HomeMy WebLinkAbout06-6003
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,
William P. Douglas, Esq.
Supreme Court J.D. #37926
Douglas Law Office
27 W. High St.
Carlisle, PA 17013
Telephone (717) 243-1790
r.........Carollne..A:...Potler..an<ft)"ouglas..A:...........r............hi..theT:ourF"oTcommon..Pleas..o{"".......ml
\ Potter, Administrators of the estate of! Cumberland County Pennsylvania I
! the Estate of Melissa A. Potter, I I
I deceased and Caroline A. Potter and ! !
I Douglas A. Potter, as parents of I I
I Melissa A. Potter, deceased j No. 06 _ ~O(j 3 Civil Term I
vs
Horace Mann Insurance Company
Petition for Settlement Approval
;............................................................................................................!?~!.~~9.:~~..L........................................~~~~...!.\~~~....!:~~........................................J
Praecipe to Issue a Writ of Summons
Dear Mr. Long:
Please issue a writ of summons against the defendant, Horace Mann Insurance
Company.
date: October 13, 2006
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Commonwealth of Pennsylvania
County of Cumberland
. Writ of Summons
To: Horace Mann Insurance Company
250 St. Charles Way
Ste. 250
York, PA 17402
You are hereby notified that Caroline A. Potter and Douglas A. Potter,
Administrators of the estate of the Estate of Melissa A. Potter, deceased and
Caroline A. Potter and Douglas A. Potter, as parents of Melissa A. Potter,
deceased have brought an action against you.
October 13, 2006
William P. Douglas, Esq.
Douglas Law Office
27 W. High St.
Carlisle, P A 17013-0261
717-243-1790
Attorney for Plaintiff
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William P. Douldas, Esq.
Supreme Court 1.D.#37926
Douglas Law Office
27 W. High St.
POB 261
Carlisle Pa 17013
Telephone 717-243-1790
,........caroiine.iCI5otter.ancl"tSougfas..A:....... .........In..the..Court""o(Common"fjleas..of'.......,
Potter, Administrators of the estate of Cumberland County Pennsylvania
the Estate of Melissa A. Potter,
deceased and Caroline A. Potter and
Douglas A. Potter, as parents of
Melissa A. Potter, deceased
No. 06 - 6CC3 Civil Term
Plaintiff
vs
Horace Mann Insurance Company
Petition for Settlement Approval
..............................................................................!?.~!~~9.-.~!.L............................~~Y.?:~.A~~~...~~~...............................
Petition for Approval of Compromise Settlement
and Proposed Distribution of Underinsurance
Proceeds
1. The Petitioner, Douglas A. Potter, is an adult individual residing at 310
Saw Mill Rd., Newville, Cumberland County, Pennsylvania.
2. The Petitioner, Caroline A. Potter, is an adult individual residing at 310
Saw Mill Rd., Newville, Cumberland County, Pennsylvania.
3. Douglas A. Potter and Caroline A. Potter, are the parents of Melissa Anne
Potter, deceased. Melissa Anne Potter was not married and had no children at
the time of her death.
4. The respondent, Horace Mann Insurance Company is an insurance
company licensed to do business in the Commonwealth of Pennsylvania with a
place of business located at 235 St. Charles Way, Ste. 250, Y or~ Pennsylvania,
17402.
.. ~
5. On May 23, 2005, Melissa Anne Potter was killed in a motor vehicle
accident at the intersection of Oakville Road (S.R. 3005) and Newville Road (S.R.
0533) .
6. At the time of the accident, Melissa Potter was a passenger in a vehicle
being operated by Heston Husler. Mr. Husler also died as the result of the
accident.
7. Douglas A. Potter and Caroline A. Potter were granted Letters of
Administration by the Register of Wills of Cumberland County, Pennsylvania.
8. At the time of her death, Melissa Potter resided with her mother, Caroline
Potter. Caroline Potter is insured by Horace Mann Insurance Company, policy
No. 37-20463120, said policy carrying a $100,000 Underinsured Motorist Limit.
9. As a result of the death of Melissa Anne Potter, Horace Mann Insurance
Company has tendered its $100,000 Underinsured Motorist limit.
10. The Pennsylvania Department of Revenue has approved the allocation of
the $100,000 settlement proceeds at 25% to the survival action and 75% to the
wrongful death action.
11. There are no outstanding bills of the Estate.
12. There are no attorney's fees to be deducted from settlement proceeds.
WHEREFORE, Petitioners respectfully request court approval of the settlement
on behalf of the Estate.
William P. Douglas, Esq.
Attorney for thepetitione
Douglas Law Office
Affidavit
William P. Douglas, being duly sworn according to law, depose and say that the
averments of the within petition are true and correct, to the best of his
knowledge, information, and belief.
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0.CT/1 3 2006
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.......Caroiine.fC"i~otter..an(fi5ougfas..A':......T........In.the.C.ourt..o{Common.Pleas..or.....
Potter, Administrators of the estate of! Cumberland County Pennsylvania
the Estate of Melissa A. Potter, !
deceased and Caroline A. Potter and ~
Douglas A. Potter, as parents of j
Melissa A. Potter, deceased ;:;:
No. 06 - 6003 Civil Term
Plaintiff ~
vs
Horace Mann Insurance Company
Petition for Settlement Approval
Defendant. Civil Action Law
"'.........................................................................................................................................................................................................................
Order of Court
AND NOW, this 13th day of October, 2006, in consideration if the attached
petition, the proposed underinsurance settlement of $100,000.00 for the death of
Melissa A. Potter, is approved, and the following distribution is directed:
Douglas A. Potter and Caroline A.
Potter as parents of the late
Melissa A. Potter
$75,000.00
Caroline A. Potter and Douglas A.
Potter, Administrators of the Estate of
Melissa A. Potter, deceased
$25,000.00
By the Court,
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