HomeMy WebLinkAbout07-0083
IN THE COURT OF COMMON PLEAS
STANLEY HOFFMAN,
CUMBERLAND
COUNTY
Plaintiff( s )
KEYSTONE STATE LIFE
INSURANCE COMPANY,
AMERICAN HERITAGE LIFE
INSURANCE COMPANY,
ALLSTATE FINANCIAL GROUP, &
DORIS ROBINSON,
CIVIL DIVISION
No.0'1-f3 /) [~
~.tOl l~
v.
Defendant( s)
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 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, TELEPHONE THE OFFICE SET FORTH BELOW
TO FIND OUT WHERE YOU CAN GET LEGAL HELP.
IF YOU CANNOT AFFORD A LAWYER, THIS OFFICE MAY BE ABLE TO
PROVIDE YOU WITH INFORMATION ON AGENCIES THAT MAY OFFER
LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE.
CUMBERLAND COUNTY BAR ASSOCIATION
32 SOUTH BEDFORD STREET
CARLISLE, P A 17013
717.249.3166
IN THE COURT OF COMMON PLEAS
STANLEY HOFFMAN,
CUMBERLAND
COUNTY
Plaintiff( s )
CIVIL DIVISION
v.
No.dl-?~
eluiT~
KEYSTONE STATE LIFE
INSURANCE COMPANY,
AMERICAN HERITAGE LIFE
INSURANCE COMPANY,
ALLSTATE FINANCIAL GROUP, &
DORIS ROBINSON,
Defendant( s)
COMPLAINT
1. This case is a declaratory judgment action regarding a contract for life
insurance. The court has jurisdiction under section 7532 of the Judicial
Code. 42 Pa. C.S. ~ 7532.
2. Venue is proper in Cumberland County because Doris Robinson, one of
the Defendants, resides in Cumberland County and because, upon
information and belief, the remaining defendants regularly do business in
Cumberland County.
3. Stanley Hoffman is the Plaintiff. Mr. Hoffman is a natural person
residing in New Bloomfield Pennsylvania.
4. Doris Robinson is a Defendant. Ms. Robinson is Mr. Hoffman's mother.
Ms. Robinson resides in Carlisle Pennsylvania.
5. Keystone State Life Insurance Company is a subsidiary of American
Heritage Life Insurance Company and a member of the Allstate Financial
Group (collectively "Keystone"), all doing business in Pennsylvania.
6, The authorized agent for Keystone is Terry Urich 11 Tuscarora Path,
Ickesburg, Pennsylvania.
7. Stanley Hoffman was born on March 29, 1964, the son of Stanley
Hoffman (Sr.) and his wife Doris Hoffman.
8. In the late 1960s, the Hoffmans were divorced.
9. In 1969, Doris married Herman Robinson.
10.0n April 1, 1993, Mr. Robinson took out a life insurance policy that was
assumed by Ohio National Life (Ohio National Policy).
11. On August 1, 2000, Mr. Robinson took out a life insurance policy with
Keystone State Life Insurance Company (Keystone Policy) for purposes
of burial in the amount of $7,000.00. The Keystone Policy number was
04023283. The Keystone Policy is the subject of this dispute.
12.1n late August or early September of 2004, the Robinsons separated and
in January of2005, they were divorced.
13.0n September 20,2004, Mr. Robinson visited the office of Mr. Urich for
the purpose of changing his beneficiary designation on both the Ohio
National Policy and the Keystone Policy to Mr. Hoffman.
14.The Keystone Policy "BENEFICIARY CHANGE FORM" dated
September 20, 2004, is filled out in Mr. Urich's handwriting and signed
by Mr. Robinson. It names Stanley Hoffman as beneficiary under the
policy. See Plaintiff s Exhibit 1.
15.0n the same date and time, Mr. Urich also assisted Mr. Robinson in
completing a beneficiary change form for the Ohio National Policy.
16.Mr. Urich submitted both change forms to the respective insurance
companIes.
17.0hio National changed the beneficiary designation, Keystone did not.
