HomeMy WebLinkAbout94-03352
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EDWIN DUFFUS,
Plaintiff
IN TilE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
NO. 11 )1); ()( .~J' t.. Jtll ,'.....
vs.
NATIONWIDE INSURANCE
COMPANIES,
Defendant
NOTICE
You have been sued in court. If you wish to defend against
the olaims 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 defense 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
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 SIIOULD TAKE TillS PAPER TO YOUR LAWYER AT ONCE. IF YOU
DO NOT IIAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE TilE
OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL IIELP,
Cumberland County Court Administrator
Cumberland County Courthouse
1 Courthouse Square
Carlisle, PA 17013
(717) 240-6200 or 697-0371
polioy covering the Lightner v.hiol. 1a d.....d to b. the aouroa
of Firat Party Ban.tita to Plaintitt, on the .am. baaia aa if h.
had him..lt b.en a nam.d in.ur.d.
7. On 5/7/93, the Lightner vshiole wae ineured by
Oetendant, under policy number 58370937529, which provided tor
tir.t party medical benefit. of up to $100,000.00, and tor fir.t
party inoome lose benefit. of up to $25,000.00, with a monthly
maximum inoome loss benofit of $1,500.00.
8. At the time of his injury on 5/7/93, PIaintift wa.
emp10y.d a. an agricultural laboror, earning wage. ot $878.91 per
month.
9. At all times sines 5/7/93, plaintiff ha. been
due to the injuries he suffored when .truck by the
vehiole on that date.
10. Fallowing the 5/7/93 incident, Plaintifr .ubmitted a
claim for first party benefit. to Defendant, which assigned claim
numbar 58 37 8 937 529 050793 01 BVP to the claim.
disabl.d
Lightn.r
11. Defendant paid Plaintiff'. claim tor income 10.. trom
5/12/93 to 1:!/1:~/\l:1 , but has refused to pay income 1088 benetite
beyond that time, despite Plaintiff'. continuing di.abiIity due
to injuries he suffered in the 5/7/93 motor vehiole incident.
12. Det.ndant'. failure to pay income 10.. benetit. due
Plaintiff by realon of hi. injurie. lack. rea.onable ba.i. in law
or in faot.
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EDWIN DUFFUS, I IN THE COURT OF COKHON PLEAS OF
Plaintiff I CUMBERLAND COUNTY, PENNBY1NANlA
I
v.. I CIVIL ACTION - LAW
I
NATIONWIDE INSURANCE I NO. 94-3352
COMPANIES, I
Defendant I JURY TRIAL DEMANDED
TOI NATIONWIDE INSURANCE COMPANIES, DEfENDANT
REQUEST FOR ADHISSIQHI
.
",
-
Pursuant to Pa.R.civ.P. 4014, you are hereby reque.ted to
admit the following, within thirty (30) days of service of this
request I
1. You have paid First Party Income Loss benefits to Edwin
Duffus from 5/12/93 to 12/12/93 at ths rate of $703.13 per month.
2. Agricultural labor is not light duty work.
3. In a letter dated 12/13/93 (attached hereto liS Exhibit
A) to Thomas Green, M.D" who was the Plaintiff's treating
physician, Patricia B. Grier, Physical Therapist, reported that
Plaintiff had been participating in a work hardening program
s\nce 11/2/93 that his current level of activities would be
graded as light duty, and that "...it seems appropriate to
suggest that the patient be ret.urned to light duty activities."
4. On 1/10/94, Plaintiff'~ counsel transmitted a copy of
Ms. Grier's 12/13/93 report to you, along with his own cover
letter, a copy of which is attached as Exhibit B.
5. On 2/10/94, Plaintiff's counsel transmitted to you
copies of treatment records from Rehab Medicine Associates, P.c.,
who had begun caring for Plaintiff on 1/21/94. The records were
.
accompanhd by a cover letter, a copy ot which 11 attached hereto
II Exhibit C,
6. Among the record. trom Rehab Hedicine A..ociate., P.C.
wa. a letter dated 1/21/94 from J.J. Cho, H.D. to Thoma. Green,
H.D., a copy of which is attached hereto as Exhibit D.
7. on 3/18/94 Plaintitt's counsel wrote you to inquire a.
to the status ot the income loss claim. A copy of that letter is
attached hereto a. Exhibit E.
B. On 6/8/94, Plaintiff's counsel sent you a report dated
5/20/94 authored by J.J. Cho, H.D., of Rehab Hedicins A.sociatea,
P.C., concerning Edwin Duffu8, together with a cover letter, a
copy ot which i8 attached hereto as Exhibit F.
9. In the la.t paragraph ot Dr. Cho'. report of 5/20/94, a
copy ot which ia attached a. Exhibit a, the doctor atat..1
"While I wa. providing treatment in the past four month., the
patient waa not able to return to work aa a farm laborer nor did
I recommend that he return to work."
GRIFFIE , ASSOCIATES
Attorneys for Plaintiff
.
(
D.oteb.r II, 1..,
Thorn.. Gr..n, ",Po
Hldl~.l ~rt. lulldln;
220 ..rklr Itrllt
carll.ll, P~ 11013
UI EdwLn Duff..
Work CondLtlonLn; It.tu.
Dlar Dr. Or.ln,
Your patLlnt, Edwin Duff.., ha. blln partlclpatLn; Ln a flvl tLml1 plr
wllk work condLtLonLn9 program ILncI 11/2/.3. Pat Lint con.L.tlntly placla hLI
paLn llvll at 4/10 at bl.t .nd 1~'/10 at wor.t. DUI to tr.n.port.tLon dLffl-
cultLI., th. patilnt particlpatld only Ln a thr'l hour program which Lncludld
ao mlnutl' of moiat h..t .t the Ind of hi. ....Ion.
p.tl.nt'. curr.nt l.v.l of .ctiviti.. would b. 9r.d.d at light duty.
patl.nt do.. not tol.rat. ao pound. con.i.t.ntly for a two hInd clrry, but LI
u.in; la.5 pound. for a on. hand clrry. p.tient i. working tr.naferrin; .mllL
bo... w.L;hing from fLve to t.n pound. for 15 minutl' of time. 'It Lent 1.
l1ftLn; only Ind II pound buck.t from I low to I mLd l.vel. 'ItLlnt 1. t.kLn9
fr.qu.nt wllk. on the treadmill, 901ng only 10 minutl' time bICIU.I of cog-
plaLnt. of llg paLn. Pati.nt L. tolerating only 40 pound. on thl Ibdomlnal
pra.., 40 pound. on the leti.. imu. blr and 10 ml nut.. on the upper body Irgoml-
t.r wLth ao watt. of re.i.tanc., Patient will not tol.rat. kne.lln~ tor work
activiti.. b.cau.. of complaint. of right knee pain. Th. right knee plLn ha.
only b..n a complaint in the l..t two we.k..
PatL.nt'. ...rci.. progr.m h.. includ.d lumb.r .t.bilie.tion 1..rcL... I'
w.ll .. .tr.tchinll of the hlm.tring., g..trocn.miu. Ind lumbo..cr.l mu.cull-
turl. Plti.nt will fr.qu.ntly unil.t.rllly decide th.t h. i. unlble to perfo,.
hi. 'p.cifl.d .ctiviti... He h.. r..i.t.d .11 .ffort. to incr.... hL. work
lo.d. WI hlv, b..n .bl. to .dv.nc. hUm to an~ul.tion without. c.ne with.
minimal 9.it d.viation. Pltl.nt wIll often r.v.rt blck to the c.ne wh.n h.
fl.l. h. i. in p.in, but b.c.u.. of Improp.r u... thi. cau... a much more
.bnorm.l g.it pltt.rn. Plti.nt i. frequ.ntly r.-in.truct.d in prop.r po.tur.
and body m.ch.nic. .nd continu.. to r.qulr. ma.imum cu.. for correct I,.rform-
InCI of .impl. Ictivitie..
