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HomeMy WebLinkAbout01-0731HELEN M. JONES Plaintiff V. GENERAL ELECTRIC CAPITAL ASSURANCE COMPANY Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW No. r31 - NOTICE YOU HAVE BEEN SUED IN COURT. If you wish to defend against the claims set forth in the following pages, you must take action within twenty (20) days after this Complaint and Notice are served, by entering a written appearance personally or by attorney and filing in writing with the Court your defenses or objections to the claims set forth against you. You are warned that if you fail to do so the case may proceed without you and a judgment may be entered against you by the Court without further notice for any money claimed in the Complaint or for any other claim or relief requested by the Plaintiff. You may lose money or property or other rights important to you. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. LAWYER REFERRAL SERVICE CUMBERLAND COUNTY BAR ASSOCIATION 2 Liberty Avenue Carlisle, PA 17013 717-249-3166 HELEN M. JONES, Plaintiff GENERAL ELECTRIC CAPITAL ASSURANCE COMPANY, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW COMPLAINT NOW COMES plaimiff, Helen M. Jones, by and through her attorneys, The Law Firm of May & May, P.C., and files the following complaint, averring as follows: 1. Plaintiff is Helen M. Jones ("Mrs. Jones"), an adult individual whose residence is Messiah Village, 100 Mount Allen Drive, Mechanicsburg, Cumberland County, Pennsylvania, 17055. 2. Defendant is General Electric Capital Assurance Company ("GE Capital"), a Deleware business corporation with a principle place of business located at 1650 Los Gamos Drive, San Rafael, Marin County, California, 94903. 4. policies. 5. GE Capital regularly conducts business in Cumberland County. GE Capital is engaged in the business of providing long term care insurance Mrs. Jones was bom on September 1, 1916. 6. On or about December 4, 1990, at the age of 74, Mrs. Jones applied for Nursing Home Indemnity Insurance, with a daily benefit of $50.00 per day (with five percent annual increases until age 85) underwritten by AMEX Life Assurance Company ("AMEX"), 1650 Los Gamos Drive, San Rafael, California 94903, through AMEX's licensed sales agent, Lois J. Valencia. A copy of the policy is attached as Exhibit 1 (hereinafter referred to as the "Policy"). 7. The Policy sold to Mrs. Jones on or about December 4, 1990, replaced long term care policy no. PL0646971A issued by Pioneer Life Insurance Company with a daily benefit of $50.00 per day. 8. The Policy was approved by AMEX with an effective date of February 1, 1991, issued as policy no. HFN6406180. 9. On or about June 30, 1996, AMEX merged with and into GE Capital. As a result of this merger GE Capital assumed all of the fights and obligations under the Policy. AMEX was previously a wholly-owned subsidiary of GE Capital. 10. On or about May 20, 1998, Mrs. Jones suffered a stroke and was admitted to Hershey Medical Center in Hershey, Pennsylvania, where she was treated for approximately 21 days. 11. On or about June 10, 1998, Mrs. Jones was discharged from Hershey Medical Center and admitted to Health South Mechanicsburg Rehab Center in Mechanicsburg, Pennsylvania, where she was treated for approximately 86 days. 12. On or about September 4, 1998, Mrs. Jones was discharged from Health South Mechanicsburg Rehab Center and admitted to the William Penn Wing of Country Meadows of West Shore, II, in Mechanicsburg, Pennsylvania, where she was treated for approximately 289 days. 13. On or about June 20, 1999, Mrs. Jones was discharged from the William Penn Wing of Country Meadows of West Shore, II, and admitted to Outlook Pointe at Creekview in Mechanicsburg, Pennsylvania, where she has been treated for approximately 353 days. 14. On or about June 8, 2000, Mrs. Jones was discharged from Outlook Pointe at Creekview and admitted to Messiah Village in Mechanicsburg, Pennsylvania, where she has been treated ever since. 15. GE Capital allowed coverage of Mrs. Jones claims under the Policy for her stays at Health South and Messiah Village but denied coverage for her stays at Country Meadows and Outlook Pointe. 16. At each of Health South, Country Meadows of West Shore, II, Outlook Pointe at Cmekview, and Messiah Village, Mrs. Jones met the requirements of the Policy, namely: she required assistance with all activities of daily living, including dressing, bathing, walking, taking medication, grooming, personal laundry and toileting. Mrs. Jones medical diagnosis included dementia, aortic stenosis and diabetes mellitus, at all times from the date of admission to Health South through the present. 17. Each of Health South, Country Meadows of West Shore, II, Outlook Pointe at Creekview and Messiah Village meet the requirements of the Policy, namely: they are licensed by the Commonwealth of Pennsylvania, have a nurse or doctor on call 24 hours a day, have formal arrangements for the services of a doctor or nurse for medical emergencies, have an awake, trained and ready-to-respond employee on duty at all times, provide three meals a day, accommodate special dietary needs, maintain clinical records on each patient, and have methods and procedures for handling and administering drugs and biologicals. 18. Mrs. Jones, through her attorney-in-fact, Daniel M. Jones, her son, with the assistance of Lois J. Valencia, GE Capital's agent who sold the Policy to Mrs. Jones, applied to GE Capital for benefits under the Policy for both Country Meadows of West Shore, II, and Outlook Pointe at Creekview, as required under the policy, and appealed denials of coverage, exhausting all avenues of relief available through GE Capital. 19. GE Capital denied appeals of coverage of Mrs. Jones' claims for long term care benefits under her policy in letters dated October 27, 1999, and November 1, 1999, respectively, stating the wrongful and erroneous reasoning that the Commonwealth of Pennsylvania licenses under which the subject facilities operated excluded such facilities from the Policy coverage. 20. Mrs. Jones' attorneys, The Law Firm of May & May, P.C., by letters dated December 1, 1999, and April 28, 2000, respectively, asked GE Capital to reverse the denial of benefits and explained to GE Capital its wrongful and erroneous reasoning under Pennsylvania law pertaining to insurance coverage. 21. GE Capital, in letters dated January 6, 2000, and June 1, 2000, respectively, repeating the wrongful and erroneous reasoning that the Policy does not cover the subject licensed personal care facilities, continued to deny coverage of Mrs. Jones under the Policy. 22. At all times pertinent hereto, Mrs. Jones was eligible for coverage under the Policy, and has supplied all information requested or required by GE Capital to establish Mrs. Jones eligibility for and right to benefits thereunder. 23. Mrs. Jones meets all requirements of the aforesaid Policy and is entitled to benefits thereunder. 24. GE Capital's denial of benefits to Mrs. Jones under the Policy, and GE Capital's continual refusal to pay such benefits, is wrongful, erroneous, inconsistent with the provisions of the Policy, and constitutes a breach of the terms and provisions of the aforesaid Policy. 25. GE Capital's denial of Mrs. Jones application, and continued refusal to pay Mrs. Jones the benefits to which she is entitled under the Policy, constitutes bad faith. 