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HomeMy WebLinkAbout08-2774V!LTH OF PENNSYLVANIA COURT OF COMMON PLEAS C.umbev-?Q rid Obun4l JUDICIAL DISTRICT rPobe,r+ V. YY)o.r Lov?- NOTICE OF APPEAL FROM DISTRICT JUSTICE JUDGMENT COMMON PLEAS No. 198- A7,74 01--vi I Trm NOTICE OF APPEAL Notice is given that the appellant has filed in the above Court of Common Pleas an appeal from the judgment rendered by the District Justice on the date and in the case mentioned below. owns v. nrrc ??w nMAO. (IN ST. NO. OR NAME OF D.J. v^ I 0q -' oo? ADDRESS OR PPELLAHT CITY STATE ZIP CODE 333 io r` P1 PP 19,61 5) DATE OF JUDGMENT IN THE CASE OF (Plaintiff) (Celendant) H-l0-0 CLAIM NO. SIGNATUR F PELLA OR HI ATTORNEY OR AGENT CV 19QQ0014)--;Z-O7 LT 19 This block will be signed ONLY when this notation is require der Pa. R.C.P.J.P. No. 1008B. If appellant w Claimant (see Pa. R. C. P.J. P. This Notice of Appeal, when received by the District Justice, will operate as No. 1001(6) in action before District Justice, he a SUPERSEDEAS to the judgment for possession in this case. MUST FILE A COMPLAINT within twenty (20) days after filing his NOTICE of APPEAL. Signature of Prothonotary or Deputy PRAECIPE TO ENTER RULE TO FILE COMPLAINT AND RULE TO FILE (This section of form to be used ONLY when appellant was DEFENDANT (see Pa. R.C.P.J.P. No. 1001(7) in action before District Justice. IF NOT USED, detach from copy of notice of appeal to be served upon appellee). PRAECIPE: To Prothonotary Enter rule uponi-?qwsrc? ow 1p? Wk 0-are 3y ?rr appellee(s), to file a complaint in this appeal Name of appellee(s) (Common Pleas No. J 'v; I ) within twenty (20) days after servic f ru o .suffer entr f jud ent of non pros. Terry ?11 ?1 ss''------ Signature ellant or his attorney or agent RULE: To ?T Yhi v? n v? ? (???(JQ ? ? l'Q? /?te?'naopellee(s) Name of appellee(s) (1) You are notified that a rule is hereby entered upon you to file a complaint in this appeal within twenty (20) days after the date of service of this rule upon you by personal service or by certified or registered mail. (2) If you do not file a complaint within this time, a JUDGMENT OR NON PROS WILL BE ENTERED AGAINST YOU. (3) The date of service of this rule if service was by mail is the date of mailing. Date: '99 ?9 O$ s i 0(?.p e, p Sig ture of Prothonotary or Deputy AOPC 312-90 COURT FILE TO BE FILED WITH PROTHONOTARY 0 --PRttO?Qt SER C`E 9F C*IdE"0F APPEAL AND RULE TO FILE COti IN]u t -, (This proof of service MUST BE FILED WITHIN TEN (10) DAYS AFTER filing the notice of appeal. C a 1 e ) COMMONWEALTH OF PENNSYLVANIA 1 COUNTY OF....... .... ____.._.__ Ra ') I J_ AFFIDAVIT: 1 hereby swear or affirm that I served ? a copy of the Notice of Appeal, Common -Pleas No. . upon the District Justice designated therein o. (date of service)_ 19 ? by personal service ? by (certified) (registered) mail, sender's receipt attached hereto, and upon the appellee, (name) --- Or, - .-__-, 19-_-- ? by personal service ? by (certified) (registered) mail, sender's receipt attached hereto ? and further that I served the Rule to File a Complaint accompanying the above Notice of Appeal upon the appelle fs whom the Rule was addressed on -- 19 ? by personal service ? by (certified) {regisi mail, sender's receipt attached hereto. t SWQaU(A LR1AED4 AI'ND S S BEFORE ME THIS ?Y > 49 ? 13 gnaItire of afft, 4 Signature of official before whom affidavit was made Title of official My commission expires on .19 t:. cx? 9-b oo?O1 L -"t1 -l = N a ._ 0- c v > ? 1V ? ri a t CQW, WEAt_TH OF PENNSYLVANIA NOTICE OF JUDGMENT/TRANSCRIPT CIVIL CASE COUNTY?OF: 0MOMA " Mag. Dist. No.: 09-1-02 PLAINTI.Fy:. NAME and ADDRESS r11Y01LING VALLEY M&LT8 Cmm SYS, ET7 I MDJName: Hon. 33 VALLEY VIEW DAL . ROBERT; V. MANLOVE PLYMOUPB, PA 186.51 Address's 1901 STATE ST L J CAMP SILL. PA VS. I ' ' --t ? ° -[?JENDANT. v? NAME and,ADDRESS EAit ik r t. Telephone (717 i /`61-0583 x170.11-0000: +?. s iw . 3 3 3 'VALLEY VIEW D>6t PLYNDYTH, PA 186'S1 L J _ KARYN THOILAB 333 VALLEY VIEW DR Docket No.: CV-0000412-07 PLYXO'0 R, PA 18651 Date Filed: 11/20/07 THIS IS TO NOTIFY YOU THAT. DEFAULT JUDMMT PLTF (Date of J?ud ment? 4/10/08 Judgment was entered for: (Name) WYOKING VALLEY HEALTH CABLE SYS Judgment was entered against: (Name) THOM", 1 405 0 KASYN in the amount of $ ' Defendants are jointly and severally liable., Damages will be assessed on Date & Time t F-] This case dismissed without prejudice. k Amount of Judgment Subject to Attachmeht/42' Pa.C.S. § 8127 Portion of judgment for'physical damages arising out of residential lease $ r ` ANY PARTY HAS THE RIGHT TO APPEAL WITHIN 30 DAYS AFTER THE ENTRY OF JUDGMENT BY FILING A NOTICE OF APPEAL WITH THE PROTHONOTARY/CLERK OF THE COURT OF COMMON PLEAS, CIVIL DIVISION. YOU MUST INCLUDE A COPY OF THIS NOTICE OF JUDGMENT/TRANSCRIPT FORM WITH YOUR NOTICE OF APPEAL. EXCEPT AS AL DISTRICT JUDGES, IF THE JtJ GII FNT HO DgR E_L?ECTS_ TO VIDEDIN THE RULES OF ENTER THE JUDGMENT IN'TkiE OW. OF COMMON P EAS,.ALL FUPTHE?3.P.kaOCESS ?VIU4T „w UEI? ' THE Ml1 l$?EE #IAL?ISTRI JU . COME FROM THE'Ct?l1RT OF COMMON PL'W AND NO'FURi*[gR 0AO ESS Mk' BE_ J Cfi UNLESS THE JUDGMENT IS ENTERED IN THE COURT OF COMMON PLEAS, ANYONE INTERESTED IN THE JUDGMENT MAY FILE A REQUEST FOR ENTRY OF SATISFACTION WITH THE MAGISTERIAL DISTRICT JUDGE IF THE JUDGMENT DEBTOR PAYS IN FULL, SETTLES, OR OTHERWISE COMPLIES WITH THE JUDGMENT. ate ist?rral•Qi Prt ct Jg0ge '4e'D ce Ai _ 't t this is a true anal r.e spy of• a p rd th ' _the judgrrt' t. fu a ister4 l,District Judge Date G w' SEAL, My commission expires first Monday of January, aoa AOPC 315-07 DATE PRINTED: 4/10/08 10:18:00 Al[ Post al :ServiceT M E F IED MAIL . REC IPT t (Do M estic ail Only; No I ns urance C o erage Provided) ru r- - Ln Postage $ M Certified Fee C3 ° Return Reaept Fee 7 _ (Endorsement Required) fl Restricted Delivery Fee ul (Endorsement Required) ri ` M Total Postage & Fees $ r Post al Ser viceT h, F RTIF IED I UTAIL Tr ., REC EIPT estic M ail Only ; No Ins urance C overage Provided) For ivery in formatio n visit o ur web site at www.usps.conto fiJ ' f`- U-l page $ rn Certified Fee Postmark E:l Postmark Here ° Return Reciept Fee Here Q (Endorsement Required) C] Restricted Delivery Fee Ln (Endorsement Required) r-1 ru M Sent To r- 3Fiee4 iipt rvo., or Po ewr rb.-- t. State, ZIP44 rn Total Postage & Fees $ NO t o n aQ.r_ZWi,-t?---------------------------------- r- s?livi or PD ew Ab- ----------------------------------------------- PROOF OF SERVICE OF NOTICE OF APPEAL AND RULE TO FILE COMPLAINT of s, vice MUST BE FILED WITHIN TEN (10) DAYS AFTER filing the notice of appeal. Check applicable boxes) OMMONWEALTH i:)F PENNSYLVANIA -OUNTY O ?? Lit (? ....... s 4FFIDAV TA rx Fey swear or affirm that I served the Notice of Appeal, Common Pleas No.09T-J , upon the District Justice designated therein c" . ... by personal service by (certified) (registered) mail, senae° 19 .hed hereto, and upon the appellee, (nan7e) ?.1,? Qm. f\g.- 4s receipt attached he-ct= - , tg by personal service by (certified) (registered) mail, sender's receipt attached he-c`= f'-at I served the Rule to Pile; "iii Complaint accompanying ?the above Notice of Appeal upon the appeliee(s, L ale was addressed 19 by personal service by (certified) (registerF , s receipt attached hereto. IOR'N k_ ~ IND SUBSCRIBED BEFORE ME - 45 _?-- -. 1Z - aIr? " Signature of sa. (r -ii affidavit was made to of core:, 19 WEiALTH OP PENNSYLVANIA NOTARIAL SEAL KATHRYN M. PIERSON, NO-tARY PUBLIC KINGSTON BOROUISHt LUZERNE COUNTY MYPOMMISSION 6X 9 MAY 21, 2011 C= n C7-1) -n crs 'Tj Sir1 y 1? C??a + N ? t---. C . L C_q 1 p.q COMMONWEALTH OF PENNSYLVANIA NOTICE OF APPEAL COURT OF COMMON PLEAS FROM _ JUDICIAL )DISTRICT ` DISTRICT JUSTICE JUDGMENT COMMON PLEAS No. 'Yo r NOTICE OF APPEAL Notice is given that the appellant has filed in the above Court of Common Pleas an appeal from the judgment rendered by the District Justice on the date and in the case mentioned below. NA F APPELLANT AOOR(!Y ,/k13?i(S.L1 III` PELLAINT O OF JUDGMENT I IN *HF =p yE OF CLAIM NO. a. op NAME --- STATE ,. ,. to r „ .? ?.,rte IT1?RE OF -.Pl LLA N. OR NI ATTOp NEy P AOE T - LT 19 This block will be signed ONLY when this notation is requiredunder Pa. .RJ.P. No. 1008B. If appellant was Claimant lsee Pa R.C This Notice of Appeal, when received by the District Justice, will operate as No. 1001(6) in action before District Justice, f a SUPERSEDEAS to the judgment for possession in this case. MUST FILE A COMPLAINT within twenty (20) days after filing his NOTICE of APPEAL. Signature of Prothonotary, or Deputy RRAECIPE TO ENTER RULE TO FILE COMPLAINT AND RULE TO FILE-, (This section of form to be used ONLY when appellant was DEFENDANT (see Pa. R.C.P.J.P. No. 100,1(7) in action before District Justice IF NOT USED, detach from copy of notice of appeal to be served upon appellee). PRAECIPE: To Prothonotary Enter rule upon ??? ,%oI t ?{r vzAmf-I rs appetlee(s), to file a complaint in this appe?+ ti + Name of appetlee(s) (Common Pleas No.?= within twenty (20) days after service of rule'or suffer entry of judgment of non r)ro?:. Term Signature of'- ppellant or his attorney or agent , RULE: To I,? ?rti?sr JaIt A")0.k?) 0(irC r Ppellee(s) -Name of hppetlee(s) (1) You are notified that a rule is hereby entered upon you to file a complaint in this appeal within twenty (20) days after tine lal, service of this rule upon you by personal service or by certified or registered mail. (2) If you do not file 6 complaint within this time, a JUDGMENT OR NON PROS WILL BE ENTERED AGAINST YOU. (3) The date of service of this rule if service was by mail is the date of mailing. Date: -; Aar; i 6t2-- , .Q-_. w6g s ? P ? p Sign ure of Prothonotary or Deputy PETERS & WASILEFSKI By: Stephen F. Moore, Esquire Attorney ID #62077 2931 North Front Street Harrisburg, PA 17110 [717] 238-7555 Attorney for Plaintiffs WYOMING VALLEY HEALTH CARE SYSTEM and THE PMA INSURANCE GROUP Plaintiffs V. KARYN THOMAS Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION DOCKET NO: 08-2774 (cv0000412-07) 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 Plaintiffs. You may lose money or property or other rights important to you. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. Cumberland County Bar Association 32 S. Bedford Street Carlisle, Pennsylvania 17013 717-249-3166 800-990-9108 AVISO USTED HA SIDO DEMANDADO/A EN CORTE. Si usted desea defenderse de las demandas que se presentan mas adelante en las siguientes paginas, debe tomar accion dentro de los proximos veinte (20) dias despues de la notificacion de esta Demanda y Aviso radicando personalmente o por medio de un abogado una comparecencia escrita y radicando en la Corte por escrito sus defensas de, y objecciones a, las demandas presentadas aqui en contra suya. Se le advierte de que si usted falla de tomar accion como se describe anteriormente, el caso puede proceder sin usted y un fallo por cualquier suma de dinero reclamada en la demanda o cualquier otra reclamacion o remedio solicitado por el demandante puede ser dictado en contra suya por la Corte sin mas aviso adicional. Usted puede perder dinero o propiedad u otros derechos importantes para usted. USTED DEBE LLEVAR ESTE DOCUMENTO A SU ABOGADO INMEDIATAMENTE. SI USTED NO TIENE UN ABOGADO O NO PUEDE PAGARLE A UNO, LLAME O VAYA A LA SIGUIENTE OFICINA PARA AVERIGUAR DONDE PUEDE ENCONTRAR ASISTENCIA LEGAL. Cumberland County Bar Association 32 S. Bedford Street Carlisle, Pennsylvania 17013 717-249-3166 800-990-9108 PETERS & WASILEFSKI By: Stephen F. Moore, Esquire Attorney ID #62077 2931 North Front Street Harrisburg, PA 17110 [717] 238-7555 Attorney for Plaintiffs WYOMING VALLEY HEALTH CARE SYSTEM and THE PMA INSURANCE GROUP Plaintiffs V. KARYN THOMAS Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION DOCKET NO: 08-2774 (cv0000412-07) JURY TRIAL DEMANDED COMPLAINT NOW COME, the Plaintiffs, Wyoming Valley Health Care System and The PMA Insurance Group (collectively "Plaintiffs"), by and through their attorneys, Peters & Wasilefski, and file this Complaint and, in support thereof, aver as follows: 1. Plaintiff, Wyoming Valley Health Care System ("Wyoming Valley") is a corporation with a principal place of business at 575 North River Street, Wilkes-Barre Luzerne County, Pennsylvania, engaged in the delivery of health care services. 2. Plaintiff, The PMA Insurance Group ("PMA") is a corporation with a place of business at 500 N 12th Street, Lemoyne, Cumberland County, Pennsylvania, authorized to sell insurance policies and adjust insurance claims in the Commonwealth of Pennsylvania. 3. Plaintiff PMA provided workers' compensation coverage to Plaintiff Wyoming Valley and provided workers' compensation claims services to Defendant Thomas including the actual adjustment of the claim and the issuance and processing of various payments, as referenced below, at all times relevant to this complaint. The payments generated in this matter and Defendant, Karyn Thomas' failure to repay the same are at the heart of the transactions and occurrences that form the basis for the present suit. 4. Defendant, Karyn Thomas is an adult individual residing in the Commonwealth of Pennsylvania at 333 Valley View Drive Plymouth, Luzerne County, Pennsylvania 18651 5. On or about October 2, 2003, Defendant Thomas was injured in a motor vehicle incident which occurred during the course and scope of her employment. 6. Workers compensation benefits were paid to or on behalf of Defendant Thomas by the Plaintiffs. 7. The workers compensation benefits referenced in the preceding paragraph totaled $2,044.18. 8. The workers compensation benefits referenced in the preceding paragraphs were adjusted and processed by Plaintiff PMA, with a place of business in Cumberland County Pennsylvania. 9. Defendant Thomas initiated a third party civil action against the driver of the vehicle who caused the October 2, 2003, motor vehicle incident. That suit was settled by general release for the sum of $4,200.00. 10. Pursuant to Section 319 of the Pennsylvania Worker's Compensation Act, 77 P.S. Section 671, Plaintiffs are entitled to be repaid from Defendant Thomas' third party recovery for workers' compensation benefits with a pro-rata deduction for counsel fees and expenses. 2 11. Pursuant to Section 319 of the Pennsylvania Worker's Compensation Act, 77 P.S. Section 671, Plaintiffs are entitled to recover $1,302.73 from Defendant Thomas after a pro-rata deduction of fees and costs. 12. Defendant Thomas has received the proceeds of the third party settlement. 13. Defendant Thomas has not paid any monies over to Plaintiffs. 14. Defendant Thomas has not paid the sum of $1,302.73 to Plaintiffs. COUNT I - SUBROGATION 15. Plaintiffs incorporate their allegations as contained in Paragraphs 1 through 14 above as though the same were fully set forth herein at length. 16. Pursuant to Section 319 of the Pennsylvania Worker's Compensation Act, 77 P.S. Section 671, Plaintiffs are entitled to be repaid from Defendant Thomas' third party recovery for workers' compensation benefits with a pro-rata deduction for counsel fees and expenses. 17. Pursuant to Section 319 of the Pennsylvania Worker's Compensation Act, 77 P.S. Section 671, Defendant Thomas is obligated to pay Plaintiffs the sum of $1,302.73. 