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Home My WebLink About01-2412 John A. Staffer, Esquire Attorney I. D. No. 43812 GOLDBERG, KATZMAN &SHIPMAN, P.C. 320 Market Street ?.O. Box 1268 Harrisburg, PA 17108-1268 Telephone: (717) 234-4161 Attorney for Defendant Erie Insurance Group KEITH W. ROSSMAN and · IN THE COURT OF COMMON PLEAS SUSAN L. ROSSMAN, Individually and · CUMBERLAND COUNTY, PENNSYLVANIA as Co-Administrators of the ESTATE OF · CHRISTOPHER W. ROSSMAN, · CIVIL ACTION - LAW Plaintiffs · o v. : NO. 01-2412 CIVIL TERM o ERIE INS~CE GROUP, : Defendant · PETITION FOR COURT APPROVAL AND ALLOCATION OF WRONGFUL DEATH AND SURVIVAl. ACTION SETTI,EIVIF~NTS AND NOW, comes the Defendant, Erie Insurance Group, by its attorneys, Goldberg, Katzman and Shipman, P.C., who file this Petition for Court Approval of Wrongful Death and Survival Action Settlements based on the following: 1. Plaintiffs Keith and Susan Rossman are adult individuals, husband and wife, who reside at 305 Cherokee Drive, Mechanicsburg, PA 17050. 2. Defendant Erie Insurance Group is an insurance company authorized to conduct business in the Commonwealth of Pennsylvania with a principal place of business at 4901 Louise Drive, Mechanicsburg, Pennsylvania 17055. 3. At all times relevant hereto, Plaintiffs were insured by the Erie Insurance Group for automobile insurance under Pioneer Family Auto Policy number Q09 1703197H. (A tree and correct copy of the Declaration Page for the Erie policy is attached hereto as Exhibit "A"). 4. The Pioneer Family Auto policy provided $500,000.00 in stacked underinsured motorist coverage to the Plaintiffs. 5. Plaintiffs Keith and Susan Rossman were the parents of Christopher W. Rossman, who was killed in an automobile accidem in the State of Texas on June 10, 2000. 6. At the time of his death, Christopher W. Rossman was 21 years old, unmarried, with no children or other dependents. 7. Plaintiffs have settled the liability claim against the party at fault for this accident, and now seek court approval to settle their claim for underinsured motorist benefits against Erie Insurance Group. 8. Erie Insurance Group has agreed to pay its full underinsured motorist policy limits of $500,000.00 to settle the Plaintiffs' claim. 9. The proposed settlement will be allocated as $380,000.00 to settle the wrongful death action and $120,000.00 to settle the survival action arising out of the death of Christopher W. Rossman. 10. The Commonwealth of Pennsylvania, Department of Revenue, has been apprised of the proposed allocation between wrongful death and survival claims and has approved the proposed allocation. (A copy of the March 14, 2001 approval letter form the Department of Revenue is attached hereto as Exhibit "B"). WHEREFORE, Defendant Erie Insurance Group respectfully requests this Honorable Court to approve the proposed settlement and allocation of wrongful death and survival action claims in accordance with the terms outlined in this Petition. Respectfully submitted, GOLDBERG, KATZMAN & SHIPMAN, P.C. By: Jo ' Attorney I. D. No. 43812 320 Market Street P. O. Box 1268 Harrisburg, PA 17105-1268 Telephone: (717) 234-4161 Attorneys for Defendant Erie Insurance Group DATE: c~/~.