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HomeMy WebLinkAbout94-00901 " '1 I'i , " I . ., , I , 'I " , , , I 1"1 . , ", , , , , " I " ',. " " " .. I 1"1 . , . " " , '" , , .A I .... DELLA URICK, Indlvlduallv and II Parent and Natural Guardian of TIFFANY URICK, a mlnor, PETITIONER V, : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA TRESSLER LUTHERAN SERVICES, RESPONDENT , : 94-0901 CIVIL TERM PBJHB OF COUBI AND NOW, thll 1/..1 day of October, 1996, following a heertng, and being utllfled with the propriety of thle compromlae eettlement, IT 18 ORDERED: 1. Petitioner II permitted to execute the Settlement Agreement and RellIIlIe, attached al Exhibit "B" to the within Petition, In favor of the relpondent and r..pondent'l Insurance carrler, Preferred Rlek Mutual Insurance Company. 2. Distribution of the proceeds are authorized fll follows: a, The lum of $12,375,00 to David M, Pollick, Esquire aa attomey'a fe..; b, The aum of 5225.74 to David M, Pollick, Eaqulre for coetl advanced; c. The lum of $5,000,00 to Pennlylvanla Natlonallnaul'8l1ce to aallatv minor Petitioner' a ltatutory lien; d, The lum of $10,899.26 to Tlffanv Urick, a minor, bom March 17, 1979, The '10,899,26 shall be placed In a federallv Inlured account at a PNC Bank In the name of Tiffany Urick. The account Ihall contain a provlalon that NO WITHDRAWAL CAN BE MADE UNTIL THE MINOR ATTAINS HER MAJORITY EXCEPT AS AUTHORIZED BY A PRIOR ORDER OF COURT OF COMPETENT JURISDICTION, mm.()rHCE r,r: Tfr Ir...'1"lrmrNlY % nr,r (J f'11' I , S CUi0,,'i'.',' ,.'iU(;IY Plil~N;;;I...VMA " I'" .1 ',1 I I I, I, I, " ir I 1,'1 ,j ..j' ,I 'II., Iii " .~ I .... 11/~e/lai' lll~& 717-t:ljJ-j.,j'J M!:':IlLL ~ 1'1111.[ l'l2 .... OertUleate of Depollt Account Verification PNCBANK I'IC lank, .IUOIII1 AllOdiUM '1U'An A UIlICX m LA'IIIIOU YAU.IY IlOAD 10M ".1101 'A un, vr .IO,....U ., , ...... 4.121 In'''..' bt. 4.4'0' '''",1ve un'il ,.... ., 1..1 , , 'I I' ,I , "I I I't, I. ."1 , il: I I I " , ,I:' . , " i'l ., I " , , ',; : , ! " I I ., " CII'I'IU. 'A 11/0e/li9' 111~~ 717-6l3-92~2 '. ,....... ~... M':':ALL HOME PA'S: 1113 IDST ____ CI50 3 IDS CDA/REA RESTRAINT INI 1~/04/96 15.34.34 8~K 40 ACT N UCCE FU . . I A,CT> 31100064595 PRID> ~A BRANCH ~ 16i C T ~ENTER 0000165 'tvS OMER NUM !R 3100023127 SU PRD NP READY CCESS C HAM URICK IFFANY A SU OWN 01 REGULAR ~~IRA~2R PLAC~ IXPIRE AMSUNT T~PE cooR' ~RDE~~G2~fL6TI~F~A~{~7 18TH 8IRf~6l~ .26 C " TOTAL ASSIGNMENTS 1 10,899.26 D~~~EisH~~~L~F~S'8 ~E~oXh tOSIA~C~~A~-Ct34 10-C110 11-CIll 12-C115 E 8 , ' , ., ' " I , , I , , , , , I' , I , 'I ., , I , , ," , I , " , , , I " I 'I, , , , , , I I , 'I I I I' , II; ,>, eol b; l,', VI .. ~L(t . ('" " ., .J " I" '. .. . " J~ " I: ',lj ~)I' 61' i.'/ i'11. flit I "'I) I. I I. ". 0" I' '" , t '" 'I" "YlI<i'," P",',l,W '11"."" "I IJ~ 1'111'), '11 ",..",~ "I.. II Ill," '" c.5 =: . ~ ~ ~ . n ~ . ~ ~2~~ u ~ ~ o ~ .t ~ ~t III ~ ~ . .. ~ ~ a , F. , , I, I I , .. .,'" (I;',' .~, .l /.',i" \ \, ,\ ',1',", .'. .',. , . , \ \ , , ,I " , , ;'1 Ii .1 I , , , 1 1 'I , " I' I I, " I, , , " , .' " " '" , I' I: , " ''I '11, ',I 1'1, , ' " " " 'I' I, 1,1 I I " " ':' ,I 'i . " 'I , I DILLA URICR, Individuallr and a. Parent and Natura Guardian ot TIFFANY URICK, a lIinor, Plaintitt v.. , IN THE COURT or COMMON PLIAS , CUMBERLAND COUNTY, PENNSYLVANIA , , CIVIL ACTION - LAW , , NO. 901-1994 . , , , JURY TRIAL DEMANDED TRESSLER LUTHERAN SERVICES . Defendant PETITION FOR SETTLEMENT AND OISTRI'UTIO~ or PROCEEDS OF A MItfOR' S CLAIM Petitioner, Della Urick, by her attorney, David M. Pollick, E.quire, re.pecttully repre.ente that' 1. Petitioner, Della Urick, ia an adult individual residing at an Latimore Valley Road, York springl, York county, Pennaylvania, and is the parent and natural guardian ot Tittany Urickr a minor, havinq a date ot birth ot March 17, 1979 (hereinatter referred to a. minor Petitioner). a. Re.pondent, Tn..ler Lutheran Service., i. a penn.ylvania bu.ine.. with regiltered offical at 960 Century Drive, I ~A"',,~.~~.\ ~~~l.~,,~. I~ I', I "', ""'''', 11 I... 1',_"",,,,,,, . ~. ! Mechlnic.burq, Cumberland county, Penn.ylvlni~. 3. On July a, 1993, lIinor Petitioner, wa. attending Tr...ler Wilderna.. camp, a phylical traininq and leaderahip conference callp in B011ing Springl, CUllberland county, Pennaylvania, operated by Tre.aler Lutheran Servicea. 