18. Pursuant to Section 319 of the Pennsylvania Worker's Compensation Act, 77 P.S. Section 671, Plaintiffs are entitled to recover $1,302.73 from Defendant Thomas. WHEREFORE, Plaintiffs demand judgment against Defendant Thomas in the amount of $1,302.73 exclusive of interest and costs, making this case appropriate for compulsory arbitration. COUNT II - CONVERSION 19. Plaintiffs incorporate their allegations as contained in Paragraphs 1 through 18 above as though the same were fully set forth herein at length. 3 20. Defendant Thomas initiated a third party civil action against the driver of the vehicle who caused the October 2, 2003, motor vehicle incident. That suit was settled by general release for the sum of $4,200.00. 21. A portion of the funds referenced in the preceding paragraph - $1,302.73 was and is the property of Plaintiffs. 22. Defendant Thomas has been asked to provide the $1,302.73 to Plaintiffs but has not provided the funds. 23. Defendant Thomas has converted the $1,302.73 to her own use and control. WHEREFORE, Plaintiffs demand judgment against Defendant Thomas in the amount of $1,302.73 exclusive of interest and costs, making this case appropriate for compulsory arbitration. COUNT III - UNJUST ENRICHMENT 24. Plaintiffs incorporate their allegations as contained in Paragraphs 1 through 23 above as though the same were fully set forth herein at length. 25. Defendant Thomas initiated a third party civil action against the driver of the vehicle who caused the October 2, 2003, motor vehicle incident. That suit was settled by general release for the sum of $4,200.00. 26. A portion of the funds referenced in the preceding paragraph - $1,302.73 was and is the property of Plaintiffs. 27. Defendant Thomas has been asked to provide the $1,302.73 to Plaintiffs but has not provided the funds. 4 28. Defendant Thomas has maintained the $1,302.73 for her own use even though she is statutorily and contractually obligated to return the funds to Plaintiff, and therefore, has been unjustly enriched. WHEREFORE, Plaintiffs demand judgment against Defendant Thomas in the amount of $1,302.73 exclusive of interest and costs, making this case appropriate for compulsory arbitration. COUNT IV - BREACH OF CONTRACT 29. Plaintiffs incorporate their allegations as contained in Paragraphs 1 through 28 above as though the same were fully set forth herein at length. 30. Defendant Thomas initiated a third party civil action against the driver of the vehicle who caused the October 2, 2003, motor vehicle incident. That suit was settled by general release for the sum of $4,200.00. 31. A portion of the funds referenced in the preceding paragraph - $1,302.73 was and is the property of Plaintiffs. 32. By operation of law, Plaintiffs have an absolute right of subrogation in the amount of $1,302.73. 33. By operation of law, Defendant Thomas had an obligation to return the $1,302.73 amount to Plaintiffs but has not done so. 34. By operation of law, a contract existed between the parties hereto, with respect to the $1,302.73 referenced herein, which required that said funds be returned to Plaintiffs. 35. Defendant Thomas has breached her contractual obligations by failing to provide the $1,302.73 amount to Plaintiffs. 5 WHEREFORE, Plaintiffs demand judgment against Defendant Thomas in the amount of $1,302.73 exclusive of interest and costs, making this case appropriate for compulsory arbitration. Date: ?le Peters & Wasilefski By. Step An oor , Esquire Att#62077 2931 North Front Street Harrisburg, PA 17110-1250 [717] 238-7555 Attorney for Plaintiffs 6 VERIFICATION I hereby affirm that the following facts are correct: The PMA Insurance Group is a real party in interest. The attached Complaint is based upon information which I have furnished to my counsel and information which has been gathered by my counsel in preparation for this lawsuit. The language of the Complaint is that of counsel and not of me. I have read the Complaint and to the extent that the Complaint is based upon information which I have given to my counsel, it is true and correct to the best of my knowledge, information and belief To the extent that the content of the Complaint is that of counsel, I have relied upon counsel in making this verification. I hereby acknowledge that the facts set forth in the aforesaid Complaint are made subject to the penalties of 18 Pa. C.S. §4904 relating to unsworn falsification to authorities. Crain Authorized Representative of The PMA Insurance Group Dated: MAY CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing, Complaint, was served on all parties of interest by placing the same in the United States mail, via first-class mail, postage prepaid, at Harrisburg, Pennsylvania on this Z-- (d ay of May, 2008, and addressed as follows: Todd Johns, Esquire 960 Scranton-Carbondale Highway Archbald, Pennsylvania 18403 PETERS & WASILEFSKI -+-t ?Al y ? ?' TODD A. JOHNS, ESQ. Attorney for Defendant, KARYN THOMAS Identification No. 80327 Law Offices: %0 Scranton/Carbondale Hwy. Archbald, Pennsylvania 18403 Phone: (570) 876-6903 WYOMING VALLEY HEALTH CARE SYSTEM and THE PMA INSURANCE GROUP, vs. Plaintiffs KARYN THOMAS, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY CIVIL ACTION JURY TRIAL DEMANDED DOCKET NO. 08-2774 NOTICE You are hereby notified to file a written response to the enclosed Preliminary Objections within twenty (20) days from service hereof or a judgment may be entered against you. To: Wyoming Valley Health Care System The PMA Insurance Group c/o Stephen F. Moore, Esquire Peters & Wasilefski 2931 North Front Street Harrisburg, PA 17110 Respectfully submitted, TODD A. JOHNS, ESQ. Attorney for Defendant, KARYN THOMAS Identification No. 80327 Law Offices: 960 Scranton/Carbondale Hwy. Archbald, Pennsylvania 18403 Phone: (570) 876-6903 WYOMING VALLEY HEALTH CARE SYSTEM and THE PMA INSURANCE GROUP, Plaintiffs vs. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY CIVIL ACTION JURY TRIAL DEMANDED KARYN THOMAS, Defendant DOCKET NO. 08-2774 PRELIMINARY OBJECTIONS OF DEFENDANT TO COMPLAINT OF PLAINTIFFS AND NOW, comes the Defendant, Karyn Thomas, by and through her counsel, Todd A. Johns, Esquire, and files these Preliminary Objections to Plaintiffs' Complaint and in support thereof, avers as follows: 1. The Plaintiffs filed a Complaint against Defendant on or about May 27, 2008, Containing Counts for Subrogation, Conversion, Unjust Enrichment and Breach of Contract. A copy of Plaintiffs' Complaint is attached hereto, incorporated herein and labeled Exhibit "A". 2. On or about October 2, 2003, Defendant was involved in an automobile accident in Luzerne County, Pennsylvania. 3. The current action arises out of a dispute between the parties with regard to a subrogation claim made by Plaintiffs against Defendant in regard to worker's compensation benefits allegedly received from the Plaintiffs by the Defendant. 4. Defendant now timely files these Preliminary Objections to Plaintiffs' Complaint 5. Defendant files her Preliminary Objections pursuant to Pennsylvania Rule of Civil Procedure 1028(a)(1), (2), (3) and (4) which state in pertinent part as follows: Rule 1028. Preliminary Objections (a) Preliminary objections may be filed by any party to any pleading and are limited to the following grounds: (1) lack of jurisdiction over the subject matter of the action or the person of the defendant, improper venue or improper form or service of a writ of summons or a complaint; (2) failure of a pleading to conform to law or rule of court or inclusion of scandalous or impertinent matter; (3) insufficient specificity in a pleading; (4) legal insufficiency of a pleading (demurrer); ... Preliminary Objections: Pa.R.C.P. 1028(a)(1) 6. The current action was filed by Plaintiffs in the Cumberland County Court of Common Pleas; however, at all time relevant hereto, the Defendant has been and remains a resident of Luzerne County, Pennsylvania. 7. The accident at issue which resulted in Defendant's injuries and alleged benefits provided by the Plaintiffs also occurred in Luzerne County, Pennsylvania. 8. Defendant's employment at Wyoming Valley Health Care System took place exclusively in Luzerne County, Pennsylvania. 9. For the reasons set forth above, Plaintiff objects to the current action remaining in Cumberland County as a forum non conveniens pursuant to Pa.R.C.P. 1006. 10. Contemporaneous to the filing of the current Preliminary Objections, the Plaintiff is also filing a petition to transfer this matter to the Luzerne County Court of Common Pleas pursuant to Pa.R.C.P.A. 1006(d)(1). Wherefore, the Defendant, Karyn Thomas, moves this Honorable Court to grant her Preliminary Objections pursuant to Pa.R.C.P. 1028(a)(1) and Order that this matter be transferred to the Luzerne County Court of Common pleas as well as granting any other relief deemed appropriate. Preliminary Objections: Pa.R.C.P. 1028(a)(2) & (4) 11. Court IV of Plaintiffs' Complaint is for breach of contract; however, there is no contract attached to Plaintiffs' Complaint in violation of Pennsylvania Rule of Civil Procedure 1019(i). 12. Pennsylvania Rule of Civil Procedure 1019(i) states the following: Rule 1019. Contents of Pleadings. General and Specific Averments (i) When any claim or defense is based upon a writing, the pleader shall attach a copy of the writing, or the material part thereof, but if the writing or copy is not accessible to the pleader, it is sufficient so to state, together with the reason, and to set forth the substance in writing. (emphasis added) 13. As stated above, Plaintiffs' Complaint as filed, fails to attach a copy of any writing to support its claims for subrogation, conversion, unjust enrichment or breach of contract. 14. As such, it is respectfully submitted that Plaintiffs' Complaint fails to state a claim upon which relief can be granted and Plaintiffs' Complaint should be dismissed for failure to conform to law or rule of court and legal insufficiency pursuant to Pa.R.C.P. 1028(a)(2) & (4). Wherefore, the Defendant, Karyn Thomas, moves this Honorable Court to grant her Preliminary Objections pursuant to Pa.R.C.P. 1028(a)(2) & (4) and dismiss Plaintiffs' Complaint as well as granting any other relief deemed appropriate. Preliminary Objections: Pa.R.C.P. 1028(a)(3) & (4) 15. Plaintiffs' Complaint alleges that Defendant is obligated to pay Plaintiffs the sum of $1,302.73 "after a pro-rata deduction of attorney's fees and costs". 16. Plaintiffs' Complaint, however, fails to provide sufficient specificity to support this averment. 17. Additionally, Plaintiffs' Complaint fails to reflect a pro-rata deduction of fees and costs from the sum of $1,302.73 and seeks to recover the full amount. 18. The Plaintiffs' claim that it is entitled to recover $1,302.73 is contrary to Paragraph 11 contained in Plaintiffs' Complaint which provides the following: Pursuant to Section 319 of the Pennsylvania Worker's Compensation Act, 77 P.S. Section 671, Plaintiffs are entitled to recover $1,302.73 from Defendant Thomas after a pro-rata deduction of fees and costs. (emphasis added) 19. In spite of this averment, Plaintiffs seek to recover the entire sum of $1,302.73 without providing the calculation of any pro-rata deduction of fees and costs. 20. Plaintiffs also fail to provide a calculation of the benefits allegedly provided to the Defendant. 21. It is respectfully submitted that Plaintiffs' Complaint contains insufficient specificity in violation of PA. R.C.P. 1028(a)(3) and fails to state a claim upon which relief can be granted and should be dismissed pursuant to Pa. R.C.P. 1028(a)(3) & (4). WHEREFORE, the Defendant, Karyn Thomas, moves that this Honorable Court dismiss Plaintiffs' Complaint pursuant to Pennsylvania Rule of Civil Procedure 1028(a)(1)(2), (3), & (4) as well as an award of reasonable costs and attorney's fees and granting any other relief that this Honorable Court deems just and appropriate. Respectfully submitted, Attorney for Defendant, KARYN THOMAS PETERS & WASILEFSKI By: Stephen F. Moore, Esquire Attorney ID #62077 2931 North Front Street Harrisburg, PA 17110 [717] 238-7555 Attorney for Plaintiffs WYOMING VALLEY HEALTH CARE SYSTEM and THE PMA INSURANCE GROUP Plaintiffs IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION DOCKET NO: 08-2774 (cv0000412-07) V. JURY TRIAL DEMANDED KARYN THOMAS Defendant 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 Plaintiffs. You may lose money or property or other rights important to you. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. Cumberland County Bar Association 32 S. Bedford Street Carlisle, Pennsylvania 17013 717-249-3166 800-990-9108 U, EXHIBIT AVISO USTED HA SIDO DEMANDADO/A EN CORTE. Si usted desea defenderse de las demandas que se presentan mas adelante en las siguientes paginas, debe tomar accion dentro de los proximos veinte (20) dias despues de la notificacion de esta Demanda y Aviso radicando personalmente o por medio de un abogado una comparecencia escrita y radicando en la Corte por escrito sus defensas de, y objecciones a, las demandas presentadas aqui en contra suya. Se le advierte de que si usted falla de tomar accion como se describe anteriormente, el caso puede proceder sin usted y un fallo por cualquier suma de dinero reclamada en la demanda o cualquier otra reclamacion o remedio solicitado por el demandante puede ser dictado en contra suya por la Corte sin mas aviso a.dicional. Usted puede perder dinero o propiedad u otros derechos importantes para usted. USTED DEBE LLEVAR ESTE DOCUMENTO A SU ABOGADO INMEDIATAMENTE. SI USTED NO TIENE UN ABOGADO O NO PUEDE PAGARLE A UNO, LLAME O VAYA A LA SIGUIENTE OFICINA PARA AVERIGUAR DONDE PUEDE ENCONTRAR ASISTENCIA LEGAL. Cumberland County Bar Association 32 S. Bedford Street Carlisle, Pennsylvania 17013 717-249-3166 800-990-9108 PETERS & WASILEFSKI By: Stephen F. Moore, Esquire Attorney ID #62077 2931 North Front Street Harrisburg, PA 17110 [7171238-7555 Attorney for Plaintiffs WYOMING VALLEY HEALTH IN THE COURT OF COMMON PLEAS CARE SYSTEM and OF CUMBERLAND COUNTY, THE PMA INSURANCE GROUP PENNSYLVANIA Plaintiffs CIVIL ACTION DOCKET NO: 08-2774 V. (cv0000412-07) JURY TRIAL DEMANDED KARYN THOMAS Defendant COMPLAINT NOW COME, the Plaintiffs, Wyoming Valley Health Care System and The PMA Insurance Group (collectively "Plaintiffs"), by and through their attorneys, Peters & Wasilefski, and file this Complaint and, in support thereof, aver as follows: 1. Plaintiff, Wyoming Valley Health Care System ("Wyoming Valley") is a corporation with a principal place of business at 575 North River Street, Wilkes-Barre Luzerne County, Pennsylvania, engaged in the delivery of health care services. 2. Plaintiff, The PMA Insurance Group ("PMA") is a corporation with a place of business at 500 N 12th Street, Lemoyne, Cumberland County, Pennsylvania, authorized to sell insurance policies and adjust insurance claims in the Commonwealth of Pennsylvania. 