witnesses that are available and scheduled to appear at the arbitration hearing. Your consideration is greatly appreciated. Very truly yours, Girard E. Rickards GER:dek c: David W. Knauer, Esquire Richard Wix, Esquire Hershel Lock, Esquire •Certifted Civil Trial Advocate by National Board of Trial Advocacy. A Pennsylvania Supreme Court Accredited Agency Bethlehem • Conshohocken • Doylestown • Greensburg • Harrisburg • Philadelphia • Pittsburgh • Wilkes-Barre 02HB-00074 LAW OFFICES OF JACOBS & ASSOCIATES 214 SENATE AVENUE, SUITE 503 CAMP HILL, PA 17011 TELEPHONE NUMBER: (717) 731-0988 ATTORNEY FOR PETITIONER IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA Nationwide Mutual Insurance Company, Petitioner VS. Gloria My Le, Respondent No. 03-6591 Civil Tenn VERIFICATION I, Barbara Noce verify that the statements made in the foregoing Petition to Compel Uninsured Motorist Arbitration or in the Alternative, to Enter Judgment in Favor of Nationwide Mutual Insurance Company are true and correct to the best of my knowledge, information and belief. I understand that false statements herein are made subject to the penalties of Pa.C.S.A. §4904, relating to unsworn falsification to authorities. Dated: "? y \??1?L? Barbara Noce 02HB-00074 LAW OFFICES OF JACOBS & ASSOCIATES 214 SENATE AVENUE, SUITE 503 CAMP HILL, PA 17011 TELEPHONE NUMBER: (717) 731-0988 ATTORNEY FOR PETITIONER IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA Nationwide Mutual Insurance Company, Petitioner vs. Gloria My Le, Respondent No. 03-6591 Civil Term CERTIFICATE OF SERVICE Girard E. Rickards, Esquire, hereby certifies that he is the attorney for the Petitioner herein, and that he caused a true and correct copy of Petition to Compel Uninsured Motorist Arbitration or in the Alternative, to Enter Judgment in Favor of Nationwide Mutual Insurance Company to be served by regular first class mail upon: David W. Knauer, Esquire Knauer & Associates 411 A East Main Street Mechanicsburg, PA 17055 Dated:_ March 25, 2004 Girard E. 'ckards, Esquire Attorney for Petitioner f7 o C o G -n l' i ? T -r; Sl _ _ ? N ( y -? C7 _ C;? ?('? _t. _ TJ i_ 3^` __ ,?? _? ?, 0211B-00074 LAW OFFICES OF.IACOBS & ASSOCIATES 214 SENATE AYENUF, SULFE 503 CAMP HILL, PA 17011 TELEPHONE NUMBER: (717) 731-0988 ATTORNEY FOR PETITIONER IN "I] IE COURT OF COMMON PLEAS (TIMBERLAND COUNTY, PENNSYLVANIA Nationwide Mutual Insurance Company Petitioner vs. Gloria My Le, Respondent No. 03-6591 Civil Term ORDER AND NOW, this _ day of 2004, upon consideration of Nationwide's Petition to Compel Uninsured Motorist Arbitration or in the Alternative to deem the Uninsured Motorist Claims withdrawn with prejudice, said Petition is hereby granted. The Arbitration Panel is to proceed promptly with the hearing and determination of the uninsured motorist claim. BY THE COURT: Exhibit A Exhibit B ¦111¦?II?Ilflll8????1??1 ?? a i ?.? '?? ? i ?I ? ?? I'? i N c? N Y ?: N r• /TE E Ap L' Oj']SU]TE 503 1 gTE S Ar"ORNEVEp UMBER: (717) 731.0988 R PETITIONER ? COUIR T lVahnnwideAfutuallnsuraneeCUA?IBE?AND O ?FCOA'11LfOVpLEAS Petitioner CofiPanY, / T Y pEWSYLVAAIIA vs. Gloria Mq , Le, R"POndent 03_6591 Civil 1 errn tftALT ?1ti1pE L N. _E?'ATTt,., COURT OF COMMON PLEAS OF CUMBERLAND COUNTY Nationwide Mutual Insurance Company, : Vs. Gloria My Le, Petitioner No. 03-6591- Civil Term Respondent : NOTICE OF APPEAL Notice is hereby given that Gloria My Le, the above named defendant, hereby appeals to the Superior Court of Pennsylvania from the order entered in this matter on the 2nd day of April, 2004. This order has been entered in the docket as evidenced by the attached copy of the docket entry. Respectfully submitted, KNAUER & ASSOCIATES, L.S.C. ` L David W. Knauer, squire Attorney for Plaintiff Attorney I.D. No. 21582 411-A East Main Street Mechanicsburg, PA 17055 Date: April 30, 2004 (717) 795-7790 MAR 2 0 2004 02RB-00074 APR 0,8 "lowf LAW OFFICES OF JACOBS & ASSOCIATES ui?L:1,0L =0 U L --ro 214 SENATE AVENUE, SUITE 503 --- -------' CArvtPHILL,PA 17011 TELEPHONE NUMBER: (717) 731-0988 ATTORNEY FOR PETITIONER IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA Nationwide Mutual Insurance Company, Petitioner vs. Gloria My Le, Respondent 03-6591 Civil Term ORDER AND NOW, this a.n,.L. day of , 2004, upon Consideration ofNationwide's Petition to Compel Arbitration or in the Alternative to declare the Respondent's uninsured motorist claim withdrawn with prejudice, said Petition is hereby granted. The claim of Gloria My Le for uninsured motorist benefits as a result of a motor vehicle accident that occurred on November 7, 1998 is deemed withdrawn with prejudice. BYTHECOURT: lfl?fv,t'::^)r,ytrrbet°u*.:,!r,t•r:;unt?°?;rhti'ft:lct0 ., 3•"ili lj1;i :tiSi 7N r:3:i: i'd;:r: at iit1:a?, ?+i.. ? _ ...- - 1•i3'a a n .t iy' 1?. PYS511 Cumberland County Prothonotary's Office Page 1 Civil Case Print 2003-06591 NATIONWIDE MUTUAL INS CO (vs) LE GLORIA MY Reference No..: Filed........: 12/26/2003 Case T e.....: PETITION Time........ : 1:49 Judgmen ......: .00 Execution Date 0/00/0000 Judge Assigned: Jury Trial.... Disposed Desc.: Disposed Date. 0/00/0000 ------------ Case Comments ------------- Higher Crt 1.: Higher Crt 2.: ******************************************************************************** General Index Attorney Info NATIONWIDE MUTUAL INSURANCE PETITIONER RICKARDS GIRARD E COMPANY 1000 NATIONWIDE DRIVE HARRISBURG PA LE GLORIA MY RESPONDANT 145 BLACK WALNUT DRIVE ETTERS PA 17319 ******************************************************************************** * Date Entries ******************************************************************************** 12/26/2003 PETITION TO APPOINT AN ARBITRATIONNCHAIRMAN FOR AN UNINSURED MOTORIST CLAIM PURSUANT TO 42 PA CSA 7305 - BY GIRARD E RICKARD ESQ ----------------- --------------------------------------- 1/02/2004 ORDER - DATED 1/2/04- - -IN-RE-NATIONWIDE'S-PETITION-TO-APPOINT - AN--- UNINSURED MOTORIST ARBITRATOR AND PETITION IS HEREBY GRANTED DANIEL ALTLAND ESQ IS HEREBY APPOINTED AS THE ARBITRATION CHAIRMAN BY THE COURT THE COURTS OF THIS PETITION ARE TO BE PAID BY - BY THE COURT GEORGE E HOFFER PJ COPIES MAILED -------------------------------------------- ----------- 3/26/2004 PETITION TO COMPEL UNINSURED MOTORIST - ARBITRATION - OR - IN - THE -------- ALTERNATIVE TO ENTER JUDGMENT IN FAVOR OF NATIONWIDE MUTUAL INSURANCE COMPANY - BY GIRARD E RICKAR:DS ESQ FOR PETITIONER --------------------------------------------- --- 4/02/2004 ORDER-DATED-4/2-04---IN-RE-PETITION-TO-COMPEL-UNINSURED- /MOTORIST ARBITRATION - IS GRANTED - HEARING AND THE DETERMINATIION PANEL OF E THE SCLAIM - GEORGE E HOFFER PJ COPIES MAILED - - - - - - - - - - - - - - LAST ENTRY - - - - - - - - - - - - - - ******************************************************************************** * Escrow Information * Fees & Debits Bw*Bal** P*ymts/Add End Bal ************************************ ****** ******************************* PETITION 35.00 35.00 .00 TAX ON PETITION .50 .50 ,00 SETTLEMENT 5.00 5.00 .00 AUTOMATION FEE 5.00 5.00 .00 JCP FEE 10.00 10.00 .00 ------------------------ ------------- 55.50 55.50 .00 ******************************************************************************** * End of Case Information ******************************************************************************** TRUE COPY FROM RECORD in TestiMMY whereof, 1 here unto set my h&W and the seal of said Court at Caruso. Ps. Pr ?Ii, `? 