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HomeMy WebLinkAbout09-0263GRAHAM & MAUER, P.C. Attorney for Petitioners By: Lisa J. Mauer, Esquire ID # 65426 The Commons at Valley Forge Suite 7, P.O. Box 987 Valley Forge, PA 19482 (610) 933-3333 CUMBERLAND COUNTY COURT OF COMMON PLEAS In re: JORDAN FLEAGLE, a minor No. 69 _ d-4r 3 U'L L PETITION FOR LEAVE TO OMPROMISE MINOR'S ACTION TO THE HONORABLE JUDGES OF THE SAID COURT: Your petitioners, Laura and David Fleagle, parents and natural guardians of a minor, Jordan Fleagle, respectfully represent that: They are the parents and natural of guardians of Jordan Fleagle, a minor, whose date of birth is August 13, 1995. 2. On February 17, 2002 Jordan Fleagle was injured in a Cumberland County motor vehicle accident while riding as a passenger in a vehicle driven by his father. 3. Said motor vehicle collision was caused by the negligence of Michelle Curtis, another driver, who was cited for careless driving. 4. At the time of said crash the tortfeasor, Michelle Curtis, was insured by an Allstate automobile insurance policy with a liability limit of $100,000.00. (See Allstate letter of December 3, 2003 attached hereto as Exhibit A.) 5. At the time of said crash, David Fleagle was insured by a State Farm automobile insurance policy, which provides $60,000.00 in underinsured motorist coverage. 6. As a result of the aforesaid accident, Jordan Fleagle sustained a mandibular fracture requiring him to undergo two surgical procedures, including an open reduction/internal fixation of that fracture. 7. As a result of said collision, Jordan Fleagle sustained severe and permanent injuries to his jaw, which have not yet resolved and will require future surgical repair once the full extent of damage can be determined as a result of the aging process. (See Cantor & Team Orthodontics letter of December 1, 2008 attached hereto Exhibit B.) 8. Allstate Insurance Company, insurer of the tortfeasor, has offered $35,000.00 (out of a $100,000.00 policy limit) to resolve Jordan Fleagle's personal injury claim. (See Allstate letter of September 23, 2003 attached hereto as Exhibit C.) 9. Valuing Jordan Fleagle's claim in excess of the $100,000.00 Allstate liability limit, State Farm, the underinsured motorist carrier, has extended an initial offer of $30,000.00 as the current undisputed value of the underinsured motorist claim. (See State Farm letter of April 29, 2008 attached hereto as Exhibit D.) 10. Jordan Fleagle does not have any unpaid accident-related medical bills, since the Fleagle automobile insurance policy provides $50,000.00 in medical benefits, which have not yet been exhausted. 11. Counsel was retained upon a one-third contingent fee agreement but has agreed to a 25% fee subject to Court approval. 12. In addition, counsel has incurred the following expenses: The Print Shop (copy photos of client) 1.46 Chartone - Carlisle Regional Medical Center (records) 31.93 The Print Shop (copy panorex/dental x-ray) 3.77 West Shore Emergency Medical Service (trip sheet) 16.42 Recordex - Hershey Medical Center (records) 68.82 Carlisle Pediatric Associates (records) 17.23 The Print Shop (copy medical records - 2 sets) 8.75 The Print Shop (copy photos of vehicles) 3.64 Adams Photography (scar photos) 110.24 262.26 13. Recognizing that the $30,000.00 offered extended by State Farm at this time represents an initial offer and undisputed current value of the underinsured motorist claim which does not require the execution of a Release or extinguish any future underinsured motorist claim with State Farm or any future settlement with Allstate, Petitioners approve this proposed undisputed portion of the underinsured motorist settlement and further approve the distribution set forth in the proposed Order attached hereto. WHEREFORE, Petitioners pray that an Order be entered approving the compromise allowing counsel fees and costs and ordering distribution. Respectfully submitted, GRAHAM & MAUER, P. C. By: f' sa . Maue Attorney for etitioners Date: t ?.Oq GRAHAM & MAUER, P.C. Attorney for Petitioners By: Lisa J. Mauer, Esquire fl) # 65426 The Commons at Valley Forge Suite 7, P.O. Box 987 Valley Forge, PA 19482 (610) 933-3333 CUMBERLAND COUNTY COURT OF COMMON PLEAS In re: JORDAN FLEAGLE, a minor No. ATTORNEY VERIFICATION In my professional opinion as counsel in this matter, I believe the proposed initial offer of $30,000.00 to resolve the undisputed portion of Jordan Fleagle's underinsured motorist claim is reasonable under the circumstances. GRAHAM & MAUER, P.C. By: 4u1-1 Attor ney fooners s Date: I I ? - GRAHAM & MAUER, P. C. By: Lisa J. Mauer, Esquire ID #65426 The Commons at Valley Forge Suite 7, P.O. Box 987 Valley Forge, PA 19482 (610) 933-3333 Attorney for Petitioners CUMBERLAND COUNTY COURT OF COMMON PLEAS " re: JORDAN FLEAGLE, a minor No. AFFIDAVIT OF r DIRT A NS We, Laura and David Fleagle, certify that: 1. We are the parents and custodians of Jordan Fleagle; 2. We approve the proposed $30,000.00 partial underinsured motorist settlement and the distribution thereof. F Fleagle David leagle 'I Lk Sworn to and subscribed before me this day of -bo? 200S Notary Public COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL MICHEL.? r< iL?r? ,')taty Public Boro of Shippeilso ft, Gwiberland County My Commiswon Expires July 16, 2012 EXHIBIT A Allstate Insurance Company 6345 Flank Drive, Suite 1000 Harrisburg, PA 17112 Claim No.: 15543120BOB19 Insured: Michelle and Timothy Curtis Date of Loss: 2/17/02 December 3, 2003 We have received your request for a policy declaration sheet. The original is a computer generated and no duplicate is kept. In fact, there is no physical policy file. Michelle and Timothy Curtis are insured with Allstate Insurance under policy number 018763098 with Bodily Injury limits of $100,000.00 per person and $300,000.00 per occurrence. Attached is a copy of a computer printout that confirms the above. Sincerely, Michael J. Donahue Front Line Perfon-nance Leader EXHIBIT B Richard J. Cantor. D.M.D., Board Certified December 1, 2008 ?a ,TEAM ORTHp? pW' G %/]W rrX q U Specialist In Orthodontics Fz Dentofacial Orthopedics We Make Smiles State Farm Insurance Companies P. O. Box 41 Concordville, PA 19331 Attn: Minda Fall Re: Claim # 38-J883-182 Date of Loss: 2/17/2002 Insured: Laura M. Fleagle Our Patient: Jordan Fleagle Dear Minda, As per the phone conversation on 10/30/08 that you had with my treatment coordinator, I am writing you to review Jordan's treatment case and determine what steps we need to take to have his treatment covered by State Farm Insurance. I have had the pleasure of working with Jordan and the Fleagle's since April 29, 2004. He was seen in my office to evaluate for future orthodontic treatment and we have been following him every six months to determine growth and decide when to commence orthodontic treatment. The motor vehicle accident that injured Jordan in 2001 has contributed to the complicated orthodontic treatment that will require orthognathic surgery to correct the malocclusion. Due to the complicated treatment plan, Jordan's orthodontic treatment will need to be in several phases spanning a 5-7 year period. The total orthodontic treatment fee is $10,096.50. There will also be fees incurred with the Oral surgeon (orthognathic surgery and implant placement) and the family dentist (Jordan will most likely need implants in the future due to loss of permanent teeth). At this time we are ready to commence the first phase of Jordan's orthodontic treatment. Please inform us of State Farm's protocol for filing for treatment so that we can commence his treatment as soon as possible. Thank you for your attention to this matter. Sincerely, 6/c and J. Cantor maq c.c.- Lisa Mauer, Esq. _ 3 TYLER COURT ¦ CARLISLE, PA 17015 717_741_R4-A7 ¦ F4x• 74-A-7030 ¦ WWW TFAMCANTnR.C(TM EXHIBIT C f• ParawNV :717-04*4 YO 0MCE 1101 RSt N*bWAV4MWAV &00440 MIMSRET CLAIM OF]"CR me RAM DOWS si c low HARMSURa PA 17112 September 23, 2003 GRAMM b VAXMK, P. C, PO DU 967 M .22 VALLEY FORM PA 19482 Allstate Insurance G=W=W CLaia Number: ISS4S124i4 814 Oux Insured: laMMLLB CURTZA Date of Loss: February 17, 2002 RE: Jordan Fleagle Dear Ns. Mahar: .J' AIRS . *0* in good hand. Piaata ba adviaad th4t I have rovi wed the inlotmation FM bans provided aaad I am prepared to axtand as offer of $36,000 to settla your cliaat?9 olaim. f3ivea Jordan's age, a str=turad swttleamemt would be an excellent opportunity for his parents. I am aneiosing various structure proposals for your review. 