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Home My WebLink About06-10-08F: \FILES\CGents\Progressive7837\Cwrent\207\7837.207.petition Created: 9/20/04 0:06PM Revised: 6/9/08 I :58 PM MARIANNE F. KRAHULEC, Individually and as Administrator of the ESTATE OF JAMES E. KRAHULEC, Petitioner, v. NATHAN Y. VRIENS, Respondent. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Orphan's Court Division ~~ ?.~c7 ~ _p m ~ -;f; ~? ~- ~: ; r--, ;~J ~ a ~_~%_ PETITION FOR COURT APPROVAL =~ ~ o .. vt 1. The Petitioner, Marianne F. Krahulec, is an adult individual residing at 781 Dogwood Terrace, Boiling Springs, Cumberland County, Pennsylvania 17007. 2. Marianne Krahulec is the widow of James E. Krahulec and the Administrator of the Estate of James E. Krahulec as evidenced by the Short Certificate, which is attached hereto as Exhibit "A." 3. On or about January 16, 2006, James E. Krahulec was operating a 2003 Crown Victoria on Kuhn Road in Monroe Township, Cumberland County, Pennsylvania. 4. After stopping at a stop sign, Mr. Krahulec began a lefthand turn when the vehicle he was operating was struck by a vehicle operated by Nathan Y. Vriens. 5. The vehicle operated by Nathan Vriens failed to stop at a stop sign. 6. Mr. Vriens was insured with Progressive Direct Insurance Company. 7. James E. Krahulec was taken to Carlisle Regional Medical Center where he was treated and released with a primary complaint of left shoulder and arm pain. 8. Mr. Krahulec followed up with a family doctor and subsequent x-rays showed evidence of a seventh rib fracture. 9. Mr. Krahulec again followed up with is family doctor in February 2006 for pain and shortness of breath regarding the left side of his ribs. 10. In February and March 2006, Mr. Krahulec underwent physical therapy at Conforti 04~ `/ r =~ `=~ c ,; .~: r , ,...~ . -., ... i .-~; Physical Therapy & Fitness Center in Lemoyne, Pennsylvania. 11. By April of 2006, the record from Mr. Krahulec's physician makes no notation of any left rib pain or left upper extremity pain as evidenced by the attached office notes from Apri14, 2006 and April 18, 2006, which are hereby attached as Exhibits "B" and "C." 12. Mr. James E. Krahulec died of causes unrelated to the automobile accident on January 16, 2006. 13. Mrs. Krahulec would like to settle this survival action in exchange for payment of Fourteen Thousand Dollars ($14,000.00) by Nathan Vriens' insurer, Progressive Direct Insurance Company. 14. The only beneficiary of these proceeds would be Mrs. Krahulec as the surviving spouse under the survival action. 15. This settlement is also intended to settle any loss of consortium claim which Mrs. Krahulec has. 16. The Petitioner is not represented by counsel and this Petition for Court Approval has been prepared by counsel retained by Progressive Direct Insurance Company to defend Mr. Vriens. 17. Counsel for the Respondent has had no involvement in the negotiation of this settlement which was memorialized on the date when the statute of limitations expired. See letter from David Pasquali to Marianne Krahulec dated January 16, 2008, attached hereto as Exhibit "D." 18. The Petitioner, Marianne Krahulec, acknowledges that she has the right and opportunity to consult with an attorney of her choosing regarding this settlement. WHEREFORE, Petitioner requests this Honorable Court grant court approval in the amount of Fourteen Thousand Dollars ($14,000.00) to settle the survival claim of James E. Krahulec and the consortium claim of Marianne F. Krahulec. Respectfully submitted, By l ar' nne F. Krahu ec, Indi idually and as Administrator of the Estate of James E. Krahulec Date: (,p f (0 ~ 0~' STATE OF PENNSYLVANIA COUNTY OF CUMBERLAND estate of JAMES E KRAH[/[ Fr SHORT CERTIFICATE I, GLENDA EARNER STRASBAUGH Register for the Probate of Wills and Granting Letters of Administration in and for CUMBERLAND County, do hereby certify that on the 9th day of November, Two Thousand and Six, Letters TESTAMENTARY in common form were granted by the Register of said County, on the late of MONROE TOVI/NSH/P /First, Midd/e, Lasi1 a/k/a JAMES EUGENE KRAHULEC in said county, deceased, to MARIANNE F KRAHULEC trust, iviiome, Last1 and that same has not since been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of said office at CARLISLE, PENNSYLVANIA, this 9th day of January Two Thousand and Eight. File No. PA File No. Date of Death S.S. # 2006- 00994 21- 06- 0994 8/29/2006 344-36-9330 ~~,/~~l n . mac. L ,7 ~~: ~~ t , ~~L ~;us 11 1 NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL Exhibit "A" KRAIIULEC, JAMES 04/04/2006 OFFICE NOTE S: 1 saw Mr. Krahulec today. He is here for follow up. 1. The patient's blood sugars are being better controlled. His blood suga*- today was 116. He has decrease his dose of Novolog and Lantus hlsulin. 