26. Mrs. Jones is entitled to recover all unpaid benefits under the Policy, costs, expenses and reasonable attorney's fees. WHEREFORE, plaintiff Helen M. Jones, requests this Honorable Court to enter judgment in its favor and against defendant General Electric Capital Assurance Company, for all sums to which she is due and owing under the aforesaid Policy, together with costs, expenses and reasonable attomey's fees, and such other and further relief as is just under the circumstances. Respectfully submitted, THE LAW FIRM OF MAY& MAY, P.C. Dated: ~-o~L~t'~e7 I / ~ I By Robert C. May Attorney I.D. #65602 3438 Trindle Road Camp Hill, PA 17011 717-612-0102 Attorneys for Plaintiff VERIFICATION The undersigned, DANIEL M. JONES, hereby verifies and states that: 1. He is Attorney-In-Fact for Helen M. Jones, plaintiff herein. 2. He is authorized to make this verification on her behalf; 3. The facts set forth in the foregoing complaint are true and correct to the best of his knowledge, information and belief; and 4. He is aware that false statements herein are made subject to the penalties of 18 Pa. C. S. § 4904, relating to unswom falsification to authorities. Dated: DanlelM. Jones CERTIFICATE OF SERVICE I, Robert C. May, Esquire, attomey for plaintiffHelen M. Jones, hereby certify that I have served the foregoing Complaint upon the defendant, General Electric Capital Assurance Company, by depositing a tree and correct copy of the same in the United States mail, postage prepaid, certified with return receipt requested, addressed as follows: Dated: February 5, 2001 Timothy P. Smith Long Term Care Division 1650 Los Gamos Drive San Rafael, CA 94903-1899 THE LAW FIRM OF MAY & MAY, P.C. Exhibit 1 Policy GE Capital Assurance GENERAL ELECTRIC CAPITAL ASSURANCE COMPANY Administrative Office: 1650 Los Gamos Drive San Rafael, CA 94903-1899 Name and Address of Insured: Helen M Jones 214 N Baltimore St Mt Holly Springs, PA 17065 Policy or Certificate Number: HFN6406180 CERTIFICATE OF MERGER (Keep this Certificate with your AMEX Life insurance documents) You are hereby notified that, effective June 30, 1996 ("Effective Date"), AMEX Life Assurance Company ("AMEX Life") merged with and into General Electric Capital Assurance Company ("GE Capital Assurance"). As a result of this merger, GE Capital Assurance has assumed all the rights and obligations under your AMEX Life policy or certificate of insurance. AMEX Life was previously a wholly owned subsidiary of GE Capital Assurance. From and after the Effective Date, all references to AMEX Life in your policy or certificate of insurance are hereby changed to General Electric Capital Assurance Company. Your rights as a policyholder or certificateholder are not affected by this merger. All the terms and conditions of your policy or certificate of insurance remain the same. The service office address and telephone numbers to use also remain the same. This Certificate of Merger is an important document and must be attached to your policy or certificate of insurance. IN WITNESS WHEREOF, General Electric Capital Assurance Company has caused this Certificate of Merger to be duly signed and executed. Presic~nt 9055-95-09 AMEX Life Assurance Company LONG TERM CARE INSURANCE NURSING HOME INDEMNITY POLICY Helen M Jones 214 N Baltimore St Mt Holly Springs, PA 17065 We at AMEX Life Assurance Company are pleased to issue this Long Term Care Insurance Policy to You. This POlicy has many important features. We urge You to read it carefully. Secretary President, Long Term Care and Group Insurance Division THIS POLICY IS GUARANTEED RENEWABLE WE HAVE A LIMITED RIGHT TO CHANGE PREMIUMS All You have to do to keep this Policy in force until benefits have been exhausted is to pay premiums on time. We cannot cancel or refuse to renew this Policy. Your premiums will not increase due to a change in Your age or health. We can, however, change Your premiums based on Your premium class; but only if We change the premiums for all similar policies issued in Your state on the same form as this Policy. Premium changes will only be made as of an anniversary of the Policy's Effective Date. We must give You at least 31 days written notice before We change Your premiums. 30 DAY RIGHT TO EXAMINE YOUR POLICY You have 30 days from the day You receive this Policy to examine and return it to Us ff You decide not to keep it. You do nor have to tell Us Your reason for returning the Policy. Simply return it, within 30 days of its receipt, to Us at Our Home Office, or to the agent or office tkrough which it was bought. We will refund the full amount of any premium paid; and the Policy will be void from the start. THIS POLICY IS NOT A MEDICARE SUPPLEMENT POLICY If You are eligible for Medicare, review the Medicare Supplement Buyer's Guide available from Us. THIS IS A LIMITED BENEFIT ItEALTH POLICY PLEASE READ IT CAREFULLY 50000J TABLE OF CONTENTS Subject Page Policy Renewal and Premium Changes .................................. 1 30 Day Right To Examine Your Policy .................................. 1 Table of Contents ................................................... 2 Schedule ......................................................... 3 Basic Contract Provisions ............................................ 4 Glossary of Important Terms .......................................... 5 Benefit Provisions Nursing Home Benefit 7 Benefit Increase Optiot~'-'~'X~'8'51 ii i iiii iiii iiii iii iii i iiiii 1118 Recovery Benefit ............................................... 9 Waiver of Premium ............................................. 9 General Exclusions and Limitations .................................... 10 Claims Information ................................................ 10 Effective Date and Premium Provisions ................................. 13 A copy of Your Application ...................................... Attached Any appropriate Riders, Endorsements, Notices and other papers ......... Attached SCHEDULE Policy Number: HFN6406180 First Premium: $352.82 Name and Address of Insured: Effective Date: Feb 1, 1991 Renewal Premium: $352.82 Premium Mode: Quarterly Helen M Jones 214 N Baltimore St Mt Holly Springs, PA 17065 BENEFITS PROVIDED AND LIMITS NURSING HOME BENEFIT Deductible Per/od Daily Benefit: BENEFIT INCREASE OPTION - THRU AGE 85 Do you have this Option: 100 Days $5O.OO Yes BENEFIT LIMIT -- Unlimited RECOVERY BENEFIT -- Automatically Included WAIVER OF PREMIUM -- Automatically Included AMEX LIFE ASSURANCE COMPANY 50000DP 3 BASIC CONTRACT PROVISIONS This section tells You: the documents which state all of the contractual agreements; the importance of completing Your application truthfully; and other basic rights, obligations and features. The Contract Entire Contract; Changes: The entire contract between You and Us is as stated in this Policy, Your application and any attached papers. No change in this Policy will be effective until approved by one of Our officers. That approval must be noted on or attached to this Policy. No agent may change this Policy or waive any of its provisions. Contesting Coverage Time Limit on Certain Defenses: (a) Misstatements in Your Application: After 2 years from the Policy's Effective Date only fraudulent misstatements in Your application may be used to: void this Policy; or deny any claim for loss incurred or disability that starts after the 2 year period. (b) Pre-Existing Conditions: We will not reduce or deny any claim under this Policy because a sickness or physical condition described in Your application had existed before the Policy's Effective Date. Other Provisions Conformity with State Statutes: If tiffs Policy does not comply with the laws of