The URL can be used to link to this page

Home My WebLink About09-6025MICHAEL SMITH and MARY SMITH, ORPHANS' COURT as parents and natural guardians of CUMBERLAND COUNTY, PENNSYLVANIA CORRINA SMITH, a minor, Petitioners NO. Q - ?a C W CIVIL ACTION -LAW PETITION FOR COURT APPROVAL OF MINOR'S COMPROMISE AND NOW, come Petitioners, Michael Smith and Mary Smith (collectively hereinafter referred to as "Petitioners"), as parents and natural guardians of Corrina Smith ("Corrina"), a minor, to petition this Court for approval of a Minor's Compromise, pursuant to Pa.R.Civ.P. 2039, and aver the following in support thereof. 1. Petitioners and their daughter, Corrina, reside at 506 Darla Road, Mechanicsburg, PA 17055. 2. Corrina is currently nine (9) years of age, with a date of birth of January 29, 2000 and, as such, has not achieved the age of majority. 3. On or about April 9, 2006, Corrina Smith was on an exercise treadmill at the residence of David M. Armitage and Linda Armitage (the "Armitages"), 408 Darla Road, Mechanicsburg, PA 17055 when she accidentally fell on the treadmill. 4. Following her fall, Corona was momentarily caught between the treadmill and a wall while the treadmill continued to operate. 5. As a result of her fall, and subsequent entrapment, Corrina experienced an abrasion to her left-upper chest, shoulder and neck area. A copy of the April 9, 2006 Milton S. Hershey Medical Center Emergency Department Note and Problem Summary are attached hereto as Exhibit "A". 6. Cortina subsequently received a split-thickness skin graft from her left thigh to her left shoulder area at the Hershey Medical Center on May 19, 2006. A copy of the May 19, 2006 Milton S. Hershey Medical Center Operative Report is attached hereto as Exhibit "B". 7. Upon information and belief, Cortina has fully recovered from the abrasions she had experienced to her left-upper chest, shoulder and neck area, and there are no current complications resulting from the skin graft. However, Corrina may require plastic surgery to her clavicle area in the future to revise/minimize the residual affects of her injury. A copy of June 1, 2006 Pediatric Surgeons of Central Pennsylvania - Camp Hill Office Progress Notes are attached hereto as Exhibit "C". 8. All of Corrina's medical bills have been paid, and there are no outstanding medical bills arising out of Corrina's medical care. 9. It is anticipated that additional medical bills, not to exceed Twenty-Five Thousand Dollars ($25,000.00), will be incurred by Corrina in the future pursuant to her receipt of additional medical care and treatment arising from her injuries prior to reaching the age of majority. 10. The Armitages maintained a homeowner's policy of insurance with United Services Automobile Association ("USAA") as of April 9, 2006. 11. USAA has agreed to pay Corrina, and Petitioners have agreed to accept on Corrina's behalf, a lump sum of Twenty-Five Thousand Dollars ($25,000.00) from USAA in a single lump sum payment to be made within thirty (30) days of the Court's approval of this settlement in addition to the following payments to be made on Corrina's behalf in full and final settlement for Corrina's injuries arising out of the April 9, 2006 accident: $15,000.00 guaranteed lump sum, payable on January 29, 2018; 2 $20,000.00 guaranteed lump sum, payable on January 29, 2021; $25,000.00 guaranteed lump sum, payable on January 29, 2023; $30,000.00 guaranteed lump sum, payable on January 29, 2025; $35,000.00 guaranteed lump sum, payable on January 29, 2027; and $48,600.00 guaranteed lump sum, payable on January 29, 2030. 12. The decision to accept the foregoing payments in full and final settlement for Corrina's injuries is based upon the fact that Corrina has mostly recovered from her injuries, and the uncertainties associated with litigation. A copy of the proposed Release and Settlement Agreement is attached hereto as Exhibit "E". 13. Petitioners have agreed to accept payment of the foregoing sums on Corrina's behalf pursuant to a structured settlement administered by National Settlement Consultants as more particularly set forth at Exhibit "F". 