9J cA ? J) C OQ `? ?J 0 O L -a 0 -a P ? o 0 cn Z V W Oa O NATIONWIDE MUTUAL INSURANCE COMPANY V. GLORIA MY LE IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVNIA 03-6591 CIVIL TERM IN RE: STATEMENT OF REASONS ORDER OF COURT AND NOW, April 30, 2004, notice having been received that an appeal has been taken in the above-captioned matter, it is ordered and directed that the appellant forthwith file with the trial judge a concise statement of the matters complained of on the appeal, together with reference to any statutory authority or any rule of court. Upon the failure of the appellant to file such reasons within ten days, the court will presume that the appeal has been abandoned. By the Court, eer, P.J. David W. Knauer, Esquire 411-A East Main Street Mechanicsburg, PA 17055 For Appellant Girard E. Rickards, Esquire 214 Senate Avenue, Suite 503 Camp Hill, PA 17011 For Nationwide Mutual ?t. v v,of ,) 17 8h ?£ tJd £- t?WhOUZ dt?blOCWOk{10d 3H130 R)JI40-0314 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA Nationwide Mutual Insurance Company, Petitioner No. 03-6591- Civil Term Vs. Gloria My Le, Respondent DEFENDANT'S CONCISE STATEMENT OF REASONS FOR APPEAL PURSUANT TO PA.R.A.P. 1925(B) The Defendant's concise statement for reasons for appeal pursuant to Pa.R.A.P. No. 1925(b) are: 1. The Court never had jurisdiction over the Defendant because: a.) the Plaintiff never attempted to serve the Defendant; b.) The Plaintiff's counsel never requested that the undersigned accept service of any type of initial pleading; c.) The Defendant never accepted service of any type of initial pleading; 2. The Defendant never had any duty pursuant to Pa.R.C.P. No.1026 to reply to the Plaintiffs petitions because the Plaintiff did not have a notice to plead on either petition. 3. In addition to the foregoing, the Court deprived the Defendant of the right to be heard and her due process rights because: a.) the Plaintiff filed its initial petition on Friday, December 26, 2003 and the Defendant did not receive her copy of the petition until Monday, December 29, 2003. Two business days later, on January 2, 2004, the Court granted the Plaintiff's petition; b.) the Plaintiff filed its motion to compel on March 26, 2004 with the Defendant receiving the copy of the petition on March 29, 2004. Four days later, the Court granted the petition and dismissed the Defendants claim. 4. The Plaintiff violated R.P.C. No. 3.3(d) when it filed its initial petition that was an ex parte petition because it failed to inform the Court of "all material facts". The material fact was that the Plaintiff pled that the arbitration had to take place in the county and state of the insured's residence, paragraph 10. Although the Plaintiff knew that the Defendant resided in Houston, Texas, it failed to reveal to the court the Defendant's address. The address is a material fact because proposing a neutral arbitrator who is not a Texas lawyer when the arbitration should be held in Houston and appointing a Dauphin county lawyer is an abuse of discretion. 5. The insurance policy between the Plaintiff and the Defendant is a contract of adhesion that must be construed strictly against the insurer. The uninsured/underinsured provisions of the aforesaid policy do not contain any provision that would prohibit the Defendant from withdrawing her request and later re-filing it. By way of example only, Pa.R.C.P.No. 229 and 231 the rules governing discontinuances permit the withdrawal of a claim and the re-filing of the claim. a.) the contract of insurance did not contain any provision that would allow the claim to be dismissed should the insured withdraw the request for arbitration of the underinsured claim and then re-file it or give to any court the authority to dismiss the Defendant's claim. 6. The Order of April 2, 2004 dismissing the insured's underinsurance claim constituted a violation of the due process requirements of both the United States Constitution and the Constitution of the Commonwealth of Pennsylvania and deprived the Defendant of rights and property for the following reasons: 2 a.) the lack of jurisdiction precluded the Court from rendering any decision on any matter related to the petition presented; b..) in the alternative, the granting of the first petition on the fourth day after the petitioner filed the petition was insufficient time for the Respondent to reply to the petition even if the Petitioner had placed a notice to plead on the petition; c.) the granting of the second petition on the fourth day after the petitioner filed the petition was insufficient time for the Respondent to reply to the petition even if the Petitioner had placed a notice to plead on the petition; d.) Pa.R.A.P. No. 1925(b) provides that the statement required thereunder be filed within fourteen days of the entry of the Order. The court's Order under Pa.R.A.P. No. 1925(b) only provided the insured with ten days from the date of the order; e.) Nationwide's insurance policy is a contract of adhesion and must be interpreted strictly against the insurance company. The policy does not prohibit the withdrawal of a claim and the re-filing of the claim at a subsequent date. The court's dismissal of the claim with prejudice violated the terms of the policy. The Pennsylvania Rules of Civil Procedure permit the discontinuance of a claim without bar of a second action. The Court's grant of the dismissal request would not be sustained if the case were brought as a civil case; f.) the two orders the court issued were both ex parte orders and Nationwide's counsel did not comply with the requirements of Pa. R. No. 3.3(d) in that Nationwide did not give the court the information necessary to enter an exp parte order, g.) there was no reason that ex parte orders should have been issued in this case; h.) the court did not have subject