18.Most likely as the result of a clerical oversight, Mr. Urich's office failed
to affix the signature of a witness to the Keystone Policy form, although
his office did affix a witness signature to the Ohio National Policy form.
19.Because the Keystone BENEFICIARY CHANGE FORM lacked a
witness signature, Keystone refused to change the beneficiary
designation.
20.Mr. Robinson died on December 5, 2006.
21.Mr. Hoffman was named in Mr. Robinson's will as Executor.
22.0n or about December 6,2006, Mr. Hoffman spoke with Mr. Urich for
the purpose of ascertaining how much money was available to spend for
Mr. Robinson's burial.
23.Mr. Urich assured Mr. Hoffman that "at least seven thousand dollars was
available, for sure" or words to that effect.
24.Based on these representations, Mr. Hoffman arranged for Boyer's
Funeral Home to provide for Mr. Robinson's arrangements.
25.Boyer's Funeral Home provided Mr. Robinson's arrangements and sent
Mr. Hoffman a bill for $5,848.00. See Plaintiffs Exhibit 2.
26.Mr. Hoffman paid the bill in full.
27.As it turns out, Mr. Urich's representation that "at least seven thousand
dollars was available, for sure" was the result of a conversation that he
had with Doris Robinson wherein they discussed the clerical oversight
and agreed that the purpose of the Keystone Policy was to pay for Mr.
Robinson's funeral arrangements.
28.During that conversation, Ms. Robinson agreed to rectify the situation by
signing over the Keystone Policy check, when it arrived, to Mr. Hoffman.
See Plaintiffs Exhibit 3.
29.Based upon Ms. Robinson's representations, Mr. Urich arranged for Mr.
Hoffman to bring Mr. Robinson's death certificate to Mr. Urich's office
for the purpose of submitting a death claim on the Keystone Policy.
!,,' ~
. DEC-27-2006 11:06
F'.07/07
VERIFICATION
I, Stanley Hoffman, hereby affinn that the facts contained in the
foregoing document are true and correct to the best of my knowledge and belief.
I make the forgoing affinnation subject to the penalties provided for
unsworn falsification to authorities provided in 18 Pa. C.S. ~4904.
Date: ~ i: ~
12/27 !o~
I '
DEC-26-2006 11:17 AM TERRY K URICH
7174383358
P.04
iSEP.OO4 09". rust~'Z~D'(~:7 ~ P01
. KeyItOM S~ Life I A~~==
_ Irwul'llnCl Com..ny . Gr.nville, South i:lrcllne 2J602-9DBS
A.....'."tlI AI.. "nWlclll aroup TIl,pnone: 100-243-4311 · 110: B64-_~
BE~TE'ICIARY CHANGE FORM
In!trtlCtions on bad,
'Lb. PROVIDX VOI.l1l SOCIAL SECUJUTY NUMBER WHEIE INDICA TED
poucy;re~m-'MBE1l 040'l~~:r~ '
IN5L'RED , ANNUlT"NT: Her f^M E. ~bt't.PtJ%OCIAL SliCURlTY ~ ;} 0 g' -
OWNER: i'y\'/Ql E!It in ~ SOCIALSECUJUTY It,
a 1. PJlIMA1lY)KNlPlaAllY (lES) RmATJONSHJP
I'ULL NAME, ADDllESS . SOCIAL SKct7lU1'Y , TO INSURBD
,3D
DATS OF
BIRTH
E. 1-Io~'::hJA rJ
PE. oj () I! /11\ '1Q
3 - ;J.9- G4-
I ,Ob y......
CON'I'L"'GENT IEND'ICIAKY aD)
Ftl'LL NA.\tt. ADDUlJ " SOCIAL SECUJUTY .