J do not f..l th.t thl. cli.nt i. .chi.vlng the m..lmum b.n.fit. ot . work
conditioninfil progrlm. Thu.fon, J ucollVTl.nd that w. di.continu. thi. pr09ram
.t thi. point in tim.. You m.y wi.h to con.id.r . functional c.p.city Iv.lul~
tlon It '010' point in the future to det.rmin. hi. r.turn to work .tltU'. It 11
difficult to .Ift through rhi. ,.ntl.man" m.ny .nd v.riou. complaint.. H.
r.port. th.t h. i. un.bl. to r..d .nd ..pr..... lack of und.r.tandln9 with many
of our in.tructlon., If th.l. .r. no .i,nific.nt 'indlng with the kn'l prob-
lem, it "'10' .ppropriat. to .ug9l1t th.t th. p.ll.nt b. return.d to l1ght duty
activlll.., If you h.v. .ny qu..Uon., r',lrding th... co....nt., pl.... do not
h..itat. to contact m..
/i,lllld 1 "A"
.
R.cfwb Mcdidl~ A.'iSOciutCSI r.c.
"'ClAU.tJ~"" "'~~'ICA&. "'lOICIN( AND RI...llU'''''IO''
JAY J~HO tHO MD
I.oNQ I ....."" ... 0
'llIANMW lOf'f.LIr.lO
y,. "2' E '''nel'' Rilla
M'O\''''''lbu'9 p" "OU
r.l,phan, 11 I 7118&''''3
'11,1 "11"',1"2
Cl '20 N llh S"," Su'" 10.
Ch'mb"'bUlg. PA 17201
TeI'phon, {11112&H73a
F.. ,1\11 2e'-0508
January 21, 1994
Thoma. oreen, M.D.
Medical Arts Building
220 WilBon Street
Carlisle, PA 17013
REI Edwin H. Duffus
Initial Evaluation
Dear Tom:
This gentleman who complains pain in the back and both legs
with muscle cramps in both legs, worse on the left, was seen in
the office today.
According to the patient's history, this patient came to
this country from Jamaica in 1973 and has been working on farms
as a laborer. Patient is not able to read or write. When this
patient was riding his bicycle on Hay 7, 1993 and trying to cross
the road, an automobile hit him on the left side. This patient
fell down on the ground and injured his back, leg and testicle.
The patient went to the Carlisle Ilospital and received treatment
b~' ~'ou and neurologist, Dr, Jurgensen. Patient had to IlIlve 1
testicle removed in October, 1993 and he reports receiving 7
epidural injections and/or trigger point injections by an
anesthesiologist in carlisle. The lllst injection was on December
27, 1993 and he has another appointment again in a few days.
Patient states that the injection sometimes worked for about 2
weeks, Patient is taking a medication before sleep for
relaxation and anxiety which was given by the anesthesiologist in
Carlisle, but he does not recall the name of the medicine.
Patient received physical therapy treatment at Alexander
Springs until December, 1993, Due to increased pain and muscle
cramps, especially in the left leg, this patient could not work
as a farm worker. This patient does not have his own vehicle or
transportation.
In his past history, patient states that he had hypertension
but he never saw a doctor to get med! cat ion. Pat! ent was an
inpatient at the Hershey Medical center a couple of years ago due
to kidney problems. Patient has no known allergies.
HIfJr,lT "p"
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Dr. Grein
REI Edwin H. Duttua
PllljJl 2
January 21, 1994
Physicnl eleam: straight leg raising is negative bilaterally
on sitting and lying but there is a complaint of a lot of muscle
cramps in the hamstring. Patient needs support from both arms to
rise up to over 90 degrees in lying position. Patient is able to
walk on heels and toes with limping on the left leg. Range of
motion of tho lumbar spine is almost full but the patient is
doing it with support of the anns in all directions. Patient
complains of severe tenderness on both sides of the low L-S,
worse on left, and 5J joint. DTR symmetric 2+ in the lower
extremities. There is no focal muscle weakness. Patient
complains of some difficulty urinating with hesitation of
initiating urination since the testicle surgery.
Today, J got a copy of the MRJ study of the lumbar spine
which was done at Magnetic Imaging Center on June 3, 1993. It
showed a small central disc herniation at L4-5.
On today' s physical exam, I cannot pick up any obvious
neurologic impairment. Patient may have a central herniated
disc which might be causing some pressure and giVing some bladder
Bymptoms, I am not sure whether the bladder symptoms are related
to the back unless the patient has a CMG test by an urol09ist.
However, in my findings today, his main complaint of pain in the
hamstring and back is more of a result of muscle ligament strain.
Today I advised patient as below:
1.
2 .
I gave him samples of llaprosyn 500 mg. b.i.d. to try.
TherBpeutic exercises as he can until we get approval
further treatment.
We will contact the patient's lawyer
direction we can take to provide medical
patient.
what
this
for
3.
regarding
care for
Patient will be back to see me in 4 weeks.
Bincerely,
JJC/clw
Dietl 1-21-94
Transl 1-24-94
}~,
J}Y J. Cho, H. D.
RtfUlb Mtdkitle AssoCiaWSI P.C.
IrICWJIJf<<I ~ ~~ ~lC)lCJNI "'NO AlliAllJ1Attml
JA, ,1I.JHQttQ CuQ "'D
HOHO . ,..".. D
''''''~Wl()lllt1...C
&12. E 1"""1' Road
M,c""",clllU'O PA 170&&
nMtphont(71717iS'7t43
F..t71711g&.li.2
a 120 N 7th 51'ttl. 5uIlt 102
Chlmb.,IllUIO, PA 17201
nMtphont (71np.87.n3t
F.. (7171 257'0&OS
Hay 20, 1994
Fred H. Halt, a.qulr.
200 North Hanover Stre.t
Carli.18, PA 1701)
ala Idvin DuffuI
Dear Hr. Haiti
This is in response to your letter dated April 26, 1994
regarding Mr. Edwin Duffus. Mr. Duffus was initially evaluated in
my office on January 21, 1994 referred by an orthopedic surgeon in
Carlisle, Dr. Thomas Green, for his low back problem and pain in
both legs.
According to the patient'. history, the patient had been
workinq on a fann !I& a laborer. Unfortunately, patient was
involved in an accident on May 7, 1993 whils the patient was ridinq
his bike. When hs tried to cross a road, his bike was hit in the
rear on the left by a car. lie fell down and injured his low back,
leq8 and testicle. He went to the Carlisle 1I0spital and received
a full orthopedic evaluation and also seen by a neurologist.
Patient had to have one testicle removed in october, 1993 and he
Btated that he received 7 epidural steroid injections in his low
back including a trigger point injection at Carlisle Pain Clinic.