the state in which You reside on its Effective Date, We will treat it as ff it had been changed to comply with those laws. Time Periods: All tune periods begin and end at 12:01 a.m. Standard Time at Your residence. GLOSSARY OF IMPORTANT TERMS This section gives the meaning of special words and phrases used in the Policy. In addition, the terms Benefit Limit, Daily Benefit and Deductible Period appear in the Schedule and are more fully described in the Benefit Provisions. To help You recognize these special words and phrases, the first letter of each word, or each word in the phrase, is capitalized wherever it appears. You, Your The Insured named in the Schedule. We, Us, Our AMEX Life Assurance Company. We are a stock company. Our Home Office is at 1650 Los Gamos Drive, San Rafael, California 94903-1899. Day of a Nursing Home Stay Each day You are confined as an inpatient in a Nursing Home for which a full day's room and board or subsistence charge is made. Doctor Someone, other than a Nurse, who is legally qualified and licensed to practice medicine and is operating within the scope of that license. The term "Doctor" does NOT include: You or a member of Your immediate family; anyone who resides in Your household; or anyone who has an ownership interest in, or is an employee of, any Nursing Home in which You stay. Nurse Someone who is licensed as: a Registered Graduate Nurse (RN); or a Licensed Practical Nurse (LPN); or a Licensed Vocational Nurse (LVN). The term "Nurse" does NOT include: You; a member of Your immediate family; or anyone who resides in Your household. Immediate F~mily Nursing Home The following relatives of You or Your spouse: spouse, parents, aunts, uncles, cousins, brothers, sisters and children. A facility or distinctly separate part of a hospital or other institution which is licensed by the appropriate licensing agency to engage primarily in providing nursing care and related services to inpatients and: Provides 24 hour a day nursing service under a planned program of policies and procedures which was developed with the advice of, and is periodically reviewed and executed by, a professional group of at least one physician and one Nurse; and · Has a Doctor available to furnish medical care in case of emergency; and Has at least one Nurse who is employed there full time (or at least 24 hours per week if the facility has less than 10 beds); and · Has a Nurse on duty or on call at all times; and · Maintains clirdcal records for all patients; and · Has appropriate methods and procedures for handling and administering drugs and biologicals. NOTE: The above requirements are typically met by licensed skilled nursing facilities, comprehensSve nursing care facilities and intermediate nursing care facilities as well as some specialized wards, wings and units of hospitals. Those requ/xements are generally NOT met by: rest homes; homes for the aged; sheltered living accommodations; residence homes; or similar living arrangements. 50000J 6 BENEFIT PROVISIONS This section describes Your benefits under the Policy. It tells You: the conditions under which benefits will be paid; how much will be paid; and how long benefits will be paid. NURSING HOME BENEFIT Benefit Conditions We will pay the Daily Benefit for each Day Of A Nursing Home Stay after the Deductible Period, if: · the Policy is in force when the Nursing Home stay starts; and You are confined in the Nurs'mg Home as an overnight resident patient and a room and board charge is made for that day; and · Your Nurs'mg Home Stay Is Necessary, as described below. Note: The next page describes how the Daily Benefit and Deductible Period are determined. Determining W~nen Your Nursing Home Stay is Necessary Your Nursing Home Stay Is Necessary as long as: (1) a Doctor certifies that Your admission is required due to injury or sickness; and (2) there exists a level of functional incapacity which makes Your continued Nursing Home stay appropriate and reasonable. No Spec'file Care Level Required This Policy makes no distinction, in the duration or amount of benefits You will be paid, for different levels of care (whether skilled, intermediate or custodial) as long as Your Nursing Home Stay Is Necessary. How Long Benefits Will Be Paid After the Deductible Period, this benefit will be paid for as long as Your Nursing Home Stay Is Necessary and the Benefit Limit (described on the next page) has not been reached. 7 How the Deductible Period Works How the Benefit Limit Works Daffy Benefit The Deductible Period is the number of consecutive days at the start of each Nursing Home stay needed to qualify for benefits. The Schedule shows the Deductible Period. You will not be paid benefits for the Deductible Period. Once You have qualified for benefits, You do not need to satisfy a new Deductible Period for later Nurs'mg Home stays which: · are due to the same or related cause or causes; and · are separated from each other by less than 6 months. The Benefit Limit is the maximum number of days for which You will be paid benefits under the Policy. The Schedule shows the number of days in the Benefit Limit. This is a limit for all Your Nursing Home Benefits and Recovery Benefits combined. The Policy terminates when the Benefit Limit has been reached. If the Schedule shows that Your Benefit Limit is "Unlimited," there is no limit on the number of days for which benefits may be paid during Your lifetime. The amount of Your Daily Benefit is shown in the Schedule. That amount may be changed, over time, by the Benefit Increase Option described below. BENEFIT INCREASE OPTION-TItRU AGE 85 (The Schedule states whether or not You have this Option) When and How It Works If You have this option, Your Daily Benefit will increase on each anniversary of the Policy's Effective Date. Annual increases will continue until and includ'mg the increase which happens wtfile You are 85 years of age. Each increase will be equal to 5% of Your original Daily Benefit. Increased amounts will apply to each day benefits are payable under the Policy on or after the date of the increase; even while You are in a Nursing Home. 8 Benefit Conditions How Long Payable Benefit Conditions RECOVERY BENEFIT To aid in Your recovery, We will pay a benefit for each day of Your convalescence after a Nursing Home stay, if: · Benefits were paid under the Nursing Home Benefit for the Nursing Home stay; and · You make claim for this Benefit giving Us satisfactory evidence that You were convalescing outside of a Nursing Home or duly Licensed hospital on that day; and · Your Benefit Limit has not been reached. The amount We will pay for each day will be equal to the following percentage of the Daily Benefit paid on the last day of Your most recent Nursing Home stay. Percentage of Day of Convalescence First thru 30th day 31st thru 60th day 61st day and later Daily Nursing Home Benefit Payable 7O% 60% 50% This Benefit will be paid for up to the number of days benefits were paid under the Nursing Home Benefit for the prior Nursing Home stay; but not for any day You are in a Nursing Home or duly licensed hospital. All benefits end and the Policy terminates, once the Benefit LLmit (described in the Nursing Home Benefit) has been reached. Remember: Each day We pay Nursing Home or Recovery Benefits counts toward Your Benefit Limit. WAIVER OF PREMIUM We will waive the payment of any Policy premiums which become due during a Nursing Home stay after benefits have been paid for at least 90 consecutive days beyond the Deductible Period. This waiver stops when the Nursing