matter jurisdiction; i.) the proper procedure should have been the issuance of a rule to show cause so that the Defendant would have had an opportunity to make a reply thereto especially because the Plaintiff did not have a notice to plead. Respectfully submitted, KNAUER & ASSOCIATES, L.S.C. avid W e , Esquire Attorney for Plaintiff Attorney I.D. No. 21582 411-A East Main Street Mechanicsburg, PA 17055 Date: May 10, 2004 (717) 795-7790 4 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Nationwide Mutual Insurance Company, Petitioner Vs. Gloria My Le, Respondent No. 03-6591 Civil Term CERTIFICATE OF SERVICE I, David W. Knauer, hereby certify that I did this 10nth day of May, 2004, serve a true and correct copy of the Defendant's Concise Statement Of Reasons For Appeal Pursuant To PA.R.A.P. 1925(B) on all counsel of record by United States mail, first class, prepaid addressed as follows: The Honorable George Hoffer Girard E. Rickards, Esquire Cumberland County Courthouse 214 Senate Ave., Suite 503 One Courthouse Square Camp Hill, PA 17011 Carlisle, PA 17013 Dawd W. Knau r Attorney for Plaintiff Attorney I.D. No. 21582 411-A East Main Street Mechanicsburg, PA 17055 (717) 795-7790 r?'? ?? -i _ .-i • 'T' _? " ;'.l i__. 1 __ -;C n ?`? r`? '= E. C,? C '' ? ?.. G ? . IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Nationwide Mutual Insurance Company, : Petitioner No. 03-6591- Civil Term Vs. Gloria My Le, Respondent : MOTION TO OBJECT TO JURISDICTION NUNC PRO TUNC 1. The Petitioner commenced the above matter by filing a Petition to Appoint an Arbitration Chairman for an Uninsured Motorist Claim Pursuant to 42 Pa.C.S.A. 7305. 2. The Petitioner never provided to the Sheriff of Cumberland County a copy of the aforesaid motion to serve upon the Respondent. 3. Although the Petitioner knew that it had not provided a copy of the aforesaid motion to the Sheriff of Cumberland County, it presented the aforesaid Petition to the Court for action without informing the Court that it had not attempted to obtain jurisdiction over the Respondent and had not served the Respondent with any original process. 4. In paragraph 10 of the aforesaid petition, the Petitioner stated that the arbitration had to be held in the county and state where the insured resided. 5. Prior to the filing of the aforesaid petition, the Petitioner knew that the Claimant resided and had resided for a number of years in Houston, Texas. 6. Although the Petitioner presented the aforesaid Petition as an ex parte motion, it breached its duty as set forth in Pennsylvania Rules of Professional Conduct No. 3.3(d) by failing to include any statement that the Petitioner did not have personal jurisdiction over the Respondent and had not attempted to obtain jurisdiction over the Respondent for service of process and that the Respondent resided in Houston, Texas. 7. Given that the hearing would have to be held in Houston, Texas, the appointment of a Dauphin County attorney, P. Daniel Altland, Esquire as chairman of the arbitration panel would be not be appropriate. 8. The Court by Order dated January 2, 2004 granted the Petitioner's Petition filed on December 26, 2003 and appointed Mr. Altland as chairman of the arbitration panel. 9. The Petitioner then filed a Petition to Compel Uninsured Motorist Arbitration or in the Alternative to Enter Judgment in Favor of Nationwide Mutual Insurance Company on March 26, 2004. 10. On April 4, 2004, the Honorable George E. Hoffer granted the motion to compel but did not grant the motion to dismiss. However, when the Prothonotary's office certified the order for the Respondent's counsel in another matter, it certified the order Judge Hoffer did not sign and not the order that he signed. However, on May 10, 2004, the Petitioners counsel informed the Respondent's counsel in another matter that he had received both orders certified as signed by Judge Hoffer. Petitioner's counsel did not inform either Judge Hoffer or the Respondent's counsel in another matter that he had certified copies that showed both mutually exclusive orders had been certified as signed. 11. In the alternative, on both petitions the Petitioner failed to include a 2 notice to plead and pursuant to Pa.R.C.P. No. 1026, the Respondent had no duty to respond to the aforesaid petitions. 12. The Respondent wishes to enter a limited appearance for the purpose of challenging jurisdiction over the Respondent and that all proceedings be stayed in the meantime. WHEREFORE, the Respondent prays that Your Honorable court will issue a rule to show cause on the Defendant to show cause why the Respondent should not be allowed to enter a limited appearance nunc pro tunc to challenge jurisdiction over the Respondent and that all proceedings be stayed in the meantime. Respectfully submitted, KNAUER & ASSOCIATES, L.S.C. i v4 avid W. Knauer, Esquire Attorney for Plaintiff Attorney I.D. No. 21582 411-A East Main Street Mechanicsburcf, PA 17055 Date: May 11, 2004 (717) 795-7790 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Nationwide Mutual Insurance Company, : Gloria My Le, Vs. Petitioner Respondent : No. 03-6591 Civil Term CERTIFICATE OF SERVICE I, David W. Knauer, hereby certify that I did this 11 nth day of May, 2004, serve a true and correct copy of the Motion To Object To Jurisdiction Nunc Pro Tunc on all counsel of record by United States mail, first class, prepaid addressed as follows: The Honorable George Hoffer Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 Girard E. Rickards, Esquire 214 Senate Ave., Suite 503 Camp Hill, PA 17011 David W. Knauer Attorney for Plaintiff Attorney I. D. No. 21582 411-A East Main Street Mechanicsburg, PA 17055 (717) 795-7790 n ° ? C ? i ?^ ? T -?G ' "n . _ _ n T Y ?_' ?" !?<7 ? ?-. 7i CJ 'A =< ? IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Nationwide Mutual Insurance Company, : Petitioner No. 03-6591- Civil Term Vs. Gloria My Le Respondent : ?j,? ORDE , ` AND NOW, this day of 2004, upon consideration of the attached Motion to Object To J diction Nunc Pro Tunc, it is hereby ORDERED and DECREED that the aforesaid Motion is hereby GRANTED and a rule to show cause is issued on the (Petitioner to show cause why the Respondent should not be allowed to enter a (limited appearance nunc pro tunc to challenge jurisdiction over the Respondent. All proceedings are stayed in the meantime. Rule returnable within 2,0 days of service. By the Court, oh 4 v? gS :? ?!d t ? ??whaaz ldd1J?:? X10' ?L4120 02HB-00074 LAW OFFICES OF JACOBS & ASSOCIATES 214 SENATE AVENUE, SUITE 503 CAMP HILL, PA 17011 TELEPHONE NUMBER: (717) 731-0988 ATTORNEY FOR PETITIONER IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY. PENNSYLVANIA Nationwide Mutual Insurance Company, Petitioner VS. Gloria My Le, Respondent 03-6591 Civil Term PETITIONER'S RESPONSE TO RESPONDENT'S MOTION TO OBJECT TO JURISDICTION NUNC PRO TUNC 1. Admitted. By way of further answer, the Petition was filed on December 26, 2003. Said Petition was served via first class mail upon counsel for the Respondent on December 24, 2003 as evidenced by the Certificate of Service and cover letter attached hereto as Exhibit "A" and incorporated herein by reference. 