Unfortunately, the pain did not get any better. When I saw this
patient, he was takin9 Elavil for sleep to relax and relieve
anxiety. Patient received outpatient therapy at Alexander spring
outpatient physical therapy facility until December, 1993 with not
much improvement. Patient had SMG test which showed L5 nerve
damage and MRI of the lumbar spine on June 3, 1993 showed a small
central disc herniated at L4-5.
BaBed on my physical exam on January 21, 1994, 1 could not
pick up any neurological tindin9s to indi~ate a pinched nerve. My
diagnosie wae low back pain with contusion with muscle ligament
atrain and henllated dilic at L4-5 without pinched nerve. Also, the
patient is still liIuttering with testicle contusion. I recommended
to this patient to take nonsteroidal anti-inflammatory medication
and have outpatient therapy at Alexander spring outpatient therapy
tacility.
rxllllllT "r;"
. ,
Mr. Halt
REI Edwin Duffus
Page 2
Hay 20, 1994
Patient was lien by me aqain on February 21, 1994. My
impression was muscle ligament strain in the low back with chronic
low back pain syndrome.
Another visit was on March 21, 1994 and he still complained of
severe pain in the low back and leg cramps. Patient was still
ambulating with a cane. My impression was still severe low back
pain as a result of MVA on May 7, 1993 which damaged muscle
ligaments in the low back. I gave him an elastic corset and
encouraged him to stop using cane and do therapeutic exercises. He
was also to take Naprosyn.
His last visit was on May 9, 1994 and hs still complained of
pain in the low back and cramps in both legs, worse on the right
with pins and needle feeling in both legs. My physical examination
did not indicate any new neurological findings but from muscle
liqament point, there is markedly limited range of motion in the
low back with complaint of tenderness in the low back muscles. Due
to poor improvement one year after injury, I recommended that the
patient repeat MRI ~can of the low back and that he might need
psychological evaluation and repsat EHG test to see if there has
been any deterioration as a result of HVA on May 7, 1993.
Based on the above notes after following this patient for 4
months in my office, the pain in the low back and legs did not
change at all in spite of medication and outpatient therapy. The
only objective pathological finding is central herniated disc at
L4-5. 1I1so, EMG test showed L5 pinched nerve but clinical physical
exam did not support this. The primary diagnosis is still severe
muscle ligament strain in his low back with herniated disc at L4-5
without pinched nsrvs. While I was providing treatment in the past
4 months, the patient was not able to return to work as a farm
laborer nor did I recommend that he return to work. Patient i.
scheduled to sse me again after he has repeat L-S spine x-rays and
HRI to compare with the studies done a year ago. Patient may need
further work-Up in his low back orthopedically, neUrOlogicallr and
may be from psychological point to rule out any kind of anx ety,
frustration or depression.
Sincerely,
lk
J. Cho, H.D,
JJC/clw
EDWIN DUFFUS,
Plaintiff
I IN THE COURT OF COMMON PLEAS OF
I CUMBERLAND COUNTY, PENNSYLVANIA
I
: DOCKET NO: 94-3352
VII.
NATIONWIDE INSURANCE
COMPANIES,
CIVIL ACTION - LAW
De fendant
JURY TRIAL DEMANDED
PLAINTIFF'S ARBITRATION DRIBF
This is an action in which Plaintiff seeks to recovery First
Party Income Loss Benefits for disability caused by injuries he
lIuffered when he wall struck by a motor vehicle on 5/7/93, while
he was riding a bicycle. Plaintiff suffered back injuries, and a
urological injury as a result of that incident. For purposes of
this action, only the back injury is relevant.
At the time of his injury, neither Plaintiff nor anyone in
his household owned a motor vehicle, nor was Plaintiff a named
insured under any motor vehicle insurance policy.
Under such
oircumstances, Seotion 1713(a) of the Kotor Vehicle Finanoia1
R..pondbUity Lav ("KVFRL"), 75 Pa.C.S. Section 1713(a) provides
that the source of First Party Benefits is "...the policy on any
motor vehicle involved in the accident."
Therefore, Plaintiff
sought First Party Benefits under the insurance policy covering
the vehicle which struck him, which was driven by Robert
Lightner, and insured by Defendant. That policy provided for
First Party Income Loss Benefits to an aggregate amount of
$25,000.00, subject to a monthly maximum of $1,500.00.
At the time of his injury, Claimant was employed as an
agricultural laborer, earning wages of $878.91 per month.
Defendant paid Plaintiff income loss benefits from 5/12/93 to
1
.
Return to Work A.....msnt author.d by J.J. cho, H.D., on. of
Plaintiff's treatinq physicians, dat.d 8/16/94. That Exhibit wa.
.ent to Defendant'. counsel on 8/24/94.
Defendant has never requested an indepsndent medical
.xamination, It certainly could have done so under .eotion 17..
of tbe KVrRL, 75 P..O... .ection 17.. it it felt that Plaintiff
had not sufficiently documented his disability. Plaintiff'.
medical proofs are, therefore uncontradicted. It ie submitted
that Plaintiff's evidence is credibls, and does eetablish that he
remained disabled after 12/12/93. If you find Plaintiff's
evidence credible as to disability, then it nece.sari1y follow.
that Plaintiff did furnish rea.onable proof of income 10.. at the
times detailed in the Request For Admi..ion., and that he is
entitled to be awarded the income loss benefits that he seek..
.eotion 171. of tbe KVrRL, 75 P..O... .eotion 171', provide.
that benefits are payable within thirty (30) days after the
insurer receives reasonable proof of the benefits due, and that
over due benefits bear interest at ths rats of 12\ per annum from
the date thsy become due. This ie not a penalty, It is simply
the interest rate that the leqislature established must be paid
whenever benefits are over due. H111-~_Ki~lAn4-1~ CD., 310
Pa. .uperior ct. 181, 417 A.2d 324 (1.83). Therefore, Plaintiff
is entitled to intersst at the rate of 12\ per annum from th.
date that each month'. income loss bsn.fit became due.
J
.
n. DlrlllDAIIT SHOULD BI ORDIlRlD TO PAY
OLAIMAMT'S COUH81L rllS INCURRlD IN
IRINOINO THIS AOTION BIlOAUSI IT DID
NOT BAVI A RlUONAIlLI BUIS rOR
rAILINO TO PAY TKI CLAIM.
.eotion 1711 of the KVrRL, 75 P..O.S. seotion
1711, states in part:
In the event the insurer is found to have
acted in an unrsasonable manner in refusing to
pay the benefits when due, the insurer shall
pay, in addition to the benefits owed and
interest thereon, a rsasonable attorney fee
based upon actual time expended.
8.otlon 17tl(b) of tb. KVrRL, 75 P..o.s. Section 17'I(b),
provides I
In the event an insurer is found to havR
acted with no reasonable foundation in
rerusing to pay the benerits enumerated
in subsection (a) when due, the insursr
shall pay, in addition to the benefits
owed and interest thereon, a reasonable
attorney fee based upon actual time
expended.
The courts have not provided a great deal of guidance in
construing these requirements, either under these sections, nor
under the same language found in sectlon 107(3) of the now
repsaled No-rault Motor Vebicle Insurance Act, the predecessor of
the MVFRL.
Some cases have interpreted the attorney
tee
provisions of Sections 1716 and 17'8(b) as intended to act as a
penalty and deterrent for bad faith behavior on the part or the
insurer.
See, e.g. lAY., VI Irle IneUranoe .Kohanqe, ..3 'e.
110, tll A.1d Ht (1'11) (construing the No-Fault Act) I 1I1~1 Y.