Home stay ends. To keep the Policy in force after the waiver stops, You must pay any future premiums as they become due. GENERAL EXCLUSIONS AND LIMITATIONS This section states the conditions under which benefits will not be paid even if You otherwise qualify for benefits. Please remember that when Nursing Home stays are not covered, the Recovery Benefit does not apply. What's Not Covered The Policy will not pay benefits for any Nursing Home stay: · outside of the United States of America or its possessions; · in a Veteran's Administration or federal government institution; unless You or Your estate are charged for the stay; · which results from war or act of war, whether declared or not; · which results from an attempt at suicide or an intentionally self-inflicted injury; or · which results from mental, nervous, psychotic or psychoneurotic deficiencies or disorders without demonstrable organic disease. The Policy will, however, cover qualifying stays which result from Alzheimer's disease or similar forms of senility or irreversible dementia. CLAIMS INFORMATION This section tells You when to notify Us of a claim; what to send Us; how We pay claims; and other rights .and responsibilities under the contract. Telling Us About a Clakn Notice of Claim: We must be told in writing when You have a claim for benefits. The notice can be given to Us at Our Home Office or to Our agent. It must be received within 30 days (60 days in Kentucky and 6 months in Montana) of the date the covered loss starts, or as soon as reasonably possible. Include in the notice at least: Your name; Your Policy Number; and an address to which the claim form should be sent. 10 How to File a Claim When to File a Claim How and When Claims are Paid Claim Forms: When We get notice of Your claim We will send out a claim form to be used to file proof of loss. The claim form has instructions on how to fill it out and where to send it. Please read the form carefully. Answer all questions and send all required information to the address on the form. If You or Your representative do not get the claim form within 15 days (10 working days in Georgia), proof of loss can be filed without it by sending Us a letter which describes the occurrence, the character and the extent of the loss for which claim is made. That letter must be sent to Us at Our Home Office within the time period stated in the next paragraph. As a minimum, the description should tell Us such things as: Your name and address; whether You are claiming Nursing Home or Recovery benefits; the names and addresses of Your Doctors and the places You stayed; Your diagnosis; and the periods for which You are claiming benefits. Proofs of Loss: We must get written proof of loss within 120 days after the end of each month for which benefits may be paid. If it was not reasonably possible to give Us written proof in the time required, We shall not reduce or deny a claim for being late if the proof is filed as soon as reasonably possible. Unless the claimant is not legally capable, the required proof must always be given to Us no later than 1 year (15 months in Hawaii) from the time specified. Time of Payment of Claim: After We receive the proper Written proof of loss, We will pay any benefits then due: (1) monthly, when the loss is expected to result in on- going benefits; and (2) immediately, when Our liability has ended. Payment of Claims: All benefits will be paid to You. Any benefits unpaid at Your death will be paid to Your estate. If benefits are payable to Your estate, We may pay benefits up to $1,000 ($3,000 in Florida) to someone related to You by blood or marriage who is deemed by Us to be justly entitled to the benefits. We will be discharged' to the extent of any such payment made in good faith. 11 How to Appeal a Claim Physical Examinations: We have the right to require a medical exam when a claim is made and at reasonable intervals while You are claiming continued benefits. If an exam is required, You will not have to pay for it. Misstatement of Age: Your age may have been misstated in Your application. In that case, We will pay the benefits that the premiums You have paid would have purchased at Your true age. If, based on Your true age, the Policy would not have become effective, We will only be liable for the refund, upon request, of all premiums paid for this Policy. You will be informed by Us in writing ff a claim, or any part of a claim, is denied. Appeal Process: We evaluate Your claim based on the Policy and the information given to Us by: You; Your Doctor; the Nursing Home; and other available sources. If You do not agree with a claim decision, You may then ask for a review. Your request must be in writing to Us and include any information You think will help Your claim. No special form is needed. We will act promptly on Your request. Please allow more tune for special circumstances. Our decision will be in writing with Our reasons stated clearly. You may authorize someone else to act for You under this review procedure. Legal Actions: You cannot sue on Your claim before 60 days after written proof of loss has been given as required by this Policy. You cannot sue after 3 years (or in Florida, the applicable statute of limitations) from the time written proof of loss is required to be given. 12 EFFECTIVE DATE AND PREMIUM PAYMENT PROVISIONS This section tells You such things as: when Policy becomes effective; how and when to pay premiums; the importance of paying premiums on time; and what happens if premiums are not paid on time. The Policy Taking Effect Paying Premiums What Happens When Premiums are Not Paid Effective Date and Consideration: This Policy is issued based on: the statements made in Your application; and payment of the First Premium shown in the Schedule. It takes effect on the Effective Date shown in the Schedule; provided the First Premium is paid. The Premium Mode shown in the Schedule states how often premiums are to be paid. Each premium after the first is due at the end of the period for which the prior premium was paid. Grace Period: This Policy has a 31 day grace period. If a renewal premium is not paid on or before the date it is due, it may be paid during the following 31 days. The Policy will stay in force during the grace period. If the premium is not paid during the grace period, the Policy will terminate at the end of the grace period. This is called a lapse. Lapse will not affect any continuing claim thal begins before the Policy terminates. Reinstatement: Once this Policy lapses, We may or may not put it back in force (reinstate) at Our option. An acceptance of late premium by Us (or by an agent authorized to accept payment) without requiring an ~pplication for reinstatement will reinstate this Policy. If We or Our agent require an application, You will be given a conditional receipt for the premium. If the application is approved, this Policy will be re'mstated as of the approval date. If We do not give You prior written notice of Our disapproval, the Policy will be reinstated on the 45th day (30th day in New Mexico) after the date of the conditional receipt. 13 The reinstated Policy will cover only loss that results from Nursing Home stays which be=4n after the date of reinstatement. In all other respects Your rights and Our rights will remain the same; sub.ject to any provisions noted on or attached to the reinstated Policy. Any premiums We accept for a reinstatement will be applied to a period for which premiums have not been paid. No premiums will be applied to any period more than 60 days before the re'restatement date. Unpaid Premiums: When a claim is paid, any premium due and unpaid will be deducted from the claim payment. Please keep this Policy in a safe place with Your other important documents. 