2• The patient states he is very weak and fatigued. He was told by Dr. Katz that he was anemic, and he feels that this may be contributing to his fatigue. His hemoglobin was 9.1, according to him. 3• Hypertension. Blood pressure is under satisfactory control. Allergies: No known drug allergies. U: Vital sig;is: Blood pressure 122/68, temperature 97.4, heart rate 80. HEENT: Pupils equal and reactive to light. Sclerae anicteric. Ears: Extenial canals normal. Nose: Turbinat~s 2+. Mouth: Oral mucosa moist. The patient is pale and conjunctivae and mucous are pale. Neck supple. Cardiovascular system: First and second sounds heard. Lungs clear to auscultation and percussion bilaterally. Abdomen soft. Lower extremities: No edema. A/P: 1 • Patient with extreme fatigue and paleness. Could be related to anemia. I have sent him to Holy Spirit Hospital to have his CBC checked. If this shows him to be anemic, he will benefit from admission, transfusion and colonoscopy to determine the source of blood loss. ?• Diabetes mellitus. Blood sugars under good control. 3• Coronary artery disease, asymptomatic at the present time. Patrick Ratnasmy, M.D./asap Exhibit "B" hlam ,~ Date ~, Ti~r~~,`_- w~l~ht ~ _~-iEin.r,t_ PUlse ` ~~~ ~lc'IfiF7 CC ~%"~ ~~ ~cl~ 1 n . ~l ~ a i ~~~ JAi'~IES E KRAHULEC 4-18-06 office I saw him today, he is here for follow-up of 1. Diabetes mellitus. His blood sugars have been Winning high in the 140's to 150's. I have asked him to increase the dose of Lantus from 30 to 35 units at hs, he is to use Humalog 10 units subcu tid. 2. Hypertension, blood pressure under satisfactory control. No headaches. No change in vision. No trouble swallowing. 3. Hyperlipidemia, is able to tolerate Lipitor 80 mg. 9 day. No myalgias. 4. Cellulitis RLE resolved following treatrnent with Vancomycin. No fevers or chills. 5. GERD, symptoms under control with Prilosec 20 mg, bid. 6. Anemia, his blood coi.ints have remained stable. He does have an injection of Procrit which he would like to take. I told him that it is best to recheck the CBC first. Allergies - no known drug allergies. Review of Systems: Complains of shortness of breath on exertion. He is morbidly obese. He denies any fevers, chills, nausea, vomiting or abdominal pain. O: Blood pressure was 1 16/64, temperature 98, heart rate was 92 sclerae anicteric. Ears -external auditory canals normal. Nose -~turbinates 2+6 MouHEEQ 1 ~ co ~ Dist. Neck supple. No 1}~n1ph node enlargment. i~lo JVD. No thyroid gland enlargement or carotid bniit. Cardiovascular -- first and second sounds heard. Lungs were clear to percussion and auscultation bilaterally. Abdomen soft, non-tender, bowel sounds present. Lower extremities -RLE patient has 1+ edema, left lower extremity artificial limb. A&P: .Patient with anemia, check CBC. Procrit if necessary. Diabetes mellitus, increase dose of Lantus as detailed above. CAD, asymptomatic. Morbid obesity. Recommend patient watch his diet, join `iVeight 'vVatchers, his wife was aware of this too. Malaise, fatigue -this is resolving. The patient is to follow-up in two weeks time. PR/Iab Q~ ~~ ~S-s-G (o- Imo Sumo oV. ncn ~jir~ U~ Exhibit "C" i~ a«~<~~a„ ,~ PROGREll/!/E January 16, 2008 Marianne Krahulec 781 Dogwood Terrace Boiling Springs, PA 17007 Policyholder: Our Claim #: Date Of Loss: Underwritten By: Dear Mrs. Krahulec, Vriens, Nathan Y 067585560 01/16/2006 Progressive Direct Insurance Company 5053 Ritter Rd, Ste 101 Mechanicsburg, PA 170556915 (717) 791-5120 1-R00-PROGRESSIVE Facsimile: (717) 697-671! progressive.com The purpose of this letter is to confirm the settlement amount of $14,004.00 for the injury claim of your late husband James E. Krahulec. We have forwarded our file along with a copy of this letter to counsel to seek court approval of the settlement amount. If you have any questions regarding this matter, feel free to contact me at 717-791-5179. Sincerely, r- V+,~ ,, David A Pasquali xt.5179 Claims Representative David A_Pasquali@progressive.com DAP/dp Exhibit "D" VERIFICATION I have read the Petition for Court Approval and it is true and correct to the best of my knowledge, information and belief. This statement and verification are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities, which provides that if I make knowingly false averments, I may be subject to criminal penalties. { ~ ~~ - arianne F. Krahulec, Indi idually and as Administrator of the Estate of James E. Krahulec