3. Plaintiff PMA provided workers' compensation coverage to Plaintiff Wyoming Valley and provided workers' compensation claims services to Defendant Thomas including the actual adjustment of the claim and the issuance and processing of various payments, as referenced below, at all times relevant to this complaint. The payments generated in this matter and Defendant, Karyn Thomas' failure to repay the same are at the heart of the transactions and occurrences that form the basis for the present suit. 4. Defendant, Karyn Thomas is an adult individual residing in the Commonwealth of Pennsylvania at 333 Valley View Drive Plymouth, Luzerne County, Pennsylvania 18651 5. On or about October 2, 2003, Defendant Thomas was injured in a motor vehicle incident which occurred during the course and scope of her employment. 6. Workers compensation benefits were paid to or on behalf of Defendant Thomas by the Plaintiffs. 7. The workers compensation benefits referenced in the preceding paragraph totaled $2,044.18. 8. The workers compensation benefits referenced in the preceding paragraphs were adjusted and processed by Plaintiff PMA, with a place of business in Cumberland County Pennsylvania. 9. Defendant Thomas initiated a third party civil action against the driver of the vehicle who caused the October 2, 2003, motor vehicle incident. That suit was settled by general release for the sum of $4,200.00. 10. Pursuant to Section 319 of the Pennsylvania Worker's Compensation Act, 77 P.S. Section 671, Plaintiffs are entitled to be repaid from Defendant Thomas' third party recovery for , workers' compensation benefits with a pro-rata deduction for counsel fees and expenses. 2 11. Pursuant to Section 319 of the Pennsylvania Worker's Compensation Act, 77 P.S. Section 671, Plaintiffs are entitled to recover $1,302.73 from Defendant Thomas after a pro-rata deduction of fees and costs. 12. Defendant Thomas has received the proceeds of the third party settlement. 13. Defendant Thomas has not paid any monies over to Plaintiffs. 14. Defendant Thomas has not paid the sum of $1,302.73 to Plaintiffs. COUNT I - SUBROGATION 15. Plaintiffs incorporate their allegations as contained in Paragraphs 1 through 14 above as though the same were fully set forth herein at length. 16. Pursuant to Section 319 of the Pennsylvania Worker's Compensation Act, 77 P.S. Section 671, Plaintiffs are entitled to be repaid from Defendant Thomas' third party recovery for workers' compensation benefits with a pro-rata deduction for counsel fees and expenses. 17. Pursuant to Section 319 of the Pennsylvania Worker's Compensation Act, 77 P.S. Section 671, Defendant Thomas is obligated to pay Plaintiffs the sum of $1,302.73. 18. Pursuant to Section 319 of the Pennsylvania Worker's Compensation Act, 77 P.S. Section 671, Plaintiffs are entitled to recover $1,302.73 from Defendant Thomas. WHEREFORE, Plaintiffs demand judgment against Defendant Thomas in the amount of $1,302.73 exclusive of interest and costs, making this case appropriate for compulsory arbitration. COUNT II - CONVERSION 19. Plaintiffs incorporate their allegations as contained in Paragraphs 1 through 18 above as though the same were fully set forth herein at length. 3 20. Defendant Thomas initiated a third party civil action against the driver of the vehicle who caused the October 2, 2003, motor vehicle incident. That suit was settled by general release for the sum of $4,200.00. 21. A portion of the funds referenced in the preceding paragraph - $1,302.73 was and is the property of Plaintiffs. 22. Defendant Thomas has been asked to provide the $1,302.73 to Plaintiffs but has not provided the funds. 23. Defendant Thomas has converted the $1,302.73 to her own use and control. WHEREFORE, Plaintiffs demand judgment against Defendant Thomas in the amount of $1,302.73 exclusive of interest and costs, making this case appropriate for compulsory arbitration. COUNT III - UNJUST ENRICHMENT 24. Plaintiffs incorporate their allegations as contained in Paragraphs 1 through 23 above as though the same were fully set forth herein at length. . 25. Defendant Thomas initiated a third party civil action against the driver of the vehicle who caused the October 2, 2003, motor vehicle incident. That suit was settled by general release for the sum of $4,200.00. 26. A portion of the funds referenced in the preceding paragraph - $1,302.73 was and is the property of Plaintiffs. 27. Defendant Thomas has been asked to provide the $1,302.73 to Plaintiffs but has not provided the funds. 4 28. Defendant Thomas has maintained the $1,302.73 for her own use even though she is statutorily and contractually obligated to return the funds to Plaintiff, and therefore, has been unjustly enriched. WHEREFORE, Plaintiffs demand judgment against Defendant Thomas in the amount of $1,302.73 exclusive of interest and costs, making this case appropriate for compulsory arbitration. COUNT IV - BREACH OF CONTRACT 29. Plaintiffs incorporate their allegations as contained in Paragraphs 1 through 28 above as though the same were fully set forth herein at length. 30. Defendant Thomas initiated a third party civil action against the driver of the vehicle who caused the October 2, 2003, motor vehicle incident. That suit was settled by general release for the sum of $4,200.00. 31. A portion of the funds referenced in the preceding paragraph - $1,302.73 was and is the property of Plaintiffs. 32. By operation of law, Plaintiffs have an absolute right of subrogation in the amount of $1,302.73. 33. By operation of law, Defendant Thomas had an obligation to return the $1,302.73 amount to Plaintiffs but has not done so. 34. By operation of law, a contract existed between the parties hereto, with respect to the $1,302.73 referenced herein, which required that said funds be returned to Plaintiffs. 35. Defendant Thomas has breached her contractual obligations by failing to provide the $1,302.73 amount to Plaintiffs. 5 WHEREFORE, Plaintiffs demand judgment against Defendant Thomas in the amount of $1,302.73 exclusive of interest and costs, making this case appropriate for compulsory arbitration. Date:.le Peters & Wasilefski By. Step n F. oo ,Esquire .Attorney I #62077 2931 North Front Street Harrisburg, PA 17110-1250 [717] 238-7555 Attorney for Plaintiffs 6 VERMCATION I hereby aThm that the following facts are correct: The PMA Insurance Group is a real party in interest. The attached Complaint is based upon information which I have furnished to my counsel and information which has been gathered by my counsel in preparation for this lawsuit. The language of the Complaint is that of counsel and not of me. I have read the Complaint and to the extent that the Complaint is based upon information which I have given to my counsel, it is true and correct to the best of my knowledge, information and belief. To the extent that the content of the Complaint is that of counsel, I have relied upon counsel in making this verification. I hereby acknowledge that the facts set forth in the aforesaid Complaint are made subject to the penalties of 18 Pa. C.S. §4944 relating to unworn falsification to authorities. Craine Authorized Representative of The PMA Insurance Group Dated: MAY ? 2t!!,3 CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing, Complaint, was served on all parties of interest by placing the same in the United States mail, via first-class mail, postage prepaid, at Harrisburg, Pennsylvania on this ?LLd ay of May, 2008, and addressed as follows: Todd Johns, Esquire 960 Scranton-Carbondale Highway Archbald, Pennsylvania 18403 PETERS & WASILEFSKI TODD A. JOHNS, ESQ. Attorney for Defendant, KARYN THOMAS Identification No. 80327 Law Offices: 960 Scranton/Carbondale Hwy. Archbald, Pennsylvania 18403 Phone: (570) 876-6903 WYOMING VALLEY HEALTH CARE SYSTEM and THE PMA INSURANCE GROUP, Plaintiffs VS. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY CIVIL ACTION JURY TRIAL DEMANDED KARYN THOMAS, Defendant DOCKET NO. 08-2774 CERTIFICATE OF SERVICE I, Todd A. Johns, Esquire, certify that on the day of June, 2008, I made service of Preliminary Objections of Defendant to Complaint of Plaintiffs, upon the following, by United States first class mail, addressed as follows: Stephen F. Moore, Esquire Peters & Wasilefski 2931 North Front Street Harrisburg, PA 17110 ?v ,Z.: i? t m C TODD A. JOHNS, ESQ. Attorney for Defendant, KARYN THOMAS Identification No. 80327 Law Offices: 960 Scranton/Carbondale Hwy. Archbald, Pennsylvania 18403 Phone: (570) 876-6903 W z viviuvU vALLtY HEAL'1H CARE SYSTEM and THE PMA INSURANCE GROUP, vs. Plaintiffs KARYN THOMAS, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY CIVIL ACTION JURY TRIAL DEMANDED DOCKET NO. 08-2774 DEFENDANT'S PETITION PURSUANT TO PA R.C.P. 1006(d)(1) RAISING THE DOCTRINE OF FORUM NON CONVENIENS AND NOW, comes the Defendant, Karyn Thomas, by and through her counsel, Todd A. Johns, Esquire, who hereby files the following Petition Pursuant to Pa. R.C.P. 1006(d)(1) Raising the Doctrine of Forum Non Conveniens, and, in support thereof, avers as follows: 1. The Plaintiffs filed a Complaint against the Defendant on or about May 27, 2008. 2. The current action arises out of a dispute between the parties with regard to a subrogation claim made by Plaintiffs against Defendant in regard to workers' compensation benefits allegedly received from the Plaintiffs by the Defendant. 3. At all times relevant hereto, the Defendant has been and remains a resident of Luzerne County, Pennsylvania. 4. The accident at issue which resulted in Defendant's injuries and alleged benefits provided by the Plaintiffs occurred in Luzerne County, Pennsylvania. 5. Defendant's employment at Wyoming Valley Health Care Systems also took place exclusively in Luzerne County, Pennsylvania. 6. Venue for the current action is based solely on the fact that Plaintiffs' corporate office is located in Cumberland County, Pennsylvania, however, Plaintiffs do business throughout the Commonwealth of Pennsylvania, including, but not limited to Luzerne County. 7. Since Cumberland County has no relationship with the Defendant, the Defendant's employer or the accident giving rise to the Defendant's injuries and alleged benefits, it would be unfair to require this Court's jurors to sit on this suit. 8. It would also serve as an inconvenience for the Defendant and Defendant's witnesses who all reside and do business in Luzerne County to defend the current action in the Cumberland County Court of Common Pleas. 9. The location of the Defendant and witnesses in Luzerne County supports the transfer of the instant suit to the Court of Common Pleas of Luzerne County, Pennsylvania. WHEREFORE, Defcendant, Karyn Thomas, hereby requests that her Petition be granted and suit be transferred from this Honorable Court to Luzerne County, Pennsylvania as well as granting any other relief that the Court deems just and appropriate. Respectfully submitted, OJOHNS, ES 0 TODD A. JOHNS, ESQ. Attorney for Defendant, KARYN THOMAS Identification No. 80327 Law Offices: 960 Scranton/Carbondale Hwy. Archbald, Pennsylvania 18403 Phone: (570) 876-6903 W Y UIVllNU VALLEY HEALTH CARE SYSTEM and THE PMA INSURANCE GROUP, vs. Plaintiffs KARYN THOMAS, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY CIVIL ACTION JURY TRIAL DEMANDED DOCKET NO. 08-2774 CERTIFICATE OF SERVICE I, Todd A. Johns, Esquire, certify that on the day of June, 2008, I made service of Defendant's Petition Pursuant to Pa. R.C.P. 1006(d)(1) Raising the Doctrine of Forum Non Conveniens, upon the following, by United States first class mail, addressed as follows: Stephen F. Moore, Esquire Peters & Wasilefski 2931 North Front Street Harrisburg, PA 17110 Respec 11 u mitted, V\ .1 1 TODD A. JOHNS, ESQUIRE C o O ` co `rt TJ 0- r r; C- C:: - .> n rn C T, 77 t PRAECIPE FOR LISTING CASE FOR ARGUMENT (Must be typewritten and submitted in duplicate) TO THE PROTHONOTARY OF CUMBERLAND COUNTY: (List the within matter for the next Argument Court.) CAPTION OF CASE ----------------------- ------___-_--------- ------ ------- ------------ ----- (entire caption must be stated in full) Wyoming Valley Health Care System and The PMA Insurance Group vs. Karyn Thomas No. 2774 2008 Term 1. State matter to be argued (i.e., plaintiff's motion for new trial, defendant's demurrer to complaint, etc.): Defendant's Preliminary Objections 2. Identify. all counsel who will argue cases: (a) for plaintiffs: F. Moore, Esquire (Name 2931 North Front Street, Harrisburg, PA 17110 (b) for defendants: Todd A. Johns Es wire (Name and Address) 960 Scranton/Carbondale Highway, Archbald, PA 18403 3. 1 will notify all parties in writing within two days that this case has been listed for argument. 4. Defendant, Karyn Thomas Attorney for Date: _ i / o - (l INSTRUCTIONS: 1. Two copies of all briefs must be filed with the COURT ADMINISTRATOR (not the Prothonotary) before argument. 2. The moving party shall file and serve their brief 12 days prior to argument. 3. The responding party shall file their brief 5 days prior to argument. 4. If argument is continued new briefs must be flied with the COURT ADMINISTRATOR (not the Prothonotary) after the case is relisted. Todd A. Johns Esquire Print your name rT t? PETERS & WASILEFSKI By: Stephen F. Moore, Esquire Attorney ID #62077 2931 North Front Street Harrisburg, PA 17110 [7171238-7555 Attorney for Plaintiffs WYOMING VALLEY HEALTH IN THE COURT OF COMMON PLEAS CARE SYSTEM and OF CUMBERLAND COUNTY, THE PMA INSURANCE GROUP PENNSYLVANIA Plaintiffs CIVIL ACTION DOCKET NO: 08-2774 (cv0000412-07) V. JURY TRIAL DEMANDED KARYN THOMAS Defendant 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 Plaintiffs. You may lose money or property or other rights important to you. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. Cumberland County Bar Association 32 S. Bedford Street Carlisle, Pennsylvania 17013 717-249-3166 800-990-9108 AVISO USTED HA SIDO DEMANDADO/A EN CORTE. Si usted desea defenderse de las demandas que se presentan mas adelante en las siguientes paginas, debe tomar accion dentro de los proximos veinte (20) dias despues de la notificacion de esta Demands y Aviso radicando personalmente o por medio de un abogado una comparecencia escrita y radicando en la Corte por escrito sus defensas de, y objecciones a, las demandas presentadas aqui en contra suya. Se le advierte de que si usted falla de tomar accion como se describe anteriormente, el caso puede proceder sin usted y un fallo por cualquier suma de dinero reclamada en la demanda o cualquier otra reclamacion o remedio solicitado por el demandante puede ser dictado en contra suya por la Corte sin mas aviso adicional. Usted puede perder dinero o propiedad u otros derechos importantes para usted. USTED DEBE LLEVAR ESTE DOCUMENTO A SU ABOGADO INMEDIATAMENTE. SI USTED NO TIENE UN ABOGADO O NO PUEDE PAGARLE A UNO, LLAME O VAYA A LA SIGUIENTE OFICINA PARA AVERIGUAR DONDE PUEDE ENCONTRAR ASISTENCIA LEGAL. Cumberland County Bar Association 32 S. Bedford Street Carlisle, Pennsylvania 17013 717-249-3166 800-990-9108 PETERS & WASILEFSKI By: Stephen F. Moore, Esquire Attorney ID #62077 2931 North Front Street Harrisburg, PA 17110 [717] 238-7555 Attorney for Plaintiffs WYOMING VALLEY HEALTH IN THE COURT OF COMMON PLEAS CARE SYSTEM and OF CUMBERLAND COUNTY, THE PMA INSURANCE GROUP PENNSYLVANIA Plaintiffs CIVIL ACTION DOCKET NO: 08-2774 V. (cv0000412-07) JURY TRIAL DEMANDED KARYN THOMAS Defendant AMENDED COMPLAINT NOW COME, the Plaintiffs, Wyoming Valley Health Care System and The PMA Insurance Group (collectively "Plaintiffs"), by and through their attorneys, Peters & Wasilefski, and file this Complaint and, in support thereof, aver as follows: 1. Plaintiff, Wyoming Valley Health Care System ("Wyoming Valley") is a corporation with a principal place of business at 575 North River Street, Wilkes-Barre Luzerne County, Pennsylvania, engaged in the delivery of health care services. 