4. At that tille, minor Petitioner wa. required to de.cend a lipline (Which wa. aUlpended approximately 60 teet above the ground) on a zipcord, when .he .truck the di.mount board. It ia ,. ! Petitioner'. contention that the Re.pondent w.. neqliqent and cau.ed minor Petitioner the injurie. ..t forth her.inafter. &. A. a re.ult of thi. accidant, minor P.titioner .uffer.d a fracture ot the riqht temur, .oare on the ri9ht thiqh and tracture ot the r19ht kn... 6. All minor P.titioner'. medical bill. have b..n paid to- data by the applioable worker'. comp.n.ation in.uranoe carri.r, with aaid m.dical bill. totalling approximat.ly $13,200.00. Minor P.t.itioner ha. not be.n treat.d tor the injuri.. .utterad in thia accident &inca November 13, 199/l. Minor Petitioner'. treatm.nt occurr.d at Carli.le Ho.pital, Oani.1 P. Hely, M.D. and Hanov.r orthopaedic A..ociatea, Ino. No future m.dical car. i. anticipated. 7. In addition to medical paym.nta, minor Petition.r'. applicabl. workmen'. compen.ation oarrier, p.nn.ylvania National Inauranca, paid tamporary di.ability b.n.tit. in accordanc. with the P.nn.ylvania Work.ra' CompenaaUon Act, with medical and di.ability payment. totallinq approximat.ly $33,000.00. 8. In .ccordanoe with the P.nnaylvania Workere' comp.n.ation Act, Pennaylvania National In.urance po....... a riqht of .ubr09ation aqa1n.t any tort claim by minor Petitioner tor the payment. de.cribed in paragraph 7 above. 9. A. part of thi. ..ttl.m.nt, P.nn.ylvania National In.urance ha. a9reed to compromi.e it. lien and accept the .Um of " I I j i nAt.. .. ""ltT'''.. ._, ", "I ,,,.,,....,, .." I ,.;::.:....,:.:,;.". i 'I 2 $5,000.00 a. paymant in full ot tha lien. Thh will ba accomplilhad by virtua ot a halrinq under Saction 449 of tba Pann.ylvlnia Worker.' Compan.ation Act. 10. aa.pondent, by it. in.uranca carrier, hi. otterad to compromiae minor Petitionu'a claim tor the .UII of Forty Nina Thou.and Fiva Hundred and nollOO ($49,500.00) Oollara, in the form ot I atructured .ettlllment payabla a. par Exhibit "A". Ra.pondent ha. raquaetad I .iqned settlement Aqreamant Ind Ralea.a a. part ot! thil aattlalllant, a copy ot which ia attached herato and marked Exhibit "B". 11. Patitioner h awara that accaptinq tha .ottar of .attlamant will re.ult in a waiver ot the riqht to a jury trial and a waivar ot tha r!qht to racovar any turther damaqa. on bahalf ot the minor Petitioner ariainq out of thi. accidant in tha tuture. 12. con.iderinq tha nature and axtant ot minor Patitio~ar'. injuria. and har rMoovery, Petitionar baliave. thi. .ettlement to be tair and relllonable and in the minor Petitionar'. ba.t interaat. Petitioner ha. tully dilou..ed thia .ettlalllent with har ooun.el, David M. Polliok, Eaquira. 13. Petitionar haa a continqant tea Iqre..ent with her attornay in tha amount of twenty-five peroant (215') of any ..~ "." . ll.........:\~~r.,~.~' " II reoovary or award made. "'<"'."". , \,,~. H...." '_j. , .' :) b....~';:~~,~f'.~~. " ,II '."n I't....,..... " ~~ 14. If compromiaed aettlement ia .pproved, Petitioner hareby requa.t. the followinq diltributionl a. $28,500.00 ol.h at the time of aettlaaant, 1. The aum of $12,315.00 to David M. Polliok, laquire .a attorneya fae., 2. The aum of $225.14 to David M. Pollick, Ilquire for coat. advanoed, 3. The aum of $5,000.00 to Pennaylvania National Inauranoe to aatiafy minor Petitioner" atatutory lien, 4. The aum of $lQ,899.26 to Della Uriok, ae parent and natural guardian of Tiffany Uriok, a minor, which ia to be plaoed in a aavinqa aooount in a federally inaurad bank or .avinqa and loan aaaociation for the aole and exoluaive uae of aaid minor, and aaid aooount ahall not be ueed for any raaaon without Court approval until the minor reaohea tha age of majority, b. U, 000.00 guaranteed lump aum paY/lble to Tiffany Uriok by Praferred Riak Mutual Inauranoa company on Maroh 11, 1998, o. $3,000.00 guaranteed lump aum payeble to Tiffany Ur iok by Pra ferred Riak Mutual Inauranoe Company on Maroh 17, 19 9!l , d. $4,000.00 guaranteed lump aum paY.ble to Tiffany Urick by Praferred Riak Mutual Inauranoe company on Maroh 17, 2000, 4 '.." ."", bAl.. ., A''',,,,,,,,, I~, ,', <~.. ~'" ~..", .'"", ...' " ,~ "', \....'.........""... "...... DELLA URICK, Individually and a. Parent and Naturel Guardian ot TIFfANY URICK, a minor, Plaintiff IN THE COURT or COMMON PLEAS CUMBER~D COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. !ilOl-U!il4 va. TRESSLER LUTHERAN SERVICES Defendant JURY TRIAL DEMANDED ORDER AND NOW, thb day ot , 1!il!il6, upon pre.entation ot the within Petition and a hearinq on the meritl, the Court i. here~y .ati.tied with the propriety at thi. comprombe ..tUement and di.tr ibution ot proceedl .. preaented by Petitioner, and hereby turther direct. al tollow.. 1. Petitioner i. permitted to execute the Settl~.ent Aqreement and Rdea..e, attached U Exhibit "B" to the within Petition, in tavor ot the re.pondent and re.pondent'. in.urance carrier. 2. Di.tributicn ot the proceed. ar. authorized a. tollowl' a. $28,500.00 calh at the ti... ot ..ttl....nt' 1. The BUm ot $12,375.00 to David M. POllick, t.quire al .ttorney. t..., 2. The au.. ot $225.74 to David M. Pollick, E.quire tor coat. advanced, 3. The .UID ot $5,000.00 to penn.ylvania National In.uranc. to lati.ty ..inor P.tition.r" .tatutory lien, ,.., H.'