4
Hation_ide In.. Co., 311 Pa. superior ct. 114, 170
(1"01' DeKiabele Y. .rie In.uranae ..abanae, 311 Pa.
ct. 634, 161 A.2d 1271 (1'1'1.
In Bill, an award or attorney rees against the insurer was
upheld even though the carrier presented medical evidence which,
if found credible, would have enabled it to win. The Court found
that the insurer's position was neither credible nor reasonable
in light of the overwhelming contrary medical evidence presented
by Hr. Hlll.
lIere, Nlttionwide's position is even weaker than the stand It
took In the lIill case. It has never requested an Independent
medical examination, and presumably, can offsr no medical
svldence to counter that presented by plaintiff.
Furthermore, the facts of this calle demonstrate not only
that Nationwide cannot refute Plaintiff's medical proofs of his
disability, but that it has another motive for stonewalling
Plaintiff's claim for income loss benefits, a motive which easily
demonstrates that this i. not simply an honest dispute over
whether Plaintiff is still disabled, namely, that the same
insurance policy is both the source of any First party Benetits
due Plaintiff, and will, in the event Hr. DuffUS later asserts a
tort claim, also be the source of payment for any such award. It
is well known that the extent of a tort plaintiff'e disability
has a direct bearing on the size of any potential awards. Thus,
it Is quite svidsnt that in this case, Nationwide Is in the
unique position of being able to seek to minimize its exposure in
ths tort caRe by attempting to restrict payment of First Party
A.2d 174
superior
5
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pcnulIun. .lnt.l plllpelly Il;l...e IMuled ctlul~lltnl !
uf bll lusl "llu, MOlley ~ Sllle Farm MUl I
AulU Inl, Co, .....v A.~d tJ01, 1m PaSuper. lZO, .
l'JItll. affirmed .aM A.,ld tm, 50l PI lB.
Under thll ItCllun prO\'ldm. fUf Innuet lu be
U.bl, fOf "fe~lCCmenl Ifr\1CCI Iou" plymenll
"tOt an awe,lle pcnod ~t one year," uuwtd
.U tnIJII.d 10 reimbunemcnl fOf ,6.5 111)'\ of
IUch ICMUl, ntn ..hen repl.cemenl MI"IK:Ct
di)1 uu:uned mOil IhAn . fUI aher her Injunct. I
fhbccier y, NlliOnVi'1de 1M. Co, "! AZJ 1222. I'
m PI.S.p" 41>1. 1911.
lc,wllure', we uf term ",ureIJle" 1ft ltua I
ItclJoa p,uVldilll Ib.t lI\IU'ef .111 be hlbll fur ;
"tepl.uRlenr semen Iou" p.ymenu "for ID
aWe'llI proud 0' olle ye...., rtquue. rclcvt.al
pcnod 10 be . a)Ulthun of two or mote lpealSe
qulnUlIU allim. ud thus phrase "pcnod of OM
)'tar" cannot be lt1CW!d II uDlle, lXlntUlUOUl
Iln:&ctt of una. of ]6,$ dl)'l' dunuoD. Hae.u,
Y. NIlJOOWIdl JIlL Co.. ..., A.1d 11%1 :99
....S.p',. 46.1, 1911. ,
InJW'td pcdarnln. .ho wu lufftMI . de&u ,
from her DC'Wty opcaed buslnC\l, wu an indMdu. ,
aJ ""'ho hu not pfeYlouVy eamtd inrome bora ~
WOf"" WIthin munin, of No-flul! ",,1 and. thus. 1
her probable Income oould be dtltnntntd la
Ja1Jrdlnn *Ilh \1.luIOry funnulii. ~4aIlII'
Empklyen Mul. CompIIUU. .un A.:d flI6. 2"M
PI.S.p'" m, IIH1. ,
EYldun:. Includin, teUlmuny nf MItt,,1 of .
malar whlde inlury VK11m', '.'Ulln. phyvalftl, I
,upponrd ronclUllon thai "'dim', wnWU,UD,
medical dlmt'Ultltt rellled 10 her .uto amdtaL,
Uld merefo" lmunr was obha'led 10 alnhlllM
10 pay 'or her medical cosb. B~nn. It NIlIOfl. .
.;di! In' Co, un A 21.1 MJI'J. 194 r. Su~r SM. .
1912
Undu n...llulllnu.lunce II.. ,"suuntt c.mu
*1.\ ohhllled 10 rtlmbunc pt't\On '"luud In
Yehlcle .arodenl fnr all medical bIlls ~nd rthlb1h.
Iltllln "nd for finl I UJU' uf Iou wiles.. rt,ard.
Ins nlln~ nelll,enee un par1oj' .n~lIne rltlUl.
mln ~ r.btl. ,&:1 A.:d 67). :lU P. Super, lU,
19MI.
WOIker InJuled In Iulomoblle ..['(Idenl \lrU
enllllcd 10 wort Iou brnrfin from t1l1 no-faull
,"SUIU (or ptflod durin. which "'OIhr', labor
union eOlaled In I sulkl. In Ih.1 undcr No-f.ull
MOlal Vrhu:le Inlut.nce At! nlllablhry 0' olher
employment musl be conlldeled, rllhcr Ihu
merely ...'w.bllll)' of . V"lCllm.s p'nJcular lob
which he ..u ptlfOlmlR' .II lime 0' .In .ccujtnl,
Ind thUI Since ""otkc, ..u phyo.lUlly 1Rc~p.blc u,
pcr10rtnlnl euher hll re~ulJf UI olher aUllabl.
lub"llulr "Oft Junn, Ihe period In lJuulllln.
hilppcnUln~e uf J labOl utlke! "".. 01 nu wnle.
,",uen,e Ene Ins E.uhilnlt ~ Roule. ,&:0 A:d
11), ~~9 PI Super -lO, 1'JI80
L'ndcr \Ccuon 11Il of Ihe no-.-repuled Penn.
I)'lunJl :-.Iu.Fauh MUlot Vchlde Imunnce Act.
..0 P,S , II'}!} IOl (repuled). ~-l.houf...d'YI Ln.
huml nUlllnl clre ronllllults .In "llIow.bll p.
penu" e~en If nuuIII, home tafe uull IS An :
altrm'lI~e Ihmbcl'u \I Ene Inl Cu, U 0 . I
C~lh .tIl8. 19Y~. .mrmed 6]) A:J 1:27
An Insuled ..ho II IhlUlfd dunn. ~11 UUuJl I
lfltl alii him, bum a we hide lullowlnl I maiO' I
uh.de ~ltldenl II nOl Imlll~ed In Ihe "m,unle. j
.~....d
end..
I Au.
"'''Y'' OD
...,od
1,4n
lied l.
.am,
ler Ib,
.....,.
lb_1 I
. labor
. Iou
11' lb.
, duId
......,
.... .,
\uper.
01 I
IlVII<
r .....
s lhll
, Iou
'kllit')'.
ie In.
......
lenl I
...Uy
nWlde
::U,
240
..
.. .
.~..,:,...
,;.
.~
VEIIICl.ES
75 Pa.C.S.A. 0 1713
Not. 1
n.nee or we uf I molor l/etu~'I." under IfrtlOD
103 of Ihr nuw.fepellrd rennl)'tvanll No-F.ull
InJwlJu:c Al', ..0 PS. I HJJ9IUJ. (Repellrdl,
.IJ1d II Dul eouOrd hI rta1YCr bUIe pcnoaaJ
lRIWJ' prolectlon bueDt!. Nud. 't, MOIONO
M.1. IN. Co, II 0 A C.llll <>lO. IW~ Ilr....d
b16 A~ 12J. 4U PI,Super 641.