2. Plaintiff, The PMA Insurance Group ("PMA") is a corporation with a place of business at 500 N 12th Street, Lemoyne, Cumberland County, Pennsylvania, authorized to sell insurance policies and adjust insurance claims in the Commonwealth of Pennsylvania. 3. Plaintiff PMA provided workers' compensation coverage to Plaintiff Wyoming Valley and provided workers' compensation claims services to Defendant Thomas including the actual adjustment of the claim and the issuance and processing of various payments, as referenced below, at all times relevant to this complaint. The payments generated in this matter and Defendant, Karyn Thomas' failure to repay the same are at the heart of the transactions and occurrences that form the basis for the present suit. 4. Defendant, Karyn Thomas is an adult individual residing in the Commonwealth of Pennsylvania at 333 Valley View Drive Plymouth, Luzerne County, Pennsylvania 18651 5. On or about October 2, 2003, Defendant Thomas was injured in a motor vehicle incident which occurred during the course and scope of her employment. See report attached hereto and incorporated herein as Exhibit A. 6. Workers compensation benefits were paid to or on behalf of Defendant Thomas by the Plaintiffs. 7. The workers compensation benefits referenced in the preceding paragraph totaled $2,044.18. See itemization of payments made on Defendant Thomas' behalf attached hereto and incorporated herein as Exhibit B. 8. The workers compensation benefits referenced in the preceding paragraphs were adjusted and processed by Plaintiff PMA, with a place of business in Cumberland County Pennsylvania. 9. Defendant Thomas initiated a third party civil action against the driver of the vehicle who caused the October 2, 2003, motor vehicle incident. That suit was settled by 2 general release for the sum of $4,200.00. See correspondence acknowledging Attorney client relationship between Attorney Johns and Defendant Thomas attached hereto and incorporated herein as Exhibit C. See also, correspondence with attachments acknowledging resolution of third party claim for the sum of $4,200.00 attached hereto and incorporated herein as Exhibit D. 10. Pursuant to Section 319 of the Pennsylvania Worker's Compensation Act, 77 P.S. Section 671, Plaintiffs are entitled to be repaid from Defendant Thomas' third party recovery for workers' compensation benefits with a pro-rata deduction for counsel fees and expenses. 11. Pursuant to Section 319 of the Pennsylvania Worker's Compensation Act, 77 P.S. Section 671, Plaintiffs are entitled to recover $1,302.73 from Defendant Thomas after a pro-rata deduction of fees and costs. 12. Defendant Thomas has received the proceeds of the third party settlement. 13. Defendant Thomas has not paid any monies over to Plaintiffs. See communications attached hereto and incorporated herein as Exhibit E outlining discussions regarding repayment of the $1,302.73 amount identified above. Exhibit E also contains a Pennsylvania Department of Labor and Industry form LIBC-380 which outlines the reimbursement calculations staring with the total benefit amount paid of totaled $2,044.18 (see exhibit B) and using Defendant Thomas' information regarding counsel fees and costs (see exhibit D) to arrive at the $1,302.73 amount. 14. Defendant Thomas has not paid the sum of $1,302.73 to Plaintiffs. 3 COUNT I - SUBROGATION 15. Plaintiffs incorporate their allegations as contained in Paragraphs 1 through 14 above as though the same were fully set forth herein at length. 16. Pursuant to Section 319 of the Pennsylvania Worker's Compensation Act, 77 P.S. Section 671, Plaintiffs are entitled to be repaid from Defendant Thomas' third party recovery for workers' compensation benefits with a pro-rata deduction for counsel fees and expenses. 17. Pursuant to Section 319 of the Pennsylvania Worker's Compensation Act, 77 P. S . Section 671, Defendant Thomas is obligated to pay Plaintiffs the sum of $1,302.73. 18. Pursuant to Section 319 of the Pennsylvania Worker's Compensation Act, 77 P. S. Section 671, Plaintiffs are entitled to recover $1,302.73 from Defendant Thomas. WHEREFORE, Plaintiffs demand judgment against Defendant Thomas in the amount of $1,302.73 exclusive of interest and costs, making this case appropriate for compulsory arbitration. COUNT II - CONVE RSION 19. Plaintiffs incorporate their allegations as contained in Paragraphs 1 through 18 above as though the same were fully set forth herein at length. 20. Defendant Thomas initiated a third parry civil action against the driver of the vehicle who caused the October 2, 2003, motor vehicle incident. That suit was settled by general release for the sum of $4,200.00. 4 21. A portion of the funds referenced in the preceding paragraph - $1,302.73 was and is the property of Plaintiffs. 22. Defendant Thomas has been asked to provide the $1,302.73 to Plaintiffs but has not provided the funds. 23. Defendant Thomas has converted the $1,302.73 to her own use and control. WHEREFORE, Plaintiffs demand judgment against Defendant Thomas in the amount of $1,302.73 exclusive of interest and costs, making this case appropriate for compulsory arbitration. COUNT III - UNJUST ENRICHMENT 24. Plaintiffs incorporate their allegations as contained in Paragraphs 1 through 23 above as though the same were fully set forth herein at length. 25. Defendant Thomas initiated a third party civil action against the driver of the vehicle who caused the October 2, 2003, motor vehicle incident. That suit was settled by general release for the sum of $4,200.00. 26. A portion of the funds referenced in the preceding paragraph - $1,302.73 was and is the property of Plaintiffs. 27. Defendant Thomas has been asked to provide the $1,302.73 to Plaintiffs but has not provided the funds. 28. Defendant Thomas has maintained the $1,302.73 for her own use even though she is statutorily and contractually obligated to return the funds to Plaintiff, and therefore, has been unjustly enriched. 5 WHEREFORE, Plaintiffs demand judgment against Defendant Thomas in the amount of $1,302.73 exclusive of interest and costs, making this case appropriate for compulsory arbitration. COUNT N - BREACH OF CONTRACT 29. Plaintiffs incorporate their allegations as contained in Paragraphs 1 through 28 above as though the same were fully set forth herein at length. 30. Defendant Thomas initiated a third party civil action against the driver of the vehicle who caused the October 2, 2003, motor vehicle incident. That suit was settled by general release for the sum of $4,200.00. 31. A portion of the funds referenced in the preceding paragraph - $1,302.73 was and is the property of Plaintiffs. 32. By operation of law, Plaintiffs have an absolute right of subrogation in the amount of $1,302.73. 33. By operation of law, Defendant Thomas had an obligation to return the $1,302.73 amount to Plaintiffs but has not done so. 34. By operation of law, a contract existed between the parties hereto, with respect to the $1,302.73 referenced herein, which required that said funds be returned to Plaintiffs. 35. Defendant Thomas has breached her contractual obligations by failing to provide the $1,302.73 amount to Plaintiffs. 6 WHEREFORE, Plaintiffs demand judgment against Defendant Thomas in the amount of $1,302.73 exclusive of interest and costs, making this case appropriate for compulsory arbitration. Peters & Wasilefski B Ste en . Moore, Esquire Attorney #62077 2931 North Front Street Harrisburg, PA 17110-1250 [717] 238-7555 Date: ?Q l fdl?r Attorney for Plaintiffs 7 C,X?,? A s? 30"4 PC?V Fax PACE 000/013 ?p01 611812p07 2,1g ? ? .x Suez ?ga06 SOW lose ? ? a acn?m?NU+"?" 170 161 6171 $WORT O-M OF lJ?? wMOtw lIw wIAE %AwR" w*o isou" FMVMUO i?VALv vAv Dws pLyywvm OVIM L now Woo it °f p 001W 0 WYCONS wv ssv ' acom 4324 !w 14 GOOM arm ? OVWWWAWVMW Faa i°? " of qMuwv I"$ *A "A FULLWVOOAV x °0' ti U.v VrwO° WOO ? wwo aam?? 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(888) 329,2721 P.O. fts =Al Lewsh Valley, PA KNAMO 91 23164M oATe FiteMwn - - 100620p3 QMIlee otAIN• nlli?M.1e erM1M eibNnel d riAOeee/? Itie101Am AO "IL C, " ?L?w+ B 04THE PMA. All Payments A N j KARYN THOMAS - W890366391 U, MUP Total Payments: $2,466.29 Payments made 01/01/03 up to 04/01/08 Medical $2,044.18 Tax ID: 240795505 WYOMING VALLEY HLTH CARE SYSTEM INC $1,124.15 04/10/08 Page 2 Payee Name Check Issue Date WVHCS HOSPITAL INC WVHCS HOSPITAL INC WVHCS HOSPITAL W60 WVHCS-HOSPITAL WVHCS HOSPITAL W60 WVHCS HOSPITAL INC WVHCS HOSPITAL INC WVHCS HOSPITAL W60 WVHCS HOSPITAL INC Pay Start Date Pay End Date Pavment Amount 10/06/03 10/06/03 27.38 10/03/03 10/02/03 10/03/03 10/02/03 64.46 164.86 10/15/03 0/15/03 1 27.38 10/03/03 _ 10/15/03 52.99 10/06/03 10/28/03 535.48 10/30/03 10!30/03 27.38 11/11/03 11/11/03 27.38 11/13/03 11125103 169.46 11/25/03 11/25/03 27.38 Tax ID: 232929807 INTERMOUNTAIN MEDICAL GR $620.63 Payee Name Check Issue Date Pay Start Date Pay End Date Payment Amount INTERMOUNTAIN MEDICAL GR 07/07!04 07/07/04 620.63 Tax ID: 207328985 EDWARD CAREY MD $143.70 ee Name 'I Check Issue Date Pa Pay Start Date Pay End Date Payment Amount y EDWARD CAREY 11/13/03 11/13/03 71.07 EDWARD CAREY 07/16/04 07/16104 72.63 Tax ID: 207328985 EDWARD CAREY $72.63 Payee Name sue Date Check Is Pay Start Date Pay End Date Payment Amount EDWARD CAREY I - 0ffiw 06/03/04 06/03/04 72.63 Tax ID: 233056167 SAPPHIRE EMERGENCY PHYS $65.96 Payee Name Check Issue Date Pay Start Date Pav End Date Payment Amount SAPPHIRE EMERGENCY PHYS 10/02/03 10/02/03 65.96 Tax ID: 200114570 RADIOLOGY ASSOCIATES OF WYOMING $18.35 Payee Name Check Issue Date Pay Start Date Pay End Date Payment Amount RADIOLOGY ASSOCIATES 10/02103 10/02/03 18.35 Tax ID: 043579738 INJURED WORKERS PHARMACY -$1.24 Payee Name Check Issue Date Pay Start Date Pav End Date Payment Amount -1.24 + l,/ ?; t c;wv Fax Server 6/18/2007 3:09 PAGE 012/021 Fax Server LAW oRFiCU of W p u3-` TODD A. JOHNS, ESQUIRE -.0" M ICMN' M - CMI NDALL HWY. ` 9 Ili PUBLIC IWA L KITE 310 MCHULD, PA WO WIMMMU ?y1y? Imi PHONL OM)#% PHOP49, RA1ii (Ii'lp 17i.H07 PART i on= --?? Wpllr t0; December 8, 2004 Employee Health Services W111ces-8trre General Hospital 575 North River Street VANces-Barn,, PA 18764 RR: Karyn Thomas OOS: 06/23/1067 Mi 201-411-3463 To Whom R May Concern; With regard to the above refinnced malty, please be advised that my offim has been retalned to rapree t the interests of Mo. Thomas In relation to Injuries sufYared in an automobile aoddent on October 2, 2003. It has come to myattrntion ftt you have tnmote d Ms. Thomas for her Injuries. At this 0mee I am respeftilyrequesting that you please forvard all medoal bill and medleW racw& to my of Mm. I have enclosed an Authorization for Relase of Medical Recordt Ind co" that i am auttarized to rewW sine, Thank you for your time and attention to thl matter. If you have any questions or vomnw tx mp dlnq the above or require any additional Iftmetion, please do not hesitate to eor6act me. Very truly yours, ls 'T oj&a. adow Todd A, Johns, Esquire TMtjmb Enclosure Cc: Karyn Thomas •' • , r Fax Server 6/18/2007 3:09 PAGE 013/021 Fax Server AUTHOWA110N TO USE AND/OR DISCLOSE MEDICAL RROMAI w .,,?. 1 aut a te, (rams of heath Mre provldar? &QM Ufft4hSOAy CA I to use wWw disclose a copy of tree spsdttc hUM and medical htxmetion idenWad below for KARMN TNOMM to (Mme and address of recipient) TOMB A. JOHNS, ESOUIM 16 PUtiit M S4UARR SUrM 210, WRX184sARRE, PA ill for the bit *tl purpeeee: To pursue a personal injury sobon mwitlnp from in)udw wsgdned in a car accident on / 6"2k In __ Oy lntb ftte apaoes below. I spsoita* affiortaa the use andlor dladauro of ft following health intrmatibn wdibr rtte An I wwo, K such kdormaden srdlwr rseords sidst: Plasse sand ttte entire rt e"I record (all k tbrnvftn) to the above named mclplent. AN holW records W4Wdng Oftion Am dwt noble nundntp reoot+tle and propriees nods) TreroMrtbsd hoeplW reports Ntsdloal hounds needed for continully of care Most resent Iva-year his" _.? EmegWwy and urgent are rewords Dental r¦OM$ Uftrebry reports Ptok0y rapoft Disprtostio Imping reports _ 11" abbemana air: "The loNowlrtrg Poems must be InIklsd to be kWAMM In tha use endror disclosure of otfw health InfomWon; - WAIOS relstsd information andlor records Mmw IW O Assiut iMONm ton wAtr records "asi" le Weft Mmtatlon andbr reooNs . _ MrtqftlOahol dlagnesls, peabrnnt or nehrtal IMorrrnatbn r;Redanl reguWlone requMe i desorlpdwrt of how muoh and what kind of lnformatton is to be disclosed.) Describe; undareWd that, if the person or antNy MW" the Informs M b not • ft*W ears PMW*f or hoft pin Coveted by fsdarai Onq regal*M, the information described above may be redleclosad turd no der probcbd by two regulations. However. Me melptent may be WhMad from disabling substance sburse hnfan Wn undarths Federal Substance Abuse Conlidenbilly Requintmenbs. I also undaNtnd that the parson I am nuthorWrp to use and/or dWd W the information May raosWe comperaadon for daing se. Other undavland that I may Wfuse to sign this suftdutbn and last my rsfusat to elgrt will not OW may ablMty to oMaln Croat n t or paynwnt or my *W6* for benef . I may inspect or copy any Information b be used andlor dMMW under this auembiathn. Fax Server 6/18/2007 3:09 PAGE 014/021 Fax Server ¦ r W V Fluty, l un"Mond that 1 Hwy rmko this authorization in writing at any time, provided ht I do ao in *11*0, +XPt to the extant that action hp bean taken in'eiiana upon No authorization. unim revoked sew. t* aulhorbcdlon A aocpira 180 days from the date of signing, s.s.r moo/ yfSr/63 S#nduW t or Pabdo L"M R.p luntaft Kann Thomas Print Patl.nh Deane Prbtt Nana of LGO oprasanta A ) (A oopy of ttUs signed bnn A be provided b the patient) Ex ktb(t b 30°?Q ?'?? Fax Server 6118/2007 2:19 PAGE 004/013 Fax Server 02111y2007 60 18:69 PAZ 070 416 7790 NC9PR 1AW OFFICES A-tt LAW GOR1Cf9 Oir "rC Q TODD A. JOHNS, ESQUME sto ICRANTOMOCARIONVALZ arw, , AW,HBALD, PA te1W FAXI tel. Mr PM MRS 94WO lokuf dpkw-w Rrpty to: , coal/004 w is W t1 pulUX eQUADRMU11196 IPA 1x70! RNONf+ pNl 8"01 FALRMINIPrs" 9dwifivy /rLwa ftw 1w. -A- January 0, 2006 arren Cralrw The IN" Insurarm a" Custnter erivb.jCwftr . PO bore 26260 t etttph Valley, PA 160024= 717.730-tit6Q • RE: Your Insured; Wyotninp Valley Wealth Oro Your Claim Me; YY---a-- I Our CNntK Ka" Thom Dear W. OWN: With further rapard to the above refarenoed tnattsr, kindly allow tlti9 W--pondenos to serve es a blowup eon esratttort of "y's dots, Spec Rally, enclosed 'wwA ?t pkar Q t blbwirtp wris Ali verifft that this MOW was se6lsd forthe amount of 54,200.00: 1. 