6incaraly, PATRICIA A. NDPn AN Allstate Insurance Company SM06/0/01/1 Of 8nc10sure l d' 80S 'ON Zl lLt '?d 124 'SNI hViSlIV WdoZ:Z E00Z 'tZ 'd? EXHIBIT D State Fame Providing Insurance and Financial Services Home Office, Bloomington, Illinois 61710 April 29, 2008 LISA J MAUER GRAHAM AND MAUER PC THE COMMONS AT VALLEY FORGE SUITE 7 PO BOX 987 VALLEY FORGE PA 19482 IoilIIllilliIliIIifililliIlIIilI RE: Claim Number: Our Insured: Date of Loss: Your Client: Dear Ms. Mauer: 38-J883-182 Laura and David Flegale February 17, 2002 Jordan Flegale Cw=rdv& Operatim Carder One Stale Farm Drive PO Box 142 C mrdville, PA 19331-0142 I am writing as a follow-up to your letter of April 23, 2008. The $30,000 offer extended at this time would represent our initial offer. This would be the undisputed value of the UIM claim. Please advise if there is anything additional you may need at this time. Please feel free to contact me with any questions. Sincerely, Robert S. Bro III Claim Representative 724 743 4957 State Farm Mutual Automobile Insurance Company sr?n t?tr IMtYt?YC? 24/660/964460 GRAHAM & MAUER, P.C. Attorney for Petitioners By: Lisa J. Mauer, Esquire ID # 65426 The Commons at Valley Forge Suite 7, P.O. Box 987 Valley Forge, PA 19482 (610) 933-3333 CUMBERLAND COUNTY COURT OF COMMON PLEAS In re: JORDAN FLEAGLE, a minor No. CERTIFICATE OF SERVICE Ah I, Lisa Mauer, Esquire, hereby certify that on this 5 day of cat` - , 2009 a true and correct copy of the forgoing Petition for Leave to Compromise Minor's Action was sent via first class mail, postage prepaid to the following: Robert S. Brown III State Farm Mutual Automobile Insurance Company 1 State Farm Drive P. O. Box 142 Concordville, PA 19331-0142 and Heather Bean All State Insurance Company 6345 Flank Drive, Suite 1000 Harrisburg, PA 17112 GRAHAM & MAUER, P.C. By: isiJ. )Ifauer Attorney for Pe loners 70 ?JL ?.71i JAN 2 '12009 61 GRAHAM & MAUER, P.C. Attorney for Petitioners By: Lisa J. Mauer, Esquire ID #65426 The Commons at Valley Forge Suite 7, P.O. Box 987 Valley Forge, PA 19482 (610) 933-3333 CUMBERLAND COUNTY COURT OF COMMON PLEAS In re: JORDAN FLEAGLE, a minor No. O4 -- .20 ENTRY OF APPEARANCE TO THE PROTHONOTARY: Kindly enter the appearance of Lisa M. Mauer, Esquire, as attorney for Petitioners, David Fleagle, Laura Fleagle and Jordan Fleagle. GRAHAM & MAUER, P.C. By: ? y - a . Mau Attorney fo Petitioners Date: 1- H 101 71 -, r t ° ? ri? i `} GRAHAM & MAUER, P.C. Attorney for Petitioners By: Lisa J. Mauer, Esquire ID #65426 The Commons at Valley Forge Suite 7, P.O. Box 987 Valley Forge, PA 19482 (610) 933-3333 CUMBERLAND COUNTY COURT OF COMMON PLEAS In re: JORDAN FLEAGLE, a minor No. C >q - a 4- 3 01 U C, ?F1L PRAECIPE FOR DETERMINATION Kindly submit the enclosed Petition for Leave to Compromise Minor's Action to the Honorable Judges of Said Court for determination. Oral argument is not requested. Respectfully submitted, GRAHAM & MAUER, P.C. P, d. C By: a . Mau Attorney for etitioners Date: ? ) 4-o l -71 .,.j V GRAHAM & MAUER, P.C. By: Lisa J. Mauer, Esquire ID # 65426 The Commons at Valley Forge Suite 7, P.O. Box 987 Valley Forge, PA 19482 (610) 933-3333 BY THE COURT: JAN 21 200, Attorney for Petitioners CUMBERLAND COUNTY COURT OF COMMON PLEAS In re: JORDAN FLEAGLE, a minor No. QQ - e243 cluz ORDER AND NOW, this 22 ay of T Zr-z 4 , 2009, upon consideration of the forgoing Petition, it is hereby ORDERED that the partial undisputed underinsured motorist settlement of this action for the amount of thirty thousand dollars ($30,000.00) is hereby approved, counsel fees and expenses are allowed and distribution is dictated as follows: TO: GRAHAM & MAUER, P.C. (for costs) TO: GRAHAM & MAUER, P.C. (for counsel fees - 25%) TO: JORDAN FLEAGLE, a minor - in a restricted account until Jordan Fleagle reaches the age of majority $ 262.26 $ 7,500.00 $22,237.74 f U J. to t'; A A `i- ' J C f@ 1 C-2 V 1 G~ & MAUER, P.C. By: Lisa J. Mauer, Esquire ID # 65426 Suite 7, P.O. Box 987 Valley Forge, PA 194$2 Attorney for Petitioners (610) 933-3333 ~'' fi r ~:~~ "r" ..:~~; c~:s CUMBERLAND COUNTY COURT OF COMMON PLEAS r;rc ~' E:,; ~'? -~..: C> 5~ '' _.... g°~ In re: JORDAN FLEAGLE, a minor No. 09-263 ~' ~~ :~::,:~ PETITION FOR LEAVE TO COMPROMISE MINOR'S ACTION ~ = ° ~" -< w, TO THE HONORABLE JUDGES OF THE SAID COURT: Your petitioners, Laura and David Fleagle, parents and natural guardians of a minor, Jordan Fleagle, respectfully represent that: They are the parents and natural of guardians of Jordan Fleagle, a minor, whose date of birth is August 13, 1995. 2. On February 17, 2002 Jordan Fleagle was injured in a Cumberland County motor vehicle accident while riding as a passenger in a vehicle driven by his father. 3. Said motor vehicle collision was caused by the negligence of Michelle Curtis, another driver, who was cited for careless driving. 4. At the time of said crash the tortfeasor, Michelle Curtis, was insured by an Allstate automobile insurance policy with a liability limit of $100,000.00. (See Allstate letter of September 10, 2010 and the Affidavit of No Other Insurance signed by Michelle Curtis on Dec. 5, 2003, both of which are attached hereto as Exhibit A.