14. Payment of $85,000 from United Services Automobile Association shall be structured through the purchase of an annuity from USAA Life Insurance Company, an "A++" rated life insurance carrier by A. M. Best Insurance Ratings Service. The payments will be guaranteed by USAA, as set forth in the proposed Release and Settlement Agreement. 15. In accordance with the Release and Settlement Agreement, USAA will fund the obligation to make the periodic payment(s) through the purchase of a "Qualified Funding Asset", as defined in Section 130(d) of the Internal Revenue Code of 1986, from USAA Life Insurance Company which will make the future periodic payments to Corrina Smith in accordance with the aforementioned schedule. 3 16. Any payment made after the death of Corrina Smith, pursuant to the terms of the Release and Settlement Agreement, shall be made to the Estate of Corrina Smith (unless a designated beneficiary is otherwise listed within these documents). After reaching the age of majority, Corrina Smith may submit a change of beneficiary in writing to USAA Life Insurance Company. The designation must be in a form acceptable to USAA Life Insurance Company. 17. Petitioners, Individually and as parents and/or natural guardians of Corrina Smith believe that this compromised settlement offer is fair and in Corrina's best interests. 18. Petitioners understand and approve of the Release and Settlement Agreement attached hereto as Exhibit "E". 19. Petitioners understand that by accepting the aforementioned settlement terms that they and Corrina forever relinquish any right they may have to later bring a lawsuit or claims against USAA, David M. Armitage, and/or Linda Armitage arising out of any injuries or damages suffered by Corrina as a result of the April 9, 2006 accident. 20. Petitioners also understand that the instant Petition and Minor's Compromise was drafted by counsel for USAA, and that said counsel does not represent Petitioners or Corrina. WHEREFORE, Petitioners, Michael Smith and Mary Smith, Individually, and as parents and natural guardians of Corrina Smith, a minor, respectfully request this Honorable Court to grant their Petition for Court Approval of Minor's Compromise, that they be authorized to enter into the Release and Settlement Agreement on behalf of themselves and Corrina for all liability and other insurance claims arising out of the April 9, 2006 accident, and that the sums set forth in the structured settlement included herein be paid by USAA to Petitioners, upon Petitioners executing a copy of the Release and Settlement Agreement Individually, and as the parents and/or natural guardians of Corrina Smith. 4 Date: ?- s /' oR By. ?A Michael Smith Date: By: mith :718951.1 5 USAA 7/24/2009 10:32:50 AM PAGE 8/024 Fax Server M nn State Nuuan 5. liersfiey Medical Center Penn State Collage of Medicine Health Information Service's, HU24 500 Utdvetssy Drive P.O. Box 850 Hershey, PA 170330850 Patient Name: SMrrK CORRINA A Patient Soot: Female Patient Location: EMER. Visit Type: Emergency P5UHMC MRN: 1273123 Date of Birth: 184/2000 Visit Number: 09075250 Tel: (717) 531-8055 I? T T n '1 '? P-1 .r1 !'1 E m e r g e n c y D e p a r t m e n t N o t e D o c u m e in t Final Document Electronically Signed by: Olympia, Robert P 4/1012006 3:15:43 PM ED SUMMARY Name: SMITH, CORRINA A HMC Number: 1273123 DOB: 01 /29/2000 Date of Service: 04/0912006 CHIEF COMPLAINT: Chest abrasion. HPI: This is a 6-year-old Caucasian female with no significant past medical history who, this afternoon while she was on a treadmill, accidentally fell and sustained an abrasion to her anterior chest. She denies any difficulty breathing or shortness of breath. She suffered no other injuries. No head injury, no loss of consciousness, no amnesia to the event, no abdominal pain, no vomiting, no diarrhea. REVIEW OF SYSTEMS: Otherwise negative. PAST MEDICAL HISTORY: None. MEDICATIONS: None. ALLERGIES: No known drug allergies. FAMILY HISTORY: Noncontributory. SOCIAL HISTORY: The family lives in Mechanicsburg, PA. PHYSICAL EXAM: Temperature is' 36.1, heart rate 101, respiratory rate 20, sating 99% in room air. In general, she is awake, alert, in no respiratory distress. Normocephalic, atraumatic. Cranial nerves II through XII are intact. She has no facial, maxillary, or mandibular