Perwon &.od _)Nt UC\Ul1y benldtl ptyabll to
.I rclllU by VU1Ull of tu.a pln'lOW employmul
ml~ be u~d 10 cumpull thr ....uk.1ou bcnefJu In
'*hl"b I flUlft II tnUlled WIIJU thu MCbOa
I Repuled). CUIIUtJ v. Artman', FlUId IlL
Gl. 19 0 A CJd IlOo, 19".
An ",mployed, !up _ dnlp-<>ul _b_
unly .mploymtDI bid bUD. IWDmtr CET A ;ob.
ItId _bo bab,ul and IfIlIU.d fo, laI.1llod i<>bt.
tLu . rU.lualbie npectlllOa ot ttalllla. iIlaJml
U II f1qwnd by tubvc Ie I 0' WI MdJoI ill
urder 10 rtaMr .",~.Iou beadilL Black Y.
TII"'~" I.. Co, II 0 .. C ld Il, 1\I&l
I 1713. Sourer or benenll
(II Gen.ral NIL-E.cept u proVIded '" oectlon 17U ,,,,ianni to in.Ul1ble cWm.
antal, I penon who .wren lnJW')' &riatnll' out 01 the nwnt.enantt or UN at I ,moLor
vehkle lhall reeover lint party benellu IplJl.It IppU<Ab1t llaunnce cvvUl(t '" thl
(oUowlnl onler 01 prionty:
(I) For IlWIled lnaured. lbl poUcy on wluch hi ilth. lWlled InaUMld.
,21 For III Inaured. thl poUcy ,,,..riIIl the lnallnld.
(3) For lbl OC<\IpIIlu olllllnaurod motor vehlcle, lbe poUcy on that motor Vehlcll.
(41 For I penon who Is not the OCtUpIIll o( I motor vehicle. the poUcy on any motor
.ehid. Involved In the ItcidenL For lJi. P1lI'pOII ollhls pl/'liTlph. I parked wi
unOC'CUpird motor vehicle iI not I motor y!tucle involved 111 an acodent un.Ies.s It wu
parked 10 u to eau.. lUU'UIllnable ruk o( 1l\llU)',
Ibl Multiple IOUrntI o( equal pnonly,- The insurer 19awl whom I cWm Is
.....rwd lint under the pnonU.. ..I (onh '" lub..ctIon III shaU pnxesa and PlY the
dlllT1 u if ..hoUy ""p"rwbl.. Th.insurer.. thereafter enDUed to f'O<Over c:onlrlbuUon
pro rot.l /rom any other inaurer (or the benellu paid and the <0110 o( proceuiJlf thl
clllm, II ",n",buDon ia lOulht ,,"onl U\Junn "'p"na,ble under lubaection IIW.
proroUon Ihall be bued on the number of ,"volved molDr v.lud..,
1984. Fob, 12. P L, Z6. So, 11, I 3, elrectlVe Oct. I. 198.J, ..... amended 1984. F.b, 12.
PL. 53. So. 12, I 3. e1TtctJve 0t1. 1, 1984.
l'oallnlcUaa and .ppUaIJOD I
Onltiua. Wldtr ~~hIlJl All !
latohelllcal La .rndtDl J
\tOhlfT)d. .nldtaU :
tkruPUlI .&
Soln of Uecislon.
plompl ,nJ .I..Jequllc p.vmenl Ijf bwc Ioy bene.
lilS tur mlllor webltle .Ia:ltJrnl "'lclunl JJld ,umy-
vl1 0' deeeucd Yl'lIml LJ Implcmcnfed by nquU'.
In. Ih~1 lhe VU:uml be pluJ bcntlin U'trtpccu'oC
vi f.lull Uuou&Jl " .;ump~ry fU\t.pll1'Y uuw.
..nee I)'Ilem III .bJdt VlCllm was 10 be p&.Id 'or
u.unomlc Iou direct!) try hLS IJW1I llUwe, III by
~mp&.o~ LnnUIIlI O*1lrr of ve Iucll , Peruuyt\-..
ru. r\1.illfled alilnS Ptu' hlSuruce Ulafr of
C<lm. ,&:0 A.':d :.5. ~oI Pa.Cm..lt.h. 93, 1980
nit finl pnon!)' (ot ml rtrover, of tinl'pltt}'
benefill II Iht lIUurance poliO' 01 llIy ~eblcle
lf1~ul..td In the u~denl under ~~ Pl CS A
t PUUll41. ..here .:r mmur pcdulmn 'I r'\0I "
nilmed mtufed ,In .In'" polhL'l .Inll II nul 1 Inl'
Jenl In we house-hold ,II .I named Inlulul PTl'
~tlle w Ceil ev'l'. " 0 .. C ~Ih .:Jll. I~Z
Insured PIIUtIllu ...tw Ullluu 'finl'plny"
luneral benrrits lJndrr In Ihlurlnct pllh\.)" LUued
punuinl 10 Ihe Prnnl)'lvilnll ~o-I.ult InlunnC't
Acl IoU' PSt BIN 101 u ~q I RepuJel1l.1l1
lUll enlllled 10 cnlleL1 llauJar bUenl' under Ihe
ili-lVer' poliLY Imed u.nder Iha Chiplrt MIUTI'.
w Eue Inl, E.uh.nle. SO" c...tb 606. I~
An unlntured pc:dnrn&n UNU fin. b,- au
IUlHuured mUlo"u ""d WIG by I.Q uulllld mo-
10nl' u nol entitled 10 ten''''lry of WWlIUfld
mOhHltl bencnu llDder Ihe L'tuntultd MUlonl!
.\-tutul Vet\lde lR1UI' -\'1 foU) P S f :10'1 bul I' enlltled 10 ben.nll
Uile"lde sYllem III lJndrr the \-tolul \'ehldl FinanLuJ Rupunl.lbllll'
W
t. Coaltnlrtlon..d .ppllalloD
Inlulu 01 Jlubled wehlClt .u ItlPflRllbl1 for
paymenl of finl pa.ny btnetlu 10 Ictldenl VIctim
....ho 'olin ,Iruck m thlld pall)' ,fler 1UVlnl "Mlh.
a ~ehld( 1ft ')Idu Itl nmlt.lL'lbltd Vl!hldl, rven
thoUlh "'''1m ....u nUl "f)U'up.nl" III dlYbled
_chide. ....hcfe Jlwhlrd \'ehll:le ""11 deal'" ~ehlde
'n\ul\'rd In ,he Jl"l:ldcnf .lnd "011 nol "p.llhd
.chlde" UIlwfUnl ~ IhrleV'Mllc Ins ell, ,.12
.\:d "II. .U: PJ Super, 15. Super l~~
\tlllDl ..chide Insuru of e,"phl~u, mlllhu. In
l4ho\C hou-'Chuld employee fUIlJl!d. ...as utllllJI'
(d 10 PlY finl rift) txnefill 10 employee ..bo
WQ inJured In wOft Itllled motor ydude ICCI.
dent ..bile ndUl' III employer', ~rhll.:le. punullu
10 prwllly pruvUloru uf Ihl.llt,tllJn; mOlD, ~bl.
de IIIlwrr 01 emplO}'ct, .ho h.d f'lled 10 ohtlln
"{}Iter'l Mmtxn"IIUQ bt:ncfiu (l)~e"le, .U
nnl Ii.blt 101 finl pJrt)' bc:ntfh.. Olnllle"
Well Amwun hu E.,,'hlnlc. Ul A.ld 412. )61
Ila Supet. lN, IClljl
PurpoH: 01 Ii'll! ~1...laUlt
,,"Lt ALl III nl~h~,h ..