RIlLAnONSmP
TO INS'UJED
DA 11! Of
B1R11I
UJIlL.ESS O'IllBaWlSS DlUCTBD PP.OCiiPS WILL BE PAID IN !QUAL SHAlU!S 1'0 ANY PRIMAR Y BENI!PlCIAllIBS WHO
Su.VJVE THE M~. BUT 1F NONE SURVIVE, PROCEEDS WILL BE PAID (}II EQUAl SHAKES 1'0 ANY CONTINOENT
BBNZPlC1AII!S WHO 3'lmV1V! 1H! INSURED.
o 1. 'B1lST AS nJMAlI\' IEND'lCIARY
(NAME OF TltUSTl
(TRUST TAX 1.0, NUMBER) (CUltR.BNT TIlUSTEl!)
~ ANY stlCCESSOII OR SUC:CP,SSORS rN TRUST UNDEll AOUI!M!NT DA'mD (MMIDDlYY)
AND ANY A..'JIBNDMEN'I'S 'IliIilUITO, OR IF 'mE TRUST 15 1'I!.lM1NATBD, TO THE OWNER. OR nI! EST'" 'I'B OF nm OWNER.
PI...EASE PKOvmE A. COPY OF THE JDST AM) LAST PAca OF TRUST ISTABI~ TRtlSTEE. AND 1M U.
ElTBIR ONE OK Bom 0' TIlE FOLLOWING MAY D SIl.ECTED D'DISIAID.
Q A. POSTPONED CLAUSE. ~ NO CASE SHAll ANY 'tA Y)IENT BB MADE TO ~y BI!NIPICIARY DESIGNATED ON THIS
FORM UNTD. MOlNlOHT OP TK! 30TH DAY POLLOWING DEA'nl AN)) IN 'nIB EVENt' Of THE DEA. TIt 01' A
BENEFlCwtY DtJRINO S'UCH PBJUOD. PA YMIU'IT SHAll BB MAD!! IN 11lI! SAMB MANNEK AS rROvtDED IN nns
FOIl.M HAD SAID BBNBFlClARY PREDBCBA.SED THE lNSUR1!.D. nItS PIl.OV~lO/ll SHALL NOT APPLY TO ^ TRuSTEE.
Q B. Pl!R STIRPES . IF A BlWEFlClAIlY PREDECEASES 'tHE ~$Ulm), LBA VINO CRllJ)1U!.N WMO SURVlVF. 'I"tl:!.INSURE:D.
THE SHARE SUCH DECEASED BENEfICIAllY WO'UU) HAVE !ECElVED HAD SU0I8!NBFlCl.UY SURVlVED THE
INSTJlED SIWJ..IS11 PAID INJ!.QUAL SHAllES TOTHBSUlt.VMNO CJm.DRP.N Of SUCH DECEASED BENEFICIARY.
'.H9 0901 KEY 8!NE CHid'lG8,.,lUC '.... \ or ~
DEC-26-2006 11:18 AM TERRY K URICH
7174383358
P.05
?EP-20-2004 09:17
CUSTOMER RE~~TION5
P.r.12
I DIUCT l1W' AllY JNl)OUlM!NT 0. TKB POUCY UQU!STm II BPJI!(."!m) BY lB'l'l1M OP nas lBQl..'IlST wrI1I THB
COMl'ANn AC~. J ACllBB'I'IVoTTHI eoMPANY WAYWAMlANYJIOUCY~V1SIONUQWUNG
PUSlNTATION ON 1111 poua POa BNDOR.S!M!NT. BUY MAY l!CIUIU SUCH'mBNTATlON 11 WIRED,
DATED AT fi'<.c$ f.1(A.R, (J, 'l'HIS ';;0 ~ DAY Of S c ~-r ..__' 10.!2.::l.
WITNESS (P~ SEB BELOW~
.J. ?I ~ -:ol A --- ~~ ~...