tenderness. She has full range of motion about her neck. She has no midfine neck tenderness. Lungs are clear. Heart is regular without murmurs. Abdomen is benign. Extremities are well perfused. Capillary refill is less than 2 seconds. Neurologic exam is nonfocal. Her skin exam reveals an extensive superficial abrasion to her anterior chest that extends from her mid-neck to the nipple line. There are areas that are marked with particles of dirt or surface of the treadmill. There is no active bleeding. There is no chest crepitus. There is no Date Panted- 712311009 Time Printed- 4:14 PM USAA Confidential USAA 7/24/2009 10:32:50 AM PAGE 9/024 Fax Server PENNSTATE ® Milton S. Hershey Medical Center College of Medicine A i S 01 ? ""? y NAME: SMITH, CORAINA A MD: FAGELMAN KERRY M MDM: 26090 URO: 1273123 DOB: 01/2912000 SEX: F INS: BLUE CROSS OUT OF BOS WIALPHA LOG: ERF DOW 9eD121B VISIT DATE: 06/05/2006 RECORD # PROBLEM SUMMARY PATIENT NAME: Known Allergies: KNOWN SIGNIFICANT MEDICAL DIAGNOSIS AND CONDITIONS FROBLEM, SIGN PROBLEM SIGN PROBLEM SUMMARY KNOWN SIGNIFICANT OPERATIVEIINVASIVE PROCEDURES PROCEDURE PROCEDURES SIGN DATE L Y- f" h& D JL4 C S-' MR 96 (REV 3106) Page f of f 110111111111111111111111111111 JSAA 7/24/2009 10:32:50 AM PAGE 10/024 Fax Server ACTIVE (ONGOING) PROBLEMS A i s. 01 211 2009 i ,? ????!Ef(1t??IlEi? ALLERGIES NAME ?DI"ll 1'I ft 1 'f /Yl i l?I BIRTHRATE 113 -73J 1? 3 DATE ' - - - CODE DATE PROBLEM DESCRIPTION RESOL RESOLUTION i I (,! ICi.E. University Physicians Group ACTIVE PROBLEMS 101 Erford Road, Suite 101 Camp Hill. PA 17011 F X A ; ?', ? ,B USAA 7/24/2009 10:32:50 AM PAGE 4/024 Fax Server Penn State Milton S. Hershey Medical Center Pear State College of Medicine Health Information Services, HU24 500 Utdveraity Drive P.O. Box 950 Hershey, PA 17033-0950 Patient Name: SMITH, CORRINA A Patient Sex: Female Patient Location: 2EAS, 2000, 15 Visit Type: Some Day Cate PSUHMC MRN: 1273123 Date of Birth: 1292000 Visit Number: 07129696 Tel: (717) 531-8055 T-i 1 v L r- 'C b W V 1O p e r a t I v e N o t a D o c u m e n t Final Document Electronically Signed by: Fagelman, Kerry M OPERATIVE REPORT Name: SMITH, CORRINA A HMC Number: 1273123 DOB: 01/29/2000 Date of Service: 051912006 SURGEON: Kerry Fagelman ASSISTANT(s): Theodore Foley PREOPERATIVE DIAGNOSIS: Full-thickness skin abrasion left shoulder. POSTOPERATIVE DIAGNOSIS: Same. 5/22!2006 3:35:06 PM OPERATION PERFORMED: Split-thickness skin graft from left thigh to left shoulder area. ANESTHESIA: General. INDICATIONS: The patient is a 6-year-old female who over a month ago fell on a treadmill and was caught between the wall and the treadmill suffering a severe abrasion injury to the left upper chest, shoulder, and neck area. This has been treated with Silvadene applications twice a day with complete healing of all but an area of 4 x 1 to 1.2 cm in size over the area of the medial left clavicle. Significant overgrowth of granulation tissue has developed at this site, and in order to get complete healing, it was recommended that the granulation tissue be excised and a split-thickness skin graft be taken from the left thigh to this area. She was brought into the hospital at this time for the procedure. OPERATION: With the patient in the supine position, the head extended and turned to the right, the left shoulder area and left thigh were prepped and draped in the usual fashion. Using *a Goulian knife; the granulation tissue was excised from the area of the injury down to a site level with the skin adjacent to it. The bleeding from the bed was controlled by application of epinephrine solution soaked gauze, 1:200,000. This effectively achieved hemostasis except at the upper edge which was cauterized in order to achieve good hemostasis. At this point, attention was directed to the left thigh which was cleansed with alcohol and then mineral oil was used to lubricate the site. A Zimmer dermatome set to O.OOB of an inch thickness was used to take a graft 4 cm wide and only about 1 to 1-114 cm long. This proved to be the exact size necessary to cover the injured site. The donor site was also treated with a 1:200,000 concentration heparin solulion. The Dare Printed- 112312009 7nne Printer 4:13 PM USAA 7/24/2009 10:32:50 AM PAGE 5/024 Fax Server rautlmLI NOUN: 1G/s12S O p e r a t i v e N o t e D o c u m e n t Flnat Docurocnt Electronically Signed by: Fagelman, Kerry M 512212006 3.35:06 PM r. C' 4-..s graft was placed on a 1.5:1 meshing device and was meshed to that ratio. 