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Home My WebLink AboutNOTICE(NO DATE) e e PENNSYLVANIA MANUFACTURERS ASSOCIATION INSURANCE COMPANY, Plaintiff IN THE COURT OF COMMON PLEAS DAUPHIN COUNTY, PENNSYLVANIA v. CIVIL ACTION - LAW NO. /<;?~-(j-, "~ If. -1[\---. < L~ /( ) COMMONWEALTH NATIONAL BANK, Administrator of Estate of ROBERT W. ROLAND, SR., ROBERT W. ROLAND, JR., CHRISTINE J. ROLAND, and COr-1r-lONWEALTH NATIONAL BANK, Guardian of DAVID G. ROLAND, Defendants JURY TRIAL DEMANDED NOTICE YOU HAVE BEEN SUED IN COURT. If you wish to defend against the claims set forth in the following pages, you must take action within twenty (20) days after this Complaint and Notice are served, by entering a written appearance personally or by attorney and filing in writing with the Court your defenses or objections to the claims set forth against you. You are warned that if you fail to do so the case may proceed without you and a judgment may be entered against you by the court without further notice for any money claimed in the Complaint or for any other claim or relief requested by the Plaintiff. You may lose money or property or other rights important to you. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET HELP. DAUPHIN COUNTY LAWYER REFERRAL SERVICE 213 N. Front St. Harrisburg, PA 17101 PHONE: (717) 232-7536 e e NOTICIA Le han demandado a usted en la corte. Si usted quiere defenderse de estas demandas expuestas en las paginas siguientes, usted tiene viente (20) dias de plazo al partir de la fecha de la demanda y la notificacion. Usted de be presentar una apariencia excrita 0 en persona 0 por abogado y archivar en la corte an forma escrita sus defensas 0 sus objectiones alas demandas en contra de su persona. Sea avisado que si usted no se defiende, la corte tomara medidas y puede entrar una orden contra usted sin previa aviso 0 notificacion y por cualquier queja 0 alivio que es pedido en la peticion de demanda. Usted puede perder dinero 0 sus propriendades 0 stros derechos importantes para usted. LLEVE ESTA DEMANDA A UN ABROGADO IMMEDIATAMENTE. SI NO TIENE ABOGADO 0 SI NO TIENE EL DINERO SUFICIENTE DE PAGAR TAL SERVICIO, VAYA EN PERSONA 0 LLAME POR TELEFONCO A LA OFICINA CUYA DIRECCION SE ENCUENTRA EXCRITA ABAJO PARA AVERIGUAR DONDE SE PAUEDE CONSEQUIR ASSISTANCIA LEGAL. DAUPHIN COUNTY LAWYER REFERRAL SERVICE 213 N. Front St. Harrisburg, PA 17101 PHONE: (717) 232-7536 e e ", PENNSYLVANIA MANUFACTURERS ASSOCIATION INSURANCE COMPANY, Plaintiff IN THE COURT OF CO~~ON PLEAS DAUPHIN COUNTY, PENNSYLVANIA CIVIL ACTION - LAW v. COMMONWEALTH NATIONAL BANK, Administrator of Estate of ROBERT W. ROLAND, SR., ROBERT W. ROLAND, JR., CHRISTINE J. ROLAND, and COMMONWEALTH NATIONAL BANK, Guardian of DAVID G. ROLAND, Defendants NO. JURY TRIAL DE~ffiNDED COMPLAINT 1. Plaintiff, Pennsylvania Manufacturers Association Insurance Company ("PMA") is an insurance company, duly authorized by the Commonwealth of Pennsylvania to write, inter alia, workmen's compensation insurance, with a local office at P.O. Box 311, Lemoyne, Cumberland County, Pennsylvania 17043. 2. Defendant, Commonwealth National Bank, maintains offices at P.O. Box 1010, Harrisburg, Dauphin County, Pennsylvania, and is the Administrator of the Estate of Robert W. Roland, Sr., deceased. 3. Defendant, Robert W. Roland, Jr., is an adult individual who resides at 607 Magaro Road, Enola, Cumberland County, Pennsylvania 17025. 4. Defendant, Christine A. Roland, is an adult individual who resides at 607 Magaro Road, Enola, Cumberland County, Pennsylvania 17025. e e 5. Defendant, Commonwealth National Bank, with offices at P.O. Box 1010, Harrisburg, Dauphin County, Pennsylvania, is the Court appointed Guardian of David G. Roland, a minor. 6. Robert W. Roland, Sr., was the father of Robert W. Roland, Jr., Christine, A. Roland, and David G. Roland at all times relevant to Plaintiff's Complaint. 