} ~~ i~'a F`A'Y e~3 rJ c-~ ~ v 5. As a result of the aforesaid accident, Jordan Fleagle sustained severe and permanent injuries to his jaw, which have not yet~resolved and will require future treatment. 6. At the time of said crash, David Fleagle's State Farm automobile insurance policy provided $50,000.00 in medical coverage, of which $32,878.36 has been paid to date (See State Farm Certificates of Coverage and Payment Log of Aug. 25, 2010 attached hereto as Exhibit B.) 7. Allstate Insurance Company, insurer of the tortfeasor, is now tendering the $100,000.00 liability limit in the farm of a structured settlement annuity to resolve 3ordan Fleagle's personal injury claim. (See Allstate letter of September 10,2010 attached hereto as Exhibit A.} 8. Said structured settlement annuity will be paid as follows: Attorng,~s Fee (paid as cash up front) Benefit Monthly Income $250.00 per month guazanteed 3 years starting at age 18 on 8/13/2013 I`4o.~~Y Income $350.00 per month guaranteed 4 years starting at age 21 on 8/13/2016 Monthly Income $S 18.00 per month guaranteed 5 years starting, at age 2S on 8/13/2020 Lump Sum $50,000 at age 30 on 8/13!2025 $ 25,000.00 Guaranteed Tax-Free Yield $ 9,000.00 $ 16,800.00 $ 31,080.00 $ 50.000.00 $106,880.00 The Cost of the structure is $100,000.00. (Please see the Individually Designed Settlement attached hereto as Exhibit C). 9. Rating of structure guarantor, Metropolitan Life Insurance Company, is A.M. Best A+ (superior). (Please see the rating sheet for Metropolitan Life Insurance Company attached hereto as Exhibit C). 10. At the time of said crash, David Fleagle was insured by a State Farm automobile insurance policy, which provides $60,000.00 in underinsured motorist coverage. (See State Farm letter of September 20, 2010 and the four attached Certificates of Coverage attached hereto as Exhibit B.) 11. On January 22, 2009 this Honorable Court approved the partial undisputed underinsured motorist settlement with State Farm in the amount of $30,000.00. (See the January 22, 2009 Order attached hereto as Exhibit D.) 12. As Ordered,, the net proceeds of said underinsured motorist settlement in the amount of $22,237.74 have been placed in a restricted Certificate of Deposit (account # 2895549620}, which cannot be accessed by Jordan Fleagle until he reaches the age of majority. (See Sovereign Bank account restriction attached hereto as Exhibit E.) 13. State Farm is now tendering the balance of the underinsured motorist limit in the amount of $30,000.00. (See State Farm letter of Sept. 20, 2010 attached hereto as Exhibit B.) 14. .Counsel was retained upon aone-third contingent fee agreement but has agreed to a 25% fee ($32,500.00: $25,000.00 from the Allstate Settlement and $7,500.00 from the State Farm settlement) subject to Court approval. 15. In addition, counsel has incurred the following expenses: Cumberland County Prothonotary (filing fee for minor's petition - 2009) 78.50 (filing fee for minor's petition - 2010) 92.00 1.J. S. Postal Service (certified mail settlement proceeds to bank) 4.90 Cantor 8t Team Orthodontics (dental records) 75.00 Total $ 250.40 16. The net proceeds from this portion of the underinsured motorist settlement ($22,249.60) will be added to the restricted Certificate of Deposit (account #2895549620). 17. Recognizing that the $100,000.00 liability limited tendered by Allstate and $30,000.00 balance of the underinsured motorist policy limit tendered by State Farm represent all of the automobile insurance available to compensate Jordan Fleagle, Petitioners approve this settlement and further approve the distribution set forth in the proposed Order attached hereto. WHEREFORE, Petitioners pray that an Order be entered approving the compromise allowing counsel fees and costs and ordering distribution. Respectfully submitted, GRAHAM & MAUER, P.C. Date: ~ ~ _ 2 ~ 1 ~' ~~ By: ;,, sa .Mauer Attorney for itioners GRAHAM & MAUER, P.C. By: Lisa J. Mauer, Esquire ID # 65426 The Commons at Valley Forge Suite 7, P.O. Box 987 Valley Forge, PA 19482 (610) 933-3333 Attorney for Petitioners CUMBEI~tLA-ND COUNTY COURT OF COMMON PLEAS In re: JORDAN FLEAGLE, a minor No. 09-263 ,AFFIDAVIT OF GUARDIANS We, Laura and David Fleagle, certify that: 1. We are the parents and custodians of Jordan Fleagle; 2. We approve the proposed $130,000.00 settlement and the distribution thereof. Fleagle David Fleagle Sworn to and subscribed, before me this ~ day of . C~1 Z~ z'L 2010. Notary ~ i~ MMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL TAMMY SUE HELMAN, Notary Public QulBord Twp., revs February 10, 2014 Gammlaslen Exp -- GRAHAM & HALTER, P.C. Attorney