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HomeMy WebLinkAbout14-1101 Supreme Coi 20331157 C Y Jer KMH n t ;v Tennsvly ania �r «'R # }3 - Court:o Comi Pleas - - /-'/ Y% Civil Cover -Sheet For Prothonomy L'se Ontr: C UMBERLAND County Docket No: << 177e information collected on this form is used soleh for court administration purposes. This form does not supplement or replace the filing as?d service of pleadings or other• papers as required by lair! or rules of court. Commencement of Action: S 13 Complaint ❑ Writ of Summons ❑ Petition E Transfer from Another Jurisdiction Declaration of Takin C Lead Plain&aftfi rm Mutual Automobile Lead Defendant's Name: T rahob C ompany ABDISALM HAJI .I 0 Are money damages requested? E) Yes ❑ No Dollar Amount Requested: ® within arbitration limits N (check one) ❑ outside arbitration limits Is this a Class Action Suit? ❑ Yes IR No Is this an NMJ Appeal? ❑ Yes 60 No A Benjamin W. Lawrence,209032 Name of Plaintiff /Appellant's Attorney: ❑ Check here if you have no attorney (are a Self- Represented ]Pro Se] Litigant) 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 Protection Administrative Agencies ❑ Malicious Prosecution ❑ Debt Collection: Credit Card ❑ Board of Assessment ❑ Motor Vehicle ❑ Debt Collection: Other ❑ Board of Elections ❑ Nuisance ❑ Dept. of Transportation S ❑ Premises Liability ❑ Statutory Appeal: Other j E [3 Product Liability (does not include [3 Employment Dispute Mass tort) Discrimination C /Slander/Libel/Defamation ❑ Employment Dispute: Other ❑ Zoning Board T L`I Other: ❑ Other: I Sv�rogcr i L� O ❑ Other: N MASS TORT ❑ Asbestos B ❑ Tobacco REAL PROPERTY MISCELLANEOUS ❑ Toxic Tort - DES ❑ Ejectment ❑ Common Law /Statutory Arbitration ❑ Toxic Tort — I.mplant ❑ Eminent Domain /Condemnation ❑ Declaratory Judgment ❑ Toxic Waste ❑ Ground Rent ❑ Mandamus ❑ Other: ❑ Landlord/Tenant Dispute ❑ Non - Domestic Relations ❑ Mortgage Foreclosure: Residential Retraining Order ❑ Mortgage Foreclosure: Commercial ❑ Quo Waranto ❑ Partition ❑ Replevin PROFESSIONAL LIABILITY ❑ Quiet Title ❑ Other: ❑ Dental ❑ Other: ❑ Legal ❑ Medical . ❑ Other Professional: Updated 1/1/2011 FEB V to. Soo cU Y LVANI A IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION ,tate Farm Mutual Automobile Insurance Company - - -- - -- . . Plaintiff No: VS. COMPLAINT IN CIVIL ACTION ABDISALM HAJI Defendant FILED ON BEHALF OF Plaintiff COUNSEL OF RECORD OF THIS PARTY: Benjamin W. Lawrence,209032 WELTMAN, WEINBERG & REIS CO., L.P.A. 325 CHESTNUT STREET SUITE 501 PHILADELPHIA, PA 19106 -2614 215 - 599 -1500 FAX: 215 - 599 -1505 20331157 C Y Jer KMH a w,k Q IU9.^7 S-(� A t J IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION State Farm Mutual Automobile Insurance Company Plaintiff VS. Civil Action No ABDISALM HAJI Defendant COMPLAINT AND 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 an 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. 