..... \ ,.. I'~..... "... "... 4. The aum ot $lO,eee.26 to Dell. Urick, a. p.rent and natural guardian of Tittany Urick, Il lIIinor, whioh ia to be placed in . aavinga account in a tederally in.ured bank or .aving. and loan ...oebtion tor the aole and eX111uaiv. u.. ot aaid minor, and aaid aQcount ahall not ba uaad tor any ra.aon without Court approval until tha minor r..ch.. tha a98 ot majority/ b. $2,000.00 quarant.ad lump aulll payable to Tiffany Urick by Preferred Riak Mutual Inaurenca Company on March 17, lillie/ c. $3,000.00 guarant.ed lump aum payable to Tiffany Urick by Pratarred Riak Mutual Inauranca COlllpany on March 17, 11199/ d. $4,000.00 quaranteed lump aum payable to Tiffany Ur ick by Preferred Riak Mutual Inaurance Company on March 17, 2000/ e. $11,000.00 quarant.ed lUlllp aum payable to Tiffany Urick by Prefarred Risk Mutual Inauranea Company on Ma~ch 17, 2003/ and f. $20,000.00 quarantaed lump aum payablato Tiffany Urick by Prefarred Riak Mutual Inaurenca company on March 17, 2001l. Datad. J. a ~" AI~tl ,1_,', "",,, ", '., '. -/I,I'~ I "~'>I ",,,,,, "I "," .1'" I _ ,," .... A 11." " '1 I '1,1 ,I " ., , , " " 'I " , :i " " .' " " " , II,' " I I. " 11'-\\-38 WED 08124 , '. FAX IfJ. 6162816182 ,. 03/03 PREFERRED RISK LIFE Structured Settlement Proposal - Prt""" JUlIe "......l'1 I111 AIIlwortb R.OId W4IIt Dtt Moillll, Iowa SOZ4S 'I 0 UIII of IfIlUl: OJ/I7n9 PnpIrIcII .~tJ__ 1l,IPH CASR AT Sr,TTUMJ'.NTr 21,~OO.OO LUMP SUM PA YMlNTSI @AOE 19 03/1719. II 14.0120 03117/99 ~AOIi 21 OJ/I7flOOO II AOB 24 0311712003 @A0130 03/171200P Subtotal 2,000.00 3.000.00 4,000.00 5,000.00 20 fW\ QO 34,000.00 ,.....-- " ' , " , I , ' , , " i , ' I ."j " "I < ,II I " , rI I I " I' " . Ij , , ,i I , , " "'II ,..,..., It YIIW .... JO .)'1. P'AIPIUID R"IC. Ul'lllllllUJtANCI COMPANY I "I'MlIelm I , I ~\':~i1 l~~ 11 It,.'..; .:1-" ... ..... ... . kl.I~'llli'- ..tlllA,l 'lI#'~_IIl'I~~I1,\JI.ll"111l Nt'll'......'QN'1 I' " '" IJlhIIlt . ,. .." ,I '1 " \. , " " , , .. SEP-1I1-38 ~D 09160 PREFERRED RISK LIFE FAX NO, 6162876182 ',02110 SI:1'l'LI:MENT AGREEMENT A..'4D ULlAB& TIIIa ........ent Ap'Nllllllt .nd a..... (th. "S,"ll11W1'1r All_m.nl') ~ mild. BM .n"red InIIO thII dAY ot _, 1996. by IIld iIIIlOIII: 'Clalm"nJ" PARENT. lJldlvtdua!ly. alld u pareDl and Ieaa! 8IIudlaD of Tllfmy Urick . 'fmaler L.udlcrlll Pl.r.ded RIJk Mutual IDlW'1mO Company "DtflDdanl" 'lOIW'Or" Rec1ta11 A. Tb.e CI.lm'llJ IW IlIbmlltld . claim 10 recover monewy 4amtaa u a relll1l of an IDcldem that oceumd on or About OATF. at Or ne.r LOCATION whTch 11llUl1r.d In [lIlmlllal and ~~I~:~UlJuri" 10 TLffIDY Ur~k, I m.lAor IIld p.no'" IDd ,1I'11d ftuMclll blJurin to InIuler II the Uabllity lmunr of the Dlf.ncwll, 1114 II 1UCh., would be obU,al*lco PlY IJl,Y claim mad. or juclpnom obfalMd ..aWl Defendant wbIch II covcnd by lU pol~ with Deft1tdaDl. The partlq dqlrc co C'lUCr bua thla Sculemcnr ApocnICIllIn ordor to provldo tor conaiIl r:~:e ~1:n~J:i ~ ~ :o:~::b :..: ~~III"':~O~ below. B. c. ~ Tho putiIa ... u foUow.: , 1.0 ...... utd DIIdlarp 1.1 III colWdmt1ol1 of d1e PlymellU 1&1 forlb 111 SectIon %.0, Clllnwu bcreby complaly rela.. alld forever dllchlrps DetendNlt and JlIIlurer tram Bny and .n pllt. prMel'lt nr I\wro olalml. dotllllldt, obll.atiOlll, 1llIiolll, cauaoa of actiolll, wroqiul dath lI1a1me, =clamaP.l' CORl. loaa of IICMCCS, ClI:pCIlIes and compenndon of any. 1lIa&nl w 1IOmr. Wbetber bUllS on . lOR. contraet Ol' oIber 1beorY' of recovery. WII1eIl tb.e DOW bu, or wbleb IIlI)' borafter -=ue or otbarwtll be ~, OD 1CC0llIlI ot, or may 14 lAY way pow OUI of tbllDcldl.o& deacribld 1l111cltal A aboW, I~bt.dll,'l', wUbout l.In1.1taUOD. 'D.)' IICI all koo~" or WlkDown clalma tor bodily mcl pcnonal IiIJUri,ea to Cia""..... Of my future wroqI\Il death c1a1ma of Cl.l",.nt' a npreumallv.. or MIra. wbich bave nev.llIDcl or 11I&'1 rtIUll troin IbI all'Plela or omluloll.a of IbI Dtftndan&. 1.2 ThIA 1'11_ And dllChlrp Rhall aIM ~Iy tn n.fendanl'. and TIIAW'Ir'. (!IAt. I,lI'UIIlt and twul'l offlctn. dlreccora. ftOClkbolden, auol1ll)'l, ",lUI, MI'VIll.tI, I'IIlnHIIlativII cmploywat IUbltdLu1u. amua.. parcnen, prlldeclllton IIld ..Iet.llon In ImIrInl_1;I UlIPIl/lll all oIIIar penolll. IIrma or corporatlona with wllom lilY of dle former have Deen. 1ft DOW, or IUY blftatter be alllllalld. 