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Home My WebLink About06-2025 GRAHAM & MAUER, P.c. By: Lisa J. Mauer, Esquire ID # 65426 Suite 22, P.O. Box 987 Valley Forge, PA 19482 (610)933-3333 Attorney for Petitioner CUMBERLAND COUNTY COURT OF COMMON PLEAS In re: VICTORIA TRAVERS, a minor No. 01.", - ,),6JS C,'u~L ~I PETITION FOR LEAVE TO COMPROMISE MINOR'S ACTION TO THE HONORABLE JUDGES OF THE SAID COURT: Your Petitioner, Bridgette Travers, parent and natural guardian of a minor, Victoria Travers, respectfully represents that: I. She is the parent and natural guardian of Victoria Travers, a minor, whose date of birth is July 9, 1993, and who was involved in a motor vehicle accident on June 11,2004. 2. Victoria Travers, a minor, currently resides with her father, Carroll 1. Travers, Jr. and her mother, Bridgette Travers, at 11 Longstreet Drive in Carlisle, Pennsylvania. 3. This Petition is brought in Cumberland County, the county in which the Travers family resides. 4. The accident occurred when Bridgette Travers, driver of the vehicle in which Victoria Travers was a passenger, lost control, causing a collision with another vehicle. 5. As a result of the aforesaid motor vehicle accident, Victoria Travers was ambulanced to Nanticoke Memorial Hospital where she was an inpatient from June 11-13,2004. 6. Nationwide Insurance Company, Petitioner's automobile insurance carrier, insured Victoria Travers for $5,000.00 in medical benefit coverage, which has now been exhausted. (See Nationwide first party payout ledger attached hereto as Exhibit A). 7. Counsel was retained upon a twenty-five (25%) percent contingent fee basis by Petitioner. In addition, counsel has incurred the following expenses: Nanticoke Memorial Hospital (medical records) Staples (copy medical records) Delaware State Police (accident report) Cumberland County Prothonotary (Minor's Compromise) 9.75 3.96 12.50 55.50 81.71 8. Subsequent to exhausting the Nationwide Insurance medical benefits, Petitioner incurred an additional medical bill which remains unpaid (See unpaid medical bill attached hereto as Exhibit B): Nanticoke Radiology 551.00 9. Nationwide Insurance Company, insurer of the tortfeasor, has offered $17,000.00 to settle Victoria Travers' personal injury claim. 10. The settlement will be structured as follows: Cash at time of settlement (for attorney's fee, costs, and unpaid medical bill): $ 4,882.71 Lump sum paid to Victoria Travers on 7/9/2011: $14,710.53 II. The rating of structure guarantor, Hartford Life Insurance Company, by A.M. Best is A+ (superior). (See attached rating sheet attached hereto as Exhibit C.) 12. Petitioner approves Nationwide's proposed settlement, and further approves the proposed distribution set forth in the proposed Order attached hereto. WHEREFORE, Petitioner prays that an Order be entered approving the compromise allowing counsel fees and costs and ordering distribution. Respectfully Submitted, By: ,),0 ( i,' "1/' l, lJ."Ma . Ma Itr, Es uire Attorney fi Victoria Travers, a minor Date: l\J7-olo GRAHAM & MAUER, P.e. By: Lisa J. Mauer, Esquire ID # 65426 The Commons at Valley Forge Suite 22, P.O. Box 987 Valley Forge, PA 19482 (610)933-3333 Attorney for Petitioner CUMBERLAND COUNTY COURT OF COMMON PLEAS In re: VICTORIA TRAVERS, a minor No. ATTORNEY VERIFICATION In my professional opinion as counsel in this matter, 1 believe the proposed Seventeen Thousand ($17,000.00) Dollar structured settlement is reasonable under the circumstances. GRAHAM & MAUER, P.C. By: /1 {./ - r, A:1 'c'7).AA.', /f.'tJ.