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Home My WebLink About13-2542 Supreme Court of Pennsylvania Court of Common Pleas Civil Cover Sheet For Prothonotary Use Only: Cy M kaL &yp County Docket No: .1'he inf00nati077 collected on this is sole/); fnr Coral/ admirristratirna J:rrrhoses•, '/'his form does rtnt stt:nler nr rel)lace the_i . ling arecl sert4ce of pleadin,f,s or wher papers as required by lave or rules ofcotrrt. Commencement of Action: S Complaint 0_ Writ of Summons F1 Petition ❑ Notice of Appeal ❑ Transfer from Another Jurisdiction ❑ Declaration of Taking E C Lead Plaintiff s Name: Lead Defendant's Name: T E IV D 1✓� C i co I RQCU JetLr U Name of Plaintiff/Appellant's Attorney: N Are money damages requested? : es ❑ No Dollar Amount Requested: ❑ within arbitration limits (Check one) ! 'y outside arbitration limits A Is this a Class Action Suit? ❑ Yes ` No Nature of the Case Place an "X" to the left of the ONE case category that most accurately describes your PRIMARY CASE. If you are making more than one type of claim, check the one that you consider most important. TORT (do not include Mass Tort) CONTRACT. (do not include Judgments) CIVIL APPEALS ❑ Intentional ❑ Buyer Plaintiff Administrative Agencies ❑ Malicious Prosecution ❑ Debt Collection: Credit Card ❑ Board of Assessment ❑ Motor Vehicle ❑ Debt Collection: Other ❑ Board of Elections ❑ Nuisance — ❑ Dept. of Transportation El Premises Liability ❑ Zoning Board S ❑ Product Liability (does not include ❑ Statutory Appeal: Other mass tort) F1 Employment Dispute: ❑ Slander/Libel/ Defamation Discrimination ❑ C ❑ Other: Employment Dispute: Other T _ -- Judicial Appeals ❑ MDJ - Landlord/Tenant I Other: ❑ MDJ - Money Judgment d MASS TORT V N D 1~&U)SAD ❑ Other: ❑ Asbestos 4WTD %2cSr C'_.t..610 N ❑ Tobacco [] Toxic Tort - DES ❑ Toxic Tort - Implant REAL PROPERTY MISCELLANEOUS ❑ Toxic Waste ❑ Ejectment ' ❑ Common Law /Statutory Arbitration B ❑ Other: ❑ Eminent Domain/Condemnation F1 Declaratory Judgment ❑ Ground Rent ❑ Mandamus ❑ Landlord/Tenant Dispute ❑ Non - Domestic Relations --�— ❑ Mortgage Foreclosure Restraining Order PROFESSIONAL ❑ Partition ❑ Quo Warranto ❑ Dental ❑ Quiet Title ❑ Replevin ❑ Legal ❑ Medical ❑ Other: ❑ Other: ❑ Other Professional: Pa.R.C.P. 205.5 212010 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA BETTYE J. ANDERSON, CIVIL ACTION - LAVIE Plaintiff V. No. 6- as�l GEICO GENERAL INSURANCE ° -. COMPANY, a Defendant JURY TRIAL DEMAND NOTICE TO DEFEND 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, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE CAN PROVIDE YOU WITH INFORMATION ABOUT HIRING A LAWYER. IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. CUMBERLAND COUNTY BAR ASSOCIATION 2 LIBERTY AVENUE CARLISLE, PA 17013 -3387 TELEPHONE NO. (717) 249 - 3166 o t o)g.-�* at-w 6 �sb (2 4 A-- aCo2ba s w EN LA CORTE DE ALEGATOS COMUN DEL CONDADO DE CUMBERLAND, PENNSYLVANIA DIVISION CIVIL NOTICIA Le han demandado a usted en la corte. Si usted quiere defenderse de estas demandas expuestas en las paginas siguientes, usted tiene viente (20) dias to plazo al partir de la fecha de la demanda y la notification. Usted debe presenter una apariencia escrita o en persona o por abogado y archivar en la corte en forma escrita sus defenses o sus objeciones a las demandas en contra de sus persona. Sea avisado que si usted no se defiende, la corte tomatara medidas y puede entrar una orden contra usted sin previo aviso o notificacion y por cualquier queja o alivio que es pedido en la peticion de demanda. Usted puede perder dinero o sus propiedades o otros derechos importantes para usted. LLEVE