for Petitioners By: Lisa J. Mauer, Esquire ID # 65426 The Commons at Valley Forge Suite 7, P.O. Box 987 Valley Forge, PA 19482 (610) 933-3333 CUMBERLAND COUNTY COURT OF COMMON PLEAS In re: JORDAN FLEAGLE, a minor No. 09-263 ATTORNEY VERIFICATION In my professional opinion as counsel in this matter, I believe the proposed offer of $130,000.00, all remaining policy limits, to resolve Jordan Fleagle's personal injury claim is reasonable under the circumstances. GRAHAM & MAUER, P.C. is J. Mau Attorney fo etitioners Date: C ~ ~2~_ ~ C~ ~~~~/ ~A~I~~I~aMlY~6~RISBIIRG PAI17112UITE 1000 Vbu?e in pool hands ~I'IItII~~~~~~~~'~~~+~~~'I~~~t~l~~~~~~~II~~III~~I~~II~II~III~II~~ LISA MAUER PO BOX 987 VALLEY FORGE PA 19482-0987 September l0, 2010 INSURED: MICHELLE CURTIS DATE OF LOSS: February 17, 2002 CLAIM NUMBER: l 554312080 B37 Re: Jordan Fleagle Dear LISA MAUER, PHONE NUMBER: 800-726-8890 FAX NUMBER: 717-540-7540 OFFICE HOURS: Mon -Fri 8:OOam - 5:30pm This letter will confirm that we have offered our policy limits of $100,000 in final settlement of your client's bodily injury claim. Enclosed is a copy of the proposed release as well as proof of our insured's policy limits. Please advise if you would like any structured settlement proposals for this matter. Please forward a copy of the court approval documents as well. if you have any questions, please contact me at 717-540-7590. Sincerely, xeaifier Bean Heather Bean 717-540-7540 Allstate Insurance Company GENI001 1554312080 B37 Allstate Insurance Company 6345 Flank Drive Suite 1000 Harrisburg, PA 17112 9/10/10 Graham and Mauer 1220 Valley Forge Suite 7 Valley Forge, PA 19482 Claim #: 1554312080 B37 We have received your request for a policy declaration sheet. The original is computer generated and no duplicate is kept. In fact, there is no physical policy file. Michelle Curtis is insured with Allstate Insurance under policy number 0187b3098 with Bodily Injury Limits of $100,000 per person and $300,000 per occurrence. Attached is a copy of a computer printout that confirms the above. Sincerely, Heather Bean Allstate Insurance Company DESK: 637 *** COVERAGE DISPLAY - AUTO *** 09/10J10 10:34:32 CLMNUM: 1554312080 POLNUM: 018763098 EFFDT: 02/12 LOSSDT: 02/17/02 LINE: 10 ORG YEAR: 91 INSD: MICHELLE CURTIS ADDR: 350 GREEN SPRING RD CITY: NEWVILLE ST: PA ZIP: 172419608 YEAR: 99 MAKE: CHERO VIN: 1J4FF68S8XL594924 TYPE: 10 STANDARD OPTION(S}: FULL TORT LPC NAME: KEYSTONE FINANCIAL BANK {LEASE} ADDR: P O BOX 398168 CITY: MINNEAPOLIS ST: MN ZIP: 554398168 AGENT NAME: PAUL MATTUS AGY INC AGENT NUM: 0017875 PHONE: 717-731-5456 ACCT CO: 010 ALLST CASUALTY OPT PKG: N/A OPENABLE: AA 100,000/300,000 BB 50,000 CC 5,000 CF 2,500 DD - 500 HH - 100 SS 100,000/300,000 - STACKABLE SU 100.000/300,000 - STACKABLE POLICY S-CODES: VEHICLE S-CODES: RDBL MULTI-CAR PASS-RES ENTER ACTIVITY: 1-PRNT SCRN 12-ADL POL-S 13-ADL VEH-S 14-FORMS 17-ADL LPC A~,astvit of No Otter Ieanrance I, Miebe~b Gbrds, do swear and affirm that to the best of my Imowledg~e: 1.0a Febrpsry 17, 3002, the only liability iastn+eace coverage that was m ei9b~at providing covaaccage, for parsoaal it~urie~ sad p~opeay damage sustained by Jor~Ln Flea~e, ariaiag otirt of the aotomwb~le accident on that date was s policy with ADttate Iptu~sAOe Compaay, paticlr mzmber Q38763!?l8 03/12, whidi has limits of 5100,000 acct perwuoi and 5300,000 each amt liability coveetaEe. Attached h~eaeto is a true and correct copy of tht dealaratian cheat or ec}uivslent docaa~ent(a) applicable to that policy. 2.On February 17, 3002, tl~e waa m otlres coverage tbro~ugh Amba~e Iaearaaos of any otlLer inarttaabce caazt~my or ulf iasuraace wlricb. pt+oteoted against the risk of liability ~ P~!~ ~llmy ~ Sa~Y ~~8 out of tlLC afat+~=aid accident including but not limited tD reiaamaaae caversge, excxss coverage, mnbralla cov~oragc, iasuraaoe ott as0- otb~er a~vt~ed or leased varhicde, cava~rage issued to any relative family mcsabar, or say otl~ coves wb~ateoever. I veai$- that thQ ststemenda taade above are true and auraat to the beat oaf ~ knowledga, ia£armation sad belief In zmdetstand tlsat false statements b~ea~eia are made subject to the pes~slties of 18 PaC.3. ;4904 relatinE to mosworn falsification to authmiti~ee. sD~..o3 Z "d 9Cti'ON lllCl 'Ed `t4H 'SNI 3!tllSlld Wdll~Z ~0~~ ~~~"~/ State rarm insurance VurriNa~~~C~ September 20, 2010 Lisa Mauer Esq Graham & Mauer, P.C. PO Box 987 Valley Forge, PA 19482 RE: Claim Number: 38-J883-182 Date of Loss: February 17, 2002 Our Insured: Laura M Fleagle Your Client: Jordan Fleagle, a minor Dear Ms. Mauer: iNS~~~ State