1.3 TbIa releale. on the pan Of die ClIIDwIl. ,ball be a M1y blndllll lIlll Ctlmplae lCUlemcnt amon, till CIAh"anl, llIe OefllldalU andtbe Insurer. and dielr hell'll, IUltan' .nd SUCUQl)rI. 1 ",\'IF.D S[~ 11 'S6 SiN He \!ED 081.60 PREFERRED RISK LIFE FAX NO, 6162875182 P,03/10 1.4 The Clalmant admowlldp, and '11I''' tba& Lbe pi.... IIId dllclwat ... ton.b above I. . pul'l.l rei..... CIainlIIlI ollpreuly w.hCl .Dd "0_' tho riIk 0' ury IDII all ~1allIlI tot llADIIPt wbk:b oxllt .., at lbIi cl&II, blI& of wlllclll.bl CIlImW clota IIQ( IaIOw or IlUl*t to exUt. wherMr tllrouah IlJlOlUICI, o~rt.I~ht, error, IItIUpnct, or othtlWlIt. IIld wblch, It kDown. W'OII.Id /lIIcarfaJly .ffect CIaJmw . _IoIoM 10 Il!.ter iJIIo Ihit SoulGlllOlllt A.-.caa. 1110 CI.IIDlJll runber qnellhe ClalllllllE baa ~lCd paymenc of lho ~ fPlCitlId bmln u a campi. comproni.tat of lIIIIIIn IIIvC)lvllll dlaD\llllt iaIIIelI of law IlIll fll:L C1ainwl& iIIIUm.. tbI ri.k tIlIt lb. ractI or law = III oilwr tlwI ClllitlWl& bellevee, It I. undentood and IIrad to by tbe pU1los thai tbl. emtlU I.c I c:ompromlM of a doubd'ul IlIll d~ claIm, .1Id the p.ymenll are 110110 be COIIIlIIIed ... ID IdlliWlon 01 \JablUry on tbIl part ot tbI o.f.nda.a&. by whom lI.bUlly i. txpreoaly deciId. Z.O h1mentl 14 ~/lIIdetIIlOll of the rtll... set tanh abvvt, dill IDI\lm on behalf of dill Dcfvndant ~ to pay to tbIllndivldual. Il.Illled belC)w ("pay"") rJ1Il111111 OIItllllld belC)w: 2.1 Paym.tllll at tb.llm. tit' ..1II.m.nt III tallow.: 2.2 Periodic payment. mlde accordln,,/) Ihe schedule .. follow. (the "Periodic: PaymemaO): P~Yiiblll III TlflllJ1Y Urick.: All AWl 1ft rollll blreill CO/lilUtulc damalCl on U;COllllt of perlOW UlIurloJ IDlI IlckDIlI. within the mconhll C)f Sectiall104<a)(2) of Ibe IDrenla.l RtvlllUe CCldt or 1986. u 1IDtIIdId. 3.0 Cl........t'. RfPt to PaymcIlU Claimant .c:lcMwledpl 'hat the PeriodIc PaymenlA c:annnt he 1CCt1....red, deferred. tncl'llMd or docm:ued by lbo Clalnwlt; oor tbaI1 Ibe Clo'",o", hav. Iha pOWlr 10 .U, lDOrtpp. 0 eocwnbet. or IIlllclpllt lba PcrtOl1lc PaymcDII. or any pan t1Iereo'. by ...........111 or otberwl... ~O ep"''P'''nt'. Bt.utl1dar1 ~ paymalltl 10 be maQc d\or the death of Tiffany Urick pIlI1UUIt 10 the fIIrDlI of tbt Sclti1C1'11CDt ApI;c:mcm .balI bo I/lJdll to aw:b pllI'IOI1 or oncity II iIbIl1 bo dcalpatllllln wriw. by e'efmo"t to 1bI IIIIunr or lhIlnsum'. AAiIJIIe. It DO ~ or ~ II 10 datpteil bY C1almanr. or If tbe penon dealpllld II IlOf Tlvl.aa R..he drne of tile Pi1ll" deatb. audl ptymlDtl abaIl III JUde 1Il the tlU of TIIfaAy Cr!cIr. No Neb dMl(IIldoll, IIOr ~ i'IVoc:II1oI tbIreot, Iba1\ be e/fecl1vt WlIM IIla iii wrI~ IIld delivered to iJII IDIUnr or _ JnIum'. Au_. The dulllWloD must be In a fonn acceptIble to die rtllUm or the Xaaurw'. Aaalpea IlItore auch paY/lWllllIrlIllld.. 1.0 Couent to QuIJUlId AIIICDIIWd 5.1 Clalllt...t acknoWlcd~c. aJlll apw. lIIat dlo DofClldUlt lIldIor lbI IDI\Irer may DIIb . "QU1Ifted aul&DmtDl wldll1l tbe ~ or Secl10n 13O(c) ot Iblt lntenIal bvtDlt COde ot 1916. u IJIUlridcd\ of tbe Defendanr'. i.ndIor die rnaum'. Uablllly to make the PerlodJc ft.ymtIltI lit fOM III Seolion 1.1 10 i\Jlavu Amarioa Lit. ~. COIIlpUly (rJ1I .A11I.....), TIIII AMIII_', obJlpLlun IIJr IlIYIIICIlI. uC liIII Perlodl.o Pa)'1I/I1I/I IflaI1be IliO 2 e~',~n S~ 1 J. '~F PREFERREO RISK LIFE P,04/10 SEP-II-38 ijED 081~1 6.0 7.0 '.0 '.0 10.0 FAX NO, 6162876182 '.% ~-: I.ban cbl.1 of Dcknd&DI amIor 1M IJwrlDl' (whltblr by Ju4.PIIlII or ......Al) lallly pncedllla 1M ""1""'11& of I.IIe Ptr10CIk 'aYIMDlI obll,aUOIl. ::r 1IlcJ\ uallJllllOllC, It DIldo, tAI.ll be ICCCplIld by dlo ('1.1....... widloW ript of lCjcodon sJlaII ~"ltly I1l1m UId dl.IcJwp 1M Dtl't1lillllll1lll11.11e IDNm frOiD rbI hriodkl PI~.n.. obll,Ado" wllnld IIllhe ::;frlfJl. The Claimant I"IICOpl1.11l that. In IN avenco' 11IIGb IA u.l~nl, dw Aul~ be 1M 1011 obJllof ",lib ~ CO IbI PtriocS1o Paymma obupl!oll. LOl1 I!IIl all OlbIr ltlluel wldl l'tIpect CO lbij hriodlc PaYDlIDlI obllJllIon that pertain to rhe liability of the De,O'IIdult aM the I/IIW'II' ihlJl IJIIiwpon become fIuJ, imvocable Uld ablOlult. IlIIbt to I'IIrcI1a.M 11II AIlowty n. D.teadaA& aDlllor dw Imunr. Iltelf or thrcIItb I" A"i,nee, lClCrw t1Ia riIb& to l\wl dJc liability III make 1M Periodic Pa)'m.tIIU /!lrO~ rbI ~ of 111 ~ po~y. I'rom Pref'eried R1.k Lift IMllrRIlCI ('.mIlI'.n)'. 'The J')I'endan~= IMllTII' or die AMil'!l ~h.1I he the .ole owner of Ibo IMUlty pollc)' UId aball have all of OWlllrlblp. Thi DeftDdaA&, lilt IJlIUrer or lilt Asll,oee may bav. '"term! R111l: ~ llIIUl'IIICCl Co~y mall pa~1JII dil'lClIy III the Payee. The Cr.imanl .hall he responalbl. tor maIIIIaInllll a correct DlaIllDa addreN for Payee with lb. ANI",... Dtlcbarp of ObllplioD n. ObUaatlQR of the Dc*ndanI, the 1/IIW'C.r and/or Alllpco to mW eac:b hriod1c: paymem Iba1l be dlscharaed UPOIl I1le maUiIlI of a valld cbeck In lilt IIDOWIl or aucIl paymem co ~ deaiJlWlC!. &ddrllu of the Pay.. IlIDlId i.ll SectloD Z, 2 of tile Slttlemenr AI"*"'JlI. lepnMIIW10ll of Compnh""IJIon 01 Doc\JmeI!t La .1ltIriq iDtO die Seul.tmIIll AIftIIIlRl tile ClaiIllanI repl'lMlIII Ibat Clalmanr haa ra11ed UJlC?D tilt advice Of ber momay, who II die IItOnIe)' of ber own l:bolClt. collCml.lDl tile 11,11 aD4 ~ tax cOllllQUtnca of tbI Sttdllll'Dl A,ciee1lN'Dl: that tho lDmlI of thll ScalemeN ' A,l.