ESTA DEMANDA A UN ABODAGO INMEDIATAMENTE. SI NO TIENE ABOGADO O SI NO TIENE EL DINERO SUFICIENTE DE PAGER TAL SERVICIO, VAYA EN PERSONA O LLAME POR TELEFONO A LA OFICINA CUYA DIRECCION SE ENCUENTRA ESCRITA ABAJO PARA AVERIGUAR DONDE SE PUEDE CONSEGUIR ASISTENCIA LEGAL. SI USTED NO PUEDE PAGARLE A UN ABOGADO, ESTA OFICINA PUEDE PROVEERE INFORMACION ACERCA AGENCIAS QUE PUEDAN OFRECER SERVICIOS LEGAL A PERSONAS ELIGIBLE AQ UN HONORARIO REDUCIDO A GRATIS. CUMBERLAND COUNTY BAR ASSOCIATION 2 LIBERTY AVENUE CARLISLE, PA 17013 -3387 TELEPHONE NO. (717) 249 -3166 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA BETTYE ANDERSON, : CIVIL ACTION Plaintiff V. NO. GEICO GENERAL INSURANCE COMPANY, , Defendant JURY TRIAL DEMANDED COMPLAINT AND NOW, this—!�ay of May, comes mes Plaintiff, by and through her attorneys, Diveglia and Kaylor, P.C., who files this Complaint on her behalf and avers in support thereof- 1 . Plaintiff, Bettye Anderson, is an adult individual who resides at 2 West Oakwood Drive, Carlisle, Cumberland County, Pennsylvania 17015. 2. Defendant is a corporation licensed to transact insurance business in the Commonwealth of Pennsylvania, with its office at 5260 Western Avenue, Chevy Chase, Maryland, 20815. 3. On or about December 11, 2007, Plaintiff was insured with Defendant for a motor vehicle insurance policy providing for underinsured coverage, a copy of said policy number 4075- 62 -17 -08 being issued and in the possession of Defendant, but attached hereto is the declaration sheet related thereto, attached as Exhibit 1 4. The policy issued by Defendant to Plaintiff provided for underinsured motorist coverage protection for Plaintiff in the event she was involved in a motor vehicle collision and the colliding vehicle involved lacked sufficient insurance coverage to satisfy the incurred claims of Plaintiff. 5. On December 11, 2007, Plaintiff was involved in a motor vehicle collision and incurred injuries and losses, which well exceeded the $15,000 policy limits of the tortfeasor. Said limits were tendered and accepted by Plaintiff with the consent of defendant on August 31, 2011. 6. In addition to obtaining the consent to settle third party claims from defendant, Plaintiff has in all other manner fully and completely complied with the provisions and conditions set forth by Defendant in its policy to obtain underinsured motorist benefits. 7. To the best of Plaintiff's knowledge, the policy at issue did not contain a mandatory arbitration clause. 8. The collision involved was entirely the fault of the third party tortfeasor in that he negligently struck the rear of Plaintiffs vehicle while Plaintiff was stopped or nearly stopped to merge into the adjacent roadway which at the time was filled with oncoming vehicles thus requiring plaintiff to stop. 9. As a result of the aforesaid collision caused by the negligence of tortfeasor, Plaintiff incurred injuries to her low back and was required to undergo physical therapy, injections, and eventually low back surgery. 10. As a result of the aforesaid collision, Plaintiff was disabled from her employment and suffered an uncompensated loss of earning. 11. As a result of the aforesaid collision and injuries, Plaintiff had to return to his employment and worked in pain and incurred great mental distress. 12. The injuries from the aforesaid collision caused Plaintiff pain and discomfort which continues to the present. 13. The injuries caused and continue to cause Plaintiff serious impairment of bodily function of her low back that has caused serious disruption of her daily life's activities from date of accident to present. 