Farm Insurance Companies PO Box 142 Concordville, PA 19331-0142 Fax: 1888) 713-4693 In follow up to our recent conversation, please be advised that we will extend the balance of our policy limits to conclude the underinsured motorist claim of Jordan Fleagle, a minor, for an additional $30,000. We paid $30,000 for this claim on February 3, 2009. I have enclosed certificates of coverage to verify the underinsured motorist benefits, coverage W, of 15/30 on four household vehicles for a total benefit of $60,000. Once the signed order has been secured, please send it to me and I will see that our drafts are issued promptly. If something more is needed, please let me know. Sincerely, ~~~~, ~ . ~~y~~ l ~ ~ Mary ~C. Bechman v Claim Representative (724) 743-4962 State Farm Mutual Automobile Insurance Company Enclosure(s): Four Certificates of Coverage HOME OFFICES: BLOOMINGTON, ILLINOIS 61710-0001 State Farm Insurance CERTIFICATE OF COVERAGE Claim Number: 38-K152-695 Companies Vehicle Number: 002 The undersigned is a Claim Team Manager for: State Farm County Mutual Insurance Company of Texas State Farm Lloyds, Inc. State Farm Indemnity Company State Farm Mutual Automobile Insurance Company State Farm Fire and Casualty Company STATE BAR M INSYRANCE State Farm Insurance Companies PO Box 142 Concordville, PA 19337-0142 Fax: (888) 713-4693 This certifies that policy number 6673-104-38Q, covering a 1979 Ford F150, was issued to Laura M & David E Fleagle and was in effect on the accident date of February 17, 2002. The coverages and limits of liability for this policy on that date were: A 50/100/50, C2 SO,000,H,U-BI 15/30,F 2500,Y 5000,W 15/30 ,Z This policy provides Full Tort. ~1 Theresa L. Wilson Claim Team Manager State of Pennsylvania )ss. County of Washington Subscribed and sworn to before me this a~~ day of (Year) i o 'r'~l~s~E-ate-- ~ ~~~. Notary Public 1"~Lfsl~'~tORP~A ~ 1@INc NotarW Seal MarFanne V. tfan!®nn. Notary PubYc My Commisafon E,x{1Mes Nov. 2.2011 ~ obile Insurance Company HOME OFFICES: BLOOMINGTON, ILLINOIS 61710-0001 State Farm Insurance CERTIFICATE OF COVERAGE Claim Number: 38-K152-678 Companies Vehicle Number: 001 The undersigned is a Claim Team Manager for: State Farm County Mutual Insurance Company of Texas State Farm Lloyds, Inc. State Farm Indemnity Company State Farm Mutual Automobile Insurance Company State Farm Fire and Casualty Company fiAi[ IARM INSYRANCE State Farm Insurance Companies PO Box 142 Concordville, PA 19331-0142 Fax; (888) 713-4693 This certifies that policy number 0314-888-38A, covering a 2001 Polaris 325 Cc, was issued to Laura M & David E Fleagle and was in effect on the accident date of February 17, 2002. The coverages and limits of liability for this policy on that date were: A 50/100/50,C S,000,L100,U-BT 15/30,W 15/30 / CJ' F~ ?t Theresa L. Wilson Claim Team Manager State of Pennsylvania ss. County of Washington Subscribed and sworn to before me this d~/y'-~ day of ~~~~zt (Ye r) ~-O/O / dot ~~n-~-~- :/ , Notary Public M~O i`11~RR~ P~l~'~L llA Notarie! Seal AAerianne V. Fianfaon, Nola Pt~ic Cad .. WaahYglon raxlb '~~' obile Insurance Company f~Aembsr, PenmylvaMa Msodadon d NoYrNs HOME OFFICES: BLOOMINGTON, ILLINOIS 6 1 7 1 0-0001 State Farm Insurance CERTIFICATE OF COVERAGE Claim Number: 38-J88.3-182 Companies Vehicle Number: The undersigned is a Claim Team Manager for: fTATE FARM INfYRANCE O State Farm Insurance Companies PO Box 142 Concordville, PA 19331-0142 Fax: f888- 713-4693 003 State Farm County Mutual Insurance Company of Texas State Farm Lloyds, Inc. State Farm Indemnity Company State Farm Mutual Automobile Insurance Company State Farm Fire and Casualty Company This certifies that policy number 6673-104-38Q, covering a 1989 Pontiac Sunbird, was issued to Laura M & David E Fleagle and was in effect on the accident date of February 17, 2002. The coverages and limits of liability for this policy on that date were: A 50/100/50,C2 50,000,D,G500,H,U-BI 15/30,F 2500,Y 5000, W 15/30,2 This policy provides Full Tort. ti T eresa L. Wi son Claim Team Manager State of Pennsylvania )ss. County of Washington Subscribed and sworn to before me this a'~~ay of (Year) a- ~p Notary Public Nole~et Seel Marferxte V. Flere~sort, No Public Wp., 8S Oin ~` 17 mobile Insurance Company .Penns ania Aasodatlon of Notarlss HOME OFFICES: BLOOMINGTON, ILLINOIS 6 1 7 1 0-000 1 State Farm Insurance CERTIFICATE OF COVERAGE Claim Number: 38-K152-694 Companies Vehicle Number fTATt tARM INfYRANCE State Farm Insurance Companies PO Box 142 Concordville, PA 19331-0142 Fax: (888) 713-4693 001 The undersigned is a