{.,/0 / 61546.1 VERIFICATION AND CONCURRENCE WE, KEITH W. ROSSMAN and SUSAN L. ROSSMAN, hereby verify that we have reviewed the proposed Petition for Court Approval and Allocation of Wrongful Death and Survival Action Settlements and concur in the proposed settlement and allocation. DATE KEITH W. ROSSMAN SUSAN L. ROSSMAN Exhibit A · ERIE INSURANC~ EXCHANGE PIONEER FAMILY AUTO POLICY CONTINUATION NOTICE AA7646 FETROW INS ASSOCIATES 09/17/99 TO 09/17/00 Q09 1703197 KEITH W ROSSMAN & SUSAN L ROSSMAN 3 05 CHEROKEE DR ° MECHANICSB~G PA 17055-2506 AGENT - FETROW INS ASSOCIATES 5299 E. TRINDLE RD. AGENT PHONE - (717) 766-3200 MECHANICSBURG PA 17055 3552 * ONG~T~TIONS~ A PIONEER EXPERIENCE ~TING CREDIT ~S * *' BEEN APPLIED TO ********************* POLICY PREMIX. ITEM 4. AUTOS COVERED AUTO YR ~~ VIN ST TER SYM ~TING C~SS DDP 1 93 FORD EXPLORER 1FMDU34X7PUA68888 PA 4F 6 A1AS-~LTI 2 00 BUIC LESABRELTD 1G4HR54K7YU121903 PA 4F A A1BS-~TI ITEM 5. INSU~CE IS PROVIDED WHERE A PREMIX, OR INCL, IS SHO~ FOR THE CO~~GE. COVE~GES, LIMITS ~D ~AL PREMISs ~E AS FOLLOWS- ~1 ~2 *****GOOD DRIVER ~TES APPLY***** - THE FULL TORT OPTION APPLIES TO ALL PRIVATE PASSENGER VEHICLES ___ LIABILITY PROTECTION_ BODILY IN~y $250M/PERSON $500M/ACC ' PROPERTY D~GE $10 OM/ACC 64 66 FIRST P~TY BENEFITS- 47 50 MEDICAL EXPENSE $100M INCOME LOSS SiM/MONTH, $15M ~IM~ 49 37 ACCIDENTAL DEATH $5M 11 8 F~E~L BENEFIT $2.5M 1 1 ~INS~ED MOTORISTS CO~~GE- 2 1 BOD INJ $250M/PERSON $500M/ACC-STAC~D ~ERINS~ED MOTORISTS COVE~GE_ 22 22 SOD INJ $250M/PERSON $500M/ACC-STAC~D PHYS I CAL D~GE COVE~GES _ 81 81 COMPREHENSI~ - $50 DED COLLISION_ $500 DED 33 61 OPTIONAL COVE~GES _ 79 13 7 RO~ SERVICE 4 4 T~Sp EXPENSES _ COLL $20/DAY, $900/LOSS 12 12 TOTAL ~aL PREMI~ FOR ~CH AUTO 4 05 480 TOTAL ~AL POLICY PREMI~ $ 885 ITEM 6. APPLIC~LE POLICY, E~ORSEMENTS, EXCEPTIONS TO DEC~TiONS ITEMS ALL A~OS - FAP 04/97, AFPN01 10/98- AFPA03 10/98- ~PE01 12/90 A~O 1 - AFPU01 04/99,. , A~o 2 - AFPU01 04/99,. ' · Exhibit B COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE . BUREAU OF INDIVIDUAL TAXES DEPARTMENT 280601 HARRISBURG, PA 17128-0601 Telephone 3/14/2001 717-783-0972 Michael j Kane, Esquire Kane and Mackin 3300 Trindle Road Camp Hill, PA 17011-4432 Re: Estate of Christopher W Rossman File Number 2100-0595 Dear Mr. Kane: The Department of Revenue has received a letter discussing the Petition for Approval of Settlement Claim to be filed on behalf of the above- referenced Estate in regard to a wrongful death and survival action. It has been forwarded to this Bureau for the Commonwealth, s approval of the allocation of the proceeds paid to settle the actions. Pursuant to the letter, the 21 year old decedent died as a result of a motor vehicle accident. Decedent is survived by the decedent s parents, Keth W. Rossman and Susan L. Rossman. ' Please be advised that, based upon these facts and for inheritance tax purposes only, this Department has no objection to the proposed allocation of the gross proceeds of this action, $ 380,000.00 to the wrongful death claim and $ 120,000.00 to the survival cl ' asset included in the ~ ....... , .a~m. Proceeds of a Pen.n.~:,],:.,.=.n.~..~ Jnh~~= _ ~ en~ s estate and are su~,,,,~-sur''vival action are an CosTs and ~_~'-,~ii~,_~nc~. uax. 42 Pa:C.S.A ~n~.-J.~ to the imoosit~on - ...... ~u~u De ~educted ~ .~_ __ ' ..... ' ,~- ~'.S. ~9106~ 9107. · allocated. In re Estate of Merryma____qn, 669 A.2d 1059 (Pa. Cmwlth. 1995). -" ~,~ same percentages as the proceeds are I trust that this letter is a sufficient representation of the Department,s position on this matter. As the Department has no objections to the Petition, an attorney from the Department of Revenue will not be attending any hearing regarding it has any questions or r .... ' Please contact me if you or the Court ~qu~res anything additional from this Bureau. Finally, the approval of this allocation is limited to this estate and does not reflect the position that the Department may take in any other proposed distribution of proceeds of a wrongful death / survival action. Sincerely, taD~cbeerTtax Division Bureau of Individual Taxes cc- Cumberland County Clerk of Courts John A. Staffer, Esquire Attorney I. D. No. 43812 GOLDBERG, KATZMAN & SI-IIP~, P.C. 320 Market Street P.O. Box 1268 Harrisburg, PA 17108-1268 Telephone: (717)234-4161 Attorllcy for Defendant Erie Insurance Group KEI~ W. ROSSMAN and · IN THE COURT OF COMMON PLEAS SUSAN L. ROSSMAN, Individually and · CUMBEP~AND COUNTY, PENNSYLVANIA as Co-Administrators of the ESTATE OF · CHRISTOPHER W. ROSSMAN, · CIVIL ACTION - LAW Plaintiffs : · o v. · NO. 01-2412 CIVIL TERM · · ERIE INSURANCE GROUP, : Defendant · ORDER AND NOW, this ~ ~ ~ day of ~ ,2001, it is hereby ordered that the Petition for Court Approval and Allocation of Wrongful Death and Survival Action Settlements in this case is APPROVED. It is further Ordered that $380,000.00 of the settlement proceeds shall be allocated to the settlement of the wrongful death action and $120,000.00 of the settlement proceeds shall be allocated to the settlement of the survival action. BY KEITH W. ROSSMAN and · IN THE COURT OF COMMON PLEAS SUSAN L. ROSSMAN, Individually and · CUMBERLAND COUNTY, PENNSYLVANIA as Co-Administrators of the ESTATE OF · CHRISTOPHER W. ROSSMAN, : CIVIL ACTION - LAW Plaintiffs · v. · NO. 01-2412 CIVIL TERM · ERIE INSURANCE GROUP, · Defendant · PRAECIPE TO THE PROTHONOTARY OF CUMBERLAND COUNTY: Please mark the above-captioned action settled and discontinued on the docket. Respectfully submitted, KEITH W. ROSSMAN and SUSAN L. ROSSMAN, Individually and as Co-Administrators of the ESTATE OF CHRISTOPHER W. ROSSMAN Plaintiffs DATE: 5-/a-z.~ / 62787.1 .CERTIFICATE OF SERVICE I HEREBY CERTIFY that I served a tree and correct copy of the foregoing document upon all parties or counsel of record by depositing a copy of same in the United States Mail at Harrisburg, Pennsylvania, with first-class postage prepaid on the ! ~ day of /~ ~ , 2001, addressed to the following: Mr. and Mrs. Keith Rossman 305 Cherokee Drive Mechanicsburg, PA 17055 Respectfully submitted, GOLDBERG, KATZMAN & SHIPMAN, P.C. B¥:~ . Jol~ A. ~atler, Esquire~~ Attorney I. D. No. 43 812 320 Market Street P. O. Box 1268 Harrisburg, PA 17108-1268 Telephone: (717) 234-4161 Attorneys for Erie Insurance Group KEITH W. ROSSMAN and : IN THE COURT OF COMMON PLEAS SUSAN L. ROSSMAN, Individually and ' CUMBERLAND COUNTY, PENNSYLVANIA as Co-Administrators of the ESTATE OF · CHRISTOPHER W. ROSSMAN, · CIVIL ACTION- LAW 305 Cherokee Drive . Mechanicsburg, PA 17055 . Plaintiffs · v. · No. o ERIE INSURANCE GROUP, · 4901 Louise Drive . P. O. Box 2013 . Mechanicsburg, PA 17055-0719 · · Defendant · PRAEClPE TO THE PROTHONOTARY OF CUMBERI~ND COUNTY: Please issue a Writ of Summons in the above-captioned matter against the Defendant Erie Insurance Group advising them that the Plaintiffs have commenced an action and that they will be required to defend. Respectfully submitted, By: KEITH W. ROSSMAN and SUSAN L. ROSSMAN, Individually and as Co-Administrators of the ESTATE OF CHR/STOPHER W. ROSSMAN 305 Cherokee Drive Mechanicsburg, PA 17055 Plaintiffs DATE: t./. / ~- .Z a~, [ 61832.1 Commonwealth of Pennsylvania County of Cumberland Keith W. Rossman and Susan L. Rossman, Individually and as Co-Administrators of the Estate of Christopher W. Rossman, 305 Cherokee Drive Mechanicsburg, PA 17055 VS. Erie Insurance Group Court of Conunon Plez~ 4901 Louise Drive P.O.Box 2013 No. _ 01-2412 Civil Term 19 .... Mechanisburg .................................... , PA 17055-0719 In ___ Civil Action_- Law To Erie Insurance Group You are hereby no6fied that Keith W. Rossman and Susan L. Rossman, Individually and -a-s---C_o_~__A~__'_n_i__s_t_r_a_t_ors of the Estate of Christopher Rossman the P]ain6ff has commenced an ac6on in ......... - .......................... ....... CJJzil- A~tiP~_r_/~1~ ............ against you which you are required to defend or a default judgment may be entered against you. - ...... (SEAL) ........ Curtis R. Long ........... ~~~_&_ .................. n~.~ .... r-- --