14. Notice of intent to claim underinsured motorist benefits from Defendant was given by Plaintiff to Defendant, and Plaintiff fully documented her claim with medical records and reports. She additionally provided defendant with prior medical records that defendant requested. 15. The parties were unable to reach an amicable agreement under the terms of the underinsured motorist policy. WHEREFORE, Plaintiff demands judgment against Defendant for a sum in excess of the arbitration limits of Cumberland County, but less than the limits required for the United States District Court to have jurisdiction. Respectfully Submitted, DIVEGLIA 8v KAYLOR, P.C. Date: Archie V. Diveglia Es , , ire Attorney I.D. # 17140 Two Lincoln Way W New Oxford, PA 17350 (717) 624 -2500 Attorney of Plaintiff EXHIBIT 1 GEICO TEL: 1 -800- 841 -3000 U- 31 -DP -19 (7 geico.com FAX: 1- 305- 503 -9278 Policy Number: 4075- 62 -17 -08 GEICO GENERAL INSURANCE COMPANY 0 5260 Western Avenue, Chevy Chase, Maryland 20815 0 = FAMILY AUTOMOBILE POLICY ENDORSEMENT DECLARATIONS This is a description of your coverage. Please keep for your records. 0 Item 1: Named Insured and Address BETTYE J ANDERSON AND JOHN D ANDERSON 0 2 W OAKWOOD DR 0 CARLISLE PA 17015 -9383 7 E -Mail Address: betjeana @aol.com Date Issued: 12 -14 -07 ENDORSEMENT EFFECTIVE: 12 -14 -07 Policy Period From 08 -28 -07 to 02 -28 -08 12:01 a.m. Local time at the address of the named insured. The insured vehicle(s) will be regularly garaged in the town and state shown in Item 1, except as noted in the Vehicle Segment. Contract Type: A30PA CONTRACT AMENDMENTS: ALL VEHICLES - A184 A301 - JA A54PA UNIT ENDORSEMENTS: A115 (VEH 1,2); A431 (VEH 1,2); A470 (VEH 1,2); A471 (VEH 1,2); UE316 (VEH 1,2); A468 (VEH 1,2) • - AS A GEICO FAMILY AUTO POLICYHOLDER, WHEN YOU OR YOUR SPOUSE (IF RESIDING WITH YOU) :"NTS- CAR -TILE U":ITED STATES OR CANADA, THE RENTAL—CAR IS COVERED UNDER YOUR GEICO POLICY. THE SAME POLICY PROVISIONS AND CONDITIONS, COVERAGE LIMITS AND DEDUCTIBLES THAT ;r APPLY TO YOUR PERSONAL CAR ALSO APPLY TO THE RENTAL VEHICLE. IF YOU HAVE MORE THAN ONE CAR INSURED, THE RENTAL CAR WOULD BE COVERED WITH THE BROADEST (HIGHEST LIMITS, LOWEST DEDUCTIBLES) COVERAGES INCLUDED UNDER THE COLLISION ON YOUR POLICY. REMEMBER COMPREHENSIVE AND COLLISION COVERAGES EXTEND ONLY IF YOU HAVE PURCHASED THEM FOR YOUR OWN VEHICLES. THE MECHANICAL BREAKDOWN COMPONENT OF YOUR MULTI -RISK COVERAGE, IF PURCHASED, IS UNIQUE TO YOUR VEHICLE AND DOES NOT EXTEND TO RENTAL VEHICLES. - Please review the reverse side of this page for coverage and discount information. -The GEICO Property Agency can arrange for your homeowner's, renter's and condominium owner's insurance needs. Just call toll -free at 1- 888 - 306 -9500. Refinancing? Let us provide the new Homeowner's Policy you need. -You are currently carrying the Limited Tort option on your policy. -Your policy has been adjusted per your recent request. INSURED COPY PAGE 1 TURN OVEI GEICO GENERAL INSURANCE COMPANY U- 31 -DP -20 (7. Date Issued: 12 -14 -07 T -8 Policy Number: 4075 -62 -17.08 VEHICLE RATED LOCATION CLASS 1 04 SATN 5GZCZ63434S894217 CARLISLE PA 17015 A -L -50 -64 -S 2 00 GMC 1 GKCT18WIYK200067 CARLISLE PA 17015 A -N -65 -69 A COVERAGES LIMI'T'S OR PREMIUMS Coverage applies where a premium or 0.00 is shown for the vehicle. DEDUCTIBLES Vehicle 1 Vehicle 2 Vehicle BODILY INJURY LIABILITY EACH PERSON /EACH OCCURRENCE $300,000/$300,000 25.70 22.50 PROPERTY DAMAGE LIABILITY $100,000 42.90 35.90 FIRST PARTY BENEFITS OPTION A 6.80 5.60 UNINSURED MOTORISTS /NO STACKING EACH PERSON /EACH OCCURRENCE $300,000/$300,000 11.20 11.20 UNDERINSURED MOTORIST /NO STACKING EACH PERSON /EACH OCCURRENCE $300,000/$300,000 12.90 12.90 COMPREHENSIVE $500 DED 16.30 6.90 COLLISION $500 DED 68.00 34.10 EMERGENCY ROAD SERVICE FULL 5.10 7.20 RENTAL REIMBURSEMENT $25 PER DAY 10.80 10.80 $750 MAX SIX MONTH PREMIUM PER VEHICLE: $ 199.70 $ 147.10 If you elect to pay your premium in installments, you may be subject to an additional fee for each installment. The fee amount will be shown on your billing statements and is subject to change. Premiums for these vehicles are based on the following Discounts and /or Surcharges: DISCOUNTS MULTI -CAR (VEH 1,2); ANTI -LOCK BRAKES (VEH 1,2); ANTI -THEFT DEVICE (VEH 1,2); 5 YEAR GOOD DRIVING (VEH 1,2); PASSIVE RESTRAINT /AIR BAG (VEH 1,2) Lienholder Vehicle 1 Lienholder Vehicle 2 Lienholder Vehicle GMAC CORNERSTONE FEDERAL CREDIT UNI INSURED COPY PAGE 0 VERIFICATION a The foregoing COMPLAINT is based upon the information which has been gathered by my counsel in the preparation of the lawsuit. I have read the COMPLAINT and to the extent that it is based upon information which I have given to my counsel, it is true and correct to the best of my knowledge, information and belief. To the extent that the content is that of counsel, I have relied upon counsel in making this verification. This statement and verification are made subject to the penalties of Pa. C.S. §4904 relating to unsworn falsification to authorities, which provides that if I make knowingly false averments, I may be subject to criminal penalties. - 31 -- A "a" Date v Bettye Oiderson, Plaintiff 1 ' IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA BETTYE J. ANDERSON, CIVIL ACTION - LAOfi'' Plaintiff V. No. 13-2542 GEICO General Insurance, Defendant ; JURY TRIAL DEMANDED CERTIFICATE OF SERVICE AND NOW, this 151h day of May, 2013, I, Archie V. Diveglia, Esquire for Diveglia 8v Kaylor, P.C., hereby certify that a copy of the foregoing COrA-PLMNT- was served by certified mail, certification number 7010 2780 002 21*79, addressed to the following: ,— � c:.:: GEICO General Insurance '° c 1 5250 Western Avenue Chevy Chase, MD 20815 and was returned signed by the defendant on May 101'', 2013, acknowledging receipt thereof, the return receipt card is attached hereto. DIVEGLIA 8v KAYLOR, P.C. Arch' . Diveglia, quir Attorney I.D. #1714 Two Lincoln Way W st New Oxford, PA 17350 (717) 524-2500 Attorney for Plaintiff SENDER: COMPLETE THIS. y r COPv?PLETE THIS SECTION ON ■ Complete items t,2,and 3.Also. A. Signature item 4 ff Restricted Delivery is desired. X 0 Agent ■ Print your name and address on the reverse 0 Addressee so that we pan return the card to you. B. Received by(Printed Name) C. Date ■ Attach this'card to the back of the mailpiece, P111101111d Btu 911, J/�—/D ./ or on the front if space permits. D. Is delNm item 1? Yes 1, Article Add to: If YES,ent9®h #Tress below: 0 No ��CO Genera! 52-too Wtstrr(I R f-l'v " t r✓ zoi ( 3. Service'iyps edMed Mall 0 Express Mail A Registered 0 Return Receipt for Merchandise 0 Insured Mail 0 C.O.D. 4. Restrioted Delivery?(Orbs Fee)Ak 0 yes 2. Article Number 7010 2780 0002 2153 9708 :5$ (transfer from service label) Ps Form 3811,February 2004 Domestic Return Receipt 102595-02-W1540 a i ' Hill 1111 H ( III. H I i C IN THE COURT OF COMMON PLEAS FOR MCC c CUMBERLAND COUNTY, PENNSYLVANIA r BETTYE ANDERSON, y, Plaintiff NO. 13-2542 n V. CIVIL ACTION - LAW GEICO GENERAL INSURANCE COMPANY, JURY TRIAL DEMANDED Defendant PRAECIPE TO SETTLE,DISCONTINUE AND END TO THE PROTHONOTARY: Kindly mark the above-captioned matter SETTLED,DISCONTINUED AND ENDED. Divegli d Kaylor, C. (�( ,3 BY: l Archie Diveglia, squ Attorney for the Aaint�4