Claim Team Manager for: State Farm County Mutual Insurance Company of Texas State Farm Lloyds, Inc. State Farm Indemnity Company State Farm Mutual Automobile Insurance Company State Farm Fire and Casualty Company This certifies that policy number 6673-104-38Q, covering a 1994 Saturn was issued to Laura M & David E Fleagle and was in effect on the accident date of February 17, 2002. The coverages and limits of liability for this policy on that date were: A 50/100,/50, C2 50,000,D,G500,H,U-BI 15/30,F 2500,Y 5000, W 15/30,2 This policy provides Full Tort. The esa L. Wilson Claim Team Manager State of Pennsylvania )ss. County of Washinston Subscribed and sworn to before me this ~~/-^~day of /~~~k~rh,, (Year) yv ~ o ~ ' ('G'~t,i-~t,x,c~ , Notary Public ~+~Dir'oS~r~i3~vavw Nofadal seal Marfarne V Ced Tbw•• waelrrglon Ccur~r ~Ed~~.ti mobile Insurance Company 1AemDsr, Pwa~sylvtRw ARSOdatfon of NwaElss HOME OFFICES: BLOOMINGTON, ILLINOIS 61 7 1 0-0001 Payment Log - Mail to: GRAHAM & MAIiF.R, P.C. PO BOX 987 VALLEY FORGE, PA 19482 SfATF FAlM INSYRANClo Claim Number: 38J883182 Injured Party: JORDAN FLEnGLE Named lnaured: FLEnGLE, LnURA M &c DAVID E 618 F.RiC DR Date of Accident: 02/17/2002 SHIPPENSBURG, PA 17257 Claim Handler: Reithie E Crawford Phone: Payment Subtotals Category Amount 600 -Medical Payment 32,878.36 Medical Payments Coverage 32,878.36 Interest 2.64 State Farm Insurance Companies 08/25/201 t) Page I e ~x~% VV'r-LL-LUlU rtti UJ•lU nm itltiviLl+ llVJVV11111:u - tnu•1VIVVJTJTTL . ~, V ~ L i~7VUViKLV.7 (800) $64-9~45U (610) 8345553 (610) 834-5442; fax. ~ndividaa~y Designed SetNemeat for Jardaa e P'roposa~ 1 ~ MetLa#'e GuAnA1v~;~ED TAX-~"R~E BgiEY~Y'Y' Yl~D Atbur~y pees X25,000.00 ~ordaa k'kaple mate 48/13/19+95 M,anthlv.,, . X250.00 pca~ xaonth guaranteed 3 $9,000.00 yoazs star~.ng at agc 18 on $l13P2013 Mon ~nc~ome ~35~ 00 patmoath guaranteod 4 $16,800.04 years starting at age 21 on 8/13/2016 MoatMv t $51$.00 p4r gosraatoed 5 $31,484.00 years starting at age 2S on 8/I3/'2020 $50,000.00 at age 30 on 550,404,04 8J13lZQZS $13X,88(1.00 Total Cast: 5100,000.40 +~ VVL OlFce Corm at g-sItan Pout ~' 490 Ntywg Road, 5ui~ ZSI, ~e Bdl, PA 19422 Ott in Principal Citias Nesitonwide www:ringlRarassoc,iates.cam .... ( .. ' ~ ~ ' v. ~i, ^ Meti~fe, inc., ttuough its subsidiaries and affil'~ates, is a leading provider of insurance arnd other financial services to indiv~.ial and institutional customers. ^ Diversified sources of rFwerwe darived from serving both - institutions) and individual markets with a variety of products. ~; ~oclucNng the foilovving: Life Insurance, Annuities, i7isab~ity Income Insurance, Benefit Funding Sdutions, lnvestm+ent- ~ ; ; related Services and dental tnsurarxe.' ~ ^ f=inancial strength built and sustained through quaiity m ~ investments snd prudent risk management. as . ~ ~ ^ Mett.ife, Inc. toad 5501.7 billion in assets under management For aver t 40 years, ~- ° $' as of December 31, Z4U8. o ^ Metropolitan Life Insurance Company is a vvhdly ovmed MetLite fps been ~ n subsidiary of Metlife, Inc. - _._.. __ -~----.. ... ..._...__._.._--~---------- one of tfre country`s assFrs uNaAe Maw4~f:MEi>~ most trusted financial Metropolitan Life Ir-surante Company~s total assets uruier management aS of December 31, 2008. lnStltUtiOl15. ,, ~,AI L U 1 Ul tut: ! 1. J t ntri r nn tr V. t. U V Y ~~s. i I , PROFITABELCrY3` ^ As of December 31, 2008, Metropolitan Life M5urarl(:e Company's net gain fnxn operafror~ (after taxes and dividends) amounted to 3552 milllor-. ^ Operating expenses have remained essentially flat since 1990. CAPITAL" ' T~tai Capital As of Cecember 31, 2008, Metropolitan life Insurance Company's total capital vvas St 5.1 billion. 3 in billions :~ ]nvestsnent Reserves ~= Surplus 70 I--- -'..... .. i .. _-.._ ~-__.~~_, i _ _._.....__. ~ _....... . f ...16.4 _.'A._._-.-~ 15 ~.~.__... .. I .._ ~ i I _.. .. ~ . I 15.1 __ I i -____I_- ~ 12.4 i ~ .7 i 14._4 E I 10.5 j ] 1.i3 ' 11.4 I ~°'"-•~ i ' i ~-- - ~ ~ 10 `: ~p ' -;-.' . ~__; _.. g:~.......~.. 10.1. ~ _ ... ! '~ _. ~ {._: ... :, - ~ , I I:. ..~ -- ~ ~M .' ~ 5 . j i ~ ~ I i ~, ~ - I~ i j I I '. i C i ~ i ~ ~ i ~ i ~ I ' !n Q ~`--- -_°'-- .I. ..Lrl._ I ' ~ I ~ I r_ i 1_.___.-i.._. _ ....~ .__L~J_L___.._._.