80ttlerrtsrtt 8lalamert? I Release of Clshw L Conesponden0e to Ahts* end a. Conspondenw ftm Allstate; In light of the same, I waWd request lhpt 6t Iisn ournnNy held by PMA Insurenoe ti" be reduced eooordlrl*$m NOht of the net proosede mosMed by Ms. Thorne. Thank you for your Vm and st wslon to this netttar, If you have any qusstlons or rsq*t any ¦ MWnet InfOMWOn, pleeae 010 not hoOds to 0omeat me. Very V* Yom? Todd A. Jahn, Esquire TAX AM Enckwure oc, Kwp Thomas (wfout enol) Fax Server 6/18/2007 2:19 PAGE 005/013 Fax Server 02AW20 7 SU 1$,, if FAX 570 625 7796 WCSPB LAW OFFICES R-B ?OOA/004 PY C C TODD A. JOHNS, ESQUME Np OAti i1wY. u nAlac fvrri 110 ASCOMW, PA 00 w?H larz FAX, aj 07 July 1, 3005 lffffU =NT =TATS Koryn ThW M V. jam Frye GROW FUNDS RECENED K200,00 LESC 1,6Z3.? AnorWG Fin (39113) ;1,400.00 Cosa Advrnood =' 193.39 Dr. Ednrd C?e?t (Tq"l ro mft) 190.00 Rworda Aoq Itlu4 o l Corp. IBM . PA 800 Poft (SoddlOd Mp" 8.00 NET FROCl DUE CLIENT i9,8'n1.82 Fax Server Ot/11400,7 0[,'N 14:47 WAX i jun. 14. im Ys40nw ? X03 -46341 i 6/18/2007 2:19 PAGE 006/013 Fax Server To 4=4 1790 wCopm LAN o"Icls N-f ODL/OOa Rt6?IRI? NU.9tlY Y. ' jib ARWALLCIA LM Uiuabarrd 9eid YYfh) 496m e din We Tw i-daim WMnNaail?, 1* I,1latm TwerM.onvdb grew Tw9m Mbuo"llon ow aP/4 ad •oolt Thom harow INtalwad, orwd In aon4MarRb oNn smog IbrrMipaNMUi k oftwAnd moo doiaao, ii4??oo.?p?, +?woff" unwwawdkm"#AwdwlaooIwaadi?aMa*oeoir9?paape?.aak In .nr V,1wM NMi Jag M1??, Dom! f Mme, Amb l l o wl V* MwI?R wwr9a w h r l r 0nd nwMM9?~.rlr?n9. ? ofuowniJ?w?wl???s,?alr.wn Ooe nKaad a1NrpaIwtf? Mnn or Ir? or ! wipon4 rVI ummw$ Ilgb MMa wwawa?.wAa1Ma.?•w9awo, owww, 9.d?ifleaate?9nd arr waa, dance, ww,.?owa, iowdwMoo9, wNea9rond e?a4tKrow94 owed a oaawanw, lo p% r» fON IRd??M M df M fll f a?Mr ?rNl f l 00n?IM00 d fh ardNll 10 aOarNd 011 er dbobt lnd dy? et Oelabw. 7004, old Or 0io1C bit 1'? i0ir?? PWnO, PA To poouA of frwY wfR, rrrvadrrahvf w hrraly+Mdl?r MnLwslMr nioha fh9n iA tta? tlaalaM ?'D IIMA Md dal o?ald/ ??? Qr d?9a1? ? ?M?? ?alw ? oaq?padM?alaaaaa nar.nq?oota?..?.aa tlaoaaiiar?w?doadaoRd'Mral 9rtwMal of Ml1p?.rtlrr.ldnwlni?ovd¦01s4a9Nrrw Mvt?i4N??Nl?i.ue?d+0w?wb?n 0 k era old I MMf?INr ?1AMh w11iI?M ?1i ?a?a, ?M Ali p191 A-A M_ raM?ll Ian psr1 Nw*aaalw ar+i r.ov??i?aao0vai unanaatr++ i?l A?d?InN,, wtwol oMw?raooa oaOa?w Vlh?ndwowofYa qR MeagnoMaalAM?UMaaipMntitoNhNWfWi AWMMWW9,baItRol?aW*#Ad uwoawn oM ?d Ia?nlraoaa dwrw?o AatM?M 1M? ooN1 deNdim owmm ft orwmK w wdu %ftftww vw and wow otw ?RNIanalwl .e1 pat0aa f111Mad odaall' Mab?+olMAn@law Mw 4f ft d o" 'o , iWA me gym III- atbmmolonioil I Mb w•? aro woww t?wywwary .a.MiwlOr MNC?ooorMad a7Mlatw erevplrwwl en?ihapw?l?..viwd.it. powma_ ftww "&lu4, M~epd tawa??w hoot o w%W4 wowotu% fiW or AiNll?lpAmgA W ieiwr pa dwam oaaiwoAealaet ?p+elodim.h?1or?iwAa"rObw A dam' aa?+"ar+e a%i ? ywhMd. ? upon, al?od ? oaMad by?M1Mw. r1uD?MnNwwtio IwowlaOq?a¦i wMl?bbaot to diwoa o4laa?a'ow a?a¦*r0?Nr oior porMwlaa orrg7lMaWa?Iic lw?ta4KNttlaMwoKw s4 HMO* w me ?Ilai ? MI/ll?l?l 111Of?11! ?S"?Nlf?t ?l?l1q MIS w? la Y/ 4?Mh maim baft"addOpowMim (GWTIQN?Ad?i101lOlA( WO Alit SAM TMaI L MY OF - _r? ..r.+? .qnt* 494 GOtIHtY d auff,,. V Who .?, 11N a w pM M 10 "1011p m Ylyd{/ w4 ww y' +_?oaawd IN arana aw lMk.?,.?oad Capp Mawr"" L4m Now olIT %W tNN ? , anaa?w?9a cao 40779" ID1O Fax Server 6/18/2007 3:09 PAGE 020/021 Fax Server 08/11/2'007 KH 13:07 FAX 170 815 7700 WC0lR JAW O"ICta w-8 ?OOt/003 .pb LAW OFMU OF 0" TODD A. JOHNS, ESQUIRE ut SCRAII'r"0lUCAUNIONDWIZr K". 15wnx IQUTA wars 218 MMMMW, w ft- ll u7ot "IwM OM) "all **w96NbMAw s ty --eapabr+w Juror 27, 2d5 fthinn Gruver AIM* 1= Vaby Cantu Pwkwy, $012 ¦athiahM, PA 10017 RE: Your Inturrd: Jowns Frye Oft of Lou: 000btr 217000 own Number 40752NM D10 Our Chart: Kwyn Thomas Doe AAo. Onnor: Wkh mgwd Io thrr sbovwrslrrra =d R W¦r, andoad tltnrwllh pNw fled a 11d1i axwu0td and not ftW Rdns* of AI CI Wms, Kindy forwmrd the tattlti i w! ohm* In the amount of t4=A0 mob perabla to ?odd A. Johns, bqulra, wttaniay for Karin and SOOK Thorrw at your now oonwnlwm. My Tax ID Nunbor it: 202 Qe. Thank you for your g= and em on fa ft mow, 2 you haw any quwtlons or rs"s any addtlonal k0omMOon, playa do not Mwltad to ooMaot Me. vary b* yan, Todd A. Johns, Eaqulrs TAYAM Enebwrt = Karin Thom (ft** VIA FAMMMU VIA MRST CI MAIL h rax Server b/lU/Zoo'l 3:09 PAGE 021/021 Fax Server w ?ooa{qoa r 0=111/,1507 KY lsr" TAI 170 121 7700 Woorp LAW OFFICES w'-B_ ell?lril??Al?l ' 1UWbU/w11ar? adilrl7'C6Y/AIrfOC1f , 101 rurarc?trunAr, 8=2 W ???rI?AlNwrnr??rwnwrw?wlwu??nwrtnnw?Mr? soeao 15 rmuc !q an 310 MKU SAM PA 307011701 Jme 24, 3006 0"= FROM 610-01-7400 N i00 N-M T81D LZ1'M WABMTTOYOUR CLMT AWTATBDMMAMCWANY CWm *mabso 40T.l 09" IaN*& MumORYB Dry of AOMM Oolohm•7, 7003 CWmaea; KARYN C'l4tMW Cwww Wpe+r0 wouleiw(?): >Om W em pbo d io bdmyoa drt vows Z7, ZOOS &mddmmadt olm kVu brodto TM A. jomi , FRB, A't77ZB W POR/ KARYN AND X20 Ti1MW in do MOM di4,100A0, 91m oink WfU M mdbd b ym amsy mn m V gpdablo ftk r or dhlmd &&BM ir+i wowAwp& gym h??a ddapgrryooR, p1r~rowml?wt your acloomslrltrpowoarliro. Kadin C, Gewrc ALWTATB HMLOANCB CoIPANY copr. X)HM iS PUBLIC dQ 47$110 WPILIQB, HARM M 117011703 cVu Golmolimmoc x?,? - ? C- Fax Server 6/18/2007 3:09 PAGE 004/021 Fax Server PMA Insurance Company P 0 Box 25250 I.ehiah Valley PA 18002 717-763-7281 FAX: 717-7304180 or 730.5181 SEND TO: Todd Johns date NAME: FROM, Darren Crain TOTAL PAOF,S: 1 DATE SENT: w 2/ A7 V TIME SENT: Comm atw WM366391 Kamm Thoma vs MgLdW Valley Health Fax to 570 825 7799 This message is ban" Aw the aue of ft individusi or entity to which it is addressed and nzy canWe ialtumadon that Is pdvilspd, oott8dsadai ad exempt ftom disclosure under apptiosbto Irvin. If the reader of this n is not the intended recipient or the employee or assent responsible for delivering the MM W to the intended recipient, you are M*y notified that wW dissentirtation, distribution or copying of this commui*wAon is strictly prohibited. N you have received this conmunieation in error, plesse notify us immediately by tclephona and n ftm the onigiaal ntmessap to us at the above addms via tho U. S. Postal Savico. Thank you. PA?-' pptEQLl ram 6/ 1g1 LOO,1 3 ; 0? ? _Se?er + r' i w sow 2014400 u w or .?? o a? Fax server 6/18/2007 3:09 PAGE 006/021 Fax Server INSTRUCTIONS FOR COMPLETING BACK OF FORM #I- &or #w foul amount of rrmrwy Who by tow wnplvm from the thkd mw Idpom. 02- OW tb * amount of (ndm vlty and modNd M""ft WA by the an*vw to to SPROWN at tM *we VOW" ww NOWW". ' .,.% a,- b w elfee*y teed end omer upanaoo mM by floe emool n to obaln romwery in tlw ftd party oodm f4 to n - ftlom tM 0o(etdatlarw In fJw ftM eebenn aid ones the rawA% Into t1w cwmr eelumn. in w omwm whh wel on i1 oaf tfw fMrMtayl WorWO ComporwoOm Act, the oatbc hwein'Lhew aoreed'etJw faNewNp iea?rtlen of prceeede re" from a . *W per"'. "*VXYMY 1. 7rwi Am m of ThWd Ift . b VIA I I, ow s. Ipartats of Raoonory +1: r? MMlmy of IL A4mW LimSrtpariM VMM a. Rowan AtMk tbb to At 76 ' h1 Lion I#+ AN.molds o(? Pfll 1M 1MI1 es ostllio t# as atewl?rt e1 Mw "m A st. ??? Mlrrterte Ilbte on ferl - Coma this Motion for d iNrd Mrty ssedstlmum. obmkft fbemory Rion ubn lot! a+M.l A - Conrplew thle caetlen w aaleutaa tiw annarte of fxseoew the antMglo?Ie obMb1 s (ON Mush WN*h Aeorued Wwkae' Corr" OM Umn IM eeladeatrq. 28WA E Rsw 48.67 Mfg Idlidtd by) /1 x 100 and Lion 8. 741.44 roe") 7• 3302.73 -02 (mbaol AO ieetr li t le fen 1110 ir?r N ww petty me¦mv m fuun , wi p --w , I %why, Now V N WVWV In f IN Or.a. tri.r tM ar AMI of tM AWWd Warbots' Dar OMMOt8 LIM M M aNr0- WOen & U27 % -3161dtd 4j fl x 1 M b fw 28 % NN of any fuorro waaldy bwwlla and rmw W w*@m@mm to wdefy k who plo eiww of 4rtpbyao'o lras and arrrrwre undl t)w wAtooetlen Mtateet b aslwrett* the brrtploloMlms-1 N tetpartawb to 10011 of ow domm "m Ib11% Film frlrtals Aimed Upon: i QA'6 OF %ft AGM rm Y I mom"" OF w my m "via et ANtrewft b-wkgoy end vet bbnt to Mherd M In %4dP to N Atedtn 1102 N dw hr=*Affb r n f ec m -knk+M wW dd tiwyM m dead lttywyk%* Act 106 of 1 ft4. &%B end W*W ON W4@W* open M*Net m kMM#Ab WM ft of 0veeramAy aewbmohear-,' 1. 4'00.00 2044.18 ?, 1573.39 Fax Server 6/18/2007 2:19 PAGE 003/013 Fax Server 03/ll+t:007 6CN M43 FAX 870 e18 77M NCSPtt LAN OPPICBS N-8 5•? ?4t1?r •.1, • i0i 'a. Data lam X00!/004 cum$ is biw 10 UWph VOW PA IMUM0 Todd Jabal 960 Arahbald?A 18403 RR: Our Iwami wyow" VA&Y mwtb Com ovew -M.. W69" M b wW Waghw K rya 7b=u DwrMr, Johm. IU DID adrift you tbt a Washers' Coax nddm ba bsao Sochi a milt of dwabm ostittiowd ., 8x whbh this oompetq? ? the e?.r. w. env Wpdetio? yva ®notb. stoat Hen ptoe?.sat to tb. abov.aldm ad! h?aty, Ptaetw,t m Saodar? 314 of the>?ylvaois Woeimte' Caotpsosrdioo Aat, "rrheeethe aoa?rebL ie sawed in whams or is putt by the Ad w omimbo of a Thied PkV, the NVIOI N dwU tie 11c the t* of the WOR I 6 his 1*omWt+epmuodi% hb aM or)h dtt md=ok qpboa Pecq? be the e?mt at the ooote payable ttiedetrtbb a+rtiale by the soiployr? teawanlr? nloewy's hw-. aai oNnedirbt n.a wb ie =md by .mmy or is dba ft a mmpeamvs ualwasnt eieeri be pseeebed bet i s the wwIoyw sod =pioyee, biB ysewatl Apewmoq hie esgds, or bis ehpwdaota.-w ?o drwa ire brs. ptid>b,044.1 t ht>ofdioai. Am? w#ttismmt swd. witba?ot ow brtprrledp a ooasaat will scot b? bindlop apoa tlu.mploree ar ? oontpe?eq?. lCiadly advise m tD tln Nebrs ?>h. third petty oLim. sum*, Daum Cribs 8tibtoSedon 9Aeddist , oo; put hnmyWals MsnWsdw*W A "kttim Immm C ep • Mooleftmo ANkm Wmmo "Opo tr kdomI sowsm Iskon"m Nod,Admft smui CUUNN ? omm - FM M? Cm. IAA Uft C*~? Fax Server ',? rItI1MiM?f, R'? YIN91?E tIET tlti01t1? Date: 2/26MO.' gawleftymn4amw P.O. I= 2M LOO Val", PA MU401e0 Todd Johm 960 Scranton Carbondale Highway Archbald PA 18403 RE: Our Insured: Wyoming Valley Health Care Our Claim No.: W990366391 [Wured Worker., Karyn Thomas Darr Mr. Johns: We appear to haw a fax document, from your oiiioes, that retarJts our prior oorrupodenoa There is no answer apparent on the documents msived that clarifies the gloms of the lien reimbursamatt. Kindly advise at this time whahor the statutory reimbursement of 51,302,73 has or will be relmbursed. Pursuant to Section 319 of the Ptatmylvania Workere' Cornpgmtlon Act, 'where the eom nimble Injury is awed in whole or in part by the Act or omission of a Turd Party, the eatployw shall be subrogatd to the right of the amploya, his personal representative, his estate or his dspendettts, against such'ITWrd Party to the extant of the compensation payable utder this article by file attployw, rwonable attonny's fees, and other proper disbarsemona incurred by obtaining recovery or in efL+aaing a compromise settlameat shall be prorated between the employer and employee, his personal representative, hie estate, or his deperridents..... 11 To date we have paid Medical $2,044.18 Indemnity S 0 Any settbrrtsttt made without our knowledge or conserit will not be binding upon the mWoyee or this company, We will look to enforce reimbuna> w of the lien against all parties, including the plaintiff, Karyn Thomas. We look forward to hearing from you. sincerely, Darren Craine Corporate WC Subrogation Specialist 717.730.8153 Karyn Thomas 333 Valley View Drive Plymouth PA 18651 Pennsyhranls Manufactured Assoelation Insurance Company • Manufaatutdn Misnae Insurance Company Penneyivenis Manutaft"Is Indantelty Conspp• PMA /a?vkN, Ineetpetatad • PMA Rabsauana Corperatlon Mk1Att?uade Rata Cseualty ntpany • PMA Mangement Cwp. - PMA Ufa 6/18/2007 3:09 PAGE 007/021 Fax Server CN?ml VERIFICATION I hereby affirm that the following facts are correct: The PMA Insurance Group is a real party in interest. The attached Complaint is based upon information which I have furnished to my counsel and information which has been gathered by my counsel in preparation for this lawsuit. The language of the Complaint is that of counsel and not of me. I have read the Complaint and to the extent that the Complaint is based upon information which I have given to my counsel, it is true and correct to the best of my knowledge, information and belief. To the extent that the content of the Complaint is that of counsel, I have relied upon counsel in making this verification. I hereby acknowledge that the facts set forth in the aforesaid Complaint are made subject to the penalties of 18 Pa. C.S. §4904.relating to unworn falsification to authorities. Darren Crame Authorized Representative of The PMA Insurance Group Dated: UUN I I InnM CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing, Amended Complaint, was served on all parties of interest by placing the same in the United States mail, via first-class mail, postage prepaid, at Harrisburg, Pennsylvania on this,_?_C* day of June, 2008, and addressed as follows: Todd Johns, Esquire 960 Scranton-Carbondale Highway Archbald, Pennsylvania 18403 PETERS & WASILEFSKI ?.- m i ` r?? ? C ? i ?r a ._-- ? { ?.?t? ? ,. ? r. Ci ,} ? ? --1 ' ' s?? _ ? ? $: PETERS & WASILEFSKI By: Stephen F. Moore, Esquire Attorney ID #62077 2931 North Front Street Harrisburg, PA 17110 [7171238-7555 Attorney for Plaintiffs WYOMING VALLEY HEALTH CARE SYSTEM and THE PMA INSURANCE GROUP Plaintiffs CIVIL ACTION V. KARYN THOMAS Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA DOCKET NO: 08-2774 : (cv0000412-07) JURY TRIAL DEMANDED PLAINTIFFS' ANSWER TO DEFENDANT'S PETITION PURSUANT TO PA.R.C.P. 1006(d)(1) RAISING DOCTRINE OF FORUM NON CONVENIENS NOW COME, the Plaintiffs, Wyoming Valley Health Care System and The PMA Insurance Group (collectively "Plaintiffs"), by and through their attorneys, Peters & Wasilefski, and respond to Defendant's Petition as follows: 1. Admitted. 2. Admitted. 3. Admitted upon information and belief. It is believed that Defendant is and has been a resident. of Plymouth, Luzerne County, Pennsylvania. 4. Admitted upon information and belief. It is believed that the motor vehicle accident occurred in Luzerne County, Pennsylvania. 5. Denied. It is denied that Defendant's employment took place exclusively in Luzerne County. Defendant travelled almost on a daily basis performing home health visits which would have potentially taken her beyond the boundaries of Luzerne County. 6. Denied. It is denied that venue is based solely upon the location of a corporate office (The PMA Insurance Group office in Lemoyne). To the contrary - a number of transactions and occurrences giving rise to the present suit occurred in Cumberland County including efforts to have statutorily due subrogation monies repaid without the need for litigation. 7. Denied. It is denied that Cumberland County has no relationship to the present matter. To the contrary, - a number of transacti ons and occurrences giving rise to the present suit occurred in Cumberland County including the workers compensation claim giving rise to the subrogation claim and the efforts to have statutorily due subrogation monies repaid without the need for litigation. 8. Denied. It is denied that Defendant and unidentified witnesses would be inconvenienced by defending an appropriately brought and properly situated action. By way of further answer, other than a blanket assertion of inconvenience, Defendant has not established actual inconvenience that would be any different than the inconvenience that would fall to the plaintiffs if this matter were transferred. 