-.nc have belli. compllltly read Uld explalDld to CI.I_,,, by her IltOnII)'l MId dw tbi tiInIlI of the SettI..nt AlmmaAl are Mly IIIlllcntooci and volWllarUy IICCCpled by CI.lmalll, Warn.aty 0' Capaclty to Exec1IW AIfIIIIIUU C1llmanl I'IJ1reM1ltA and wamn~ dill no other [IIrMn nr entity bu, l)r hid, UI)' IlIfIIreat In tbe c.IaImI, iStmllld, obll.ldon, or CUll.. of Illdi:m k.r...M 10 In dill SI&tI..lIl A....., llllCIJlt u ocherwlle let forth bmlbl; dill CIIlmaD.t bu IbII1UII ri&ht lIDII uc1l11iw IUlhudLy III IXtQlte Ibis S.w.m.nc Aammell& and netlvt dw IlIIIIIlP<<Cltrld In II: IIld dill C1a1J1Wll baa DOl told. uaigMd, rr&IIItmed, cOIlv.yed or otbIrwIae d!MPoMd of Illy of die olalma, ottma_, obllpdoDl or CII.IIC. of ICtIoD reltlt'Clli to In IhlI ScttlClllllllll Ati~o1I. A.dlIItlGaal DocwDmtl All pantea 11m 10 COQI:lerate tIllI)' IIId execult any IIIl1 all .Iemcawy docWJIelllS and to 1I1r. allllldldonalactlollll which may hllnecawy or approprWi CO live fWI tOla IIld ttrect 10 the bulc ttrma and IIU1IIIt of the SIIllImelu AarwemeDl. J ';.' ,'t:,~. ~;'1 11 'r ~ '.:'" >" SEP~II~a' WED Q8161 , . PREFERRED RISK LIFE I FAll 1<<), 6162676162 P,06/10 11.0 IAUre AcnDIn& lad Il~ In IIIt1r1et Tbla SeuIuIerI& AJI"I!l'ftC oonralnf dlo oll&lro Ip90IIIllIII betwMlI the CIII.man& UIIl .. IllIum wllll "pro to UIt IIII!tII1 III toJ1.ll In I1Il1llIlWl be blndlll8 \lP9n IlIll ....,. to - , bIIlIftc of lIII ucwlOn. .'lIiItlllOn. petIOlIIl l'Ipftllllarariv.., hiln, ",..~.~ IIIli UIir;u 01 tlcb. 13.0 rIu.I 1leI_ Clalm"Dr lntelldl to ".... TR:NlIr Lulbmn <Ooroudalll) tbmby IItDllft.tI'll all of dID d1apual1. CIlnuovmill. claiDu Uld CIWOI of ~on wbldl wac or bave 0JtIJIcd u of := of ihiI ~ or wldoh IDlY ulIt Ifter tbt cIalt of lIllIlII"ID'lIC IlI4 Ibll l'IIIuI bllla.unPrvlll\lllUl1 COlllllUtd bi'oldly tICI ~olllpllm Ndl ~ IIIlI pIIfpOII. Tbmfm, Ia coaaldetalloD of tbIll IIftIIIIIIlJI IDade bereuriler by De~, Ibd for odIor IOOd UId YJl.lIablt coDllderaclOA tbe rec,lpe &nd IUtftcllncy of wbIcIlla lI/lIalow1edpd. Clalmalll. for btnIlf, .."td..... UIIlI blln. IVCCOllon AIlIl UIl&nI. IIld pmoIlI1 rcpl'9r'''~VIl doll upreu.ly rt""" IUld tonver c1IIcIlarp Tnullr Lwfieran (Detendllll) IJId IJlIjr ~ye ~ndiIuI, beln. PI"etllon. ualpl. l.alunr. Ill'Omey~, Illd J!mClMll'lpl'lMlnutiv. froJQ III acd.on or alltlolll. CIlIIt or 0IIlIM. of aotiOD, ,\111:I. oJalma or denwldt of whatlotver IdlId or chIrIcIIr, Ie law or In eqUity, wbIIUr till UabIlllY be JolDl or IIVtnJ, ImIlWl1 or IIlIlullIWI1. which ''ll~,. or may ,xlae QII IbI dill honof or wbU:h IIlaf ,lilac In tbIll l'uturl. for. IIpOI1. or by nuon of any tnIIIIGUOD, mau.r. 0lICIIn'tDlI, ItII*DIIItI bIrttofon m.ade by a pen, or bI, lUOrlll)', or ICt, omlllion. c:auJO or thiaI wblther related ~y or IndJ.n:ctly to the IIIbJecc Dl.lltet made lIle bull of Illa clallDl bmin. 13.0 m"tI... TbiI Sattlenle1lt Apet#lent ~haI' hecnm. etfecdvt ImmedWely followlDa wcutioD by _ of dID penke. . . PAlU!l'fT, IilII1Y~11I.IIlI II pIICI1t UII1l1pl D~ IIWdIan of Tltfany Unck AnltOV!D AS TO FOaM: Law Offl<<a of Dale E. AAaclDe. P.C. Two Woac Markoc SIRet Pole omc. Box 9'1 York, PA 1740~ By: DaVid M. l'Ol.llCk Dig Pntcrrcd lUtk MIItllalllllUl'lllCe Complll1 By: TIeW: Data " ..... '''='''Ill .," . .'.'111-,1 ''':'~~, ".' . " "/:'. ....t', .<. " . ' 1 .:......:'! "',:, i....'i,.I.,." Financial Stability Tho.__ol.II,"""""O/VIIlII,*"",.nimpol1lnl_",l1IAIIIO . _.....IIlI. ~ lIllI ~ WI -... fII fund,ornolllll_liIIocj _II''''''''''' " TllI-.tIl' COMI'NlATlVI NjALVIlI ol_ _ ,....: llCllI1PIIIn\J ItIIII'IIIII'D IItIK U,. INIUIIANII. COM,AIlV ...... olfllllllllll ~................... ....IpIo... iIIulIlg 1IlI_"'I1I~ PlX*. ....._U~'-II\_ol_ loo_olllll...........__,IlWDMl.....pot1lonoll1l......... =1IIII..._"'....ol..I1I--., .-"'-*"ol___bl-"'ol_II~, IIOItI'ICAHT ,MnlIII.... or DICIMlIIIIIl. '''' DlIlIVID _ M AHHUAL ITATIlIIHT "'" c:oo.,..... bIIow III.. 01111 fit _ 01 A.-1lIIcj far fII ol_ Solvency ~w:.n:r~~o:..~ Surplus Funds =~~ ..... fInanoloI_ and I~' _.. I Nt;l1ll/PlUl fIlIo "'"Y _ I.....,.;;,v.;;&iti 10 IIko _.. *",llon. 1111II'/ -.. duI. otnqInoIoo In 1IItlIt. ~ _1I1I,..porlIon ol"""" A.-Iw_ .100 .,"a.I~....., Dol. 11, I.... IUncI.",... ......"......_. IVIAMI t6 ~ THI LAMIIT LI~I 00'1"".""" 1I0AI ,...,......D "'IK L'" ..".."'......"............. ",..n . . , I,: "'1" ..,' ~" ; '.' ~ IJIIIIII. III1d Ann\ItIy Co., CT "."..."."."".I.oa.14 .....1JII1__~,Cr.....".".,,"""" IOU' ......1JIIt ,_ C~, IL .."'.....",..,... 107.07 Coow'I~I. GIIlIrII UIe lna. CO" liT ........."""" lOU3 lquilIllIt UN AI.u_lI<lclI!y. NY .""""""