~l rc LisaA. Maye'r, ESq~re .'Attorney f+r Petitioner v' Date: 4-5-06 GRAHAM & MAUER, P.c. By: Lisa J. Mauer, Esquire ill # 65426 The Commons at Valley Forge Suite 22, P.O. Box 987 Valley Forge, PA 19482 (610)933-3333 Attorney for Petitioner CUMBERLAND COUNTY COURT OF COMMON PLEAS In re: VICTORIA TRAVERS, a minor No. AFFIDAVIT OF GUARDIANS We, Carroll L. Travers, Jr. and Bridgette Travers, certifY that: 1. We are the parents and custodians of Victoria Travers; 2. Victoria Travers does not require additional medical treatment with regard to the June 11,2004 motor vehicle accident; and 3. We approve the proposed Seventeen Thousand ($17,000.00) Dollar structured settlement and the distribution the eof /l G(~', r\ ,J .Z ~ tf1. i ~/,li:.-)() Bridgette' ravers S om to and Subscribed before me this r day of (jp17 I ,2006 COMMONWEALTH. Of PENNSYLVANIA NOTARIAL SEAL ! DAWN M. SHUGHARL Notary Public i Boro of Carlisle. Cumberland County My C<X."_n'1!~lon y,X}}.ires. No,:::2_8. 2006 t;xt1t& ,f A- - -- -'-"-- -' -,-,,,,'-'-'---"-~ '-' I.\..i-t,-ru.... ~ I 9J~u:;n OOOOQQ :sa '" 00 0 '" ~ NMI~"r"t" I If' I 1 e:: 0 00 0 0 QO<"\~O)D\ . . ,..f"')~O"'1"f CO 00> '" I , , I I \ '" l""....."",.. CO .. QOQOOe Q '" i~O"'\9\OOO III III O~\4t'OOO A~~~8.0 ~!~~r-M~~ ... ... !...0 oCIf:.eg ... I OOQCOoo 000000 io .....T Oe;OQCO ~ = QOQOOQQ Ir~UH 00 0 OM~ggO B 0", '" ~id ii El ~ ,; U; ILl" NtO PI ('4 r"'I = .. .. CI:J ~ . - ~i~ !!Ig~~~~~ i 0000'00, i OOQOOO 0 '" ~ .... ~ ClOOCQO '" '" .. sa .. . , . . . . e o.l "" "'11\0000 III '" lU ..... ... == .... CO ~r~~~~~~ . i III III '" 11'; .... eOQOee .. ~;e . IoC ""' nOeD%OO I 0;1'''' 0 ~ g ~~i~ii "".. MNrt < M~ "",," -i dJdJ ,., ~~,.,.. "'f't ~ OJ i J lu~n ~~ "" ! ... -~ .;; 3c; ~ ~ se Jmlll ""<;.)~ - ;:; .J'> iU..U 0 u~ j t;;~ I ~ ;&..g~: ... ~ t: iOU 0 .t j" .. l'1" N N C"f , I I I I . f '=j IM.::::""......... II"f f"'I ,..,,.,... ~JJ I I I I \ l :II ~g~~~~ .eO ~ ,........... nuu~ ~ B I , ~ ~ J I 1.......,....-1...... ,..;,A......... I"'tr-i r1 , I I ( , 1 is :n:g:g:n ** TOT~ PI'IGE. Ia4 ** ~ ftk"b i+ S 'NANTlCOKE RADIOLOGY DO NOT SEND PAYMENTS OR CORRESl'VNDENCE TO THIS ADDRESS. PO Box 835 Oaks, PA 19456 1314NRA#93070332 OFFICE PHL l: 302-629-3877 Office Hours: 9AM - 4PM Mon. - Fri. Fax: 1-=302-629-3952 12-16-04 BRIDGETTE A TRAVERS 11 LONGSTREET DR CARLISLE, PA 17013 Patient Name: VICTORIA TRAVERS Account #: 93070332 Amount Due: $55LOO According to our records, your balance of $551.00 is delinquent and remains unpaid to our practice. Please pay the amount in full immediately using the bottom portion of this letter or call 302-629-3877 to make payment arrangements. If pavment is not received within 10 davs vour account may be placed for collection without further involvement by NANTICOKE RADIOLOGY. Please understand that failure to pay could adversely affect your credit rating. Respond to this collection notice today. CC: Collection Coordinator FINAL NOTICE! ---------..-------------------------------------------------------------------------------------------------------------..-------------------------------------------- Please detach and return bottom portion with your payment in enclosed envelope GUARANTOR NAME AND ADDRESS: BRIDGETTE A TRAVERS 11 LONGSTREET DR CARLISLE, PA 17013 I AMOUNT OF I $ PAYMENT SERVICES PROVIDED BY: Patient Name: VICTORIA TRAVERS Account#:93070332 Amount Due: $551.00 NANTICOKE RADIOLOGY A PARTNERSHIP P. O. BOX 368 SEAFORD DE 19973-0368 1...111.1..1.1..1...1..11.11.....11.,11..1..1.1 41 ... PLEASE SEND ALL PAYMENTS AND CORRESPONDENCE TO TTTI.V 4 DDREVV Exh))i't C 130131~8~3i NAllONWIDE CLAIMS Nationwide Insurance 112/:40 03-17-2006 1/2 Prepared by Chris Parks of Financial Settlement Services Today's Date: Name: Date of Birth: March 17. 2006 Victoria Travers July 9. 