2 9. Denied. It is denied that Defendant's blanket assertion of inconvenience, without demonstration of actual inconvenience justifies the transfer of this matter. Wherefore, it submitted that the Defendant's assertion of inconvenience does not alter the fact that Plaintiffs have appropriately and in accordance with the Rules of Civil Procedure initiated suit to recoup monies due and unpaid, in a correct venue. Peters & Wasilefski Date: ? f Jal e By: Stephen Moore, Esquire Attorney ID #62077 2931 North Front Street Harrisburg, PA 17110-1250 [717] 238-7555 Attorney for Plaintiffs 3 CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing, Answer, was served on all parties of interest by placing the same in the United States mail, via first- class mail, postage prepaid, at Harrisburg, Pennsylvania on this 304day of June, 2008, and addressed as follows: Todd Johns, Esquire 960 Scranton-Carbondale Highway Archbald, Pennsylvania 18403 PETERS & WASILEFSKI = co Ll} PRAECIPE FOR LISTING CASE FOR ARGUMENT (Must be typewritten and submitted in duplicate) TO THE PROTHONOTARY OF CUMBERLAND COUNTY: (List the within matter for the next Argument Court.) CAPTION OF CASE (entire caption must be stated in full) Wyoming Valley Health Care System and The PMA Insurance Group VS. Karyn Thomas No. 2774 2008 Term 1. State matter to be argued (i.e., plaintiffs motion for new trial, defendant's demurrer to complaint, etc.): Defendant's Preliminary Objections to Plaintiffs' Amended Complaint 2. Identify. all counsel who will argue cases: - (a) for plaintiffs: Stephen F. Moore, Esquire (Name and Address) 2931 North Front Street, Harrisburg, PA 17110 (b) for defendants: Esauire and Address) 960 Scranton/Carbondale Highway, Archbald, PA 18403 3. 1 will notify all parties in writing within two days that this case has been listed for argument. 4. Signature Todd A. Johns, Esquire Print your name Date: r1.2 q, G S Defendant, Karyn Thomas Attorney for INSTRUCTIONS: A. Two copies of all briefs must be filed with the COURT ADMINISTRATOR (not the Prothonotary) before argument. 2. The moving party shall file and serve their brief 12 days prior to argument. 3. The responding party shall file their brief 5 days prior to argument. 4. If argument is continued new briefs must be filed with the COURT ADMINISTRATOR (not the Prothonotary) after the case is relisted. csa Cr, PRAECIPE FOR LISTING CASE FOR ARGUMENT (Must be typewritten and submitted in duplicate) TO THE PROTHONOTARY OF CUMBERLAND COUNTY: (List the within matter for the next Argument Court.) - --- ---------------------- CAPTION OF CASE (entire caption must be stated in full) Wyoming Valley Health Care System and The PMA Insurance Group VS. Karyn Thomas No. 2774 2008 Term 1. State matter to be argued (i.e., plaintiffs motion for new trial, defendant's demurrer to complaint, etc.): Defendant's Petition Pursuant to Pa. R. C. P. 1006(d)(1) 2. Identify all counsel who will argue cases: . (a) for plaintiffs: Stephen F. Moore, Esquire (Name and Address) 2931 North Front Street, Harrisburg, PA 17110 (b) for defendants: Todd A. Johns, Esquire (Name and Address) 960 Scranton/Carbondale Highway, Archbald, PA 18403 3. 1 will notify all parties in writing within two days that this case has been listed for argument. 4 Arm tmP_nt Cnurt na}a- Defendant, Karyn Thomas /z- G Attorney for Date: Q INSTRUCTIONS: 1. Two copies of all briefs must be filed with the COURT ADMINISTRATOR (not the Prothonotary) before argument. 2. The moving party shall file and serve their brief 12 days prior to argument. 3. The responding party shall file their brief 5 days prior to argument. 4. If argument is continued new briefs must be filed with the COURT ADMINISTRATOR (not the Prothonotary) after the case is relisted. Todd A. Johns, Esquire Print your name "TI ?W 'CJ [- { . TODD A. JOHNS, ESQ. Attorney for Defendant, KARYN THOMAS Identification No. 80327 Law Offices: 960 Scranton/Carbondale Hwy. Archbald, Pennsylvania 18403 Phone: (570) 876-6903 WYOMING VALLEY HEALTH CARE SYSTEM and THE PMA INSURANCE GROUP, Plaintiffs vs. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY CIVIL ACTION JURY TRIAL DEMANDED KARYN THOMAS, Defendant DOCKET NO. 08-2774 NOTICE To: Wyoming Valley Health Care System The PMA Insurance Group c/o Stephen F. Moore, Esquire Peters & Wasilefski 2931 North Front Street Harrisburg, PA 17110 You are hereby notified to file a written response to the enclosed Preliminary Objections within twenty (20) days from service hereof or a judgment may be entered against you. Respectfully submitted, Todd A. Johns, Es re TODD A. JOHNS, ESQ. Attorney for Defendant, KARYN THOMAS Identification No. 80327 Law Offices: 960 Scranton/Carbondale Hwy. Archbald, Pennsylvania 18403 Phone: (570) 876-6903 WYOMING VALLEY HEALTH CARE SYSTEM and THE PMA INSURANCE GROUP, IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY Plaintiffs VS. CIVIL ACTION JURY TRIAL DEMANDED KARYN THOMAS, Defendant DOCKET NO. 08-2774 PRELIMINARY OBJECTIONS OF DEFENDANT TO AMENDED COMPLAINT OF PLAINTIFFS AND NOW, comes the Defendant, Karyn Thomas., by and through her counsel, Todd A. Johns, Esquire, and files these Preliminary Objections to Amended Complaint of Plaintiffs, and in support thereof, avers as follows: 1. The Plaintiffs filed a Complaint against Defendant on or about May 27, 2008 alleging Counts for Subrogation, Conversion, Unjust Enrichment and Breach of Contract. 2. On June 11, 2008, the Defendant filed Preliminary Objections to Plaintiffs' Complaint. 3. On or about June 30, 2008, the Plaintiffs filed an Amended Complaint containing counts for Subrogation, Conversion, Unjust Enrichment and Breach of Contract. A copy of Plaintiffs' Amended Complaint is attached hereto, incorporated herein and labeled Exhibit "A". 4. Plaintiffs' Amended Complaint was served upon Defendant's counsel on July 7, 2008. 5. The current action arises out of a dispute between the parties with regard to a subrogation claim made by Plaintiffs against Defendant in regard to worker's compensation benefits allegedly received from the Plaintiffs by the Defendant. 6. Court N of Plaintiffs' Amended Complaint is for breach of contract; however, there is no contract attached to Plaintiffs' Amended Complaint in violation of Pennsylvania Rule of Civil Procedure 1019(i). 7. The current action was filed by Plaintiffs in the Cumberland County Court of Common Pleas; however, at all time relevant hereto, the Defendant has been and remains a resident of Luzerne County, Pennsylvania. 8. The accident at issue which resulted in Defendant's injuries and alleged benefits provided by the Plaintiffs also occurred in Luzeme County, Pennsylvania 9. Defendant's employment at Wyoming Valley Health Care System also took place exclusively in Luzerne County, Pennsylvania. 10. Defendant now timely files these Preliminary Objections to Plaintiffs' Amended Complaint. 11. Defendant files her Preliminary Objections pursuant to Pennsylvania Rule of Civil Procedure 1028(a)(1), (2), and (4) which state in pertinent part as follows: Rule 1028. Preliminary Objections (a) Preliminary objections may be filed by any party to any pleading and are limited to the following grounds: (1) lack of jurisdiction over the subject matter of the action or the person of the defendant, improper venue or improper form or service of a writ of summons or a complaint; (2) failure of a pleading to conform to law or rule of court or inclusion of scandalous or impertinent matter; (3) insufficient specificity in a pleading; (4) legal insufficiency of a pleading (demurrer); ... 12. Pennsylvania Rule of Civil Procedure 1019(i) states the following: Rule 1019. Contents of Pleadings. General and Specific Averments (i) When any claim or defense is based upon a writing, the pleader shall attach a copy of the writing, or the material part thereof, but if the writing or copy is not accessible to the pleader, it is sufficient so to state, together with the reason, and to set forth the substance in writing. 13. As stated above, Plaintiffs' Amended Complaint as filed fails to attach a copy of any writing to support its claims for subrogation, conversion, unjust enrichment or breach of contract. 14. As such, it is respectfully submitted that Plaintiffs' Complaint fails to state a claim upon which relief can be granted and Plaintiffs' Complaint should be dismissed for legal insufficiency pursuant to Pa. R.C.P. 1028(a)(4). 15. Contemporaneous with the filing of Defendant's original Preliminary Objections to Plaintiffs' Complaint, Defendant filed a Petition pursuant to Pa. R.C.P. 1006(d)(1) Raising the Doctrine of Forum Non Conveniens. 16. Defendant hereby incorporates all averments contained in Defendant's Petition Pursuant to Pa. R.C.P. 1006(d)(1). 17. To date, said Petition is currently pending. 18. Finally, the Defendant moves that this Honorable Court grant her Preliminary Objections pursuant to Pa. R.C.P. 1028(a)(2) based upon Plaintiffs' failure to comply with rule of court or law, specifically, Pa. R.C.P. 1019(i) by failing to attach a copy of the writing giving rise to Plaintiffs' claims. WHEREFORE, the Defendant, Karyn Thomas, moves that this Honorable Court dismiss Plaintiffs' Amended Complaint pursuant to Pennsylvania Rule of Civil Procedure 1028(a)(1), (2), & (4) as well as an award of reasonable costs and attorney's fees, as well as granting any other relief that this Honorable Court deems just and appropriate. Respectfully submitted, TO D A. S, E UIRE Attorney for Defendant, KARYN THOMAS Exhibit "A" y PETERS & WASILEFSKI By: Stephen F. Moore, Esquire Attorney ID #62077 2931 North Front Street Harrisburg, PA 17110 [7171238-7555 Attorney for Plaintiffs WYOMING VALLEY HEALTH CARE SYSTEM and THE PMA INSURANCE GROUP Plaintiffs V. KARYN THOMAS Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION DOCKET NO: 08-2774 (cv0000412-07) 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 Plaintiffs. You may lose money or property or other rights important to you. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. Cumberland County Bar Association 32 S. Bedford Street Carlisle, Pennsylvania 17013 717-249-3166 800-990-9108 AVISO USTED HA SIDO DEMANDADO/A EN CORTE. Si usted desea defenderse de las demandas que se presentan mas adelante en las siguientes paginas, debe tomar accion dentro de los proximos veinte (20) dias despues de la notificacion de esta Demands y Aviso radicando personalmente o por medio de un abogado una comparecencia escrita y radicando en la Corte por escrito sus defensas de, y objecciones a, las demandas presentadas aqui en contra suya. Se le advierte de que si usted falla de tomar accion como se describe anteriormente, el caso puede proceder sin usted y un fallo por cualquier suma de dinero reclamada en la demands o cualquier otra reclamacion o remedio solicitado por el demandante puede ser dictado en contra suya por la Corte sin mas aviso adicional. Usted puede perder dinero o propiedad u otros derechos importantes para usted. USTED DEBE LLEVAR ESTE DOCUMENTO A SU ABOGADO INMEDIATAMENTE. SI USTED NO TIENE UN ABOGADO O NO PUEDE PAGARLE A UNO, LLAME O VAYA A LA SIGUIENTE OFICINA PARA AVERIGUAR DONDE PUEDE ENCONTRAR ASISTENCIA LEGAL. Cumberland County Bar Association 32 S. Bedford Street Carlisle, Pennsylvania 17013 717-249-3166 800-990-9108 r ? r PETERS & WASILEFSKI By: Stephen F. Moore, Esquire Attorney ID #62077 2931 North Front Street Harrisburg, PA 17110 (7171238-7555 Attorney for Plaintiffs WYOMING VALLEY HEALTH IN THE COURT OF COMMON PLEAS CARE SYSTEM and OF CUMBERLAND COUNTY, THE PMA INSURANCE GROUP PENNSYLVANIA Plaintiffs CIVIL ACTION DOCKET NO: 08-2774 Y. (cv0000412-07) JURY TRIAL DEMANDED KARYN THOMAS Defendant AMENDED COMPLAINT NOW COME, the Plaintiffs, Wyoming Valley Health Care System and The PMA Insurance Group (collectively "Plaintiffs"), by and through their attorneys, Peters & Wasilefski, and file this Complaint and, in support thereof, aver as follows: 1. Plaintiff, Wyoming Valley Health Care System ("Wyoming Valley") is a corporation with a principal place of business at 575 North River Street, Wilkes-Barre Luzerne County, Pennsylvania, engaged in the delivery of health care services. 2. Plaintiff, The PMA Insurance Group ("PMA") is a corporation with a place of business at 500 N 12th Street, Lemoyne, Cumberland County, Pennsylvania, authorized to sell insurance policies and adjust insurance claims in the Commonwealth of Pennsylvania. 3. Plaintiff PMA provided workers' compensation coverage to Plaintiff Wyoming Valley and provided workers' compensation claims services to Defendant Thomas including the actual adjustment of the claim and the issuance and processing of various payments, as referenced below, at all times relevant to this complaint. The payments generated in this matter and Defendant, Karyn Thomas' failure to repay the same are at the heart of the transactions and occurrences that form the basis for the present suit. 4. Defendant, Karyn Thomas is an adult individual residing in the Commonwealth of Pennsylvania at 333 Valley View Drive Plymouth, Luzerne County, Pennsylvania 18651 5. On or about October 2, 2003, Defendant Thomas was injured in a motor vehicle incident which occurred during the course and scope of her employment. See report attached hereto and incorporated herein as Exhibit A. 6. Workers compensation benefits were paid to or on behalf of Defendant Thomas by the Plaintiffs. 7. The workers compensation benefits referenced in the preceding paragraph totaled $2,044.18. See itemization of payments made on Defendant Thomas' behalf attached hereto and incorporated herein as Exhibit B. 8. The workers compensation benefits referenced in the preceding paragraphs were adjusted and processed by Plaintiff PMA, with a place of business in Cumberland County Pennsylvania. 9. Defendant Thomas initiated a third party civil action against the driver of the vehicle who caused the October 2, 2003, motor vehicle incident. That suit was settled by 2 general release for the sum of $4,200.00. See correspondence acknowledging Attorney client relationship between Attorney Johns and Defendant Thomas attached hereto and incorporated herein as Exhibit C. See also, correspondence with attachments acknowledging resolution of third parry claim for the sum of $4,200.00 attached hereto and incorporated herein as Exhibit D 10. Pursuant to Section 319 of the Pennsylvania Worker's Compensation Act, 77 P.S. Section 671, Plaintiffs are entitled to be repaid from Defendant Thomas' third party recovery for workers' compensation benefits with a pro-rata deduction for counsel fees and expenses. 11. Pursuant to Section 319 of the Pennsylvania Worker's Compensation Act, 77 P.S. Section 671, Plaintiffs are entitled to recover $1,302.73 from Defendant Thomas after a pro-rata deduction of fees and costs. 12. Defendant Thomas has received the proceeds of the third party settlement. 13. Defendant Thomas has not paid any monies over to Plaintiffs. See communications attached hereto and incorporated herein as Exhibit E outlining discussions regarding repayment of the $1,302.73 amount identified above. Exhibit E also contains a Pennsylvania Department of Labor and Industry form LIBC-380 which outlines the reimbursement calculations staring with the total benefit amount paid of totaled $2,044.18 (see exhibit B) and using Defendant Thomas' information regarding counsel fees and costs (see exhibit D) to arrive at the $1,302.73 amount. 