14 Dai~ Benefit:~ Benefit Limit: ~Un[Imited [3 1095 Days [] 1460 Days [] 730 Days Deductible Perio~d: Daily Maximum:$ [] 20 Days [~100 Days Maximum Payment Period: Increase Option: E] 1825 Days [3 730 Days .[~'Yas [] No [] 1095 Days [] 365 Days lllllllllllllllllll ODS/LHFN6406180 Increase [] Annua) [] SemFAnnuai Option: 5;~Ouarteriy [] Monthly (EFT) [] Yes Modal [] No Premium:$ .~,~.~'_,,,2 AMEX Life Assuram;e Company I~50 LOS Games Drive, San Rarest, California ~4'903 Fo/' mo~e space, attach a signed and dated sl~eet with question number a~l details. 1. Are you eligible for benefits under Medicaid? 2. Ne you actively at work out,fibs your home On a full-time basis for at least 30 hours per weak? 3. Am you receiving disabitity if, come, workem compensation, or Social Security Disability benefits? 4. Do you.h, ave any long term nursing home or home health c~ro cover~e in force or applied for in this or any othaLcom. Aany? If"Yes, Company: r/P,,v~¢ 5. Will Ibis, insurance re. plaos er t~uca any insurance you now~aya? If "Yes, Compeny~)~x./f .'7- Policy No.: '.-.P/'//-'/f ''?'''' Type of Plan: 6. Are you currently taking any prescription medications? (If Was," list them below.) Application For Insurance Bir~'xlate O9 - ~/ -/~Age ._.7_,.~Sex[]M ~ Wt./¢~lbs. ~ar~ '~NOt MaM~ IfMarri~, is ~or~u~ a~?~as YES NO [:3 [] Ar'~Swer the foil OWJ ng; Ci;~"d_-?.t'~eaeo_ ..~_rll~ for any ~Yes' answers; and explain the details below. A. Do you use a: wheelohelr; walker; quad cane; hospital bed; dialysis machine; oxygen; or any other mechanical device? S. Do you nee(I or receive the assMance or supmvision of another person in psrformi~ any et the foll<w~ing daily fssks or functions: Bathing; Dressing; Tottering; Eating; Bowel or Bladder Co, frei; Shopping; Walking; Using transporta~n; Houaskeeplng; Cookir~g? ~ Explain any "Yes' answer: With whom/whers do y~u live? E:] Alone 'l~-6pooce ~ Family [:3 Retirement Core--her'. During the past 5 years, have you received medical advice, diagnosis, or treatment, t~ke~ any me~ca~on~--'Y~an conti~ed to any h~spite~and~ornuraing~ac~ity~rconsu~edw~hahea~thprot~s~na~forany~thefo~wingcondIt~as~:- ¢:~rCle D~orde~ '> A. Para~i$~rstroke;H~dg~diysdiseaas;Leukomia;~ymph~ma~cancer;heartsurgery~hearta~tad(;high~dpre~sure? B. C. YES NO Emphysema; shortness of breath; fainting spells; biadddg Dui; injury due te laiis or imbalance? ~ ~ Chronic loss of memo'y; b*'ain disom~'; mental illness; Nzhoimer's disease; dementia; depression; alcoholism; or drug addiction? LJ D. Multiple sclarosi~j..P.~[rkin sorl's; e~lispay; seizure: <;orwuleloos; lromor; diabetes; dialysis; cirrhosis; or skin ulcers? E. ~ste~pOras~h-~;~rothorcon~tianscausingcfippllng~imitedmeti~n~rrsquiringedaptiv~devioss? ~2~ 10. A. During the pasf 3 years, have you: bean medically advised to have surgery which has not been pedermad; or consulted ~ been treated by a health profe~onai for any reason not prsviously stated? [] ~ B. Duringthepast5years~haveyou:r~osivadhomehas~osrs;beanmedica~lyadviasdt~anteran~r~ngh~me;~rbeenconfir~ed to a hospital or o~r haslth care lacllity? E:] ~ C. Do you have, or have you been medically diagnosed as having, Acquired Immune Doticie~y Syndrome (AIDS) or AIDS Related Compisx (ARC)? [] ~ Quas. DETAILS FOR 'YES'ANSWERS TO ANY PART OF QUESTIONS 9 AND fO N~. ~es,en Consulted~'reated Dater Ftomrro Name. Address & Phone No. of Health Cae Professional/Facility 11. Docforwithmestof¥ourmedicalreco~'ds:Nama "~r-. /'~. ~. I.e..,~.~ Phone No, ( 7/.-/ ) <:,7,'/f - .~,~,2~,/ Address: I0 W, {J::)",'~.',,./' (~k.,cl,'~/c:..J;:~. /70/..,z Datelastsasn: IIR££M£NT: I agrse that: (1) the answ~Jrs cor~ained herein are fult, c0mpists and trus to the basl of my grt0wledge and hollsf (a) this applicati0~ will be a part of the policy for which I am app~ng; and (3) fha ineuranos will become valid and effective only if: (a) this appllcat~ is approved by the C~pany; (b) a policy is is~Jed dudng my Iltelime; (c) the first Femiurn has been paid; and (d) I remain insurable until the effective dale sst by the Company as slated in the policy. 60400~ Data Signed LONG TERM CARE COVER SHEET Helen M Jones 214 N Baltimore St Mt Holly Springs, PA 17065 HFN6406180 HELEN M. JONES Plaintiff GENERAL ELECTRIC CAPITAL ASSURANCE COMPANY Defendant : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : : CIVIL ACTION - LAW No. 01-731 RETURN OF SERVICE (United States Mail) The undersigned makes the following return of service: The Helen M. Jones v. General Electric Capital Assurance Company Complaint was mailed to Timothy P. Smith on February 5, 2001 at 2 o'clock p.m. at The Mail Room, 812 Camp Hill Shopping Mall, Camp Hill, Cumberland County, Pennsylvania: X The signed receipt is attached. __ The mail, refused and returned, is attached. A copy mailed to the defendant at the same address by ordinary mail with the return address of the sender appearing thereon has not been returned within fifteen days after mailing. Signature and Affidavit I, Robert C. May, certify that I am a competent adult not a party to the action. I verify that the statements made in this affidavit and return of service are tree and correct. 1 -.-.~-,,*,~,~A *hat f~le~ et~tements herein are made subject to the penalties of 18 Pa. C.S. § 4904 · Complete items 1, 2, and 3. Alas complete Item 4 Jf Restricted Delivery is desired. · Print your name and addre~ on the reverse $o that we can return the card to you. · Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: B. Date of _l:~v_ jify 2. Article Number (Copy from service label) PS Form 3811, July 1999 Domestic Return Receipt X D. Is delivery address ¢ from item 17 rly~ If YES, enter delivery'address below: r-i No 3. Service Type J~Cert~ed Mail [] Express Mail F'I Registered r'l Return Rscelpt for Merchandise [] Insured Mail [] C.O.D. 4. Restricted Delivery? (~tra Fee) r-I Yes 102595,00-M-0952 HELEN M. JONES, Plaintiff GENERAL ELECTRIC CAPITAL ASSURANCE COMPANY, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL LAW ACTION No. 01-731 DEFENDANT'S ANSWER AND NEW MATTER For its Answer with New Matter, General Electric Capital Assurance Company ("GECA"), through its counsel, Eckert Seamans Cherin & Mellott, LLC, states: 1. GECA is without knowledge or information sufficient to form a belief as to the truth of the averments of paragraph 1, and therefore denies them. 2. Admitted that GECA is a Delaware business corporation that maintains its administrative office for its Long Term Care Division at 1650 Los Gamos Drive, San Rafael, California 94903. The remaining averments of paragraph 2 constitute conclusions of law to which no responsive pleading is required. To the extent that the remaining averments of paragraph 2 require a response, GECA denies them. 3. The averment of paragraph 3 is a conclusion of law to which no responsive pleading is required. To the extent that a response is required, GECA states that some insureds under some policies of insurance written by or through GECA reside in Cumberland County, Pennsylvania. 4. Denied as stated. GECA, through its Long Term Care Division, assumed all the rights and obligations of AMEX Life Assurance Company ("AMEX") in a "Long Term Care Insurance Nursing Home Indemnity Policy," Policy No. HFN6406180, issued to the Plaintiff by AMEX (the "Policy"). 