1993 Female 'HT Age: 12 Plan #1 Guaranteed Lumo Sum Benefits: Guaranteed Amount: ~ $12.117.29 Payable - 07/09/2011 (age 18). $14.710.53 TOTAL STRUCTURE AMOUNT: Cash at time of Settlement: TOTAL PLAN AMOUNT: $14.710.53 $4.882.71 $19,593.24 $12.117.29 $4,882.71 $17.000.00 The Internal Rate of Return is approximately 3.76% and the Tax Equivalent Yield is 5.38%, based on a 30% tax bracket. This proposal Is effective tbrough MARCH 23, 2006. This is the date that the funds for the structure must be at the annuity company or this proposal will expire. This is an illustration, not a contract. "".,.....J"tt-- l\klllvllWKlo 111::>UldJI(;t;::J 0Y:':::'l 4i U-L 'i :j-l 'JJ / p2 ~ FINA.NCIAL SETTLEMENT SERVICES i Providing. Structured Solvtions- - DATE: As of July 2005 TO: Financial Settlement Services (FSS) Clients SUBJECT: Hartford Ratings The following is a summary of the current ratings for Hartford Life Insurance Company. Hartford is a highly rated company by the various rating organizations. This Hartford case would include a Qualified Assignment to Hartford Comprehensive Employee Benefit Service Company (Hartford - CEBSCO). Financial Settlement Services will request an Evidence of Guarantee from Hartford Life Insurance Company and Hartford Life. Inc. (HLI). guaranteeing the obligations assigned to Hartford - CEBSCO. This guarantee is issued with the policy and is not part of the Release and Qualified Assignment. Hartford Life Insurance Company ratings are as follows: Rating Organization Hartford Life (provider and guarantor) A.M. Best Rating & Size A+ (XV) Moody's Aa3 Standard & Poor's AA- Fitch AA Should you need any additional information, please call FSS (800) 993-9931. FINANCI.~L S"EITLEMENT SERV1CES ~53 MT. HER.MON RD. SUITE ]01 SAUSBllRY, MD. 21804 Offil;;C', 800-993-9931 x28 Office: 800-3ol-9-4180 .x. 19 Cell: 41Q-43o.S2B1 (J (;.Q ~ ::c) 7t lA ('. t J ~ (f\ "., - ~ en. ...::t C> --~~ - , I> ..a ~ ~ 0- - --c: c ~ , GRAHAM & MAUER, P.c. By: Lisa 1. Mauer, Esquire ID # 65426 The Commons at Valley Forge Suite 22, P.O. Box 987 Valley Forge, PA 19482 (610)933-3333 Attorney for Petitioner CUMBERLAND COUNTY COURT OF COMMON PLEAS In re: VICTORIA TRAVERS, a minor No. 6L -o!6~ C~UL.C!~l ENTRY OF APPEARANCE Kindly enter the appearance of LISA 1. MAUER, ESQUIRE, on behalf of Petitioners, Bridgette Travers and Carroll Travers, parents and natural guardians of Victoria Travers, a minor, in the above-captioned matter. GRAHAM & MAUER, P.c. By: Date: L\ - 5 .- Ole ....\ I", 7 GRAHAM & MAUER, P.C. By: Lisa 1. Mauer, Esquire ill # 65426 The Commons at Valley Forge Suite 22, P.O. Box 987 ValleyForge,PA 19482 (610)933-3333 .!\PR 2 8 2006 . _~~5tcc Attorney for Petitioner CUMBERLAND COUNTY COURT OF COMMON PLEAS In re: VICTORIA TRAVERS, a minor No. 0(." -.}6:2-S C Ler'M (-U~ ~ L PREL~INARYDECREE AND NOW, this ,..sr day of -1YlDq, 2006, it is hereby ORDERED and DECREED that a hearing on Plaintiffs' Petition for Leave to Compromise Minor's Action will be held on the / / 'f1-- day of ~ ' 2006, at J (). 'POtl"ln Courtroom ~ of the Cumberland County Courthouse, Carlisle, Pennsylvania. BY THE COURT: ~-\.~~ JI. \p ~O ~,D o \l - GRAHAM & MAUER, P.e. By: Lisa 1. Mauer, Esquire ill # 65426 The Commons at Valley Forge Suite 22, P.O. Box 987 Valley Forge, PA 19482 (610)933-3333 Attorney for Petitioner CUMBERLAND COUNTy COURT OF COMMON PLEAS In re: VICTORIA TRAVERS, a minor No. 0I.c. - ~O~ (Lif~- 1~ AND NOW, this \ \ day of l'\ ~ "( ORDER the furegoing Petition, it is hereby ORDERED that the sett1ement of this action for Seventeen , 2006, upon consideration of Thousand ($17,000,00) Dollars is hereby approved, counsel fees and expenses are allOwed, and distribution is dictated as follows: TO: GRAHAM&MAUER;P.C, For costs TO: GRAHAM & MAUER, P.e. For counsel fees (25%) $ 81.71 TO: MEDICAL PROVIDERS For unpaid medical bilI $ 4,250.00 TO: Structured settlement (cost) $ 551.00 Guaranteed lump sum payable to Victoria Travers on 7-9-2011: 112.117.29 $14,710.53 Total (Paid by Nationwide Insurance Co.) $17,000.00 '~.~;; BY THE COURT: ~'i~J . Vll\iWiV8NN3d ,UNnC{J r-';,,;-r".:j8!/'Jnn S I :01 Uti II A VW 9002 Ai:/V10NOHlO8d 3Hl :10 301::J.:IO-G::ffl:l ...., []I