14. Defendant Thomas has not paid the sum of $1,302.73 to Plaintiffs. 3 COUNT I - SUBROGATION 15. Plaintiffs incorporate their allegations as contained in Paragraphs 1 through 14 above as though the same were fully set forth herein at length. 16. Pursuant to Section 319 of the Pennsylvania Worker's Compensation Act, 77 P.S. Section 671, Plaintiffs are entitled to be repaid from Defendant Thomas' third party recovery for workers' compensation benefits with a pro-rata deduction for counsel fees and expenses. 17. Pursuant to Section 319 of the Pennsylvania Worker's Compensation Act, 77 P. S. Section 671, Defendant Thomas is obligated to pay Plaintiffs the sum of $1,302.73. 18. Pursuant to Section 319 of the Pennsylvania Worker's Compensation Act, 77 P. S. Section 671, Plaintiffs are entitled to recover $1,302.73 from Defendant Thomas. WHEREFORE, Plaintiffs demand judgment against Defendant Thomas in the amount of $1,302.73 exclusive of interest and costs, making this case appropriate for compulsory arbitration. COUNT II - CONVE RSION 19. Plaintiffs incorporate their allegations as contained in Paragraphs 1 through 18 above as though the same were fully set forth herein at length. 20. Defendant Thomas initiated a third parry civil action against the driver of the vehicle who caused the October 2, 2003, motor vehicle incident. That suit was settled by general release for the sum of $4,200.00. 4 21. A portion of the funds referenced in the preceding paragraph - $1,302.73 was and is the property of Plaintiffs. 22. Defendant Thomas has been asked to provide the $1,302.73 to Plaintiffs but has not provided the funds. 23. Defendant Thomas has converted the $1,302.73 to her own use and control. WHEREFORE, Plaintiffs demand judgment against Defendant Thomas in the amount of $1,302.73 exclusive of interest and costs, making this case appropriate for compulsory arbitration. COUNT III - UNJUST ENRICHMENT 24. Plaintiffs incorporate their allegations as contained in Paragraphs 1 through 23 above as though the same were fully set forth herein at length. 25. Defendant Thomas initiated a third party civil action against the driver of the vehicle who caused the October 2, 2003, motor vehicle incident. That suit was settled by general release for the sum of $4,200.00. 26. A portion of the funds referenced in the preceding paragraph - $1,302.73 was and is the property of Plaintiffs. 27. Defendant Thomas has been asked to provide the $1,302.73 to Plaintiffs but has not provided the funds. 28. Defendant Thomas has maintained the $1,302.73 for her own use even though she is statutorily and contractually obligated to return the funds to Plaintiff, and therefore, has been unjustly enriched. 5 WHEREFORE, Plaintiffs demand judgment against Defendant Thomas in the amount of $1,302.73 exclusive of interest and costs, making this case appropriate for compulsory arbitration. COUNT IV - BREACH OF CONTRACT 29. Plaintiffs incorporate their allegations as contained in Paragraphs 1 through 28 above as though the same were fully set forth herein at length. 30. Defendant Thomas initiated a third party civil action against the driver of the vehicle who caused the October 2, 2003, motor vehicle incident. That suit was settled by general release for the sum of $4,200.00. 31. A portion of the funds referenced in the preceding paragraph - $1,302.73 was and is the property of Plaintiffs. 32. By operation of law, Plaintiffs have an absolute right of subrogation in the amount of $1,302.73. 33. By operation of law, Defendant Thomas had an obligation to return the $1,302.73 amount to Plaintiffs but has not done so. 34. By operation of law, a contract existed between the parties hereto, with respect to the $1,302.73 referenced herein, which required that said funds be returned to Plaintiffs. 35. Defendant Thomas has breached her contractual obligations by failing to provide the $1,302.73 amount to Plaintiffs. 6 WHEREFORE, Plaintiffs demand judgment against Defendant Thomas in the amount of $1,302.73 exclusive of interest and costs, making this case appropriate for compulsory arbitration. Peters & Wasilefski B St-Mcn Moore, Esquire Attorney #62077 2931 North Front Street Harrisburg, PA 17110-1250 [717] 238-7555 Date: (Q ? d Attorney for Plaintiffs 7 txatoxT A as aca n Isaotlas a7o aaz et7e wypr? ? ?ptt03 YOK l3:Ot Fes' omwiro* WN??Y o*d V*wr""w %"YS sommstArow TRoMe 61WOOPAN ?W DI?tYB 333 VMOV MY11l ATM o"M LOXOM ow-wo r.W % WAS " eaeuw"cgx*V" 1w qy oo; WIrLoYM s?ecu wuNra 2014190 DAMCVW W 1 s9 :!ac* rri?tit 16631 TA PMOWASO 77001 290 4 wycobs ,pYMWADOS" 175'Nw6swSwes a" WVWW*W ODOM 6324 rnM 1" groom VTxM 1n64 M wuwa YMSOSW wxscate cow W t1A 1 Gown Lase' ? net of VIA Q6? 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FART aF MO AMM70D MI C"ll OF sum oM psyttct oWw W 20 0 ar SW@swips whh Amdw Vshids r wr of m7L *ICWY WM UPW* qS OR av2w Vom maps w m all vmy NO NO L MMIrIM1 ?iirs?athweyMblM?s?l?rAi11rM0?1MMMMNM •.-?••?.-..^ MA?1fr.! .....'.?, MII1MderMltlsldslA?OAd ~IWWolr?1b~dwdl*dP ;AW-fharus nr?ivYAd"L EicaIBiT B 11 4THE PMA. All Payments INSURANCE v*? GAUP KARYN THOMAS - W890366391 Total Payments: $2,466.29 Payments made 01/01103 up to 04101108 Medical $2,044.18 Tax ID: 240795505 WYOMING VALLEY HLTH CARE SYSTEM INC 04/10/08 Page 2 $1,124.15 Payee Name Check Issue Date Pay Start Date Pay End Date Payment Amount WVHCS HOSPITAL INC WVHCS HOSPITAL INC 10106/03 10/03/03 10106/03 10103/03 27.38 64.46 WVHCS HOSPITAL W60 - WVHCS-HOSPITAL - F 11 If 1111 ? flow 10/02/03 10/15/03 10/03/03 10/02/03 10/15/03 10/15103 - 164.86 w 7.38 52.99 VWHCS HOSPITAL W60 10/06f03 .,.. , 10/28/03 535.48 WVHCS HOSPITAL INC , ._.10/30/03 - - Tw 10/30/03 27.38 WVHCS HOSPITAL INC -.. 11/11/03 V?~v~ 11/11/03 27.38 WVHCS HOSPITAL W60 _ 11/13/03 _ 11/25/03 _ 169.46 WVHCS HOSPITAL INC 11/25/03 11/25/03 11 - 27.38 Tax ID: 232929807 INTERMOUNTAIN MEDICAL GR $620.63 Payee Name Check Issue Date Pay Start Date Pay End Date Payment Amount INTERMOUNTAIN MEDICAL GR 07107/04 07/07/04 620.63 Tax ID: 207328985 EDWARD CAREY MD $143.70 Payee Name I Check Issue Date Pay Start Date Pay End Date Payment Amount EDWARD CAREY 11/13/03 11/13/03 71.07 EDWARD CAREY 07/16/04 07/16/04 72.63 Tax ID: 207328985 EDWARD CAREY $72.63 Payee Name Check Issue Date Pay Start Date Pay End Date Payment Amount EDWARD CAREY j 06/03/04 06/03/04 72.63 Tax ID: 233056167 SAPPHIRE EMERGENCY PHYS $65.96 Payee Name Check Issue Date Pay Start Date Pay End Date I Payment Amount SAPPHIRE EMERGENCY PHYS j 10102/03 10/02/03 65.96 Tax ID: 200114570 RADIOLOGY ASSOCIATES OF WYOMING $18.35 Payee Name Check Issue Date Pay Start Date ! Pay End Date Payment Amount RADIOLOGY ASSOCIATES 10/02/03 10/02/03 18.35 Tax ID: 043579738 INJURED WORKERS PHARMACY -$1.24 Payee Name . Check Issue Date Pay Start Date Pay End Date Payment Amount -1.24 EXHIBIT C M OCRANTOM-CARSONDALE HWY. ARCHULD, PA Iii? FRON[: teat) V#403 RAXI 01708%4M "W.- x LAW OFFICES or TODD A. JOHNS, ESQUIRE a Y. 9 December 8, 2004 Employee Health Servlces Wilkes trre General Hospital S7S North River Street WIIl=-8erre, PA 18764 RR: Karyn Thomas D0111i 06/23/1967 SINi 201.48-MG3 To Whom It May Concem: 15 t111LIC 94VAi<L. ROTE 118 WILWHARt UM imi PHON& t* 01 FAXI (P% they to; V ft reprd to the above refeenoed matter, pbsse be advised that my offt has been retained to represent the inter of Ms. Thomas In relation W Injuries sWfered in an mniobile seddent on October 2, 2003. It has come to my a mendon tltat you have treated Ms. Thomas for her injuries. At this time, I am respeftily.requestlnq that you please f9mrd all mosdieW bills and medkO nooi do to n Ty office. I have endosed an Authorkftn for Release of Medical Records Inft" that I am aWaized to recelvs sewne. Thant you fbr your time and aftftn to this mow, If you have any questions or comments regarding the above or require any addthonal information, please do not hesita to contact me. very tnty yours, S -T OJAO. -gaw Todd A, Johns, Esquire TA7/jmb Enclosure Cc: Kagn Thomas . ,1 I 1, . r t r AUTMORiZATION TO USE ANDIOR DISCLOSE MEDICAL RIIECORDkb y pn?vider) et ??a6?hS?N? u s ?' I authorlm, (name of helm we t0 use and/or dlerdose a copy of the "Sc fk health and medical information WwAMW below for KAREN THOMAS to (name and address of redpNnq TODD A. JOHM, ESQUM is PUBLIC SOUAR4 Sf1ITE 210, WILK1134ARAP, PA 10701 for the lobawk V purposes: To pursue a personal lNury action rmling from blurtp wabined In a oar acoldent on J 0 • ,? dl _ _ ,,. W InNdxlnp thta some below, I almoloslly aummize the use andlor dlsebsurs of the hkwN health ihlbftrlatlan andlor medial records, d such Infommadw andrer mootdo oft Mr Phase and the entire medial record {ail InformeMm) to to above named mdpient. All hospM moor ds (irtdw" Cilnhdan office chart nobs naming records and propna note) Transdtbed hosplW reports Medical reords needed for contim* of care Most tacent fiveryar h" Emwes" and urgent we mews Dentsi fecortts Laboratory reports pathom ps Diagnoft W"kv re" Bang tlabsm"b ?OVW. 'The bWm Hems must be ktikW to be Included In the use sridlor diseloaure of clef health Inl: _,,,_'HIWAIO8 related Inlbrmatlon andlor records WNW halt kff my tbrt andlbr records ? *Gwwk W8 Infomiellm andbr am do 'Druphloohoi diapnoale, M mart or Werret InfonivAbn (seoderal mgulatlons require i deeorlption of haw mush and what kind of Inbrmabon Is to be dWftW.) Desertbe: 1% I understand that, If to person or entity rseshrlnp the Inrannagen Is not s heelth cm pvWor or hsW plan covered by %derai privacy reguNlons, the information described above may be redlacb:•d and no bnper pmbcbd by #me regulatlons. However, the. raolplent may be prohibited from dtedbeft substancs above Warmatlon under the Federal Substance Abuse Coaftdende ty Rs**smenb. I also understand that the person I am authorizing to use andror disclose the inrommmon relay recelve compensation for dolnp ee. further understand that k may refuse to sign this aulhMotlon and that my refusal to sips will not affect may Wily to obtain treatment or payment or My eCpibfllty for bsrwflts. I may Inspect or copy any information to be used andlor d*Amd under this aulhorizatlon. 1 v Finely, I undenviand that I may nicks this outhorizedon in writing at any time. provided Est I do so in writing, ampt to the extent first action has been taken In reliance upon dtb sug oftaftn. union revoked earlier, fhb audotradon wltf expire 160 dap from the date of signing. S ns?buP? or P demo L "M RepreeenbM Kean Thomas Print Podeds NOW P" Nome of L"W Ftwu enm" ) (A cW of the signed form A be provided b the patient) 8.8.10 .2& yfs"/`s Oah.12/1/dq ticalaff D 02%11'Y*001 BLN is:`e FAX 670 e20 7791 NC/Pt LAN OFFICES N-D TAW CV= OF TODD A. JOHNS, ESQUIRE m sou rror CARIOPOALZ WWY. AMCMM&A, PA 1AW , } RAF Mi . 6-MO tjokuwplow.ua Rtpry to, y January 0, 2006 ? oos?oo? w b W as FUi X.MUAM $Urm sl0 W1NL i, IPA UM NIONb m0ii10r Romto; _K- Darien Cmhs Tho P" wmrwm Group' Customs >?lervlatCertor . PO Boot 25260 Lehigh Valley, PA 1 002.6250 71T-730.84M ' RE: Your Immured: Wymft Valley Haelth Caro Yow cwm Nov, VVOKN M OurClw* KwA Thimst ' Door fir. Ombv With lather rpsrd to the above relwrtad manor, M'ttlly Allow ft oo wondana to earw 00 a blwm.up oonwratdm? of NO do%, BpaWaly, wowed hovab plus find the"bibwkp hms vl M..1. no that lhia matte wo 0efdad for me amouM of 04,200AC 1. t3sttletrtent 8latamsnt; Z RMeose Of ClaMW 3. CorraponOonoA tv Aistate; and 4. Conapondertool fm AHM01. In kht of the seem. I wall request thpt the lion cur w* hold by PMA Inouronoe Grasp be redueed sot nply In Wt of the net procssds mmlmd by Nb.1'Iro m. Thw* you for your trine and stteftn to this tt,a&v, If you have any queNone or ruin any addrlonM information, Pisses do not ha late to oonuat me. vey truly Yours, Todd A. Johns, Esquire TAJhm Encbeure CC. Karyn Thomm (w/out enW) 02%11./2007 60 1':16 FAX 670 838 7798 NC3Plt LAW OFFICES N-B "wornmor COPY TODD A. JOHNS, EsQUME M SACS Krug. AVICNk D,TA DW F SIM17 M Rmoy la July 1, 2005 3lTTLEMENT STATEMENT Ksryn ThM M V. loom" GROSS FUNDS RECEIVED LESS. Am, wts Fm (23113) Costs Advsnoad Dr. Edward C?y (n10llrQaI rooordy 530.00 Reoordeu Aog ufallion Corn dam PA NO Pd o (aoddWd repo 8.00 NET PROCEW DUE CLIENT ®00?lOOt w a ' u n?siacaQVA?s, avrr?sio W141L16aamuUN IPA 19'!11 : p2M Ot RW10:_x $19400.00 123.36 $4,200.00 1,623.30 12,Eri.02 OV114001 IL14 18:17 RAY $70 1=0 1709 WC9PR LAW OFFICES N-1 . JUN. 14. NO YI40NM ALMAIC 1% 1 wX03-4G3?t MMUOTAUMAM "Mbod MW Wlh) ooliooa NU, 511 V. LM W-M0 4offt a ins Wo ThN hdWAM W*WmW H, 11+81 i? Thenw, titovrt?e d ttoott Thomas bob faa1 ' -1 o d M Wft d AA, and k tiovR Tom hoforld bWM A for and In -a loll Wor?oftlto SMof, fmftwoodtoro Wood rpd moo odw Ir+I+naMD?«IM Isnltw aeMo d AnNfloa to 8810 MMo oipd ap dilo1t11 otsa do dotata. .0i00.0o f, b acid In iw+d dNI ,h ro F", Dom pbm owpMrirw»t?leoiaewloaotb?wobl?M?hr r,e 4' ?* dt ?? h$r* for vingm ad am a w smin m MM, fill dd?Irir?Moio. vonoiw npaaopi ad w owlpN.r a, waaad, prrd fonvr .U.nn.lgq., ow t?IwaefM Alot Inrstranoa - r ioMa •Mra?M rlbw. i?wo enn or ?? w wNi? omvi ?? *Mpg-, oooRa, ?q - Waft . bwafwMw, dollop; oad eawlo ?onl?? ms r mop ? 18ow @mn MM?*pop?w K?"N? I?r ? wmmoomwrblh? h-W w46 be Noo ord??oe ?ofr??????iob eearrid to ortbotdtltolnd dalr of Oa?eitaf. p!o?nolr blll`o i01n,to, !A dwd 1b goouo of faad oft * WAsob of w hofoby 4801, bd wo MN RMIM 1ti ptlDoc rat no M w oad stdwtt ataai? dlMbtlw of dnnAW MMda b ? mr a? ofgrptpr ?ioloroa? nr..agr sapr...d.reso Ito p? ppdattllailvtlopi r9nutet?t b dlI?MlMaa nrlwa0, Mwlro?tload ro b Nlai?rlda 1Mtbdaboiald wrrM<+o hNbartt MM aIf M?difw11! tut ofd 1118 waaR?pad ?N7oa1 db?rN end Yost 8189 rwpoo9M? 1110 Ito NMrlt b+a poRpaoont ltd *NMI i wd-. tp1101d11? p OIfMMalpwa !N! "mov Waal VMorid orob dw as o Arrtataonaidoaaden ow nidtNOnntttbfft "Worm" , id- k fatllo 0141 ytbpp btN ood dampN 140* tM add oa?idMK ona?udfy a orofd. N +rol M M tlwa wa? vw bpd am o1w NidW41WA i+altytsprlM i1m nlordadMfq 4b?r Of am aad)dedaM tlni did ?nwitM+1 oollonwt6bl oop?poeioo trpadt b tLrdwaonMOrwotrwpoo aM d" Itd as loft faro hoatotN60180d of 20wo trawl. wpat N? pd? A INfodlW pvM .lwwao of 8810 ft ofw "dw. m" o , I % d m 4m mm ft uvi%end won oral, em onnpNhNOItnuKad, wb« mbm WA ?MoNl?fr gdpd Mg?o?Nf aM n b wpm* awmiNAdN?W d b ft votMod, N "p 4 **LOW of a" by " NkOL AiW pmmv ba Jrolfta* ad u t is W im T1 v YoOra11 1 oaoo?aow"Vewpn mau w 11 11 1 IN 1.wraowosaltlaaf¦itdeftnaod1a1 FW" - Orowa btwlbo M?? - t~olrMteW a?rolo oaoodNMOtiooon.a oK wfioir qp rhrorN rri?Mb me pwm to • t?11u11ott?+tlll+ab ? s1o111naN t /Yit tlEllt>!D TN! t1AY OF T•?.c g- WM72 calmer ? . Wfis d >o IM kada ofr Md N*WN MURIK W woaAad !ta aana w IMk asaotNtd 098E "Way Ga . W aoaKnbi oWovs _- WNW Few - tNOF ww? c?+a . 407s19U O DIO s Ot/11/tO0'i KN 13:47 FAY l1TO 625 7794 wcaPR JAR 0"1133 w-8 CEO RM? >AWO7?eo>r TODD A. JOHNS, ESQUIRE meSCUMI rol i"NaMD" s ff". ++ Aatll WA VIA OW p476 1144 MMOVOU 1t•1Mdl d M Ia?t?tbnrMi "M Row w June 27, 2005 boo:?aoa M 4bb M t0 PIU5= 4QftAM /NITS alo Wn,XZ&&MUtX, PA UMI FAX, (pm min" 944wi: tjoUa?/Al?w.sM Wdeen Gruver ANsoft ISM Valley Cantor Parkway, Sub 2 oaffUeMir, PA 1017-8 RE: Your Iran** Jhnns Frye Oats of Loss: ool" 2, 2= ' CWm Number. 