2. Admitted. 3. Denied as a conclusion of law. The Petitioner served counsel for the Respondent via first class mail as evidenced by Exhibit "A" of this answer. 4. Admitted. Denied as stated. On the contrary, the Respondent had retained counsel in Mechanicsburg, Pennsylvania and appointed an arbitrator for the purposes of pursuing an uninsured motorist claim in Harrisburg, Pennsylvania. The Claimant's address as listed on the declarations page and, as of at least the date of the accident giving rise to the claim for uninsured motorist benefits, was 145 Black Walnut Drive, Etters, Cumberland County, Pennsylvania. 6. Each and every allegation of paragraph 6 represents a conclusion of law which is specifically denied. To the contrary, counsel for Gloria My Le, David W. Knauer, Esquire, was served via first class mail with the Petition on December 24, 2003. Attorney Knauer failed to raise any objection to service or jurisdiction until this past month. Each and every averment of paragraph 7 is specifically denied. To the contrary, the appointment of P. Daniel Altland, Esquire was appropriate in that the Claimant appointed arbitrator, Hershel Lock, Esquire by letter of March 11, 2002. Attorney Lock is an attorney with offices in Harrisburg, Pennsylvania. A true and correct copy of the letter of March 11, 2002 is attached hereto as Exhibit "B" and incorporated herein by reference. 8. Admitted. By way of further answer, the Prothonotary's office served upon Attorney Knauer a conformed copy of the Order appointing Mr. Altland as Chairman of the Arbitration Panel. 9. Admitted. By way of further answer, David W. Knauer, Esquire was served with a copy of the Petition to Compel Uninsured Motorist Arbitration or in the Alternative, To Enter Judgment In Favor of Nationwide Mutual Insurance Company on March 25, 2004, as evidenced by the Certificate of Service and enclosure letter attached hereto as Exhibit "C" and incorporated herein by reference. 10. Admitted in part and denied in part. It is admitted that on April 4, 2004, the Honorable George E. Hoffer granted a Motion to Compel Arbitration. The Court has represents to the parties that it did not enter any Order granting a Motion to Dismiss. The Prothonotary's office mailed to counsel for the Petitioner and the Respondent two conformed Orders, one compelling the arbitration to go forward, and the other dismissing the uninsured motorist claim with prejudice. 11. The allegations of paragraph 11 constitute a conclusion of law as to which no response is required. To the extent that a response is deemed required, the Petitioner believes and therefore avers that the Respondent has waived any objection to improper service and therefore personal jurisdiction. 12. Respondent's counsel, David W. Knauer, Esquire has already entered an appearance by filing a Notice of Appeal on behalf of the Respondent on or about April 30, 2004. WHEREFORE, your Petitioner respectfully requests your Honorable Court to deny the Motion to Object to Jurisdiction Nunc Pro Tune. NEW MATTER 13. Counsel for the Respondent was aware of the filing of the Petition to Appoint an arbitration chairman from at least December 24, 2003, when he received a copy of the Petition via first class mail. 14. Counsel for the Respondent was served with the Order of January 2, 2004 by first class mail from the Prothonotary's office as well as the offices of Petitioner's counsel. 15. By letter of January 5, 2004, your Petitioner's counsel requested that Respondent's counsel notify him if he was not intending to accept service of the Petition. A true and correct copy of the letter of January 5, 2004 is attached hereto Exhibit "D" and incorporated herein by reference. At no time did counsel for the Respondent indicate that Sheriff s service was necessary. 16. By letter dated January 15, 2004, the arbitration chairman, P. Daniel Altland, Esquire wrote to the parties and indicated that he would attempt to schedule the uninsured motorist arbitration without delay. The letter of January 15, 2004 is attached hereto as Exhibit "E" and incorporated herein by reference. 17. Respondent's counsel participated in the scheduling of the arbitration and the arbitration was scheduled for Wednesday March 24, 2004 at 9:00 a.m. A true and correct copy of the scheduling letter dated January 29, 2004 is attached hereto as Exhibit 'T' and herein by reference. 18. On or about March 12, 2004, counsel for the Respondent informed Nationwide's counsel that he intended to withdraw his uninsured motorist claim, but intended to re-file it at a later date. 19. In response to the call from Attorney Knauer, counsel for Nationwide wrote to arbitration chairman and requested that the hearing go forward. A true and correct copy of the letter of March 16, 2004 is attached hereto as Exhibit "G". 20. After the letter of March 16, 2004 was sent, the arbitration chairman informed counsel for Nationwide that he did not feel comfortable going forward with an arbitration after he had been advised by Attorney Knauer that the claim was withdrawn. Counsel for Nationwide later learned that counsel for the Respondent served an ex parte letter upon the arbitrators indicating that he was intending to withdraw his uninsured motorist claim. A true and correct copy of the ex parte letter of March 12, 2004 is attached hereto as Exhibit "H" and incorporated herein by reference. 21. On March 29, 2004, the arbitration chairman memorialized the occurrences in a letter of March 29, 2004, which is attached hereto as Exhibit "I" and incorporated herein by reference. 22. The Respondent has failed to give any reason why she failed to raise an objection to jurisdiction, service or method of service for a period of approximately five (5) months. 23. Because the Respondent has failed to give any valid reason for raising objections to jurisdiction or service for a period of five (5) months, this Honorable Court should not exercise its equitable powers to permit the filing of an objection Nunc Pro Time. 24. On May 21, 2004, Respondent, Gloria My Le was personally served with a copy of the Petition to Appoint Arbitration Chairman at 13602 Oak Bend Forest, Houston, Texas in accordance with Pa.R.C.P. 404(1). A true and correct copy of the Affidavit of Service is attached hereto as Exhibit "J" and incorporated herein by reference. 