SlON,~"n..'RB pOUCY/CONTRACT OWNER
(lP OWNED BY A COMPANY. NB!lD 'tWO SJONATURES
AND INCL\J1)i mu
nu Ul'IDKtiJGNID AGltEES TO 1'IDt UOVE UQUUTS AND CllANGU
SJGNATl1RB OP DUl!VOCABLE BEN1!PlCIAJtY (tP ANY)
SlOJIIATVlB Of ASSlONEE, INCLUDE mI.B (IF AN'Y)
"" .:~ ::';':'Fbll'~~'~~~;~~:~)'-' . :~'~,.:'/: '; ;.:
ACl:NOWL~G. OFIIIQ~Joa C~GI ~:~ ArtAOrTO'p~,'
:': ':mI~oVi'coJ.ipAft;~.~ " 'IDm~~~TED " '
.; .,.:""" ,..'t,:::'~\'..:/,. "" ."\,'
\ DATEDA'l'~SQvrjl~OIANA' ,;'::;1. ,:. ..' BY
I ' ,. , ; " ' . \.. . ',' ,,"" ',' ,: 1, .., ~", , ., ," ,
1'~~~;.
. II"
, ' .'
r
,'" ' I'
. BE S1J1tE TO ~ VB THE POlJCYOWNBR'S SIGNA TURf! WI't'JllP1iSED BY SOMEONE WHO IS NOT A RaA TM! OR BBN1!F1ClARY
INSTRUCTIONS FOR CHANGING BENEFtCIARY
111! P'UlJ. LEOAL NAMB AND RELA'llONSHlP TO 1112 tMSUUD OP BACH PRIMARy AND CON'J1NOBNT IlBNRFICLUY IS
TO BE ('1 ~ ~ Y SHOWN. rot !XAMPl.B. MAJt.'IHA BROWN SMITH (W1f!) ANI) NOT MRS.l0HN H. S~ (W'IR!).
If nm POUCY IS ASSIGNED, 'Im ASS1GNE! MUST JOIN IN $JGN1NG nm CHANOE OF BiNEP'lCI,UY AQlJ!BMEN"I'. TBJ!
CHANGE OF IBNEP'ICIAJ.Y AGl!l!MENT MUST BB DATED. AND YOtm SlONATUR! AND THAT OF mE ASSloNEE MUST BE
wrrNJ!SS!D IV A USPONSIIl.I AD\JLT.
AU.. SIGNA Tt1lt2S A.k! TO BB IN INX. nrs CHANOE wn.L BE l\E(:()tU)I!.D IV US ANt) A COPY WIlL Be M'I'tJDmD TO
1Hi OWNEll PLI4S1 DO Not UND VS YOU.R IOUCr.
TfIE, POUCYOWND REVOKP.! ANY PlUMOUS DESIONA nON 01' BBNBPICWtY AND MBTHOD OP SETTlJ!N,BNT POI. THE
PQUCY. uco.oJNO nIB INSn.'tMBNT nm COMPANY AOlEI!S. THAT THE CHAHCIl OF JENEPfClAJlY IUlQllES'TI!D SHAlJ..
BECOMB BJIIIBCTMl UPON UCIIP'T ANt) UC~ OP THIS P10PDLY CONPLII'l"fJ) POItM BY nil! COMPANY. DUJUNG nm
I.JJ'2"[1t4 OF THE 1N81J1BD. AT m HOME Of1'1CE 11'1 AUSTIN. '!!.XASI AND S1.JBIBCT TO nIB PROVJSIONS OF THB POIJCY.
WHEN MOllE l1IAN ONE Pl\lMAJlV BJ!NI!PJ~Y IS NAMBD. PAYMENT SHAll I! MADS SHAJtE ANn sHAJt1! AUKE.
SUJ,VIVOJ,S AND atlllVlVOIl. nus SIMJLAlU. Y APPLD!S WHJ!N MUL'l'IPLB CONTINOSNT BBNBFICIAlUBS ARE NAMED AND
BECOMl! ENntU!D TO THJ!Pl.N"It1InS OP THJS POLlCY.
If A alANOI Of BENliPICIAAY IJ D!Sllt.ED ON MORI'l'HAN ONI POLICY. COMPLETE A. SEPARA'T! POItM FOR. !ACH
POUCY. POR EACH INS'URDD COV!!lU!D tJN!)D ON! POLICY, COMPL!'I1! A SL'.uA'IB PORM.