11 was then placed on the injured site and anchored along its edges with interrupted simple sutures of 6-0 Vicryl. A small piece was trimmed and placed back on the donor site. The donor site was covered with a semipermeable membrane. The skin graft site was also covered by a semipermeable membrane which was perforated over the skin graft so that fluid could be expressed from underneath the membrane onto a covered gauze dressing. The she was then dressed with fluffs, and then a Kertix wrap was done over the shoulder and around the chest, also used to anchor the left arm to the chest to prevent movement. This was then covered with a 6-inch Ace. A Kerlix was also used to wrap the left thigh and around the waist to hold it in place, and this was used to protect the semipermeable membrane. She tolerated the procedure well. I was present throughout the entire length of the operation, and she was resumed to the recovery room in satisfactory condition. 187847 Review/Sign: Kerry M Fagelman, MD Pediatric Stugery: Drs. Robert Cilley, Peter Dillon, Andreas Meier, Kerry Fagelman, Brett Engbrecht Coleen Crreecher MS RD CNSD, Janet Shields MSN CRNP CS Hershey 717-531-8342 Hbg/Xork 717-920-5200 KMF /VEH DD: 05/19106 DT: 05/19/06 20:29 Date Printed- 2/2312009 Time Printed: 4:13 PM USAA Confidential Exh,Ljl? C. USAA 7/24/2009 10:32:50 AM PAGE 18/024 Fax Server Pediatric Surgeons of Central Pennsylvania - Camp Hill Office Progress Note Patient: COkRINA A SMITH Visit Date: 06-01-2006 Birth Date: 0112912000 Date of Injury: 04-09-2006 Referring Phyahiaw: Kevin Barges, M.D. SUWPkMVE: The patient is a 6 year old female seen in follow up SIP skin grafting of a burn on the left chest. She was seen for follow up at HMC last week. At that time the graft looked excellent and the donor site was still covered. Soon after that dressing came off. They have been applying cocoa butter to the skin. The graft site has a few small areas of scabs, PAST SURGICAL HISTORY: Skin grafting oft burn on the left chest 5/19106. OBJECTIVE: ABDOMEN: Umbilical hernia with 1 cm umbilical fascial defect. SKIN: The donor site is completely healed and looks excellent. The graft is well healed but has three small areas of scab formation indicating some loss of epithelium, ASSESSMENT: #1. S/P skin grafting of a burn on the left chest #2. Umbilical hernia PLAN: The scabbed areas of the graft should heal spontaneously in the next 7.10 days. Continue the use of cocoa butter or lanolin containing skin cream if healed skin is dry and flaking. Anticipate this wil I be necessary for several months and then as needed. Full activity can be resumed with no restrictions. Plan for umbilical hemiorrhaphy as an outpatient. They desire that this be done in the fill. RISKS: Umbilical Hemiorrhaphy Risks: The risks including but not exclusive of infection and recurrence were discussed. try Fagdiaan. M.D. DWI/2M 3:37 PMM- Ex hob; t 1 JSAA 7/24/2009 10:32:50 AM PAGE 13/024 Fax Server 1 77"111 :'l-r 1 t 1 U ?+ Pediatric Surgeons of Central Pennsylvania - Camp Hill Office Progress Now Patient: CORRINA A SMITH Birth Date: 01129/2000 Primary Provider: Kevin Barnes, M.D. Visit Date: 07-03-2008 Date of Injury: 04-09.2006 SUBJECTIVE: The patient is a 8 year old female seen in follow up S/P umbilical hernia repair with epigastric hernia repair. The discomfort after the surgery was mmimal. Currently the pain has completely resolved. The pain lasted 2 days. The patient has remained at restricted activity. The incision area has remained dry. PAST SURGICAL HISTORY: Skin grafting of a bum on the left chest 5/19/06. Umbilical hernia repair with epigastric hernia repair, 6/24/08. OBJECTIVE: ABDOMEN: The umbilical hernia site is healing well, with good skin and fascial approximation, without inflammation, without drainage and with normal induration. The epigastric site is palpable beneath the skin and there is no clinical evidence of the hernia. (No fascia] defect was identified at