4M6298W Data . our Cwt Karp Thomas Dear Ma. OnNer. With WOW Mowd to the above refannad MINK, sndoad 4wwMfh plsass And a and natari>ad Ralaaaa of N Clalrna, Kiridy toward the tagfaraant ohadc M tla amount d i4?200A0wwm dd pay" to ?odd A, Jobrah Lagrlrs, allonwy for Karin and Svolt TbwiW at your saftW oonvsnianoe. Tax N)NtmbK la: 20Z4&I M- Th" You fa your Ana and aSanfton to as matter, r you haw any queftne or raquh any addlllonal k tonnalten, platy do not heaped to woad me, very troy youh, Todd A. Johns, Eaqulre TAJIam Endows M Karin Thomas (VWWO VIA FAMMILE VIA FIRST CLA88 MAIL EXHIBIT E PMA Insurance Company P O sox 232so Lehigh Valley PA 16002 717-763-7281 PAX: 717-7304160 or 730.8181 w V SEND T0: Todd Johns date "107 NAME. FROM, Damn Craine p v ? TOTAL PAGES: 1 DATE SENT: TIME SENT: Coasmaw W990366391 Karns Thomas vs Wyoming Valley Health Kindy advice u to thew of t11e wottmow com>s aWon Lien > ns dw above claim. Amon t tat was w ao suauosy was s 1902.73. Out file does not t+eim it wa malved. Thole you fbr your time in dds matter. Fag to 570 825 7799 This MMP is intended for rte use of dw lndividud or entity w which it is addressed and may contain Woemados that is ptiviMgsd, contidstuld ad PAW fhm disclosure wxW applicable Intr. If the reader of this messap is not the intended recipient or the employee or agent responsible for delivering the mesap to the intended recipient, you are hereby nodfled that any disssmlnation, disuibution or copying of this coasrrwnindon is strictly prohibited. If you have received this communication in error, please notify us immediately by telephone and return the original message to us at the above address via the U. S. Postal Service. Thank YOU. T!M PARTY SooW 8wj* Nunhbar: 201"5403 Data of InMy: 10ro yyyy PA BWC CWm Number: a omm VAN draw. TOO Zymaim t. WYOU N0 YMM HEALTH " 1-? Opt N_ Lai N. fhVER STlIwf w- O-W ?? H Insure' or Third Party AdndNsl mw Of IdM?W lnsurar•o wr •r•;, 1 ^!..6L - "11 i ? V ?iI1NAi1 1 h?/ ? llff?0>; nooM i o ro ax ism ftwt 008- am Ifew ?. swwaw. IIN7i611Y ww wssssm"I Iovm CALCULA ON INMUCTION8 FOR COMPLETING BACK OF FORM f11 - bmwe the ? amount of money reodwd by the entplpyee from tM *W PMtU itch om, fit- ? the wrwunt of Indentnhy end medbal bwwffte pdd by the empbyor w the en *yee at tM dme of Me rd perry reeevmy bYw few end ether exporwas peld by the empinyee to abteln reeawry In tlw food perry ets*m w of -Prrhrnl the in the Him eekenn wed wvw the rea to Into the ca aalwnn. r In o@wWw a with eeodon i 1 of " PenneywMre WerIw's Cempenesdw i Aot, the psrtbe herein hew sorsed tb tits felbw?tq dfevlwlbn d peesssds so - 1 we from Areatie , . thw perry; BAI $*VCOVVRY 1. 7*W Amount of Thkd - Complete fhb eeadw for d *" MM 6scdWimem. Q11101190 Reesawy Y y 1 t ? !1 ?M+ .' 2. 111 1100 1 0 Got S. 40snove of weeomv 4I - 101ow of fleeetrery . wN 00 In nieeh ee of 1?? 1 3. MAnwd Won 1XI ei a fthrW a. t*new *Avb ebb to Am T. ' ? LMt+ ilLrrtete+e empleyor moor oP t? M listed 1s 611j" M as etse?te vi tier Tod to I. ? Illroe en ftr L.Ier? 1. 2. 2a44.1• s, 1529.3• a. 71fLI . i7 .rvrr???r ? - - =M. Compbw ft woom so eeleulm the wma of prveeei b the an*W Is elWW W idete lhtewtt tMhiM1 AMuW WorWsre' COmpWWAImt Lien IM edareeeeq. eerneft RM 48.67 •ol ~ bw fH x 100 Jed Lbn e• 761.64 .pi fdmw 08 roodtrd 7• 3307.73 ._r..?. -62 gdnuN N ? - Cmapiete title owdon u eeWAM hew wim fife a fawror muM fwmb M to empleyes WW psrq nmwmy an fuse eswI perwtlsn *Aft. Now Tttb ""a b u be sw4i ew U* If ly Bosomy Wilk yreeer loss do ernerwt d tin Aosr M Vftb@W Oenlpe WSWL Lin M -? ....... ...... •3 (duided 1^r) Ii x 1 e eetnoerm~ fR 30.27 b for 29 % ON of my fume weekly bwwflw and moil wrpenew to ad* It 1e . IIMMM'M Ltre Mere d jmpbyee'e few end exp m 4u A w dl tlw ewh upd,n krwnet b wo P%* y, M41• . the rntplelNflMtpLMer N tee Now fer I N% of aw owNwW40 Nwft. Ftrrtlli(! MNndb AVwf UW' A { 's 1 -M IPIWY 'e After DATi OF 1MIS AGREE w a ?i ww I UPC-* my $a vep 2) o , W TV" 0"W" Aboneedwt faswkwv end with bft""** wC is In --pow t of $000110! of the punwriwtb else be euyea is sknk+el end *A pwWV@* tltro * f umvlww Aei l W of 1 W. aide sw eenic a ors et ww6 upon nqt w w kwwdu1b whh dud ortownaft antpbpromw" t?oozraa4 67a 0:14 lit 45 114 60907 J Fi om 9010 rhi mcoo M? ,. w a+ oor ow, GMs,"' aloo os+c4 '? 1s Wcda°Ista cesw t? ,o stout* fwa wAdIO.- 06 mob glq ??a to blew$ IL r?*0 ?IM tw,wadw Otto .,a bon B' Dow* oc: r-to 1.7w.a Few coro` ? Tom a??rwtw"'MµM "'d?a?i???h" a? ?o+r??"'N Mtn C*4v,ct A% "41f Sk 1ri lMll?tt1E sEr CEO?Ik Date: 2/261001.' Todd Johns 960 Swanton Carbondale Highway Archbald PA 18403 ItE: Our Insured: Wyoming Valley Health Care Our Chaim No.: W990366391 lgjured Worker. Karyn Thomas Dear Mr. Johns: c matrtM aeaba woman qxe P.O. sex 21100 Lohlph Valley, M 1e00HM We appear to haw a fax document, from your offices, that rams our prior eorrespondenoe. There is no answer apparent on the documaw received that clarifies the :trite of the Ilan reimbursement. Kindly advise at this time whether the statutory reimbursement of S 1,302.73 has or will be reimbursed. Pursuant to Section 319 of the Pt:mmsylvania Workers' Compensatloa Ace, "where the compensable Injury is awed in whole or in part by the Act or omission of a Third Patty, the employer dual[ be subtopted to the right of the employee, him personal rib" native, his state or his dependents, against such Think Parry to the extent of the compemation payable under this article by the ervgpioyw, nascuble attomey's fen, and other proper disbtusotturtts incurred by obtaining recovery or In effecting a compromise settlement shall be prorated between the wVloyer and employee, his personal representative, his estate, or his dependents.... " To data we have paid Medical $2,044.18 indemnity S 0 Any settlnnant nude without our knowledge or consent will not be binding upon the employee or this coat any, We will look to enforce mimbursomnont of the lien R=oust all parties, including the plaintiff, Karyn Thomas. We look forward to hearing from you. Sincerely, Darren Crain Corporate WC Subrogation Specialist 717-730.8155 Karyn Thomas 333 Valley View Drive Plymouth PA 18651 Pennsylvania Manufacturers' Association Insurance Company • Manufacturers Alliance Insurance Company hnnsylvenla Mamufaoturera Indemnity Company • PMA Services, kreorporated - PMA Reinsurance Corporation Mid-Adantlc %fates Casualty Company • PMA Manasament Corp. & PMA Ufa TODD A. JOHNS, ESQ. Attorney for Defendant, KARYN THOMAS Identification No. 80327 Law Offices: 960 Scranton/Carbondale Hwy. Archbald, Pennsylvania 18403 Phone: (570) 876-6903 WYOMING VALLEY HEALTH CARE SYSTEM and THE PMA INSURANCE GROUP, Plaintiffs VS. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY CIVIL ACTION JURY TRIAL DEMANDED KARYN THOMAS, Defendant DOCKET NO. 08-2774 CERTIFICATE OF SERVICE I, Todd A. Johns, Esquire, certify that on the ), Yavy of July, 2008, I made service of Preliminary Objections of Defendant to Amended Complaint of Plaintiffs, upon the following, by United States first class mail, addressed as follows: Stephen F. Moore, Esquire Peters & Wasilefski 2931 North Front Street Harrisburg, PA 17110 Respectfully submitted, TODD A. 16H&S,T-S-QU1RE r- a {?,} :.> ?: C?- . `-,°? ---j ..? s . ?? -n C.' (z q'"' t ;<J ? ::: C_?.; t ? J ' ; ..-. •. _ } 1'i . i `? ?, ? ?;;.? PETERS & WASILEFSKI By: Stephen F. Moore, Esquire Attorney ID #62077 2931 North Front Street Harrisburg, PA 17110 [717] 238-7555 Attorney for Plaintiffs WYOMING VALLEY HEALTH CARE SYSTEM and THE PMA INSURANCE GROUP Plaintiffs IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION DOCKET NO: 08-2774 V. (cv0000412-07) JURY TRIAL DEMANDED KARYN THOMAS Defendant PLAINTIFFS' REPLY TO DEFENDANT'S PRELIMINARY OBJECTIONS NOW COME, the Plaintiffs, Wyoming Valley Health Care System and The PMA Insurance Group (collectively "Plaintiffs"), by and through their attorneys, Peters & Wasilefski, and respond to Defendant's Preliminary Objections as follows: 1. Admitted. 2. Admitted. 3. Admitted. 4. Admitted. 5. Admitted in part and denied in part. It is admitted that the present dispute arises from a subrogation claim. It is denied that benefits were allegedly received. To the contrary, the Plaintiffs paid monies to the benefit of Defendant. 6. Admitted in part and denied in part. It is admitted that Count IV of Plaintiffs' Complaint sounds in Breach of Contract. It is specifically denied that there has been any violation of a Rule of Civil Procedure. To the contrary, Plaintiffs clearly state the basis of the claim and that by operation of law, a contract was formed whereby Defendant was to reimburse the Plaintiffs. Accordingly, while there is no written contract, there is a contract between the parties. 7. Admitted that the claim was filed in Cumberland County. It is also admitted based upon information and belief that Defendant is and has been a resident of Plymouth, Luzerne County, Pennsylvania. 8. Admitted upon information and belief. It is believed that the motor vehicle accident occurred in Luzerne County, Pennsylvania. 9. Denied. It is denied that Defendant's employment took place exclusively in Luzerne County. Defendant travelled almost on a daily basis performing home health visits which would have potentially taken her beyond the boundaries of Luzerne County. 10. Admitted. 11. Admitted in part and denied in part. It is admitted only that Defendant has filed Preliminary Objections and has quoted various provisions from the Rules of Civil Procedure. It is denied that said provisions negatively impact the present matter. 12. Admitted in part and denied in part. It is admitted only that Defendant has filed Preliminary Objections and has quoted various provisions from the Rules of Civil Procedure. It is denied that said provisions negatively impact the present matter. 2 13. Admitted in part and denied in part. It is admitted only that Defendant has asserted a similar position above (in Paragraph 6 of her Preliminary Objections). Once again, it is specifically denied that there has been any violation of a Rule of Civil Procedure. To the contrary, Plaintiffs clearly state the basis of the claim and that by operation of law, a contract was formed whereby Defendant was to reimburse the Plaintiffs. Accordingly, there simply is no written contract. 14. Denied. It is denied that Plaintiffs' Complaint fails to state a claim upon which relief can be granted. To the contrary, the Complaint clearly delineates a number of viable causes of action. 15. Admitted. 16. Plaintiffs hereby incorporate all statements set forth in their answer to Defendant's Petition raising the Doctrine of Forum Non Conveniens. 17. Admitted. 3 18. Admitted only that Defendant requests the relief outlined. It is specifically denied that the relief is warranted. Wherefore, it submitted that the Defendant's Preliminary Objections should be dismissed. Peters & Wasilefski By: -,"1440? Stephen . Moore, Esquire Attorney ID 462077 2931 North Front Street Harrisburg, PA 17110-1250 [717] 238-7555 Date: 8-14-08 Attorney for Plaintiffs 4 VERIFICATION I hereby affirm that the following facts are correct: I am counsel for Plaintiffs in the foregoing action and I am authorized to make this Verification; I have read the Reply and verify that the information contained therein is true and correct to the best of my knowledge, information and belief. This Verification is made by me, instead of Plaintiffs, since much of the information stated in the Reply are better known to me. I hereby acknowledge that the facts set forth in the aforesaid Petition are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Date: 8-14-08 Step e . Moore, Esquire CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing, Reply, was served on all parties of interest by placing the same in the United States mail, via first- class mail, postage prepaid, at Harrisburg, Pennsylvania on this 14th day of August, 2008, and addressed as follows: Todd Johns, Esquire 960 Scranton-Carbondale Highway Archbald, Pennsylvania 18403 PETERS & WASILEFSKI C wpm. ry r LA, S rr Lr i WYOMING VALLEY HEALTH CARE : IN THE COURT OF COMMON PLEAS OF SYSTEMS and THE PMA INSURANCE : CUMBERLAND COUNTY, PENNSYLVANIA GROUP, PLAINTIFFS V. KARYN THOMAS, DEFENDANT : 08-2774 CIVIL TERM ORDER OF COURT AND NOW, this day of August, 2008, due to the disagreement as to facts in the answer filed to defendant's petition for change of venue pursuant to Pa. Rule of Civil Procedure 1006(d)(1), that petition is stricken from the argument court schedule for September 3, 2008. The Court Administrator should assign the petition to a judge for a hearing.' Xephen F. Moore, Esquire 2931 North Front Street Harrisburg,PA 17110 For Plaintiffs ,Todd A. Johns, Esquire 960 Scranton/Carbondale Hwy. Archbald, PA 18403 For Defendant Court Administrator :sal ' Defendant's preliminary objection to plaintiffs' amended complaint which is also listed for argument shall remain on the list. >- cc: 4 CL- E rl CD ., CL C\j Q C-D J C•..+ C..7 r- ., WYOMING VALLEY HEALTH IN THE COURT OF COMMON PLEAS OF CARE SYSTEMS and THE PMA CUMBERLAND COUNTY, PENNSYLVANIA INSURANCE GROUP, Plaintiffs V. KARYN THOMAS, Defendant NO. 2008 - 2774 CIVIL TERM ORDER OF COURT AND NOW, this 10TH day of SEPTEMBER, 2008, an evidentiary hearing on Defendant's Motion for Change of Venue will be held on MONDAY, OCTOBER 6, 2008, at 3:00 a.m. in Courtroom # 3 of the Cumberland County Courthouse, Carlisle, Pa. ZStephen F. Moore, Esquire 2931 North Front Street Harrisburg, Pa. 17110 Todd A. Johns, Esquire 960 Scranton/Carbondale Hwy. Archbald, Pa. 18403 :sld l?0 t ?S rYt ?1?V ? I # KHR AUG 20 YOUR J WYOMING VALLEY HEALTH CARE IN THE COURT OF COMMON PLEAS OF SYSTEMS and THE PMA INSURANCE : CUMBERLAND COUNTY, PENNSYLVANIA GROUP, PLAINTIFFS V. KARYN THOMAS, DEFENDANT 08-2774 CIVIL TERM ORDER OF COURT AND NOW, this `-Z10 day of August, 2008, due to the disagreement as to facts in the answer filed to defendant's petition for change of venue pursuant to Pa. Rule of Civil Procedure 1006(d)(1), that petition is stricken from the argument court schedule for September 3, 2008. The Court Administrator should assign the petition to a judge for a hearing.' By the Co Edgar Stephen F. Moore, Esquire 2931 North Front Street Harrisburg,PA 17110 L? For Plaintiffs V- 570 7 -Am Todd A. Johns, Esquire 960 Scranton/Carbondale Hwy. Archbald, PA 18403 For Defendant Court Administrator :sal ` Defendant's preliminary objection to plaintiffs' amended complaint which is also listed for argument shall remain on the list. PETERS & WASILEFSKI - By: Stephen F. Moore, Esquire Attorney ID #62077 2931 North Front Street Harrisburg, PA 17110 (717) 238-7555 Attorney for Plaintiffs WYOMING VALLEY HEALTH CARE SYSTEM and THE PMA INSURANCE GROUP Plaintiffs V. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION DOCKET NO: 08-2774 (cv0000412-07) JURY TRIAL DEMANDED KARYN THOMAS Defendant PRAECIPE TO MARK CASE SETTLED, DISCONTINUED AND ENDED TO THE PROTHONOTARY: Kindly mark the above-captioned matter as settled, discontinued, and ended. Date l Peters !& Wasil ski By: Ste en . Moore, Esquire Attorney ID 462077 2931 North Front Street Harrisburg, PA IV 10-1250 It - Todd Johns, Esquire Attorney ID # Date: 960 Scranton-Carbondale Highway / ? // ? Archbald, PA 18403 Attorney for Defendant 50 4i tJC