PLACE A.N .X" IN ONLY ONE OPTIm IOXBS NUMJD.!D I 01. 2.\NI) JNnlCATB mB DE3DUU> B8KPJ'!CIAJlY IN 11m
srACE PROVIDED. II' WOR! 1HAN ONE lOX 11 MAlUCID, 11IB JIOIlM WD.J. 8i ltETUaNW POll CLAID'lCATlON AND
PROCESSINO WUJ, 8!! D!U YBD. ONS'11IB RJLL NAME (Pl1tST NANE. MlDDI..i JNI11AL. ~ W1' NAME) AND ADDRESS OF
1111 DaJUD aJNE1llClAlY ems> AM) THE RELATICJrlISHII'. IP ANY, OF BACH TO nm tNSUJl!.1') AND nm DAD OP Imnt. POl
DESJONA1l0N NUMIII!l2. PIlOVIDS mE nUST NAME AND GN! 110! OATS OF THi nUJST AGREBMBNT,
IMPOBTAN1':
pI,U.S& PROVIJ)~ 1lIE NAMe. ADDRESS, socw. SJ!CURll"Y NUMBEll AND THE J.ELA TlONSHIP TO 1HE JNSUUD PO'R I!ACtl
BJ!N!FlCLUY, OR D'TH! C1..A&8 OP BIN1l'FJCIAlUiS 1$ NAMED. nm NAME Of EAC!i C\JaJ.lNf Jl'ENEPlCUllY IN nrE Cl.ASS.
~~_?9 Mnl K1n' Iw.N1I mANOI!. JIOIM
PIll.) 9Uo
TOTAL P.\32
09/23/1995 02:20
717-258-3310
WILLIAM E MCIVER
~l1pcr duncrcrl c:#8JmtJs
J(Jl 1 f' .\//WJ Jar,., _ ,\1'1' H/litlluJid,l. P. i J.'I() S. HijllJ SIr,.", - /J'.H'II/UI()fI. p..J
/)(J,UjI.',:> T. &~I''''_ 1-11111"",1 Di,...",JI .\1.11/1. ,"'. j()(JI' - S'IJ)f"n'j)'('1J
(711) .'HI:J.~mi (7 J i) lI.'1I-'JO.()}
ST A TEME.NJ OF FUNERAL GOODS AND SERVICE~
PAGE ~1
Chiu'ses ~ only (or lhuse items sel\1<':ted or thal an' n.-qulred. II we are "'''ll1ired by law or by a femet~ry or (naaultory t(l
utf any itellUi. w~ will explain in writlnR ~Iow where l't'!quin.'d.
NAME HERMAN E. ROBINSON DBte of Agl'.elllent: December 6, 2006 --.------,
RESPONSIBLE PARTY Stanley E. Hoffman --.-J
JOTALtl.lNP....1. HOME OIA1lGU ' UI62.00
6. ('.ASH ADV ANCES:
(theR i.... ~ ftot clwJ" lUde by Boy., PH
but _Iilled fOl'your(OftvmJfnc~.)
DNth Certiftcates-l0 @ 56.roea.
Grave OpeninR
Patriot News Obit (eIt)
JlloWer5-(:asket 'rray
Cemetery Equipment
C. TOTAL CASH AnV ANCES
p~~f
1 hav~ examined the above stated ilems and find lhem to be appro ate an a nowledge receipt of
cl copy of this agreemenl I certify that therE' are funds legally securable and pa ment will be made
within 30 days. A charge of 1.5% per month (18~ per annum) is made on all accounts over 30days.
~
,. PROFESSIONAl. SDVICBS:
SerwC'.s of funeral diredor aNI s...ff: 51400.00
Eab'......= (viewU\tU S4OO.00
1:'.albU.'''"' ia rd requil.ld In..u CMlI8. II
it .a, we haw "lIp1alMd .bov..