surgery and it was felt to be attenuation of the lines alba.) ASSESSMENT: #1. S/P umbilical hernia repair with epigastric hernia repair with excellent post operative recovery. PLAN: No special care is required. Full activity can be resumed without restrictions. Follow up as needed. -), erry Fagelman. M:D. 07M3f100a 9:M AMkd-aw c xti,b;? F RELEASE AND SETTLEMENT AGREEMENT 1. RELEASE AND SETTLEMENT A. The UNDERSIGNED, Corrina Smith, a minor, by and through Michael Smith and Mary Smith, parents and natural guardians of Corrina Smith, and Michael Smith and Mary Smith, individually, and in their own right (collectively "CLAIMANTS"), on this day of , 2009, for and in consideration of the sum of Twenty-Five Thousand Dollars and Zero Cents ($25,000.00) representing an initial lump sum cash payment, paid to us by United Services Automobile Association (USAA) ("INSURER") within thirty (30) days of Court approval of the settlement, and the payment of the sum of Eighty-Five Thousand Dollars and Zero Cents ($85,000.00) to fund the periodic payments as provided for in Section 104, Subsection (a)(2) of the Internal Revenue Code of 1986, as amended, specified in Section II, paragraph F of this AGREEMENT, which INSURER contracts and agrees to pay or cause to be paid to the persons or entities named in Section II, paragraph G, the receipt and legal sufficiency of all of which are expressly acknowledged, do hereby forever RELEASE, ACQUIT AND DISCHARGE the above INSURER, David M. Armitage, Linda Armitage, and any and all of their parents, predecessors, successors, subsidiaries, insurers, present and former servants, agents, attorneys, directors, officers, claims adjustors, employees, assigns, and shareholders, and all other persons, firms, or corporations, both jointly and severally, and any person or entity related thereto, (hereinafter collectively the "Released Parties") from any and all claims, demands, liability, actions, causes of action, suits, costs, attorney's fees, damages, expenses, compensation, and liens or other obligations of every kind, character, and description, either direct or consequential, at law or in equity, including expenses incurred or to be incurred, which the undersigned, their respective heirs, administrators, executors and assigns, may now have, whether known or unknown, including, but not limited to, those which the undersigned may now have, may have had at any time heretofore or may have at any time hereafter individually, or as parents and natural guardians of Corrina Smith, arising out of or in any way based upon any act, omission, transaction, occurrence relating to, or incidental to, injuries or damages involving Claimants or the Released Parties on or about April 9, 2006 at or near 408 Darla Road, Mechanicsburg, PA 17055 (the "Described Occurrences"). B. THIS RELEASE IS INTENDED TO AND DOES COVER ALL CLAIMS FOR INJURIES AND/OR DAMAGES, WHETHER OR NOT KNOW TO THE PARTIES AT THE TIME THIS SETTLEMENT AGREEMENT IS EXECUTED, WHICH HAVE RESULTED, MAY HEREAFTER RESULT FROM, MAY HAVE BEEN, OR MAY BE CLAIMED TO HAVE BEEN CAUSED BY OR RESULTED FROM THE DESCRIBED OCCURRENCES. C. As additional consideration for the described payments, CLAIMANTS, for themselves/their heirs, executors or administrators, and assigns, agree to and do indemnify and hold harmless INSURER and all others released by this AGREEMENT from any and all claims, demands, and causes of action of any nature or character which have been made, or which may in the future be made by any person, firm or corporation claiming by, through or under them, including, but not limited to, all hospital, medical or other expenses or liens which are or could be asserted. II. PERIODIC PAYMENTS A. Notwithstanding any other provision of this AGREEMENT, INSURER is and will remain contractually responsible for all periodic payments under this AGREEMENT. B. INSURER agrees that CLAIMANTS (to whom, or upon whose behalf, the periodic payments contracted for in the AGREEMENT are to be made) made claims against INSURER for damages arising from or involving physical injuries or physical sickness. Those claims, among others, are being released and settled by this AGREEMENT. C. The Parties further agree that all