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. LAWYER REFERRAL SERVICE CUMBERLAND COUNTY BAR ASSOCIATION 32 SOUTH BEDFORD STREET CARLISLE, PA 17013 (717) 249 -3166 WELTMAN, WEINBERG & REIS CO., L.P.A. BY: Benjamin W. Lawrence, Esquire Attorney for Plaintiff(s) Pa. Identification No.209032 325 Chestnut Street, Suite 501 Philadelphia, PA 19106 Phone: 215.599.1500 Fax: 215.599.1505 File #20331157 STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY Court of Common Pleas CUMBERLAND County VS. ABDISALM HAJI NO. CIVIL ACTION — COMPLAINT 1. Plaintiff is a business organization licensed and authorized to conduct business in the State of Illinois with a place of business located at P.O. BOX 2371 BLOOMINGTON, IL 61702. 2. Defendant is an adult individual who at all time pertinent hereto resided at 607 A GENEVA DR APT 32 MECHANICSBURG, PA 17055. 3. Plaintiff issued a policy of motor vehicle insurance whereby Plaintiff agreed to insure the motor vehicle involved in this incident ( "Insured Vehicle "), owned by Plaintiff's insured. 4. On or about July 23, 2012 Defendant was the operator of a motor vehicle which vehicle did negligently, recklessly and /or carelessly collide with the Plaintiff Insured's vehicle at or near East Trindle Road and Sheely Lane, Mechanicsburg, Pennsylvania. 5. The negligence and /or carelessness of the Defendant consisted of the following: a. Failing to have his motor vehicle under such control as the situation warranted; b. Operating his motor vehicle in complete disregard of the point and position of Plaintiff's vehicle; c. Failing to keep a proper lookout; d. Traveling too fast for conditions; e. Disregarding traffic control devices; f. Failing to abide by the Rules of the Road and the Motor Vehicle Code of Pennsylvania; g. Being otherwise negligent under the circumstances; and, h. Being negligent as a matter of law as may be relevant through discovery and /or at the time of trial. 6. As a direct and proximate result of Defendant's negligence, the Plaintiff Insured's vehicle sustained property damage and /or incurred rental charges in the total amount of $3726.16. See attached as Exhibit 1" a copy of the damage documentation which documents Plaintiff further intends to introduce at the arbitration in this matter. 7. Pursuant to the insurance policy issued by Plaintiff and as a result of the aforesaid payment, Plaintiff became subrogated to the claim of its Insured against Defendant. WHEREFORE, Plaintiff demands Judgment against Defendant in the amount of $3726.16 plus interest and costs. WELTMAN, WEINBERG & REIS, CO., L.P.A. L Benjamin A. Owrence, Esquire PA I.D. 032 325 Chestnut Street Suite 501 Philadelphia, PA 19106 (215) 599 -1500 WWR #20331157 EXHIBIT 1 STATE FARM INSURANCE COMPANIES LIKE A GOOD NEIGHBOR, STATE FARM IS THERE 1 STATE FARM DRIVE CONCORDVILLE, PA 19339 PHONE (800) 839 -8050 -- FAX ALL SUPPLEMENT REQUESTS TO (800) 916 -0342 * ** ESTIMATE * ** 07/30/2012 01:56 PM Owner Owner: ERIK M KNOBL Address: 120 N 2ND ST City State Zip: WORMLEYSBURG, PA 17043 -1309 Home /Day: (717)737 -0479 Cell: (717)798 -2681 Control Information Claim # : 38 -1H76 -32101 Loss Date /Time: 07/23/2012 Loss Type: Collision Deductible: $100.00 Ins. Company: State Farm Insured: ERIK M KNOBL Home /Day: (717)737 -0479 Cell: (717)798 -2681 Claim Rep: Team CR Unit Cl ACC COC Work /Day: (888)713 -4694 Inspection Inspection Date: 07/30/2012 01:56 PM Inspection Type: Field Inspection Location: IAA - Harrisburgh Address: 5515 Old Susquehanna Trail City State Zip: Manchester, PA 