." 104.... ca.....WtoI UIe IIlCl At!fNJI/tf 111I. CO., CO""."." 104.07 ltIrllnUle Int. C6" CT.""""".""."....."......"... loa.47 lilt UIII__ COmpo"'l, MN "".................. lOiI. " ""'*"'" NlIIoIlIl UIt I... CO., MI ..".........""..". Itl6.1Ill JolIn Hlo_ MuIuII UIe Int. Co., M'" .............. 106.111 t..Inol*lNlllollll UIt '". CO" IN ........1....".."..... '04.17 = MuIUII UIe IrlI, Co" MA ..""".".. '06.1' UIe inIu_ CO., NV ",,,..,,,..,,..,,. 104.14 IIonwIItlI Ule ,.._ CO., OH ................".. IOQ.1I1 Ntw ItlGiInd M_ UI.I... Co., M'" ..."."""... IOU' Ntw Vail< UN I... oncl MtoMt Corp" DI """".. 106.11 Ntw VOIk UIe "-"- co" NY ".."...."...""".. 106,75 ~lIm MUluIl Ule '''. Co" WI "............... 106.116 ,,_ Mu\IJoI Llltlno. CO., CA ................"..""... 'O.u. """""', Home Lift MUlulllnl. Co., CT ".........". 'OUT "rtncIpol MulUll LIlIlnl. CO., I"'......."...".."..".." 'OUO ,-.1 ","u..noe Co. of AmonOl, NJ............. 106.07 .... '""" UIe '..u.._ Co" IL"."...."..........". ',R. 11 T_t1cI 0lct0lIn.... ute Inl. Co" C"'.......... lOll." T..VIiI" 'nlu..nct Comptlny, C1......"..""....".. If I.4R AVlRAOIIIS 01' TM' LARanT LIFE C0'5.""... "05.10 "'.'."".D ..IlK UN .........................,.. ".'.11 I,.: , "", I,"" '" ".',>"'!r"i";' "",y r' ,.,! .O:';'r,tr: "I:,' 1~1~II'il,!ii,ii~i.<~!ii,~~.jl"'i..j".I~~'lW , . ',," ", '(, :,,,, .' ", I','. :,':"': ,..:.1 ,.., ;\>"::,':'.;;::::~;J':;'i ,',': Net Gain Ratio =-~...~=::" ol TolII DlIbuIMnonta:....... m~ olll1l """'IlI"'I /llIybl__.....a~llII_trom.-. "'VIAMI t6 01' THE LAMI8T LIFI CO'I......"...,0U. '''.''''''.D "ilK un ............................ "11.7'0 SUJl:lUS to Life Insurance"; . "*oIl"",,""fofllChllllllOolUlll 10 orce 1__'n'",,"'''''''roIIool "'~U'1O 11ft .."'..,...'" _ "'"1 1_' IU_ pnlOI ol I_' onngltll"" alllllltlV. IVIRAIIIIIS ~ THI LAIlOIIT L,'I CO'll"."."..... .... ,...,......0 "ilK un ................."'...,....... .,.." ... ',NANCIAL ITATlMINT IUMMAlIlY AI 01" DICIMIIPI 111, 1. ~-- "1O,IU,I70.oo . T"'~ 1R31,712,Dl7.00 1 0,... ."""', Itncl e.,..., ~ .I'l~) . ",IfO,IfUO ,..., - 112.1",11'.00 T...._ 10,1" .IU.OO ..,.."......".,. U,..4,...,ooo.00 ",", C 1 i ...."'...ftnI___"'lIlIyw_,t8Il,II1I...~._olllll_llIOI"ilIIIon'" one us on llVOflbll1n -""" wiIIlll1l"""IYlIIgIt.' i& ol me LAIIOIIT COM~ANIE5 , . ,'.' l,t:' ;" " ...); , ',.:"', ,'", ~,.' " "~i, t,:,.t.' I:t j.:, I ;I , "'1 f'~ \' 'r;; l.;'o!;;lf!r~! ',' '1 ,'..' ',' " ". '" ,<"" "'1',"':' f:rr' ~"" " 'I J.: ~}.iI'lt"4,.~ II,}:, 'I! '/I'IV ~ '. . . / "j. , I. , . .:! ',., i ,J." .11,' :P': ' 1"i,II.,Illflt.,' ','il;ll: ".Iil fill;' 'Hi: I i~.."t,t;'~i"itiH;tli.ltl'l" I.~,'t:';l'il', ',_ r::~,~.lc :~I.:t;!:" lit,; :r"f , ' . , '" , "~ . ".' , I " r (' ORTHOP~EOIC SURGERY OF C~RL.ISL.I L.TI;), DAHIlL. ~ ~IL.Y M.D January 27, 1995 "' IIL.VIDI"I n"IIT ClA"LIIL.I, ~A IVOla ?IV.......lla Mr. David M. Pollick Dale E. Anstine, P.C. Two West Market Street York, Pa. 17405 Rei Tiffany Urick Accident datel 7/2/93 Dear Mr. Pollickl I have enclosed my office record. regarding Tiffany Urick. As you know, Tiffany sustained a fracture of her right femur in a wire slide accident whUe at the TreBller Wildernells School in July, 1993. She was first seen and evaluated by me in the Carlisle Hospital Emergency Dept. After an initial period of stabilization .he underwent closed intramedullary n~iling of the right femur on July 2, 1993. Her post~operative course was uneventful, and she was discharged 3 days following surgery with limited activity on crutches, resting at home. The SUbsequent 6 months were characterized by uneventful healing. At the time of Tiffany's January 1994 office visit, she was expre..- ing difficulty with the knee which was assessed as being the result of patello-femoral pain associated with quadriceps muscle weaknes.. This was treated with sal icylates and stationary bicyc le exercises, ~nd Tiffany went on to have resolution of her symptoms. The intramedullary nail was removed in November, 1994 which was 16 months post surgery. Her course following this procedure was similarly uneventful. It required a period of protected weight bearing with crutches for 6 weeks following hardware removal. At the time of my last evaluation of Tiffany whe showed no evidence of complications and I would anticipate that the right hip and right knee will suffer no long term sequelae from the injury of July, 1993. If I can provide any additional information regarding Tiffany's case I'll be happy to provide them without charge. Sincerely, I ~., '/ ;/1 ,-'"/ --tf <. . ,/ " 1.."- (..- (./ . ( I \:";3 .. ,. 'cc:, o .v - M.D. Daniel P. Hel~ DP!!lnes encls/ = '''ITlONI '1 IXHIIIT , ~)",.. M. ,\J'lI"'''"UI, I'.,:, .'..."n..",......"