periodic payments specified in Section II, paragraph F, of this AGREEMENT are being funded by the purchase of a "Qualified Funding Asset," as defined in Section 130(d) of the Internal Revenue Code 1986, from USAA Life Insurance Company, which will provide for payment of the periodic payments. INSURER will be the sole owner of the "Qualified Funding Asset". INSURER guarantees that the periodic payments will be made as specified in the PERIODIC PAYMENT SCHEDULE. CLAIMANTS acknowledge that USAA Life Insurance Company is an affiliate of INSURER and that, because of this affiliation, an indeterminate profit might eventually inure to the benefit of the INSURER. D. Claimants agree: (1) that Insurer is not required to set aside specific assets to secure the periodic payment; (2) that the periodic payments cannot be accelerated, deferred, increased or decreased by Claimants; and (3) that the periodic payment(s) shall not be, and cannot be, subjected in any manner to sale, transfer, assignment, pledge, mortgage, encumbrance, lien, collateral, or any similar transaction. Any attempted sale, transfer, assignment, pledge, mortgage, encumbrance, lien, collateral, or similar transaction is void. E. Claimants shall have no legal, equitable, vested, or contingent interest in the "Qualified Funding Asset" and their rights against Insurer, the company from whom the "Qualified Funding Asset" is purchased, or against the "Qualified Funding Asset" will be solely those of a general creditor. F. PERIODIC PAYMENT SCHEDULE: $15,000.00 guaranteed lump sum, payable on January 29, 2018; $20,000.00 guaranteed lump sum, payable on January 29, 2021; $25,000.00 guaranteed lump sum, payable on January 29, 2023; $30,000.00 guaranteed lump sum, payable on January 29, 2025; $35,000.00 guaranteed lump sum, payable on January 29, 2027; and $48,600.00 guaranteed lump sum, payable on January 29, 2030. G. THE PERIODIC PAYMENT(S) WILL BE MADE PAYABLE TO: Corrina Smith. H. Any periodic payments to be made after the death of Claimant, Corrina Smith, under this Settlement Agreement will be made to the Estate of Corrina Smith, as designated at the time of settlement (or in writing from time to time thereafter by the guardian of said Claimant 2 with Court Approval) by said Claimant, upon attaining the age of majority, and delivered to insurer. If no person or entity is designated by said Claimant, or if the person or entity designated is not living at the time of said Claimant's death, the payment will be made to the Estate of said Claimant. I. All sums set forth herein constitute damages on account of personal physical injuries or physical sickness, within the meaning of Section 104(a)(2) of the Internal Revenue Code of 1986, as amended. J. Discharge of Obligation: The obligation of the Insurer to make each Periodic Payment shall be discharged upon the mailing of a valid check in the amount of such payment to the designated address of each Payee named in Section II of this Release, or by deposit by electronic funds transfer in the amount of such payment to an account designated by each Payee identified in Section II. III. GENERAL PROVISIONS A. It is expressly understood and agreed that this settlement is a compromise of a disputed claim, that the payments provided for may not be construed as an admission of liability by the Released Parties, and that the Released Parties expressly deny any liability to Claimants. B. Claimants covenant that no representations or promises other than those expressed in this Settlement Agreement have been made to them in regard to this settlement, that they have carefully read and fully understand this Settlement Agreement, and that they understand that upon execution of this Settlement Agreement, all rights, claims or demands Claimants may have against the Released Parties, except the contract to make periodic payments included in this Settlement Agreement, are completely extinguished. C. This Settlement Agreement is to be construed and interpreted under the laws of the Commonwealth of Pennsylvania. Any person who, with intent to defraud or knowing that he/she is facilitating a fraud against an insurer, submits an application or files a claim containing a false or deceptive statement is guilty of insurance fraud. EXECUTED BY ALL PARTIES as of the date first stated above. CLAIMANT: WITNESS: Michael Smith, Individually, and as parent and natural guardian of Corrina Smith, a minor 3 CLAIMANT: Mary Smith, Individually, and as parent and natural guardian of Corrinna Smith, a minor WITNESS: INSURER: United Services Automobile Association Name Title EXECUTED at , this _ day of 52009. 