25. On May 21, 2004, Respondent, Gloria My Le v?as personally served with a copy of the Petition to Compel Uninsured Motorist Arbitration or in the Alternative to Enter Judgment in Favor of Nationwide Mutual Insurance Company at 13602 Oak Bend Forest, Houston, Texas in accordance with Pa.R.C.P. 404(1). A true and correct copy of the Affidavit of Service is attached hereto as Exhibit "K" and incorporated herein by reference. WHEREFORE, Petitioner, Nationwide Mutual Insurance Company respectfully requests your Honorable Court to deny the Motion to Object to Jurisdiction Nunc Pro Tunc. Respectfully submitted, LAW OFFICE OF JACOBS & ASSOCIATES By irazd E. Ri ]cards, Esquire Identification No. 58867 Attorney for Petitioner Date: June 1, 2004 02HB-00074 LAW OFFICES OF JACOBS & ASSOCIATES 214 SENATE AVENUE, SUITE 503 CAMP HILL, PA 17011 TELEPHONE NUMBER: (717) 731-0988 ATTORNEY FOR PETITIONER IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA Nationwide Mutual Insurance Company, Petitioner VS. Gloria My Le, Respondent CERTIFICATE OF SERVICE Girard E. Rickards, Esquire, hereby certifies that he is the attorney for the Petitioner herein, and that he caused a true and correct copy of Petition to Appoint an Arbitration Chairm. for an Uninsured Motorist Claim Pursuant to 42 Pa.C.S.A. &7305 to be served by regular first class mail upon: David W. Knauer, Esquire Knauer & Associates 411A East Main Street Mechanicsburg, PA 17055 Dated: December 24, 2003 Girard E. 'ckazcls, Esquire Attorney for Petitioner LAW OFFICES JACOBS & ASSOCIATES DONALD R. DORER GIRARD E. RICKARDS* JOANNE E. KINZEL Employers of Nationwide Mutual Insurance Company<& Not a Partnership 214 SENATE AVkNUE, SUITE 503 CANIP HILL. PA 17011 PARALEGALS DENISE E. KAUFFMAN LISA S. WOLFGANG (717) 731-0988 (FAX) (717) 731-0987 Refer To: 02HB-00074 December 23, 2003 Curtis R. Long, Prothonotary Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 Re: Nationwide Mutual Insurance Company vs. Gloria My Le Cumberland County: Dear Mr. Long, Enclosed please find an original and three (3) copies of Petition to Appoint an Arbitration Chairman for an Uninsured Motorist Claim Pursuant to 42 Pa.C.S.A. §7305, together with a check in the amount of $55.50, with regard to the above indicated matter. Kindly time stamp and return the copy to my office in the enclosed self addressed, stamped envelope provided and forward the remaining copies to the Court Administrator in reference to the Order. Your attention is most appreciated. GER:dek Enclosures c: David W. Knauer, Esquire (w/encl.) -Certified Civil Trial Advocate by National Board of Trial Advocacy, A Pennsylvania Supreme Court Accredited Agency Bethlehem • Conshohocken • Doylestown - Greensburg • Harrisburg • Philadelphia - Pittsburgh • Wilkes-Barre Knauer & Associates, USC Attorneys-at-Law C?Bl-2 411A. East Main Street, Mechanicsburg, PA 17055 Telephone: (717) 795.7790 David W. Knauer Fax: (717) 795-7793 Email: knauer@earlv.com March 11, 2002 Randy Rulapaugh Nationwide Mutual Insurance Company 1000 Nationwide Drive Harrisburg, PA 17105-9971 Re: Your Insured Claim Number Date of Accidei Policy Number Dear Mr. Rulapaugh: Gloria My Le 58 37 C 787817 11-07-1998 IN November 7, 1998 58 37 C 787817 On March 4, 2002, at a settlement conference in Philadelphia, I learned that your company had brought and lost a case filed against the tortfeasor and Belfiore Provisions the putative owner of the vehicle that hit our mutual client. The conclusion of the New Jersey case establishes that there was no insurance involved and this case has become an uninsured motorist case. Please provide me with a copy of the entire file. Your insured has chosen Herschel Lock, Esquire as their arbitrator. Kindly designate your arbitrator. Very, toly yours, David W. Knauer DWK: bm Enclosure CC: Gloria Le Herschel Lock, Esquire Company\Le\03-11-02\ltf 02HB-00074 LAW OFFICES OF JACOBS & ASSOCIATES 214 SENATE AVENUE, SUITE 503 CAMP HILL, PA 17011 TELEPHONE NUMBER: (717) 731-0988 ATTORNEY FOR PETITIONER IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA Nationwide Mutual Insurance Company, Petitioner VS. Gloria My Le, Respondent 03-6591 Civil Term CERTIFICATE OF SERVICE Girard E. Rickards, Esquire, hereby certifies that he is the attorney for the Petitioner herein, and that he caused a true and correct copy of Petition to Compel Uninsured Motorist Arbitration or in the Alternative, to Enter Judgment in Favor of Nationwide Mutual Insurance Company to be served by regular first class mail upon: David W. Knauer, Esquire: Knauer & Associates 411 A East Main Street Mechanicsburg, PA 17055 Dated: March 25, 2004 Girard E. 'ckards, Esquire Attorney for Petitioner LAW OFFICES JACOBS & ASSOCIATES DONALD R. DORER GIRARD E. RICKARDS• JOANNE E. KINZEL Employees of Nationwide Mutual Insurance CompanA Not a Partnership PARALEGALS DENISE E. KAUFFMAN LISA S. WOLFGANG 214 SENATE AVENUE, SUITE 503 CAMP HILL, PA 17011 (717) 731-0988 (FAX) (717) 731-0987 Refer To: 02HB-00074 March 25, 2004 Curtis R. Long, Prothonotary Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 Re: Nationwide Mutual Insurance Company vs. Gloria My Le Cumberland County: 03-6591 Civil Term Dear Mr. Long, Enclosed please find an original and three (3) copies Of Petition to Compel Uninsured Motorist Arbitration or in the Alternative, to Enter Judgment in Favor of Nationwide Mutual Insurance Company, with regard to the above referenced matter. Kindly time stamp and return the copy to my office in the enclosed self addressed, stamped envelope provided and forward the remaining copies to the Court Administrator in reference to the Order. Your attention is most appreciated. Very truly yours, Girard E. Rickards GER:dek Enclosures c: David W. Knauer, Esquire (w/encl.) -Certified Civil Trial Advocate by National Board of Trial Advocacy, A Pennsylvania Supreme Court Accredited Agency Bethlehem • Conshohocken • Doylestown • Greensburg • Harrisburg • Philadelphia • Pimburgh • Wilkes-Barre LAW OFFICES JACOBS & ASSOCIATES DONALD R. DORER GIRARD E. RICKARDS* JOANNE E. KINZEL Employees of Nationwide Mutual Instance Company® Not a Partnership PARALEGALS DENISE E. KAUFFMAN LISA S. WOLFGANG 214 SENATE ANUE, SUITE 503 CANIF HILL, PA 17011 (717) 731-0988 (FAX) (717) 731-0987 Refer To: 02HB-00074 January 5, 2004 David W. Knauer, Esquire Knauer & Associates 411A East Main Street Mechanicsburg, PA 17055 