., , ., '1 ! .. D.I ,.1.. UlUCK, 1adI,lduaJ.If lid II ...... ud Nltunl GuardIaa 01 TIFFANY URICK, I _or PIaIl1tllf I IN TIll COURT 0' COMMON pi "'1.' or I ClJMJJDJ..ANDCOUNTY, PlNNBYLVANJA I CIVIL ACTION. LAW I : No. '1t)/ c~Li /?9l/ I I I I IURY TRIAL DEMANDED Y. TUSSLIR LUTHERAN SERVICES, 1)ef"-P'4-nt NQ'l:JCI'J'Q DJ'Ji.Ilm YOU HA VI BEEN SUED IN COURT. If you wllb to defend Ip!nll the clalma lit forth IpInlt you In Ihe followlna PIlei, you mult tab action within twenty (20) .Y' after 1h11 Complaint and Notice are lCl'Ved, by enterlna I written appearw:e pcrlOlll1ly or by IlIomey and ft\lnaln wrltina with the Court your defenllel or obJectiOlll to the clahm let forth aplnlt you. You are warned that If you fall to do 10, the cue may proceed wllhout you and , I I default Judament may be entered aaainlt you by the Coun without further notice for lilY I I money claimed In the Complaint or for lilY other claim or relief requelted by Ibe Pla1ntiff. You may lOIe money or propeny or other r1.htalmpnrtant to you. YOU SHOULD TAKE 11118 PAPER TO YOUlt LAWYER AT ONCE. IF YOU DO NOT HAVI A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPIIONI11I1S OFFICE SET roRm BELOW TO FIND OllT WHERE YOU CAN GET LEGAL HELP. Cumberland County Lawyer Referral Court Admlnlllrator I Courthouae Square Carliale, Pennsylvania 17013 (717) 2M) - 6200 DB .J ... URICK, IJldMduaU1 IDd II .....Dt uel Natunl GuardIaD 01 TIFI'ANY UlUCK, . aaIDor PIIbIIUf Y. TlESSLEIl LlJ'I'IlERAN SERVICES, Delendant ~ I IN THE COURT or COMMON I'LIA.t or I ClJMBi1lIAND COUNI'Y, nNNIYLVANIA I CIVIL AcrlON . LAW I I I No. I I I I IURY TRIAL DEMANDED A VISO VSTED HA 51DO DEMANDADO EN LA CORTE. 51 ulled deIea elIf...... delu queJu 'IlPllellU en Iu pqinu Ii.ulenlel, debe wnw acclon denlrO .. VMalta (20) diu I partir de II feeba. que recibio II demanda y..avllO. tJated debe praonllr c:oml*'lC*'Cla tlCri.. en penona 0 por abopdo y pruentar en 1& Corte por .IlCrilO IIUI clef.... 0 IIUI objeelonea IIu dellW1du . IU contra. Ie 1& Ivi.. que Ii no .. deflende, el cuo puede proceder IIn ulled y la Corte puede clecWir en au contra lin I1lIIlvlso 0 noUf1~1on por cllllquler dlnero rec1amado on la demandl 0 por c:ualquler otra quejl 0 compenw:lon reclamadoa por .. Demandante. VSTED PUPDB PBRDBR DINBRO, 0 PROPIBDADES V OTROS DBRBCH05 IMPOITANTElS PARA VSTED. LLEVF. ESTA DEMANDA A UN ABODAOO INMJi'.DIATAMENn. 51 VSTED NO TIENE 0 CONOCES UN ABOGADO, V AVA 0 LLAME A LA OnCINA EN LA DIRECCION ESCRlTA AB,uO PARA A VERlGVAR DONDE PlIEDE OBTENER ASI8TENCIA LEGAL. " , , I I i Il.,....:..\~~~'~.~.,., I ! 1'."'."',".":"'''" I I Cumber1and Counly Lawyer Refeml Court AdmlnlllratOr I CourthoUIe Square CUll"., Pennlylvanla 17013 (717) 240 . 6200 I ...... I . n,u.llI "::~,~~~l~.~' 1),1:'1 '''.1'',..".."".,. . DJl" .J .... l1IUCK, IDdI,WuaU, .... . Panlll IDd Natu"" GuardIu 01 TIFFANY UlUCK, . mIDor PlalDtIlf I IN mE COURT OF COMMON I'U:AI or I CUMBEIU..AND OOl1NTY, PiNfM,VANIA I CIVIL ACI'ION . LAW I I I No. I I I I lURY TRIAL DEMANDED Y. TIlUSLIIl LlJTHERAN SERVICES, DeI'DdaDt COMt!U~ I. Plaintiff, Della Urick, II an adult individual and the parent and natun1 .1W'd1an of TIffany Urick [hereinafter "Minor Plaintifr), I minor with I date of birth of March 17, 1979. Both Plaintiff and Minor Plaintiff realde It 401 North Bolton Street, New axford, Adami County, Pennsylvania 17350. 2. Defendant, Treu1er Lutheran Servlcel, II locfted at 960 Celltury Drive, Mechanl.cabura, Cumberland County, Penn,ylvanla, and opaatea the TrIuler WUdeme.. Camp, located In Bolllna Sprina.. Cumberland County, Pennlylvanl.a. 3. On July 2, 1993, Minor Plaintiff wu Ittendlna I pbyalcal IlIInIIlJ and le&denhlp conference camp held It Defendant', TmaIet Wlldemeu Camp In BoIlIn& Sprinp, Cumberland County, Pennlylvlllla. 4. Atlhat time, Minor Plaintiff was required to deacend I z1pUne, which wu auspended approldmately 60 feet above the around, on I z1pcord when she ItrUck 1M d1amount boIrd, lhellby aualna damqea and InJurtea.. more fully set forth below. I 5. Thi. Il:Cldent reaulted fmm Iho neallalll\Ql of die Delendant, and the Defendant'. employ.., and wu due In no manner whataoever to any let or tallure to act on 1M put of die Minor PlaInllff or PlaInllff. 6. At allllmea rel.vlUlt hereto, Defendant ICted lllroup Ita employ.., IpIltI lII4Ior lUVanta. 7. AI a direct and prollmate reaull of the neallpnc:e of die Defendant and die Defendant'. employ.., Minor PlaInllff auttered ..rIout and permanent Injuria Includllll, but not limited to, . comminuted trlCturt of the rlaht femur. a brulllld knee, Injury to her Imee cap, ICUTina and dl.naurement, and IIvere dam..e to her nerv.. and ntrVOU' ,yatem. 8. A, a direct and prollmate mult o( the neallaence of 1M Defendant and the Defendant', employ.., Minor Plalnllff baa .uttered, or may ,uffer, a levere Iou 01 '* eamina caplClty. '011.10.. of Income and eamlnl caplClly will, or may, c:onUnllll1n die I future. I I .., I n''',M ."','\~~~II'l". 