~
!:Ir
ii' .
, II
I, '
I'; l
, 'I
'i.'
I
II
1
II
"
!
I,
II
1
I
1
I;
;:
,
I.
IIt.d to
oiu.
cl,IIO,
-..,
ilAlltllIJ
a Pili'
~I. 116
:till!.
"'Ddat,
loa be.
eI., Act
"""lot
,-
to,...
,100 ...
. AI'"
.r. n!.
.ry1Yull
lall ud
udld 10
.......,
I1Ad Dot
;l1aplcr,
........
.ft Dot
..."..
161./11
c ollbt
J 10 "-
"lib of
titled 10
:llon It.
n Com.
itll DUn'
~n.OIl
:iJ, U:
h.lf "e:hi.
.nlul.1I
'rpwlu,
..hlel"
ullh of
,n, .,...'
om. ku
,tenl 01>
\ltI.....
bth'pl.,
.n"lutln
16.1910
I mulul
"e ul use
1. vI un.
f)" UI nJl
J Ih"eby
thl,II"
IIh 616,
'pe' 614
lXImml>-
1 butDlI
=r 15 ,.
rl v El1e
,
~.. ...
. .
vt:IIICI.ES'
I
A penon .,hu hu r..i1ld 10 purclllM minimum
WIUlftCt bul Dr\'lnbel.u Uiplrlltl . a.olor "'.
Iud. nlpll.tld Ul PUDl)'towuua II lbe 11m. 01 u
KQllul Ill, aul IIW"" from Ibe ltuld.p.11)'
1Ont..101 m.d!taJ u:pcDICI IJId "'I..luu ben.,
Du prO't\dcd lor uader dW ItC'Uva. Muder..
YOWl" .. 0 .. C,)d m. 1911
4. D.d.........r N..h"" ""
wwtd .,u DOl eallU.d 10 dna.plJ't)' lb.llic&I
blD.OII \lAd.. luwmoo.t. poUc:y lor UlJun.. oc>
C'WTIIlI .. be wu &oad1aa mlllnall LUIO ..hi- I
de, "'111b0WUl1 of catJl&i cou.ctIon be'"_1
Ul:Jl.&r1U aDd "Iud.; 100000,.u Dol tftAI,&CUOtI
allDOaJ \0 UN of "tuel., allboup II IIl.lpl be )
ClHlWDJUI 10 ".Iud. opcnlor. Huber v EN.
tAL E.ocbu.., 111 ....:tIlll. tOl 'eSupe. Ul,l
1991.
Al&'_~' poIky d..... ad_, 11",._
.....lIa"" ,._ .......... ia,,,,,..rule 1006-
lot or uoIoIdlot IDOIOI ..1ucIc _, wlulc ....
""""" __ ..Iud. _ wild ..der thiI .......
air; ..11 GaIIIMII from law of ~--
10, Iu",... _ ia ,.-, Joi...hull
Act did lOt mdtDCI leplu", &Dlnl th.1 Dna-
_ _..... bt ""...d<d 10 --' &11 10Id-
..fWlk*b.a1 UlJW1U Huber,.. En. W. b
drlO", III ....ld III. 401 PI,Su",', Ul. 19'11. .
hut,&tCr of motorcycl. 'WU f'1q\W.d 10 pravllil !
buM: Iou bu.lil CD\'tnl' \U\du thll Itl. ......
Itloup polK'y Jld Dol pf"OVldt no-(.ull l.'C\'u'"
by III lIilttU l.lTDl. contract pnMwnl tudl
m7".n,e ..... IIDpolld by I,. Wld" UINtory
pnmilON rcqulI1D' aU mOlor wtudd flp.tllmt .
LG m. Coaunua.ullb 10 carll .nsurut. pftM.
11I1 c;:u\'U'I' (Of bUIC Iou ""n.fill. morrvvU,
ablcatt of I tpcant o:onUJ\1Ua.I pUMlIOn pro-
~dlal W"",t or lailulI to ooUe" In IddiliDnal
prclluum wuld nol U\'ttnd. Ulllltary pro~l1liJnI
Ilf lJw 1..1, MllthlU v fnultn In. (Il, ~,..
A.:.J 1:J:' S:: PI. J"" 111119
L'ndu .&0 P S "lOIN 11).11'.1'.1 :11'1 I R..
pultdl. mulurO',l, lmUfU *u It4UllflJ 10 pIt)-
Vld. b..., luw btnth! CUVII;I,t lU unln~w.d
prdutnan lItuck tty nlUlolod. of InJured. U.
Ihoulh poll"" Jid nol ..vnlllft provUlun ItllUIIUlI
lI\1U'U 10 pi' bUll.' Iou bf:atliU III UDLftJUI.d
prdcunltl ,uud b, mlllurrycl. oluuu.ud; IhoM
"'1101\.1 mid. II dUI aU mulOI ""bld.. rIp"
Itle:d In (utnmuo...uhb *.rt lequutd 10 cany
\NUlaDle pnM4in, loXl"eu" fUI bllle 10" buc.
fh.. and by v,"ue of IbOll SCL'lUru. contnt1
plUY1din, t'O\'tla,e lor bUH; IoU bt:nef\1I *u
lUlpoMd Iln InJlIJU b, 1..,* \tllthrll... TraHltn
Inl eiJ. UI A:J 1.17:. p~ Pol Supu \lH II/K8,
.allirmet.l !hol A.:t.1 I~:. !:~ ", ~,,~
NIl-flult Arl dllJ nnl ftqune lenlJll~1 'Ifnc,
In pUMc.le tnlUI.nle l:CI\'tI.l,e hi In"e \ Ul"
dUpllt Iums (II IInlll .a"cemEnl Jrn~tn' I't'.
mIUI"" UM of nhlLtt h, pt'l"lln unlltl:l SUI-
fnu" ""Ia Rrnt.~ ('.ar S\'tlCml, In~ , ClI]",:d
~~O. ~9 I', Super ,'":, 11J8h
Unlnluud mulnlltl InSUIErs ,lbh"lltln 10 UI'
'uud Iltua tutlll~ oul 1)( U)ftUlt1 ollNunnAj
IU obli,.liun II nul um. .. Ihll tlf unln.urtd
molONI. Illlr ,a ill .IIIW lhll \1' lucu:unr IU',
wunswtd motullll GICfmpao" l'nlltd Sc-,.
VItti Auln A.l.tn. 4'1'1 ^~J lI!ta. J:' P, Sure'
lll, 19"
2:12
.1..'
Vt:IIIl'LES
I.'nllel thiS ,III, 1'''1'1' u,*nu UlltltllOl "etude
.hlth I' 't,ltltud 'If "'hub lIllp'Ule:d In ("dm.
nwn",uhh by uwncr 01 Wllh bJa pcruuwoa mwl
\tnu. Ibt ".hld. for p.ymUf u. bwc loll
,,<<ndill .IpLJ fUI pattlltDl ut ""uto,,ty.JUlpal.