Odler Prepuatton:
d.-.Jna. GIOOII\In&. CUIlIllo!tk:-., COUl:hUt&
IOl~ PROFES~IONAL SERVICES. $1955.10
t. MUCHANDISE SEI.ECI'ED:
Cukft- Elderlite Cloth-Coyered
Vault- ConnetD Vllult-!M!lIkd
NQtc: c.;,,1lW&ny )UqIWC!II Vault
Thank You c.rds
ReRfsler Book
Memorial Folders
UndergarmentS
B. TOTAL~"~ISE
5 155.'.'
2. FAt.'LITI'BS AND BQUIPMENT:
ViallAation/ViewinR
Service
Ad..mJnJ8traliv(' / Offire
OperatinR Room
Gravestde Service
$ 31noO
$290.00
S 150.00
$ 9O.tX)
$ BS.OO
TOT At fAQ.U1'IU . EQUIPMENT S 975.00
3. A.urOMO~ EQUIPM'6NI':
Removal
Hearse (local!)
Flow~r /l.ead Car
S 150.00
$ 150.00
S 85.00
JOTAL 4\+.IL+.c.
..=:...~~...._.~...
TOl:Al,.AUI.QMOnvS IiOUIPM1!NT J 315.00
^..I01AL OF Alt. SOYICIS; WlSJJO
I*,
$ 700.00
S1060.(Xl
S 10.00
S 25.00
$ 40.00
S 12.00
____.__ $IM7.GO
$ 60.00
S 400.00
Sl~"t
S 106.00
S 125.00
S 111.00
~
111- --
SI"fi'" -
/ r6<> -
Y fCf&--
!/Sri ,-
DEC-26-2006 11:15 AM TERRY K URICH
7174383358
P.01
.
f' .
New York LIfe lneuran.. Complny
1 1 Tulceror. Pith, Po BOl( 202
lokeabYrg, PA 17037
n174383344 H 7H 438 3396
F 717 438 3368
turichOft,neWy'orklife.com
Terry K . Urich, LUTCF
Fin.nclll Service. Professlona'
PA" 354851
December 18.2006
Till COJllllGIfJI YO. X..,'
lle: Keystone Life Policy No. 04023283
Dear Mr. Lucas:
I am in receipt of your fax regarding the'claim on the life of Herman Robinson.
I have discussed this issue with Doris Robinson and Ihe has no problem with having the
proceeds sent to me for delivery to Stanley for the funeral costs of Herman.
I hope this information will allow for the death certificate to be released so the funds can
be released to Stanley to pay the loan with the bank.
Sincerely,
,~
~1Il1ojln. ....._r. MHlion Dalllr Rou_d TIllte
lluo"",...nd 1'o,"""lno"""oo ...._ning
NA8
Registered Representative offering
securities through NVLlFE Securitie:llnc.
Member, NASDISIPC
Llcenaed Agent
New York Life Insurence Cornpany
New Ycrk Lite Insu...nce and Annuity Corporation
lA Oeleware COrporation), New York, NY
3401 N Front St, 1st FI,
Harrisburg, PA 171 10
717 232 2556
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IN THE COURT OF COMMON PLEAS
STANLEY HOFFMAN,
CUMBERLAND
COUNTY
Plaintiff
CIVIL DIVISION
v.
No. 07-83
KEYSTONE STATE LIFE
INSURANCE COMPANY,
AMERICAN HERITAGE LIFE
INSURANCE COMPANY,
ALLSTATE FINANCIAL GROUP, &
DORIS ROBINSON,
Defendant(s)
PRAECIPE TO SETTLE. DISCONTINUE AND END
TO: THE PROTHONOTARY
Kindly mark the above-captioned matter as settled, discontinued and
ended.
Date:~
By:
Christopher S. Lucas
Attorney for Plaintiff
Pa. LD. No. 77903
Law Offices of Christopher S. Lucas LLC
220 Cumberland Parkway, Suite 4
Mechanicsburg, P A 17055
Voice: 717.691.0203
Facsimile: 717.691.3130
Email: cslucas@lucashealthlaw.com
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