~ 1999 2004 2001 21107 2003 ZOQ4 2005 2006 2007 2008 L ~. `p ': ^ Total Capit2~ is comprised of Surplus and Investment Reserves. Metropolitan Life Insurance Company's v ~ Surplus totalled 311.6 WtGon as of December 31, 2008, vivhiie investment Reserves equalled 33.5 bAlion. ^ Metropolitan Life Insurance Company's Capital Adequacy Ratio (total capital :general account assets} was 6.7°+6 as of December 31, Zfl08. ^ As of December 3i, 2008, Mexropolitan Life Insurance Company's Risk Based Capital (RBC~ ratio was in excess of the level deemed requbraed by the National Association of Insurance Commissioners (NAIL). RBC is a measure which a8ows regula#ors to determine the suffiaency of an insurer~5 capital it light of its size and risk profile. FINANCIAL SOUNDNESSS AS O~ FC$1lUARY 27, 2009 Metropolitan Life Insurance Company's finatuia! strength and daims~paying ability continue w be rated °superior, ° "excellent" or "very strong" by the majorcredit-rating ageiicie.~ Moody'ss Aa2 (Excellent) ~. t~,.,~i st,~ Standard & Poor's' AA-Very Strong) ro-~~sa~~n. A.M_ Besi~ A~+ (Superior) ~+~+ancia~ u . Fitch' AA (Very Strom tort;nanciai std ~~~/ GRAHAM & MAUER, P.C. By: Lisa J. Mauer, Esquire ID # 65426 The Commons at Valley Forge Suite 7, P.O. Box 987 Valley Forge, PA 19482 (610) 933-3333 Attorney for Petitioners CUMBERLAND COUNTY COURT OF COMMON PLEAS In re: JORDAN FLEAGLE, a minor No. ~Q - 0~..3 ~t v c ~ E1Lr/'~ ~~~ L_ AND NOW, thisay of , 2009, upon consideration of the forgoing Petition, it is hereby ORDERED that the partial undisputed underinsured motorist settlement of this action for the amount of thirty thousand dollars ($30,000.00) is hereby approved, counsel fees and expenses are allowed and distribution is dictated as follows: TO: GRAHAM & HALTER, P.C. (for costs) $ 262.26 TO: GRAHAM & HALTER, P.C. (for counsel fees - 25%) $ 7,500.00 TO: JORDAN FLEAGLE, a minor - in a restricted account $22,237.74 until 3ordan Fleagle reaches the age of majority BY THE COURT: ,w~l,~a, q~aQ' ~..,. ~ ~'~3~~' ~~'~C~~I ~;~COR~ ...;~~,~~, t two un~ sit my harp ~ it~~ :,,,~+ ~y Wald at Cartlsle. Pa. ~~% nil. 21. 2~'^ 5:16pNf ~:'o. ~5~~ F. ? Wage: 1 Document Name: untitled rDDMAIN Time Deposit Display Main Acct 289559624 A ---------_--_--------____---------CRF WINTa4W---- - ~ J©RDAN FLEAGLE MINOR F COURT E?RDERED ACCT C 516 ERIC QR SHIPPENSBURG PA 172.57-$4a4 x ~~rz~ ~.0/20/~:0 ----------- ~------------- . vE Alpha-key FLEACJ..Q2 -- TIN 7.75-75-7835 IO Birth date 68fI3f~.995 3.1 Home phone. 71'7-477,8747 09 Work phone ooo-oao-6aoo ~ xa io A -------Account Holders----____ --Acct Rel-- _--_-_Time Deposit------ tag x JORDAN FLEAGLE ~'R,INIARY Branch oo~,S 9 ~; Q0 Officer d2a ~ 10 - Acct. class 03 R Sig locator A -------------------Customer Canm-ents----- ---------____ _~p_ _-Date---- I ~ COURT ORDER 413 FILE AT SFt 2$9 NQ WITHDRAWALS UNTIL BAS Q4/30/f}~3 L ; JORDAN REACHES THE AGE bF P4A.sTG~RITY HAS ~ 4 f 30 f ~ 9 T r C ~ C ~ F3=Exit EY 17 GRAHAM & MAUER, P.C. Attorney for Petitioners By: Lisa J. Mauer, Esquire ID # b5426 The Commons at Valley Forge Suite 7, P.O. Box 987 Valley Forge, PA 194$2 (610) 933-3333 CUMBERLAND COUNTY COURT OF COMMON PLEAS In re: JORDAN FLEAGLE, a minor No. CERTI~ICA~~ Off' SERVICE I, Lisa Mauer, Esquire, hereby certify that on this ~ day of _(~ L-'' • , 2010 a true and correct copy of the forgoing Petition fpr I,~ve to Compromise Minor's Action was sent via first class mail, postage prepaid to the following: Mary Bechman State Farm Mutual Automobile Insurance Company 1 State Faxm Drive P. O. Box 142 Concordville, PA 19331-0142 and Heather Bean All State Insurance Company 6345 Flank Drive, Suite 1000 Harrisburg, PA 17112 GRAHAM~& MAUER, P.C. By. ~ ~/!'~~~ Mau Attorney fo etitioners NOV 0 2 2010 GRAHAM & MAUER, P.C. Attorney for By: Lisa J. Mauer, Esquire (ID # 65426) Suite 7, P.O. Box 987 Valley Forge, PA 19482 (610) 933-3333 CUMBERLAND COUNTY COURT OF COMMON Irk re. JORDAN FLEAGLE, a minor No. 09-263 ORDER 7! -:3 AND NOW, this 3-,I day of N pv , 2010, upon consid ration of the foregoing Petition, it is hereby ORDERED that the settlement of this action for the amount of one hundred thirty thousand dollars ($130,000.00) is hereby approved, counsel fees and expenses are allowed and distribution is dictated as follows: TO: GRAHAM & MAUER, P.C. (for costs) TO: GRAHAM & MAUER, P.C. (for counsel fees - 25%) TO: JORDAN FLEAGLE, a minor - in a restricted account until Jordan Fleagle reaches the age of majority TO: JORDAN FLEAGLE, a minor in a structured settlement: Benefit Monthly Income $2.50.00 per month guaranteed 3 years starting at age 18 on Monthly Income $350.00 per month guaranteed 4 years starting at age 21 on Monthly In?, come $518.00 per month guaranteed 5 years starting at age 25 on Lump Sum $50,000 at age 30 on 8113/2025 0-0 l o f YYL? L F --F ?NI( BY THE COURT: $ 250.40 $32,500.00 $22,249.60 13 $ 9,000.00 16 $ 16,800.00 20 $ 31,080.00 $ 50,000.00 $106,880.00 J.