5. GECA is without knowledge or information sufficient to form a belief as to the truth of the averments contained in paragraph 5, and therefore denies them. 6. GECA is without knowledge or information sufficient to form a belief as to the truth of the averments contained in paragraph 6 and therefore denies them. By way of further answer, it is admitted that the document attached as Exhibit "1" to PlaintiWs Complaint is a copy of Policy No. HFN6406180 issued to the Plaintiff with an effective date of February 1, 1991. By way of further answer, the Policy is a document that speaks for itself, and any characterization thereof by Plaintiff is expressly denied. 7. GECA is without knowledge or information sufficient to form a belief as to the truth of the averments contained in paragraph 7 and therefore denies them. 8. Denied as stated. AMEX issued the Policy to the Pla'mtiff with an effective date of February 1, 1991. 9. Denied as stated. The averments of paragraph 9 are drawn from a Certificate of Merger that was mailed from GECA to Helen M. Jones, and which is attached to the Policy attached to Plaintiff's Complaint as Exhibit "1." Inasmuch as the Certificate of Merger is a written document that speaks for itself, any characterizations thereof by Plaintiff in paragraph 9 are expressly denied. 10. GECA is without knowledge or information sufficient to form a belief as to the truth of the averments contained in paragraph 10, and therefore denies them. 2 11. GECA is without knowledge or information sufficient to form a belief as to the truth of the averment contained in paragraph 11, and therefore denies it. By way of further answer, the insured submitted a Facility Statement from HealthSouth of Mechanicsburg-Renova Center to GECA indicating that she was admitted to the facility on June 10, 1998. 12. GECA is without knowledge or information sufficient to form a belief as to the truth of the averments contained in paragraph 12, and therefore denies them. By way of further answer, Plaintiff submitted a Facility Statement dated September 21, 1998, from Country Meadows of West Shore II indicating that Plaintiff was admitted to the facility on September 4, 1998. 13. GECA is without knowledge or information sufficient to form a belief as to the truth of the averments contained in paragraph 13, and therefore denies them. By way of further answer, on October 7, 1999, Plaintiff submitted a Facility Statement from Outlook Pointe at Creek View indicating that Plaintiff was admitted to the facility on June 20, 1999. 14. GECA is without knowledge or information sufficient to form a belief as to the truth of the averments contained in paragraph 14, and therefore denies them. By way of further answer, Plaintiff submitted a Facility Statement from Messiah Village indicating that Plaintiff was admitted to the facility on June 8, 2000. 15. Denied as stated. GECA states that, pursuant to the terms and conditions of the Policy, Mrs. Jones' nursing home stays at HealthSouth and Messiah Village were covered, but her stays at Country Meadows and Outlook Pointe were not covered. 16. The averments of paragraph 16 are conclusions of law to which no responsive pleading is required, By way of further answer, the Policy is a written document that speaks for itself and any characterization thereof by Plaintiff is expressly denied. To the extent that any of the averments contained in paragraph 16 are considered averments of fact to which a responsive pleading is required, GECA is without knowledge or information sufficient to form a belief as to the truth of the averments contained in paragraph 16, and therefore denies them. 17. The averments of paragraph 17 are conclusions of law to which no responsive pleading is required. By way of further answer, the Policy is a written document that speaks for itself, and any characterization thereof by Plaintiff is expressly denied. To the extent that the averments of paragraph 17 are deemed averments of fact to which a responsive pleading is required, GECA is without knowledge or information sufficient to form a belief as to the truth of the averments of paragraph 17, and therefore denies them. 18. Denied as stated. GECA is informed and believes that Plaintiff, through her attorney-in-fact, Daniel M. Jones, made a claim for benefits under the Policy for both Country Meadows and Outlook Pointe and requested a review of the claim decision for her stays at Country Meadows and Outlook Pointe. For the remaining averments of paragraph 18, GECA is without knowledge or information sufficient to form a belief as to the truth thereof, and therefore denies them. 19. GECA admits that it advised Plaintiff of its decisions on the review of her claim for coverage of her stays at Country Meadows and Outlook Pointe in letters dated October 27, 1999 and November 1, 1999. By way of further answer, the letters referenced in 4 paragraph 19 are written documents that speak for themselves, and any characterization thereof by Plaintiff is expressly denied. 20. It is admitted that Mrs. Jones's attorneys sent letters dated December 1, 1999 and April 28, 2000. By way of further answer, the letters referenced in paragraph 20 are written documents that speak for themselves, and any characterization thereof by Plaintiff is expressly denied. 21. GECA admits that it mailed letters dated January 6, 2000 and June 1, 2000. By way of further answer, the letters referenced in paragraph 21 are written documents that speak for themselves, and any characterization thereof by Plaintiff is expressly denied. 22. Denied. The averments of paragraph 22 are conclusions of law to which no responsive pleading is required. By way of further answer, the Policy is a written document that speaks for itself and any characterization thereof by Plaintiff is expressly denied. 23. Denied. The averments of paragraph 23 are conclusions of law to which no responsive pleading is required. By way of further answer, the Policy is a written document that speaks for itself, and any characterization thereof by Plaintiff is expressly denied. 24. Denied. The averment of paragraph 24 is a conclusion of law to which no responsive pleading is required. 25. Denied. The averment of paragraph 25 is a conclusion of law to which no responsive pleading is required. 5 26. Denied. The averment of paragraph 26 is a conclusion of law to which no responsive pleading is required. WHEREFORE, General Electric Capital Assurance Company, having fully answered Plaintiff's Complaint, respectfully requests this Court issue an Order: A. Dismissing the Complaint with prejudice; B. Awarding GECA its costs; and C. Granting such other relief as the Court deems just. NEW MATTER 27. Mrs. Jones's nursing home indemnity insurance policy, attached to the Complaint as Exhibit "1," provides a specified benefit for a stay in a Nursing Home as defined by, and set forth in, the Policy. 28. The Policy specifically defines a Nursing Home and sets forth certain requirements, including licensing requirements, for coverage under the Policy. 29. The Policy further notifies the insured that certain types of services and facilities are not covered by the Policy. 30. A Long Term Care Nursing facility is licensed by the Commonwealth of Pennsylvania, Department of Health. 31. A Personal Care Services facility is licensed by the Commonwealth of Pennsylvania, Department of Public Welfare. 32. In the Commonwealth of Pennsylvania, a "Nursing Home" must be licensed as a "long-term care nursing facility" by the Pennsylvania Department of Health. 