718383.1 4 ,- .?;fi F ? ?ti SETTLEMENT CONSULTANTS Individually Designed Settlement Corrinna Smith D/O/B 1/29/00 GUARANTEED BENEFIT COST YIELD Immediate Cash $25,000 $25,000 Guaranteed Lump Sums $ 15,000 at Age 18 11,174 15,000 $ 20,000 at Age 21 11,920 20,000 $ 25,000 at Age 23 13,374 25,000 $ 30,000 at Age 25 14,425 30,000 $ 35,000 at Age 27 15,403 35,000 $ 48,600 at Age 30 18,704 48,600 $110,000 $198,600 The enclosed figures are for illustrative purposes only and should not be construed as a contract. All figures are valid for 7 days from today's date and are subject to approval by the life carrier prior to contract issuance. Please contact our office to verify figures prior to court approval as the figures are time-sensitive and vary upon funding dates. SETTLEMENTCONSULTANTS.COM 800-229-2228 r , r .?y OF THE 4.7J J ? ? ? y . yj +r($, 60 po ATM Cie it 151313 pr* a3o Ito8 t t MICHAEL SMITH and IN THE COURT OF COMMON PLEAS OF MARY SMITH, as parents CUMBERLAND COUNTY, PENNSYLVANIA and guardians of CORRINA SMITH, a minor NO. 2009 - 6025 CIVIL TERM ORDER OF COURT AND NOW, this 14TH day of SEPTEMBER, 2009, a hearing on the "Petition for Court Approval of Minor's Compromise" is scheduled for THURSDAY, SEPTEMBER 24, 2009, at 3:30 p.m. in Courtroom # 3. We are specifically interested in discovering why the $25,000.00 payable now should not be placed in a restricted account. Michael Smith 506 Darla Road Me hanicsburg, Pa. 17055 Marc A. Moyer, Esquire 305 North Front Street P.O. Box 999 Harrisburg, Pa. 17108-0999 _,,Il?an Vickovic National Settlement Consultants 4 Gateway Center Suite 425 Pittsburgh, Pa. 15222 :sld lip I 9// A Edward E. Guido, J. Fi1. HS V(..f..l'4J 4.. C)F THE cw;.,,t7;AR?' 2009 SEP 14 PH !": ;: MICHAEL SMITH and MARY SMITH, ORPHANS' COURT as parents and natural guardians of CUMBERLAND COUNTY, PENNSYLVANIA CORRINA SMITH, a minor, Petitioners NO. 09-6025 - CIVIL TERM : CIVIL ACTION -LAW MOTION FOR CONTINUANCE OF HEARING AND NOW, comes counsel for David M. Armitage and Linda Armitage, to file this Motion for Continuance of the September 24, 2009 hearing and, in support thereof, avers as follows: On September 3, 2009, Petitioners Michael and Mary Smith filed a Petition for Court Approval of Minor's Compromise. 2. By Order dated September 14, 2009, the Court scheduled a hearing on the Petition to be held at 3:30 p.m. on September 24, 2009. Undersigned counsel is scheduled to attend a series of depositions in Huntingdon County on September 24, 2009 which have been rescheduled on several occasions in separation litigation, and which require undersigned counsel's attendance due to the technical nature of the subject matter. 4. Due to undersigned counsel's inability to attend the September 24, 2009 hearing, and inability to reschedule the September 24, 2009 depositions, undersigned counsel respectfully requests that the September 24, 2009 hearing be rescheduled to a date upon which Petitioners and undersigned counsel are available. WHEREFORE, undersigned counsel respectfully requests that this Honorable Court reschedule the September 24, 2009 hearing for a date upon which Petitioners Michael Smith and Mary Smith, and undersigned counsel are available. Respectfully submitted, THOMAS, THOMAS & HAFER, LLP Date: 1, 1 c A. Attorney I. o.: 76434 305 North front Street, 6t' Floor P.O. Box 999 Harrisburg, PA 17108 717-441-3960 mmoyer@tthlaw.com 2 CERTIFICATE OF SERVICE ih On this '? day of September, 2009, I, Jennifer L. Deitch, a legal secretary with the law firm of Thomas, Thomas & Hafer, LLP, hereby certify that I have, this day, served a true and correct copy of the MOTION FOR CONTINUANCE OF HEARING OF PETITIONERS MICHAEL SMITH AND MARY SMITH document upon the person(s) and at the address(es) below named by United States First Class Mail, postage prepaid, in