Re: Gloria My Le Duong vs. Nationwide Mutual Insurance Company Cumberland County: No. 03-6591 Civil Term Dear Dave, You should already have received a copy of the Petition to Appoint an Arbitration Chairman in the above captioned matter. That has been filed with the Court, and I am enclosing an Acceptance of Service for your signature. If you do not intend to accept service, please notify me immediately, so that I can have the Sheriff effectuate service upon your client. In the interim, please give some thought to the appointment of an arbitration chairman as I have suggested. Thank you for your attention. Very E. GER:dek Enclosure -Certified Civil Trial Advocate: by National Board of Trial Advocacy, A Pennsylvania Supreme Court Accredited Agency Bethlehem • Conshohocken - Doylestown • Greensburg • Harrisburg • Philadelphia • PiMburgh • Wilkes-Barre I METTE, EVANS & WOODSIDE A PROFESSIONAL CORPORATION ATTORNEYS AT LAW HOWELL C. METTE KATHRYN L. SIMPSON 8401 NORTH FRONT STREET TIMOTHY A. HOY ROBERT MOORE P. DANIEL AL77 AND P.O. BOX 6960 KATHLEEN DOYLE YANINEK CHARLES S. ZWALLY ANDREW H. DOWLING RARRISBUR0, PA 17110.0960 JAMES M. STRONG PETER J. RESSLER MICHAEL D. REED JENNIFER A. YANKANICH LLOYD R. PERSUN PAULA J. LEICHT IRS NO. RANDALL G. HURSr CRAIG A. STONE GARY J. HEIM 43-1986006 MARK D. HIPP JAMES A. ULSH DAVID A. FITZSIMONS RONALD L. FENCE TELEPHONE F'Ag DANIEL L. SULLIVAN THOMAS F. SMIDA SCOTT C. SEUFERT STEVEN D. SNYDER JOHN F. YANINEK* (717) 232,5000 17171 488-1818 AMBROSE W. HEINZ JEFFREY A. ERNICO VICKY ANN TRIMMER http://www.matte.com January 15, 2004 Girard E. Rickards, Esquire Jacobs & Associates 214 Senate Avenue, Suite 503 Camp Hill, PA 17011 Richard H. Wix, Esquire 4705 Duke Street Harrisburg, PA 17109-3099 David W. Knauer, Esquire 411A East ]Main Street Mechanicsburg, PA 17055 Herschel Lock, Esquire 3107 North. Front Street Harrisburg, PA 17110 OF COUNSEL JAMES W. EVANS MARYLAND BAR Re: Gloria My Le Duong v. Nationwide Mutual Insurance Company Cumberland County: 03-6591 Civil Term Uninsured Motorist Claim Gentlemen: I have agreed to serve as the third arbitrator in the above-referenced UM arbitration. We will attempt to schedule this arbitration without delay. Before scheduling a hearing, I wish to have counsel for the parties agree as to the method by which testimony is to be presented. If you wish to present; testimony at the hearing, as opposed to submitted depositions, please advise as to the anticipated length of your respective cases in order that I may schedule the hearing accordingly. If counsel desire to have a stenographic record, they should agree on the selection and sharing of costs incurred. No matter how the factual matters are presented, I would suggest that counsel agree that medical testimony be presented by way of medical reports and/or depositions. g'Lo 1 101 January 15, 2004 Page 2 In any event, I request that counsel submit a memorandum of law to each of the arbitrators prior to the date set for the hearing. I would expect that counsel do not wish the arbitrators to be informed of the amount of UM insurance available for the claim. Unless I hear from anyone that the case is not ready to be scheduled at this time, I will be contacting counsel and the other two arbitrators two weeks after the date of this letter to schedule a hearing. Very truly yours, METTE, EVANS & WOODSIDE P 0M-UA aLa P. Daniel Altland C PDA:d1g 389193v1 January 15, 2004 Page 4 bps: (Girard E. Rickards, Esquire) (David W. Knauer, Esquire) I will charge an hourly rate of $160.00 for my services in this matter. It is my understanding that my fees and costs will be shared equally by the parties. - PDA 389193v1 METTE, EVANS & WOODSIDE A PROPRBBIONAL CORPORATION ATTORNEYS AT LAW HOWELL C. METTE ROBERT MOORE CHARLES B. ZWALLY PETER J. RESSLER LLOYD R. PERSUN CRAIG A. STONE JAMES A. ULSH DANIEL L. SULLIVAN STEVEN D. SNYDER JEFFREY A. ERNICO KATHRYN L. SIMPSON P. DANIEL ALTLAND ANDREW H. DOWLING MICHAEL D. REED PAULA J. LEICHT GARY J. HEIM THOMAS F. SMIDA JOHN F. YANINEK' VICKY ANN TRIMMER TIMOTHY A. HOY 8401 NORTH FRONT STREET P.O. BOX 5950 HAF4TaBVRG. PA 17110.0950 IRS NO. ES-1985005 TELEPHONE E'A% (717) 984!5000 (717) 286-1810 http://www.matte.com JAMES M. STRONG KATHLEEN DOYLE YANINEK January 29, 2004 Girard E. Rickards, Esquire Jacobs & Associates 214 Senate Avenue, Suite 503 Camp Hill, PA 17011 Richard H. Wix, Esquire 4705 Duke Street Harrisburg, PA 17109-3099 JENNIFER A. YANKANICH OF COUNSEL RANDALL G. HURST' JAMES W. EVANS MARK D. HIPP RONALD L. FINCK SCOTT C. SEUFERT AMBROSE W. HEINZ MARYLAND BAR David W. Knauer, Esquire 411-A East Main Street Mechanicsburg, PA 17055 Herschel Lock, Esquire 3107 North :Front Street Harrisburg, PA 17110 Re: Gloria My Le v. Nationwide Mutual Insurance Co. Gentlemen: Confirming conversations today with each of your offices, this writing confirms that the arbitration in the above-captioned matter is scheduled for Wednesday, March 24, 2004, 9. 00 a.m. in the Second Floor Main Conference of this law office. Please mark your calendars accordingly. If you should have any questions, please feel free to contact me. Very truly yours;, METTE, EVANS & WOODSIDE P. Daniel Altland PDA:dlg JAN 3 0 2004 390207v1 LAW OFFICES JACOBS & ASSOCIATES DONALD R. DORER GIRARD E. RICKARDS* JOANNE E. KINZEL Employees of Nationwide Mutual Imuranee Company® Not a Partnership PARALEGALS DENISE E. KAUFFMAN LISA S. W OLFGANG 214 SENATE AVENUE, SUITE 503 CAMP HILL, PA 17011 (717) 731-0988 (FAX) (717) 731-0987 Refer To: 02HB-00074 March 16, 2004 FACSIMILE TRANSMISSION Fax Number: (717) 236-1816 P. Daniel Altland, Esquire Metter Evans & Woodside 3401 North Front Street Harrisburg, PA 17110 Re: Gloria My Le Duong vs. Nationwide Mutual Insurance Company Cumberland County: Uninsured Motorist Arbitration Dear Dan, As you are aware, an uninsured motorist hearing is scheduled for Wednesday, March 24, 2004 at 9:00 a.m. in your office. I recently received a call from Attorney Knauer indicating that his client wished to withdraw her claim for uninsured motorist benefits at this time, reserving the right to file a later claim for benefits. I am requesting that either the hearing go forward for a decision on the merits, or that the arbitrators enter a decision in favor of Nationwide dismissing the uninsured claim with prejudice. This case arises from a 1998 motor vehicle accident in which Ms. Le claims to have been injured. I have witnesses under subpoena and ready to testify at the upcoming hearing. Mr. Knauer named his arbitrator by letter of March 11, 2002. The file was assigned to me and I appointed Nationwide's arbitrator on June 5, 2002. In that letter, I suggested arbitration chairmen and never received a response from Attorney Knauer as to the selection of an arbitration chairman. On December 26, 2003, Nationwide filed a Petition to Appoint Arbitration Chairman pursuant to 42 Pa.C.S.A. §7305. On January 2, 2004, Judge Hoffer signed an Order appointing you as the arbitration chairman. The Uniform Arbitration Act provides that the arbitrators are to appoint a time and place for the hearing and serve notice of the hearing to the parties. The Statute specifically provides that the arbitrators may hear and determine the controversy upon evidence produced at the hearing notwithstanding the failure of a duly notified party to appear. 