I'd IUInI *hltb Il'*Ucr vr IUlhof1J.ed operalor ml~
be liable 10 p., u d.&ma,.. tor pcnoaaJ InJu", 10
.I"' on. penon IDd fo. property dtlll'\K1loai Ul
LtI. n'Dl "runly II !WI p'UV1J.d br O'ImCf,
Irplll1bUa u (urlllled ud openuoo 01 "Iud.
II pfohlbll.d. Ti'f1It)''' PUIlI}'MIUI AMi&ncd
n..... 1'1.... <6/l A.ld III, IIV ,. Supe. 2119,
I'U
nu. Mcllun ftqWJU lh.1 lbe 00\111 DU lonler
_I... lJUura.arc I1J'\'Cn.. U I miner 01 \'OIWlIlJ)'
.onlra" bcr--UR lb. lQIWtf aad lb. lJUwed.
!nd the umllu'l utllI,allon IUDJ to lb. Y1tUm ..
m~b IL II DOl 111011 IhlD. II NAIto lb, w",.d,
nOlbUlI La lb. I1.M. males covelli' l1IaUD,lD1
",pun ..btlbu lb. >pllllor of die awlor \1I1udt
.,.-. ~- .._~-.
75 Pa,C.S.A. 11712
~ut,lpelllU [(lIn.II" CUld. :1 0 . C.Jd ,".
IV~I
Th. N~fJ\lIl MOlur V.tud. Inl\lrlllCt Ad
req\llfn nun.lunt.nll 10 maUlllla wUlla" 00
lbrlf call In tumpliaact Wr,th lu.tb It1 wlW, Iblil
LlII u. pr.Mal LD lb. CullUlloawuhb &lid thw
lb. .ndoncmcal of a Doa.maeStnl's lGIW'UCII
policy atroutta, CtMn,e 10 c:omply _11h lucb .
l.qwICIDcDllllbtl.by ",,,,,.I.d, Orutho\AM v.
Fed. Klmpe, 101 c.,. II 0 .. CJd 7ll, lIllO,
TbJl M'c110D IfqUUCl tbe l1mu 01 . IDOla'
"e:hll:l. to bt W\'tftd by liabwry wWlnu aD lbt
lum or 115.011.1 Wllb U'P'd 10 011. pcno. lid
nO.lIlJ allh 'UPCl.1 10 In) otI. acadut, bul
dott nul ftnder him In u.nuuuftd molorUI u to
th. n".. amounl IfqWJ.d to pa) .adI 01 .
aumber ul pcnoDJ UlIW.d La I WlaI' ecad'DI
lb. 11.I11I of 'U.<UI Ad&a1 v. Slit. FU1I Myt.
AulO. .... Co.. II 0 . CJd Ill. 191'9
I 1712. A..lIablllty or btntnll
An InJurer iuwnr or d.llvllUlf IJabLllty llIIlU'Il1<t poUo.. covrrtrrr any m.lDr .ohlclI
o( th. IJ'PII roquirrd lD be ...ptAlrod undu t.hJJ uU., ....pt "","ati.1IIl vrhlcl. not
IIltAlndod (.r "'rhWlY UH, mOlDl'<)'d., motor-<lnv.n tycla. or molDriud pecWcydto or
:Jk. lJ1lII v.hicl.., ...ptAlrf\J and opentA!d LO tIuo (ollUllonw.a1th, ohaIJ maIr. .vlllabl.
(or purdl... lint party benrJIta ",th rupoct tD lIIJW}I INLOr out o( th. malntAl...<t or
:.lit! or . motor ve.hicle u tollow.:
III Medltal bcn.nL- SubJf<'t lD th. llnutaUo.. o( It<tion 1 m Inlallnr lD
CUllDnu.ry ch&rpt (or tn.tm.ntl, """.nr. lD proVld. (or .....o..bl. and n.....1I')'
m.dical tn.lm.nt and ...habilltatlv. ICMC'" LOcludinr. but not llnutA!d lD, b..pltal.
d.ntal, 'UI'(1w, poyclUatnc. poytholo(lcal, o.tAlOp.We. ambuJan<t. ",,",pn<ti<, U.
....od ph)'1ICaI I.henpy. nunlnr "M"'. vocaU.nal ...habilitati.n and ocoup.tlonal
th.npy. .pooch pathololll' and .udiDlolll'. oplDm.tric ItJ"Vic.., modlcati.... medical
.uppU.a and p....th.tlc d.VI.... olJ WlLbout llnutaUon .. lD tim.. provtdod that ",thln
18 monlilJ !tom th. d.te o( th. orod.nt c.UIlOr ll\jury. it II ....ruJnahl. with
.....o..bl. modlcal pl'lb.bLllly th., furth" ""Pl!lU" m.y b. wourrrd .. a ....ult o(
tho lIIJ!U1' B.n.ftu und.r tIuo parqnph m.y LOclud. any nonmedical ",m.dia1 c....
311d lr..lm.nl rtnd....d LO .ccoro.... .,th . "",oll'\l%.d rollll'oUl m.thod o( h.alJnr.
121 Incume 1011 btnrnl-(nc1udn t.'1! (OUowml'
11) EII~lfY pertent or actuaJ lOll of ,(TOil Lllcume
1 u) R~uonlblt! t!.'t1t!nJeI ilrtuaUy Ull'Ul't1!d (or tunn" .. .ublutuUt to ptrlonn Ifll-
.mploym.nl .....".. th....by DUtl(.W1(lolI o( Il"''' incom. or (or lunnr .pc<iaI
h.lp th....by .nobilnr . penon tD ..ork and DUUptAl 10.. o( (TOU LOcom..
Incom. 10.. dOl. nol includ. lOll o( ..~ Olcom. (or any penod (OUOWUlr th.
d..th o( an Oldil1dual or ...pe.... OlNJTcd (or '.MC" perfonnod (ollo'''r th. d..th
llf an lllilivtduaJ. Income 101. .hall not cornmence. until ft\', .."rlanr d')'1 have bHn
lUll aJ'\.er the diU! oC !.he aCCIdent
III Accld.nl.1 dnth ben.nL-A d..th b.n.llt plJd 10 th. penonal rtp....ntaUV.
'If !.he 1l\J~1. should inJury rnultimt from. mOll)r vehlrle aCCIdent ClUJe death
141Lhm !~ month. trom the daw 1)( Lh. accluent.
I U .~unual b,ntnt.-E~Jlpn!l't dln<'u}' ntl.~ to l11e flmual. bun&!. cremauon or
rlUler ronn tlf di!plJlltJlln ,l( l11e ~malOl 'II i dl"{'t'ui:'d 111ltiV\duaJ. mrun?d u a rfluJt
'If 111i:' dul11u( the Indi\'ltJuaJ IU it result "f th.. accultnt alld "",thln :!~ month. from the
.tate "f thl! aCCident.
III Comhln.lIon b.n.nL-A cornhOl.unn o( b.n.Ota d.""bed Ol porlrnpha ill
through 14) U III a.llfrnIU"t to the "PintA! p~hult of thOle benentl,
161 ElluonUn.." medlc.1 ben.nta,-M.dkoJ b.n.nu. u d,lln.d in parqnph
>II, which .....d fIOO,IXMJ
HiM, Fob. 12, 1'1..26. No II. I 3, cJJectlv. Oct. I. 19~. AJ am.nd,d llJ8.l, F.b, 12.