33. Outlook Pointe at Creek View is licensed by the Commonwealth of Pennsylvania, Department of Public Welfare as a Personal Care Home, license number 3034401. A true and correct copy of Outlook Pointe's "Certificate of Compliance" is attached hereto as Exhibit "A." 34. Country Meadows of West Shore, II is licensed by the Commonwealth of Pennsylvania, Department of Public Welfare as a Personal Care Home, license number 343930. A true and correct copy of County Meadows' "Certificate of Compliance" is attached hereto as Exhibit "B." 35. As evidenced by the Certificates of Compliance issued to Outlook Pointe and to Country Meadows, neither of these facilities is a licensed Nursing Home in the Commonwealth of Pennsylvania. 36. Neither Outlook Pointe nor Country Meadows satisfy the Policy definition of a *'Nursing Home." 37. Consequently, GECA has fully performed its contractual obligations under the Policy. 7 WHEREFORE, General Electric Capital Assurance Company, respectfully requests this Court enter judgment on its behalf and dismiss Plaintiff's Complaint with pr~udice. Respectfully submitted, Dated: ECKERT SEAMANS CHERIN & MELLOTT, LLC Supreme Ct. ID #79646 Adam M. Shienvold, Esquire Supreme Ct. ID #81941 213 Market Street Harrisburg, PA 17101 (717) 237-6000 Attorneys for Defendant 8 HELEN M. JONES, Plaintiff GENERAL ELECTRIC CAPITAL ASSURANCE COMPANY, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL LAW ACTION No. 01-731 VERIFICATION I, Lori Watson, am an employee of General Electric Capital Assurance Company and am authorized to make this Verification on its behalf. I hereby verify that all of the averments of fact contained in the foregoing document are tree and correct to the best of my knowledge, information and belief. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S.A. §4904, relating to unswom falsification to authorities. Lori V~atson Exhibit A Exhibit B CERTIFICATE OF SERVICE I certify that on April 5, 2001, I served a copy of the Answer and New Matter via U.S. Mail addressed to: Robert C. May, Esquire 3438 Trindle Road Camp Hill, PA 17011 HELEN M. JONES Plaimiff V. GENERAL ELECTRIC CAPITAL ASSURANCE COMPANY Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW No. 01-731 PLAINTIFF'S REPLY TO NEW MATTER For her Reply to New Matter, Helen M. Jones ("Mrs. Jones"), through her counsel, May & May, P.C., states: 27. Denied. The averments of paragraph 27 are conclusions of law to which no responsive pleading is required. By way of further answer, the Policy is a written document that speaks for itself, and any characterization thereof by Defendant is expressly denied. 28. Denied. The averments of paragraph 28 are conclusions of law to which no responsive pleading is required. By way of further answer, the Policy is a written document that speaks for itself, and any characterization thereof by Defendant is expressly denied. 29. Denied. The averments of paragraph 29 are conclusions of law to which no responsive pleading is required. By way of further answer, the Policy is a written document that speaks for itself, and any characterization thereof by Defendant is expressly denied. 30. Denied. The Commonwealth of Pennsylvania, Department of Health, licenses "Long Term Care Facilities." Defendant's addition of the word "Nursing" is expressly denied. By way of further answer, a "Long Term Care Facility" is only one kind of facility included within the Policy and Pennsylvania law's definition of"Nursing Home." 31. 32. 33. 34. 35. 36. Denied. The Commonwealth of Pennsylvania, Department of Public Welfare, licenses "Personal Care Homes." Defendant's addition of the word "Services" is expressly denied. Denied. Pennsylvania law requires "Nursing Home" to be defined by the Policy as reasonably interpreted by the average policyholder. A true and correct copy of the Yellow Pages listing under "Nursing Homes" from the Cumberland County Wide directory is attached hereto as Extfibit "1" clearly indicating that "Outlook Pointe" is a "Nursing Home" to the average policyholder. A true and correct copy of the Yellow Pages listing under "Nursing Homes" from the Harrisburg Yellow Book directory is attached hereto as Exhibit "2" clearly indicating that "Country Meadows" is a "Nursing Home" to the average policyholder. It is admitted that Outlook Pointe is licensed by the Pennsylvania Department of Public Welfare as a Personal Care Home. By way of further answer, Outlook Pointe is licensed to care for Alzheimer's patients, including Mrs. Jones. It is admitted that Country Meadows is licensed by the Pennsylvania Department of Public Welfare as a Personal Care Home. By way of further answer, Country Meadows is licensed to care for Alzheimer's patients, including Mrs. Jones. Denied. Each facility is a "Nursing Home" as that term is defined in the Policy under Pennsylvania law. Denied. Both Country Meadows and Outlook Pointe satisfy the Policy definition of "Nursing Home." By way of further answer, the Defendant has paid benefits for Plaintiff under the Policy for her stay at the rehab hospital in Mechanicsburg ("HealthSouth") which does not have the specified license which Defendant argues by paragraph 36 is needed, thereby demonstrating that the license restriction argued by Defendant is not determinative of the Policy definition of "Nursing Home." 37. Denied, To fulfill its contractual obligations, Defendant must cover Mrs. Jones' stays at Country Meadows and Outlook Pointe. WHEREFORE, plaintiff Helen M. Jones, requests this Honorable Court to enter judgment in its favor and against defendant General Electric Capital Assurance Company, for all sums to which she is due and owing under the aforesaid Policy, together with costs, expenses and reasonable attorney's fees, and such other and further relief as is just under the circumstances. Respectfully submitted, THE LAW FIRM OF MAY & MAY, P.C. Dated: April 23, 2001 Robert C. May Attorney I.D.//65602 Robert C. May, Esquire 3438 Trindle Road, Suite 201 Camp Hill, PA 17011 (717) 612-0102 Attorneys for Plaintiff VERIFICATION The undersigned, DANIEL M. JONES, hereby verifies and states that: 1. He is Attorney-In-Fact for Helen M. Jones, plaintiffherein. 2. He is authorized to make this verification on her behalf; 3. The facts set forth in the foregoing reply to new matter are tree and correct to the best of his knowledge, information and belief; and 4. He is aware that false statements herein are made subject to the penalties of 18 Pa. C. S. § 4904, relating to unswom falsification to authorities. Dated: April 19, 2001 DANIEL M. S'O~ES EXHIBIT 1: YELLOW PAGES - CUMBERLAND COUNTYWIDE N · 278 NURSING NIPPLE CONVALESCENT HOME I N'I"ERMEDI:VI F. CARF. ORRSTOWN PERSONAL CARE INC · 24 hour skilled nursing care · Alzheimer's special care unit · P.~c~al & recreational activities · Short term, long term and respite care · Medicare certified and insurance accepted · Physical; occupational & speech therapies · Deluxe accommodations with gracious amenities www.hcr-manorcare.com ManorCare Health Service~ CARLISLE (717) 249-0085 MENNO HAVEN COMMUNITY Office Gee Our Ad At R~rement & L~ Care Communitie~ & ~omes IA25 Philadelphia A~ ChamToersbu PENNSYLVANIA ASSOCIATION OF NON- PROFIT HOMES FOR THE AGING 940 Walnut Bottom Rd. CAMP HI.LL.. (717) 737-8551 f700 Mad<et St, PERSONAL CARE CENTER SKILLED NURSING CENTER 800-722-0267 ADMINISTRATIVE OFFICES PRIVATE CATERING SERVICES FOR THE GENERAL PUBLIC SPACIOUS RESIDENTIAL LiVING COTTAGES 717-245~9041 LOW MONTHLY FI~ CUMBERLAND CROSSINGS '~ I Longsdoff Way - Carlisle PA 17013 A Subsidlar) of Carlisle Hoapltal and Health Serv/ce~, wv~/,Cb~S.or~ 4-Hour Skilled Nursing Care * Specialized Rehabilitation Services * Physical, Occupational, & Speech Therapy On-Site * Medicare & Medicaid Certified * Long Term, Country ~.