Harrisburg, PA: David and Linda Armitage 408 Darla Road Mechanicsburg, PA 17055-6659 Dan Vickovic National Settlement Consultants 4 Gateway Center, Suite 425 Pittsburgh, PA 15222 Michael Smith 506 Darla Road Mechanicsburg, PA 17055 Honorable Edward E. Guido Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013-3387 J er nDe "h- :734869.1 3 f 1_?wi?? ile'.r r" l F' "t 2009 SEA' 16 ?I? D 3 MICHAEL SMITH and MARY SMITH, as parents and natural guardians of CORRINA SMITH, a minor, Petitioners ORPHANS' COURT CUMBERLAND COUNTY, PENNSYLVANIA : NO. 09-6025 - CIVIL TERM : CIVIL ACTION -LAW ORDER AND NOW, this,;'A' day o 2009, upon consideration of the Motion for Continuance of Hearing, it is hereby ORDERED and DECREED, that the Motion is GRANTED, and that the hearing in this matter is rescheduled for the /May of October, 2009. 070N.44), A -In* E. Ghido, J. 734871.1 D. tribution List: arc A. Moyer, Esquire, Thomas, Thomas & Hafer, LLP, 305 N. Front Street, P.O. Box 999, Harrisburg, PA 17108 avid and Linda Armitage, 408 Darla Road, Mechanicsburg, PA 17055-6659 ./"Pan Vickovic, National Settlement Consultants, 4 Gateway Center, Suite 425, Pittsburgh, PA 15222 Michael Smith, 506 Darla Road, Mechanicsburg, PA 17055 ?/.z (41,C)? 12, 0-ts OF TIE: 2009 SEP 24 Pik 2: 41 CtiP ,, X"! Y ?_1r; MICHAEL SMITH and MARY SMITH, as parents and guardians of CORINNA SMITH, a minor IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 2009-6025 CIVIL TERM ORDER OF COURT AND NOW, this 19th day of October, 2009, at the request of the Petitioners, the petition is deemed withdrawn. By the ourt, Edward E. Guido, J. /hael and Mary Smith 506 Darla Road Mechanicsburg, PA 17055 Marc A. Moyer, Esquire 305 North Front Street P.O. Box 999 Harrisburg, PA 17108-0999 / an Vickovic Nationwide Settlement Consultants 4 Gateway Center Suite 425 Pittsburgh, PA 15222 :mlc nn iEs ?(-)/01 (e /?? tec OF 4w-waNDORY MY 26 AN 8: 27 PEMM" MICHAEL SMITH and IN THE COURT OF COMMON PLEAS OF MARY SMITH, as parents and :CUMBERLAND COUNTY, PENNSYLVANIA Natural guardians of CORRINA SMITH, a minor, NO. 2009 - 6025 CIVIL TERM Petitioners CIVIL ACTION -LAW ORDER OF COURT AND NOW, this 11TH day of MAY, 2010, a hearing on the Petition for Court approval of Minor's Compromise is scheduled for THURSDAY, MAY 20, 2010, 11:00 a.m. in Courtroom # 3. By u , Edward E. Guido, J. / Michael Smith Mary Smith 506 Darla Road Mechanicsburg, Pa. 17055 /Marc A. Moyer, Esquire 305 North Front Street P.O. Box 999 Harrisburg, Pa. 17108 /Dan Vickovic National Settlement Consultants 4 Gateway Center Suite 425 Pittsburgh, Pa. 15222 sld //. s/~3/~ =-~ ~ ~ ~ 0 ~ ~ ~ ~_ --~ .~ r.:"~ -- r~ «~ .~ w ~ ~~ ~ ~ r~ ~ '~` ar MICHAEL SMITH and MARY SMITH, as parents and natural guardians of CORRINA SMITH, a minor, Petitioners ORPHANS' COURT CUMBERLAND COUNTY, PENNSYLVANIA NO. 09-6025 -CIVIL TERM CIVIL ACTION -LAW ORDER AND NOW, this day of July, 2010, upon consideration of the Petition for Court Approval of Minor's Compromise, it is hereby ORDERED and DECREED: 1. The settlement in favor of Corrina Smith is hereby approved. 2. Petitioners are hereby directed to sign any and all documents in order to effectuate said settlement, including the Release and Settlement Agreement attached to Petitioners' Petition as Exhibit «D» 3. Within thirty (30) days of its receipt of the signed Release and Settlement Agreement, USAA is directed to pay the sum of $10,000.00 to Michael Smith and Mary Smith as parents and legal guardians of Corrina Smith who, upon receipt of said funds, shall deposit the $10,000.00 into a restricted account for the sole benefit of Corrina Smith where it shall remain until Corrina Smith ,~,~y~ ea ei hteen 18 ears of a e or until rely a earli~~e,~rb.~ an~ Order of this Court. ~- - U- 4. USAA shall, thereafter, m e payment of the settlement proceeds in accordance with ~ • the schedule set forth in Section II.F. of the Release and Settlement Agreement attached to Petitioners' Petition as Exhibit "D", in full and final settlement of any and all claims against David M. ~nitage, J -_ cis '_~7 Linda Armitage and USAA. ~='-~ t-- =~ -, 5. No additional accounting will be req ' ~_ ~, - ~:- _,., _ - - ~~ ,. ._ ~~ f ,:_: r..~ ~: c: ~ =-c J. :806104.1 7~7~~~ ~~