42 Pa.C.S.A. §7307. That is what I am requesting the arbitrators to do. Nationwide desires a prompt resolution of this uninsured 'Certified Civil Trial Advmate by National Board of Trial Advocacy, A Pennsylvania Supreme Court Accredited Agency Bethlehem • Conshohocken • Doylestown • Greensburg • Harrisburg • Philadelphia • Pittsburgh • Wilkes-Bane Page 2 02HB-00074 P Daniel Altland Esquire March 16, 2004 motorist claim. To permit the Plaintiff to withdraw her claim now and bring it at a later date may result in the loss of documents and/or witnesses that are available and scheduled to appear at the arbitration hearing. Your consideration is greatly appreciated. Very truly yours, Girard E. Rickards GER:dek c: David W. Knauer, Esquire Richard Wix, Esquire Hershel Lock, Esquire -Certified Civil Trial Advocate by National Board or Trial Advocacy. A Pennsylvania Supreme Court Accredited Agency Bethlehem • Conshohocken • Doylestown • Greensburg • Harrisburg • Philadelphia • Pittsburgh • Wilkes-Barre 03/17/2004 14:46 7176526?40 WIX WENGER W'EIDNER PAGE 01 Knauer & Associates, L3C Attorneys-at-Law 411A. East Main Street, Mechanicsburg, PA 17055 Telephone: (717) 795.7790 David W. Knauer Fax: (717) 795-7793 Email: knauer arlv.mm www.knauerlaw.com March 12, 2004 Daniel P. Altland, Esquire 3401 North Front Street Harrisburg, PA 17110 RE: Gloria Le v. Belfiore Dear Mr. Altland: 2004This confirms the telephone message on left on your voice mail on March 11, . My clients have withdrawn their uninsured motorist claim. I so informed Mr. Rickards. By copy of this letter; I am also informing'the other arbitrators; Richard Wix, Esquire and Herschel Lock, Esquire. Consequently, there will be no arbitration and your services will not be needed. Thank you for your willingness to be an arbitrator. Very truly yours, David W. Knauer DWK: bm CC: Gloria Le Richard Wiz, Esq. Herschel Lock, Esq, Company\Le\03-12.04Vtr METTE, EVANS & WOOD14IDE A PROB'EBSIONAL ODRPORATION ATTORNEYS AT LAW HOWELL C. METTE P. DANIEL ALTLAND 3401 NORTH FRONT STREET KATHLEEN DOYLE YANINEK ROBERT MOORE ANDREW H. DOWLING P.O. BOX 6960 JENNIFER A. YANKANICH CHARLES B. ZWALLY MICHAEL D. REED RwuunaBURG, PA 17110.0960 RANDALL G. HURST° OF COUNSEL PETER J. RESSLER PAULA J. LEICHT MARK D. HIPP JAMES W. EVANS LLOYD R. PERSON GARY J. HEIM IR9 NO. RONALD L. FINCK CRAIG A. STONE THOMAS F. SMIDA 83.1986006 SCOTT C. SEUFERT JAMES A. ULSH JOHN F. YANINEK* AMBROSE W. HEINZ DANIEL L. SULLIVAN VICKY ANN TRIMMER ??HO? FAX MARYLAND BAR 17171 ?` &6000 17171 eS8-181EI JEFFREY A. ERNICO TIMOTHY A. HOY KATHRYN L. SIMPSON JAMES M. STRONG http://www.matte.com March 29, 2004 Girard E. Rickards, Esquire Jacobs & Saba 214 Senate Avenue, Suite 503 Camp Hill, PA 17011 Re: Gloria My Le Duong v. Nationwide Mutual Insurance Company Uninsured Motorist Arbitration Dear Jerry: I write to you in the above matter in view of the unusual circumstances surrounding the withdrawal of the uninsured motorist claim. By letter dated March 12, 2004 I was advised by Attorney Knauer that his clients have withdrawn their uninsured motorist claim. He indicated that as a result of that action there will be no need for an arbitration and my services as the neutral arbitrator will not be needed. In that you were not copied on his letter of March 12, 2004, I wanted to advise you what Attorney Knauer had told me. Very truly yours, METTE, EVANS & WOODSIDE P. Daniel Altland PDA:ml Enclosure cc: David W. Knauer, Esquire Richard Wix, Esquire Hershel Lock, Esquire MAR 3 0 200¢ 394910v1 May 28 2004 3:33PM RCPS 713 453 0821 P.2 AFFIDAVIT OF SERVICE Commonwealth of Pennsylvania Case Number: 03-6591 CIVIL TERM County of Cumberland Plaintiff: NATIONWIDE MUTUAL INSURANCE COMPANY vs. Defendant: GLORIA MY LE For: Girard E. Rickards, Esq. LAW OFFICE OF JACOBS & ASSOCIATES 214 Senate Avenue Suite 503 Camp Hill, PA 17011 Received by COMPEX LEGAL SERVICES on the 21st day of May. 2004 at 3:00 P LE @ 13602 Oak Bend Forest, Houston, Harris County, TX 77083. I, Lisa F. Nabulsi, being duly swom, depose and say that on the 26th day of May, Common Pleas Court to be served on GLORIA MY 04 at 8:00 pm, I: Personally delivered a true copy of the PETITION TO APPOINT AN ARBITRATION CHAIRMAN FOR AN UNINSURED MOTORIST to tate statutes at 13 002 O42PA.C.SA.-7306 to GLORINMY LE ak Bend Forest, Houston, H Ir County, TX 77083ndorsed thereon by me, pursuant I am over the age of 18, not a party to nor interested in the outcome of the above Process Server on this day personally appeared affiant, known to me personally to be the person whose name is subscribed COMPEX LEGAL to the foregoing return and, being by me duly sworn, 2040 North LOOP 1 declare under oath that the statements therein are true suite 200 and correct. Subscribed and Sworn to before me on (713) 8ton, 61 TX 770 the 7th day of May, 2004. Our Job Serial Nw 1 Ref. 02HE-00074 N ARY PUBLIC ED Copldgat O 1892.2001 ;AND; V, ATCHMY ;'rTmna Brace of rmma Mr ?comm"M Enloe JUNE 30, 2007 bored suit. ES 2004001647 713 453 0821 P•3 May 28 2004 3:33PM ACPS AFFIDAVIT OF SERVICE Commonwealth of Pennsylvania Case Number: 03-6591 CIVIL TERM County of Cumberland Plaintiff: NATIONWIDE MUTUAL INSURANCE COMPANY vs. Defendant GLORIA MY LE For: Girard E. Rickards, Esq. LAW OFFICE OF JACOBS & ASSOCIATES 214 Senate Avenue - Suite 503 Camp Hill, PA 17011 of May, 2004 Received ei 13 02 OcOMPEX LEGAL SERVICES on the ak Bend Forest, Houston, Harris County, Texas 77083. 