~tmosphere 213 E. Main St. New Bloomfield... 582~4 EXHIBIT 2: YELLOW PAGES - HARRISBURG YELLOW BOOK 456 NURSING--OCCUPATIONAL WOODLAND CENTER YellOW BOOK.reIT1 I Faciliq C~mp Hill And New Cumberland Care Occupational Therapy Sust offi-83 Exit 15 PA 17339 ManorCare Health Service~ · 24 hour skilled nursing care · Alzheimer's special care unit · Deluxe wing with gracious accommodations & amenities Bethany Towers 335 Wesley or Mechanlcsbrg ......... 766-7698 Eet~anv Vlltage Retirement Center S25 Wesley Dr Mechanltsbrg ....... 766-0279 Beverly Enterprises 214 Senate Av :amp Hill 761-1246 gtue Ridge Haven East ~62S N Progress AY Harrisburg ....... 652-2345 claremont Nursing & Rehabilitation Center $75 Claremont Or Carlisle 766-1518 country Meedows 4Sl Sand hill Hershey 533.1880 Cumberlancl County Nursing Home Carlisle 766-'1519 Cumherlancl Crossings Retirement Community Marsh Drive cartlsle 245-994'1 Dauohln Manor 1~s s 28 st ~arrls0urg--SSS-100~ Forest Park Health Center 700 walnut Bottom Rd car(Isle ....... 243.1032 Fre¥ vlllege Retirement Center 1020 N Union st Mlddl~oWn 944.045'1 Green Acres Rehabilitation & Nursing Center t401 ivy Hlfi Rd Wyndmoor .... 215 253-5606 Integrated Health Services of Hershey At Ti~e woedlands 920 Rhue Haus Ln Rummslstown ...... 533-$3Sl Integratecl Health Services Of Hershey At The Woodlands 820 Rhuehaus Lane Summelstown .... 535-$3M CONTINUED NEXT COLUMN THE YELLOW PAGES PLACE YOUR NAME, ADDRESS AND TELEPHONE NUMBER BEFORE THE BUYER AT THE VERY MOMENT HE WANTS YOUR PRODUCT OR SERVICE. YOUR AD iN THE YELLOW PAGES iS LIKE ANOTHER STORE WINDOW, HARRISBURG (717)657-1520 800 King Russ Road CAMP HI~ (717) 737-8551 17OO Market Street NUR~/NG HOMES Jewish Home Of Greater Harrisburg 4000 Unglestown RCl Harnshurg--- -657-0700 KEPLER HOME INC THE 44 S Manet St EIIzabet~vliie ..... 717 362-8~70 LeaOer Nursing & Rehabilitation 1700 Manet st cam~ Hill ............ 737-855'1 MANORCARE HEALTH SERVICES 8~0 King Rd~ Rd Harrisl~urg .... 657-1520 940 Walnut Bottom Road Cariiste----2~9-0085 Mountvlew Nursng & Rehabilitation Center t02 ChanCre orvle ouncannon ..... {G4-4'11'1 Nursing Home Malpractice Center 5500 Grouse Dr Harrisburg. 671-0786 Odd Fellows Home Of Pennsylvania 9os W Halllsburg Pi(e Middletown----- 944-3351 Palmyra Nursing Home Palmyra .... 533-g2'13 Pteasant View Retirement Community 544 N Penryn Ed Manheim ......... 665-2445 Rice Oavld NW CumDerln~ 774-6608 Susquehanna center 1909 N Pront st Harrisburg ...... 234-4660 CONTINUED NEXT COLUMN NO WAITINGI EVER GET CAUGHT IN LONG LINES OR HUGE CROWDS ONLY TO FINe THAT THE ITEM YOU FIND DOESN'T FiT YOUR NEEDS? CHECK THE ADS tN THE YELLOW PAGES FIRST. THERE'S NO WNTINGi conunued SUSOUENANNA LUTH We Do More Than N Rehabilitation ~SO M~lcal Rd Mill, ThornwaKI Home 442 Walnut Suttom ~ Twin Oaks Nursing HC 9o West Main street Villa Teresa Nursing H 1051 AVlla ~d kL~rrl~ WOOOLANO CENTERt 78O Woo~an~ Ave Fitness 8y Fischer 21o9 Foxflre Dr Mect Hawkins Total Healtl~ 9~7 Kranzel Dr Cam~ Hershey Medical Cen~ ~0 univers~ Dr McCann Cannarcl & At 2040 chestnut St Hal Nu~rlUon Plus 788~ chambers Hill Three square Nutrrd< 940 Beech Ave sersr Nuts SEE Bolts & Nuts Oeeupax Add SEE Advertislng-D~ Mailing Lists Occupatic SEE Audiologists Clinics Drug Detection & Hospitals Occupational Physical Therapi Physicians & Sm Rehabilitation S~ Oceupation~d SEE Industrial Hyg~ Safety IFYOU~ NEIG~4BORH HANDLES A TRA OR SERVICE THESE Y KI ARE eL Rea Child CERTIFICATE OF SERVICE I hereby certify that on April 19, 2001, I served a copy of the Reply to New Matter via U.S. Mail addressed to: Adam M. Shienvold, Esquire 213 Market Street Eighth Floor Harrisburg, PA 17101 Robert C. May, Esquire The Law Office Of Gregg 1L Durlofsky BY: Gregg R. Duflofsky, Esquire Attorney I.D. 66253 111 West Germantown Pike Plymouth Meeting, PA 19462 (610) 834-9483 Attorney for plaintiff(s) IN THE COURT OF COMMON PLEAS, CUMBERLAND COUNTY CIVIL ACTION - LAW HELEN JONES Plaintiff GE FINANCIAL ASSURANCE Defendant ENTRY OF APPEARANCE TO THE PROTHONOTARY: Kindly withdraw the appearance of Robert May, Esquire of May & May, P.C. as counsel for the Plaintiff in the above captioned matter. Robert May, Esquire Kindly enter the appearance of Gregg R. Durlofsky of the Law Offices of Gregg R. Duflofsky and Robert May as co-counsel for the plaimiffin the above captioned matter. CAPOZZI & ASSOCIATES, P.C. By: Donald R. Reavey, Esquire Attorney I.D. No. 82498 2933 North Front Street Harrisburg, PA 17110 (717) 233-4101 Attorney for Plaintiff Helen Jones HELEN JONES Plaintiff VS. GE FINANCIAL ASSURANCE Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION NO.: 904q58g-3 Civil Term ENTRY OF APPEARANCE TO THE PROTHONOTARY: Kindly enter the appearance of Donald R. Reavey, Esquire, of Capozzi & Associates, P.C., as counsel for the Plaintiff, Helen Jones. CAPOZZI & ASSOCIATES, P.C. Date: _,K' / tO[Oz.- Donald R. Reavey, Esquire Attorney I.D. No. 81498 2933 North Front Street Harrisburg, Pennsylvania 17110 Telephone: (717) 233-4101 (Attorneys for Plaintiff) CAPOZZI & ASSOCIATES, P.C. By: Donald R. Reavey, Esquire Attorney I.D. No. 82498 2933 North Front Street Harrisburg, PA 17110 (717) 233-4101 Attorney for Plaintiff Helen Jones HELENJONES Plaintiff VS. GE FiNANCIAL ASSURANCE Defendant : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : CIVIL ACTION : : NO.: 99-10873 Civil Term CERTIFICATE OF SERVICE I hereby certify that I did on this 17th day of April, 2002, serve a copy of the Entry of Appearance, upon the persons and in the manner indicated below: Service by First - Class Mail Addressed as Follows: Mark E. Gebauer, Esquire Eckert, Seamans, Cherin & Mellott, LLC 213 Market Street PO Box 1248 Harrisburg, PA 17108-1248 Date: ~] I 01 07.- CAPOZZI & ASSOCIATES, P.C. Donald R. Reavey, Esquire Attorney I.D. No. 81498 2933 North Front Street Harrisburg, Pennsylvania 17110 Telephone: (717) 233-4101 (Attorneys for Plaintiff) CAPOZZI & ASSOCIATES, P.C- By: Donald R. Reavey, Esquire Attorney I.D. No. 82498 2933 North Front Street Harrisburg, PA 17110 (717) 233-4101 Attorney for Plaintiff Helen Jones HELEN JONES Plaintiff VS. GE FINANCIAL ASSURANCE Defendant : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : : CIVIL ACTION : : NO.: 01-731 PRAECIPE TO DISCONTINUE TO THE PROTHONOTARY: Kindly discontinue, close, and end the above captioned matter with prejudice CAPOZZI & ASSOCIATES, P.C. Date: Donald R. Reavey, Esq,~a'We Attorney I.D. No. 81498 2933 North Front Street Harrisburg, Pennsylvania 17110 Telephone: (717) 233-4101 (Attorneys for Plaintiff) CAPOZZI & ASSOCIATES, P.C. By: Donald R. Reavey, Esquire Attorney I.D. No. 82498 2933 North Front Street Harrisburg, PA 17110 (717) 233-4101 Attorney for Plaintiff Helen Jones HELEN JONES Plaintiff VS. GE FINANCIAL ASSURANCE Defendant : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : : CIVIL ACTION : : NO.: 01-731 CERTIFICATE OF SERVICE I hereby certify that I did on this [[ftc, dayof ~..~1.~.~ ,2002, serve a copy of the Praecipe to Discontinue, upon the persons and in the manner indicated below: Service by First - Class Mail Addressed as Follows: Mark E. Gebauer, Esquire Eckert, Seamans, Cherin & Mellott, LLC 213 Market Street PO Box 1248 Harrisburg, PA 17108-1248 Date: CAPOZZI & ASSOCIATES, P.C. Donald R. Reavey, Esquire Attorney I.D. No. 81498 2933 North Front Street Harrisburg, Pennsylvania 17110 Telephone: (717) 233-4101 (Attorneys for Plfflntiff)