17345 Primary Impact: Left Front Corner Driveable: No Received Date /Time: 07/30/2012 01:13 PM Appraiser License # 134057 Contact: BOB INNOCENT Work /Day: (800)839 -8050 FAX: (800)916 -0342 Remarks ESTIMATE WAS PREPARED BY: BOB INNOCENT (ELECTRONIC SIGNATURE) SUPPLEMENTAL REQUESTS MUST BE FAXED TO 1 -800- 916 -0342 PRIOR TO STARTING THOSE REPAIRS. IF NO FAX CALL 1- 800 - 839 -8050. ANY SUPPLEMENT TO THIS ESTIMATE REQUIRES THE APPROVAL OF A STATE FARM REPRESENTATIVE PRIOR TO THE PERFORMANCE OF THAT REQUEST. ............................. Recycled parts located @: Aumillers Auto parts, Halifax PA 717 -896 -3994 "Bumper covers do not match color of vehicle" Vehicle 1999 Ford Escort LX 4 DR Sedan 4cyl Gasoline 2.0 4 Speed Automatic 1999 Ford Escort LX 4 DR Sedan 07/30/2012 02:03 PM Page 1 of 4 Claim # : 38 -1H76 -32101 07/30/2012 Lic.Plate: UNK Lic State: Lic Expire: VIN: 1FAFP10P8XW233940 Prod Date: Mileage: 71,989 Veh Insp# Mileage Type: Actual Condition: Code: P1553C Ext. Refinish: Two -Stage Ext. Color: Silver Int. Refinish: Two -Stage Options AM /FM Stereo Air Conditioning Automatic Trans Center Console Dual Airbags Intermittent Wipers Power Brakes Power Steering Rear Window Defroster Rem Trunk -L /Gate Release Tinted Glass Velour /Cloth Seats Damages In# Op GDE Description MFR.Part No. Price AJ% B% HRS R - -- -- - - -- -------------- - - - - -- ---------- - - - - -- -- - - - - -- -- - - - - -- - - -- -- 1 EU 618 Section,Front Bod IT RECYCLED PART 1200.00* +33.00 27.4 SM MC 07 2 L 618 Section,Front Bod IT Refinish 11.4 RF MC 13 9.0 Surface 0.6 Two -stage setup 1.8 Two -stage 3 SB 143 Windshield,Shaded Sublet Repair 184.60* SM >> Windshield City, Doe Run Rd Manhiem Pa. 1 -888- 966 -4488 >> Price installed including mldings, Glass kit, primer & PA sales tax. 4 E 954 Clock Spring FBCZ14A664AA 295.43 1.0 ME 5 E 74 Module,Airbag Contro F8CZ14B321AC 281.75 1.3 ME 6 E 866 Airbag,Steering Whee F8CZ54043B13DAA 707.65 INC ME MC O1 7 E 949 Airbag,Instrument Pn F6CZ54044A74DAB 1186.30 0.5 ME MC O1 7 Items MC Message 01 CALL DEALER FOR EXACT PART # / PRICE 07 STRUCTURAL PART AS IDENTIFIED BY I -CAR 13 INCLUDES 0.6 HOURS FIRST PANEL TWO -STAGE ALLOWANCE Estimate Total & Entries Gross Parts $2,471.13 Other Parts $1,200.00 Paint Materials $296.40 Line Item Markup $396.00 Parts & Material Total $4,363.53 Tax on Parts & Material Q 6.000$ $261.81 Labor Rate Replace Hrs Repair Hrs Total Hrs Sheet Metal (SM) $48.00 27.4 27.4 $1,315.20 Mech /Elec (ME) $48.00 2.8 2.8 $134.40 Frame (FR) $50.00 Refinish (RF) $48.00 11.4 11.4 $547.20 Paint Materials $26.00 Labor Total 41.6 Hours $1,996.80 Tax on Labor ® 6.000% $119.81 Sublet Repairs $184.60 1999 Ford Escort LX 4 DR Sedan 07/30/2012 02:03 PM Page 2 of 4 Claim # : 38 -1H76 -32101 07/30/2012 Gross Total $6,926.55 Less: Deductible $100.00 - Net Total $6,826.55 Alternate Parts Y /00 /00 /00 /00 /00 CUM 00 /00 /00 /00 /00 Zip Code: 17046 LEBANON Audatex Estimating 6.0.726 ES 07/30/2012 02:03 PM REL 6.0.726 DT 07/01/2012 DB 07/15/2012 Copyright (C) 2011 Audatex North America, Inc. 2.4 HRS WERE ADDED TO THIS ESTIMATE BASED ON AUDATEX'S TWO -STAGE REFINISH FORMULA. Op Codes * = User- Entered Value E = NEW PART NG = Replace NAGS EC = ** NON -OEM PART ET = Partial Replace Labo EP = ** NON -OEM PART EU = RECYCLED PART TE = Partial Replace Pric PM = REMAN /REBUILT PART UM = REMAN /REBUILT PART L = Refinish PC = RECOND PART UC = RECOND PART TT = Two -Tone SB = Sublet Repair N = ADDITIONAL OPERATION BR = Blend Refinish I = Repair IT = Partial Repair CG = Chipguard RI = R & I Assembly P = Check RP = RP- RELATED PRIOR This report contains proprietary information of Audatex and may not be disclosed to any third party (other than the insured, claimant and others on a need to know basis in order to effectuate the claims process) without Audatex's prior written consent. Copyright (C) 2011 Audatex North America, Inc. 1999 Ford Escort LX 4 DR Sedan 07/30/2012 02:03 PM Page 3 of 4 Claim # : 38 -1H76 -32101 07/30/2012 Estimate Summary Page Gross Total $6,926.55 Less: Deductible $100.00 - Net Total $6,826.55 Audatex Estimating 6.0.726 ES 07/30/2012 02:03 PM REL 6.0.726 DT 07/01/2012 DB 07/15/2012 Copyright (C) 2011 Audatex North America, Inc. SM -SHEET METAL ME- MECH /ELEC FR -FRAME RE- REFINISH SY- SYSTEM THIS IS AN ESTIMATE. REPAIR FACILITIES MUST INSPECT THE VEHICLE TO DETERMINE IF ANY REPAIRS NOT LISTED ARE REQUIRED, AND TO CONTACT STATE FARM BEFORE MAKING SUCH REPAIRS. REPAIRER ALSO IS RESPONSIBLE FOR CONDUCTING ANY NECESSARY INSPECTION AND SAFETY CHECKS PRIOR TO AND AFTER COMPLETING REPAIRS. IF THIS APPRAISAL HAS BEEN PREPARED BASED ON THE USE OF AFTERMARKET CRASH PARTS, AND IF THE USE OF ANY AFTERMARKET CRASH PART VOIDS THE EXISTING WARRANTY ON THE PART BEING REPLACED OR ANY OTHER PART, THE AFTERMARKET CRASH PART SHALL HAVE A WARRANTY EQUAL TO OR BETTER THAN THE REMAINDER OF THE EXISTING WARRANTY. ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE COMPANY OR OTHER PERSON FILES AN APPLICATION FOR INSURANCE OR STATEMENT OF CLAIM CONTAINING ANY MATERIALLY FALSE INFORMATION OR CONCEALS FOR THE PURPOSE OF MISLEADING, INFORMATION CONCERNING ANY FACT MATERIAL THERETO COMMITS A FRAUDULENT INSURANCE ACT, WHICH IS A CRIME AND SUBJECTS SUCH PERSON TO CRIMINAL AND CIVIL PENALTIES. ANY PERSON WHO KNOWINGLY AND WITH INTENT TO INJURE OR DEFRAUD ANY INSURER FILES AN APPLICATION OR CLAIM CONTAINING ANY FALSE, INCOMPLETE OR MISLEADING INFORMATION SHALL, UPON CONVICTION, BE SUBJECT TO IMPRISONMENT FOR UP TO SEVEN YEARS AND PAYMENT OF A FINE OF UP TO $15,000. YOU ARE UNDER NO REQUIREMENT TO USE ANY SPECIFIC REPAIR FACILITY TO PERFORM REPAIRS TO YOUR VEHICLE. COSTS ABOVE THE APPRAISED AMOUNT MAY BE THE RESPONSIBILITY OF THE VEHICLE OWNER. INFORMATION REGARDING REPAIR FACILITIES WHICH WILL BE ABLE TO REPAIR THE VEHICLE FOR THE APPRAISED AMOUNT IS AVAILABLE FROM YOUR CLAIM HANDLER OR ONLINE AT WWW.STATEFARM.COM THIS APPRAISAL INCLUDES ONLY THOSE INCIDENTAL CHARGES, KNOWN AND AGREED UPON BY THE APPRAISER AT THE TIME OF APPRAISAL, INCLUDING TOWING, PROTECTIVE CARE, CUSTODY STORAGE, DEPRECIATION, BATTERY AND TIRE REPLACEMENT. ANY TOWING, STORAGE, OR OTHER INCIDENTAL CHARGES KNOWN BUT NOT LISTED ON THE ESTIMATE ARE FORWARDED TO THE CLAIM HANDLER FOR DISPOSITION. FAILING TO PRESENT THIS ESTIMATE TO THE REPAIRING FACILITY BEFORE A REPAIR MAY RESULT IN ADDITIONAL EXPENSE TO YOU. COPY OF THE FORM(S) WAS SENT /GIVEN TO THE CONSUMER ON 1999 Ford Escort LX 4 DR Sedan 