1, Use F. Nabulsi, being duty sworn, depose and say that on the 25th day of May, personally delivered a true copy of the PETITION TO COMPEL UNINSURED N THE ALTERNATIVE, TO ENTER JUDGMENT IN FAVOR?u NAToIOa tMD3EuM s pursuant GLORIA MY LE with the date endorsed thereon by me, Houston, Harris County, Texas 77083 . I am over the age of 18, not a party to nor interested in the outcome of the above on this day personally appeared affiant, known to me personally to be the person whose name ubscribed to the foregoing return and, being by me duty declare under oath that the statements therein are true and correct. Subscribed and Sworn to before me on the 7th day f tvlay,,2004. UBLIC Common Pleas court to be served on GLORIA MY at 8:oo pm, 1: rORIST ARBITRATION OR IN AL INSURANCE COMPANY to 13602 Oak Bend Forest, suit. Process Server COMPEX LEGAL ER% 2040 North Loop est Suite 200 Houston,TX 7708 (713) 861-3900 Our Job Serial Nu ber Ret: 02HI3-00074 N TARV P V551 7'WANDA V7ATCHLEY M 1y IIry py1_ sbdo Tom ?P MJUUMN_E 2004001648 02HB-00074 LAW OFFICES OF JACOBS & ASSOCIATES 214 SENATE AVENUE, SUITE 503 CAMP HILL, PA 17011 TELEPHONE NUMBER: (717) 731-0988 ATTORNEY FOR PETITIONER IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA Nationwide Mutual Insurance Company, Petitioner o. 03-6591 Civil Term VS. Gloria My Le, Respondent CERTIFICATE OF SERVICE Girard E. Rickards, Esquire, hereby certifies that he is the attorney for the Petitioner s Response to Respondent's herein, and that he caused a true and correct copy of Petitioner' Motion to Object to Jurisdiction Nunc Pro Tunc to be served by certified mail upon: David W. Knauer, Esquire Knauer & Associates 411A East Main Street Mechanicsburg, PA 17055 Dated: June 1 2004 Girard E. Rickards, Esquire Attorney for Petitioner r> ^, 0 ?? " - C.. T f C_ Il'I TI 'q l R- - ? IV ? 7 )?- J 'n L -?i 7 -_ _._ -?? .. N ?, ??I ? N ?J V7 02HB-00074 LAW OFFICES OF JACOBS & ASSOCIATES 214 SENATE AVENUE, SUITE 503 CAMPHILL,PA 17011 TELEPHONE NUMBER: (717) 731-0988 ATTORNEY FOR PETITIONER IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA Nationwide Mutual Insurance Company, Petitioner vs. Gloria My Le, Respondent 03-6591 Civil Term ORDER AND NOW, this le day of 4 k 2005, pursuant to Local Rule 208.3(a)(5), it is hereby ORDERED and DIRECTED that leave is granted to either counsel to list this matter for regular Argument Court with respect to Motion to Object to Jurisdiction Nunc Pro Tune filed by Gloria My Le on May 11, 2004. It is so ORDERED. O? BY THE COURT: 02HB-00074 PRAECIPE FOR LISTING CASE FOR ARGUMENT (Must be typewritten and submitted in duplicate) TO THE PROTHONOTARY OF CUMBERLAND COUNTY: Please list the within matter for the next Argument Court. CAPTION OF CASE (entire caption must be stated in fill) NATIONWIDE MUTUAL INSURANCE COMPANY, Petitioner VS. GLORIA MY LE, Respondent Civil No. 03-6591 2003 Term 1. State matter to be argued (i.e., plaintiff's motion for new trial, defendant's demurrer to complaint, etc.): Respondent's Motion to Object to Jurisdiction Nunc Pro Tunc. 2. Identify counsel who will argue cases: (a) for plaintiff: Donald R. Doter, Esquire (Court I.D. 39126) 214 Senate Avenue, Suite 503 (Name and Address) Camp Hill, PA 17011 (b) for defendant: David W. Knauer, Esquire (Court I.D. 21582) 411-A East Main Street (Name and Address) Mechanicsburg, PA 17055 3. I will notify all parties in writing within two days that this case has been listed for argument 4. Date: March 3, 2005 Petitioner, Nationwide Mutual Insurance Company Attorney for Donald R. Doter, Esquire Print your name It 02HB-00074 LAW OFFICES OF JACOBS & ASSOCIATES 214 SENATE AVENUE, SUITE 503 CAMP HILL, PA 17011 TELEPHONE NUMBER: (717) 731-0988 ATTORNEY FOR PETITIONER IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA Nationwide Mutual Insurance Company, Petitioner vs. Gloria My Le, Respondent 03-6591 Civil Term CERTIFICATE OF SERVICE Donald R. Dorer, Esquire, hereby certifies that he is the attorney for the Petitioner herein, and that he caused a true and correct copy of Praecipe for Listing Case for Argument to be served by regular first class mail upon: David W. Knauer, Esquire Knauer & Associates 41 lA East Main Street Mechanicsburg, P 17055 i i Dated: March 3 2005 ? J Do ald R. Dorer, Esq ire Attorney for Petitioner IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Nationwide Mutual Insurance Company, : Vs. Gloria My Le, Petitioner No. 03-6591 Civil Term Respondent : TO THE PROTHONOTARY: Withdraw the Respondent's Preliminary Objections in the above matter. Respectfully submitted, KNAUER & ASSOCIATES, L.S.C. 4 Davi na er, Esquire Attorney for Plaintiff Attorney I.D. No. 21582 411-A East Main Street Mechanicsburg, PA 17055 Date: May 3, 2005 (717) 795-7790 N ?7 C7 <_ ? ? -'-? t `ii4 ?" ?. -? ? :, . _. ?., +.. -r` _z: i -i'= (b .. ,.j _ ?;? K IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Nationwide Mutual Insurance Company, : Petitioner No. 03-6591 Civil Term Gloria My Le, Vs. Respondent : PRAECIPE TO WITHDRAW PRELIMINARY OBJECTIONS TO THE PROTHONOTARY: Withdraw the Respondent's Preliminary Objections in the above matter. Respectfully submitted, KNAUER & ASSOCIATES, L.S.C. e?/'- David W. Knau r, Esquire Attorney for Plaintiff Attorney I.D. No. 21582 411-A East Main Street Mechanicsburg, PA 17055 Date: May 3, 2005 (717) 795-7790 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Mutual Insurance Company, : Vs. iloria My Le, Petitioner No. 03-6591 Civil Term Respondent : CERTIFICATE OF SERVICE I, David W. Knauer, hereby certify that I did this 10nth day of May, 2004, ;rve a true and correct copy of the Praecipe to Withdraw Preliminary Objections all counsel of record by United States mail, first class, prepaid addressed as Mr. Donald R. Dorer, Esquire Jacobs & Associates 214 Senate Avenue, Suite 503 Camp Hill, PA 17011 L avid W. naue Attorney for Plaintiff Attorney I.D. No. 21582 411-A East Main Street Mechanicsburg, PA 17055 (717) 795-7790 _.? l _'3 GJ'? ?...? ? ' _. -'t i t ? f C:1 . ' (" ) ' "rr = C3 it ?, i #2 NATIONAWIDE MUTUAL INSURANCE COMPANY V. GLORIA MY LE IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 2003-6591 CIVIL TERM IN RE: RESPONDENT'S MOTION TO OBJECT TO JURISDICTION NUNC PRO TUNC BEFORE HESS, GUIDO, JJ. ORDER OF COURT AND NOW, this I ST" day of MAY, 2005, Respondent Gloria My Le having withdrawn her "Motion to Object to Jurisdiction Nunc Pro Tunc" it is DISMISSED with prejudice. Court, Edward E. Guido, J. Donald R. Dorer, Esquire 214 Senate Avenue, Suite 503 Camp Hill, Pa. 17011 David W. Knauer, Esquire 411 A East Main Street Mechanicsburg, Pa. 17055 U ? :sld Curtis R. Long Prothonotary office of the Protbonotarp cumberranb countp Renee K. Simpson Deputy Prothonotary John E. Slike Solicitor CIVIL TERM ORDER OF TERMINATION OF COURT CASES AND NOW THIS 29TH DAY OF OCTOBER 2008 AFTER MAILING NOTICE OF INTENTION TO PROCEED AND RECEIVING NO RESPONSE - THE ABOVE CASE IS HEREBY TERMINATED WITH PREJUDICE IN ACCORDANCE WITH PA R C P 230.2 BY THE COURT, CURTIS R. LONG PROTHONOTARY One Courthouse Square - Carlisle, Pennsylvania 17013 - (717) 240-6195 - Fax (717) 240-6573