7. On or about April 6, 1978, Robert W. Roland, Jr., Christine A. Roland, and David G. Roland were dependents of Robert W. Roland, Sr. 8. On April 6, 1978, Robert W. Roland, Sr., was employed as a journeyman electrician by General Electrical Services Company and was assigned by his employer to a job site at Hershey Foods Corporation, 19 East Chocolate Avenue, Hershey, Derry Township, Pennsylvania. 9. At the aforesaid time and place, Robert W. Roland, Sr., suffered fatal injuries when a conveyor was activated and the decedent was carried into an elevator. 10. The Decedent's injuries and death occurred while Decedent was employed by General Electrical Services Company and the Decedent's death was compensable under the Pennsylvania Workmen's Compensation Act. 11. At the time of Decedent's injury and death, PMA was the workmen's compensation insurance carrier for General Electrical Services Company, Inc. - 2 - e e ~ 12. As the result of Decedent's injury and death, PMA has paid workmen's compensation benefits to Decedent's dependent children and has further paid medical expenses in the amount of $29 and funeral benefits in the amount of $1,500. 13. As of November 12, 1984, PMA Insurance Company has paid a total of $68,500.04 in compensation benefits to the dependent children. 14. Since November 12, 1984, PMA has continued to make Workmen's Compensation payments to Commonwealth National Bank, Guardian of David G. Roland, in the amount of $140.99 per week and will continue to make such payments until October 10, 1985. 15. As a result of Decedent's injury and death, PMA's total liability for workmen's compensation benefits, including future payments until October 10, 1985, is $76,715.99. 16. As the result of Decedent's injury and death, a civil action was commenced by Commonwealth National Bank, Administrator of the Estate of Robert W. Roland, Sr., in the Court of Common Pleas of Dauphin County, to docket number 2968-S-1978, against Hershey Food Corporation. The aforesaid action was commenced under the Survival Act and Wrongful Death Act. 17. On or about April 25, 1984, the aforesaid civil action was settled for a sum exceeding PMA's total liability for workmen's compensation benefits. - 3 - e e .. 18. PMA believes and therefore avers that Defendants herein were the sole beneficiaries of the settlement of the aforesaid law suit. 19. By virtue of Section 319 of the Pennsylvania Workmen's Compensation Act, Act of June 2, 1915, P.L. 736, as amended, 77 P.S. Section 671, PMA is subrogated to the rights of the employee, his personal representative, his estate, or his dependents, against a third party tortfeasor to the extent of compensation payable under the Workmen's Compensation Act. 20. PMA has demanded from Defendants herein reimbursement of compensation payable under the Workmen's Compensation Act, but Defendants have refused, and continue to refuse to honor PMA's right of subrogation. WHEREFORE, Plaintiff, PMA Insurance Company demands judgment in its favor and against Defendants in the amount of $76,715.99 plus interest and costs. PETERS & WASILEFSKI Date ff-i;l 29 J9.J'o J , Esquire estnut St. 7101 - 4 - e e .. VERIFICATION I verify that the facts set forth in the foregoing Complaint 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 18 Pa. C.S. Section 4904, relating to unsworn falsification to authorities. oate:ftJ <:23. r9YJ' ~~ A. District Claims Manager Pennsylvania Manufacturers Association Insurance Company ('I ~'~'~:~""" c' ~,0'~ ~-, ~" ,', ,,'~'_~'~,,~ '\i '~a "01 ,,,,,, ...... , , ^~'--" .. Ar,^J'j~ ',\,-,~ ,....,~~,::.~ V ',-__i/,- ."'. .-~... '.' ." r "'f'~:: -~Hr: ~',,; 1 :.;:~.C:. ar ,f,::- ~d;~)'''\'~ "Cl\wll::::;\.A\'\t;..~ ...' --. ...., "'"'" . 1 ;- ~ 1, ~ \..~, J l'\M 3 \ l 32. ,\\ \ '", . :'-'; :- . ' ~J. c.,~. j";;J..n <".~~ C~h;.. PE-hl;:> '.. \ ....::; ) l.1ll.U,n ',f0 1;) ~lr.;BS ''f4 "0 ""fMIO,J '.' ;.' ,tJ, I ~<"~<}~".,',~:; .)" ~~,,_//~/'t,:_;~' 'yT " . - I' . . 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