07/30/2012 02:03 PM Page 4 of 4 a VERIFICATION I, Benjamin W. Lawrence, Esquire, attorney for the Plaintiff(s) do hereby swear and affirm that the averments in the attached Complaint are true and correct to the best of my knowledge, information and /or belief. These averments are made subject to the penalties of 18 Pa.C.S.A. §4904 relating to unsworn falsification to authorities. Benja n W. Lawrence Date �� Ronny R Anderson Sheriff Jody S Smith Chief Depu Richard W Stewart Solicitor SHERIFF'S OFFICE OF CUMBERLAND COUNTY oFc;-; oF,RE :4-1ERIFF - �-' THE PR -An�3 .1:` 7R/4 APR _7 PN °/72 CUN$ERLAND COUNTY PENNSYLVANIA State Farm Mutual Automobile Insurance Co. VS. Abdisalam M Haji Case Number 2014-1101 SHERIFF'S RETURN OF SERVICE 04/02/2014 Ronny R Anderson, Sheriff, being duly sworn according to law, states he made diligent search and inquiry for the within named Defendant to wit: Abdisalam M Ho/i, but was unable to locate the Defendant in his bailiwick. The Sheriff therefore returns the within requested Complaint & Notice as "Not Found" at 607 A. Geneva Drive, Apt. 32, Upper Allen, Mechanicsburg, PA 17055. Deputies were advised by a neighbor that the defendant moved from the residence within the past year and to this date the Mechanicsburg Postmaster has not been able to provide a good forwarding address and the Complaint has since expired. SHERIFF COST: $39.30 SO ANSWERS, April 02, 2014 RONNYR ANDERSON, SHERIFF (c) County SuRe Sheriff: Tel::molt Inc. WELTMAN, WEINBERG & REIS CO., L.P.A. BY: Benjamin W. Lawrence, Esquire I.D. No.209032 325 Chestnut Street, Suite 501 Philadelphia, PA 19106 Phone: 215.599.1500 Fax: 215.599.1505 File # 20331157 Attorney for Plaintiff(s) -: -i t� *6 rc1 r STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY cl CP Cumberland County Court of Common Pleas vs. ABDISALM HAJI NO. 14-1101 CIVIL PRAECIPE TO REINSTATE TO THE PROTHONOTARY: Kindly reinstate the Complaint in Civil Action in the above -captioned matter. WELTMAN, WEINBERG & REIS CO., L.P.A. By Bir amin W. Lawrence, Esquire Attorney for Plaintiff CE) opr s li�yJ CL/ Ronny R Anderson Sheriff Jody S Smith Chief Deputy Richard W Stewart Solicitor SHERIFF'S OFFICE OF CUMBERLAND COUNTY Ciitratof 30 i#Ri 1I4: ©FF:CE QF Tkv t'MrIFF :,1.JMEEaRL/ 1) CCU: PE`NSYLVPN,.=. State Farm Mutuai Automobile Insurance Co. vs. Abdisalam M Haji Case Number 2014-1101 SHERIFF'S RETURN OF SERVICE 12/15/2014 03:27 PM - Ronny R Anderson, Sheriff, being duly sworn according to law, states he made diligent search and inquiry for the within named Defendant to wit: Abdisalam M Haji, but was unable to locate the Defendant in his bailiwick. The Sheriff therefore returns the within requested Affidavit as "Not Found" at 607 A. Geneva Drive, Apt. 32, Upper Allen Township, Mechanicsburg, PA 17055. Deputies were advised by the current tentant that she just moved in one month prior to the date and she does not know the defendant. To this date the Mechanicsburg Postmaster was unable to provide a good forwarding address, a post office check was reqeusted and the Postmaster sent back our request marked COA Expired. SHERIFF COST: $44.30 SO ANSWERS, December 29, 2014 RONN? R ANDERSON, SHERIFF (c) CountySuite Sheriff, Teleosolt. inc.