1'. I.. I ,I "..,.......", ! 9. Alw u . direct and proximate reault of lIIe nealiaence of the Defendant and the Defendant', employ,", Minor PlaInllff hu underaone, and In the future may UI\deraO, .. mental and physical pain and IUfferlna, mental anaullh and humil1atlon, Iou 01111,'. pleuurea, acarrIna and dl,naurement, and . levere limitation In her punult of dally ICt\vldea, III to her a.. 10.. and detriment. 10. A. a ....ult of the nealllenee of Ibe Defendant and Defendant'. employ..., PlaInllff, Della Urick, In her own r1lht, hu Incurred expen... for the medical treatment to the Minor PlaInllff, and will continue to Incur medical expensea for an unknown time Into the future. Medical expen... to date total $7,529.40. 2 ,; , .~~I.~.~~::~:~~~~,...~~, '., I;, I ,,,,.,,,,,,,,,..,,.,,,, I I 11. AiIO U I reault of the neallJOllCll of the Defendant and the o.teadu&'. IIllploy..., p1aInlirr, Della Urick, hu lnculT\lld 11IpenIU for I renlll car and Iona cIlIfInclI telephone '1Ip1111e1 from lime 10 lime U nocellll')' In the coun. 01 the Minor PIaInl1ff'. medlca.l IJeItmelIt and care. 12. ThII IJIIUer I. Illeaed 10 ..<*Cllhe appUClble UmllI of arbitrll.lon, IIId a Jury trial II berlby del1llllded. COUNT I DEIU URICK, IodlvlduaU)' and u PutJd and Natural GuardIaa of TIFFANY URICK, . minor v. TRESSLER LUTHERAN SERVICES VICARIOUS LlABJJ.J.n: 13. Parqnph. 1 throuah 12. Inclualve, are Incorporated bereIn IIId made put 1Iereof U If fully lilted. 14. The neallaence of Defendant'. employ. conallted 01 the fol1owtna: a. PlIlIlII 10 remove the dl.mount croupblce board from the z1pl1ne before direcllnathe Minor p1ainlirr 10 delcend the zipllne; b. Pllllna 10 check the z1pllne for hawdou. condlliOlll before pennltIInt or a1lowlna the Minor p1ainlirr 10 deIcend It; c. PallIna to properly IUpervl. the chUdren present lithe zipl1ne; 3 itA-Mil M. '\~"TII"'C. P. L .. . \."..r....."..,'''.,r d. &poalnl Iho Minor Plaintiff to en unl'UlOlllble rlak 01 harm when IbI dIIcMdId IIIe "pUnt when Ihe Delendant'. .mploy.. ,"-w, or IhouId have knowa, oIlIIe ..11fenge oIlUdI harm and Ihat Ihe Minor Plainti<< would Iallto protect hetl.lf ~nlt It; e. Fllllq to .u~lIe reuonable we In carrylq on actlvltlea It IIIe TJ'IIIIer WlIderneu Camp and IIJ*lfica1ly, the dplllll; '0 Falllqto COIIllnlCt the "pllne In IUCh . InIII.Ml' .. to prevent IIIlndivl4ull from utillzlna the dpllne with Iho dl.mount croiNplece In pllce; and ,. Fallin, to construct the dl.mount crollplece In .uch . luhlOll U to alVl way to . deacendln, ulCr 01 the dpllne. 15. Delendant Treuler Lutheran Servicct'. employ. were acllna In the IKlOpI of thelr employment, under Defendant Treuler Lutheran Service'. control, and In IIIe furtherIIIce of Defendant Trailer Lutheran Service'. bullnelllnteruta It the time of thelr neall,ence. WHBRBPORE, Plaintiff, Della Urick, Individually and II Parent and NaturIl Ouardlan of Tiffany Urick, . minor, respectfully requeall Ibl. Honorllble Court to enter JudalMllt apinll the Defendant, Treuler Lutheran Servlcel, In III amount In .ltCfi. 01 Twenty-five Thouaand ($2',000.00) Dollan, plu, interest and colli II allowed bylaw. I' .~ n,\J,1I ", ,\NHTII'IM, p, ,:, " '. n,~. I.....""." ,,,,,, CO~ II DE:LJ.A UlUCK, IndlvldualJ)' and... Parent aad Natural Guardfa. of TIFFANY URICK, . mlDor Yo TRUSLER L1JTIIERAN SERVICES NEGJ.IGENT SUPERVISION 16. Parqraphl I throuah 15, Incluaive, are Incorporated herein and made put hereof u I' tully lilted. 17. The De,endant owed a duty to the Minor Plaintiff to eurd.. reuonable care In carrylna on IlIlCtlvltlel at the Tresaler Wlldemcaa Camp, Includlna the aelcclion, review and supervlllon 0' the De'endant's employees. lB. The neallaence of Defendant, Trelller Lutheran Servlcea, conllsled of tbe 'ollowlnl: a. Falllnlto properly train III employees, aaenll and/or lCrVanllln tbe proper aatety procedures to be followed 011 the z1pllne; b. FaIllnlto properly provide 'or the aal'ety and well-belnl 0' tbe attendcea of tbe Treaaler Wlldemeu Camp, specifically the Minor Plaintiff 011 the date of the accidellt In queatiOll~ c. Pallinl to properly supervlae III employeca 10 U to prevent lnJurlea 10 tbe attendees It the Treuler Wlldcmell Camp and the Minor Plaintiff In particular; d. Breachlnlill duty to the Minor Plaintiff by fallinl to Illrel.. reuonable care In aelcctlnl, revlewlol and lupervlllnl ill employees at CAe Treuler WUdemeu Clmp; 5 ~ ;]; ~' ~ :o~ ' . - 'i I~ ,':, ., '\1 ,/ \,\ ,~ ~ ""~ -,-, , '~ ~ .j .') ~ ~ )l". I (~ ~l ~'\~ "1~ .... . . l;; ~ ~ = h ~ ~ i I; . ~ · u g ~ ;.: ,. ~ well ~ ~::J~j,l . ~ ~ 0 . 'r.1~~' ~ ~ . ~ ;;: I - o . DI ~ = .oJ ~ ~ - - il I " 'Ii ,I " I II.!, . , I' . , " " , . ':~,~:,. ." . "'.