P L 1>.1. No. I~, I 3. ./f.ruv. Oct. I, 1\I8l, liIOO. F,b. 7, PI.. II, No.6. I 9. oJI'tcllv.
luly I. 19\1(1
23:1
'I
J
,
,.
"I
"
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Ill'
II
I},
I I
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I:
!
,
I,
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I!':
:II
I: I
II i
"
11 I
, I
, I ~
CIVIL I'ROCEOUIIE
, .
,..
'Iv.
, In
j1M.
'.1.
0' quort..ly. Thl, I' nol . 01,11.. Ihnlltd lu \1I'II1"lIv.
ord,"; Il ruU 1<1'011 Ih. ..hol. n.ld II( uh'IMlrllv. .nd
dll.lol')' "'1'111'1 10 (""I,al. dl"o..l')'.
In man)' (ounlln 'he marhln.ry .lrPldy niall, \\"llh ",IP-
,1.1 1I,II11m.nl or mullon JUdK" ...II.bl. .1 all 11m.. MII.I
rountlf" .1'0 providtl (or emel1,nry JUII""a lulMnf'd rut
weekend. and holiday,. In that no major cha"I". 111 .tJmlml-
lrallv. ml<hll1.1')' ,hould h. tTqul,.d
Thfn Iff, In addUlon, I number ol othrr Rultll "hlrh
provide (or the eflulvllrnl or IPU~I..rullnll 11.1)" \lrilhuul
ap.dal .lIowanl'O, 10 lhal lh. nord (or .mrrK.n,y "lion In
m.ny In,"'nl'O' will h. ohvlall'd.
(.1 nul. 40034 II .m.nd.d pmnl'" . pl/ly lu ",(u.. 10
prodll," Ih. ,Ut.m,"l o( a p.rty or . ..'In... II. n..da 110
,uy o,d.r, borall" Ih. 11111. l'uU lh. hu,d.n on Ih. ""I"..t.
Inl IJlrty to move (or In order ror produrtlon
(bl 11111. 40061.111I p,ovid.. lhal .n .n'..... to wrtllPn
IntfrTfJI.torlralo I plrty may Include .round. ({If (JbJ~rllnn,
Thla ,Imilarly puU th. hurdI'll on Ih. In'lU''''' to mov. (0'
d~ml...1 of Iho ohJorlllln .nd . dtro,lIon Ihal Ih. InlfrroKI'
101')' bo III,worrd.
1,1 lIul. 4019 conUlI1, 1 Imul' or .ddilional In'lAnro,
wh.rr lh. bu,don la pll<.d on lho mo,jnll'orty 10 010" (0'
rrll.( on lh. b..la or a. uoju,lI""bl. tr(UIII or a party or
wlln... 10 rr'pend. Thel. Includ. (.Uurr to .n'.... IntR,.
I1II.loM.. (und.. nulll 4004 ..d 400&1, ...(uIII 0(. party 10
app.ar (or d.po'llIon .n., nollrt, ",(u,a1 o( a p.rty to nh.y
In ordrr of court. lndutln, I renon to rrrute to obl')' In
order o( ,0ul1, rr(u"llo oboy III o,der or court und., I\ul.
4009 (0' produclion .nd in'prrlio, o( dorum.nU or lhlnga 0'
.nll')' upon I.nd, rr(u"llo ob.y.n o,d., o( court uod., I\ul.
4010 ror . m.dl,,1 ..amln.lion, .nd, l'n....l1y, . rau,,", 10
mike dllcovl!f')' or to obey In order or ('nurt ",llItl111 to
d~,o'.ry,
(d) Rule 4014, I"fKullti"K "''1ueILl rur .dmiuHln, prnnrlu
thlt the AnIWen"1 party mlY till! ohJectlol11 in hIli "".wer
Th. burd.n I, plar.d on lh. rrqullling p.rty 10 move r", .
d.tRrmlnalion or lh. ,umcl.nry or lh. ohJlCllon.
The requltrment or I .lay ordt'r to I'rolfl't IIA'I"~t Rhu"I""
dlacovery Ihould nol be In "l('flIIIIY(l hur~pn on thp partie"
nor should the l'ourt.. lit' ""\limped Wllh Iwltrllwtll for a
ltay. The federal uJwnl'nrp Ind the flpnnl)'hlnil @Jpt'n"
ent'e .uueat 'hit theN! In! IdrQulte I1If.nl h)' wtllrh roun.
leI an protect hil client Ind hll Vr,tnplln from ,hUllye
dll<"'1')' olh.r lh.n hy ,,,klnl p,oit!rllv, Otlt..... llld Ih.l
Ih. requtrom..l o( IIk1nl th. court (0' . ''''y o,d.. In a
Ilgnifita"' rue II I minor prorl'dural Irt
flce
flnt
,all
or
o!ll
,se
on
I.d
Iv.
or
u\d
"I,
oil
or
...
iVI!
I,
Ih.
.n.
h~
.111
".d
i,
'ad
or.
..,
o(
""
'. .
~y
! or
Ih.
.10
lral
Il\JLE 4014. IlEQlmSl' FOIl AIJIIIISSION
(al A pmy m.y .'rve upon .ny 001,1' pArty .
writlon request (or lhe .dml..lnn, (ot pur]>o.e. o( Ih.
pending action only, of Ihe lruth n( any m.tters ",thin
th. .cope or lIul.. 41~)J I thro"gh 4IK):!.fi Il1d".i,. ..t
(orth In lhe requ..l tilll rel.le to .lltom."lo or
oplnlo". o( (ael or o( the .ppliraUu" o( I.w 10 (act,
Including Ihe genuin.nu. a"Ih.ntirlly, rorrpcl"e,.,
execution, .ignlng, d.livery, mailing or rerelplo( any
document d..rtibed In th. roquell. e"I,I.. III tllll'U-
menlJl .hall be .etved ,,11h lhe requesl u"I... Ihey
have b.en or .re olherwi.. (urnl.hed or .valiahle fur
no Inap.eUon .nd ropying in Ih. county. 11,e request
nth m.y, ,,1010ut I..y. of rourt, h. urv.d UPUII Ihe 1,1.ln,
310
.nd
_el.
lh.
.ure
II'
o,k
n~;I'OSITIONS ANn nisei
U(( .n.. commoneement n( O1e ..Uon and upon any
oU.or 11Irty ",lh or aner .ervi<e o( Ihe ungill.1 pro,
ee.. "po" I h.1 p.rty
Nnlt
ThIll SUlllh"'l~llln hu t""l'n arnrnlled 10 thllllll rllhl,flnl wlll
r?n(o~lI InnM' dll~,'I)' In llll! rontent of tllp. n"t lenlt'nce or
t Ill.l, I' 3r,,,
(hI t:..h m.ll" o( which .n .dmi..lon Is reJjuIBlod
.hall b. .eparalely .et (orth TII. malloI' i. a, mlllod
unlm, "1thin Ihirty day. .ner am1ee o( Ihe roqullt
or ",lhln .urh .horlp< or longer time 1lI1he court may
.1I0w, O1e p.rty lu whum th. r.que.l I. direeled
aetv.. upon ti,e paliy r"jullting Ih. .dml..lun .n
.n.w... vPnnod hy Ihe party or .n ohj.ellun, .Igned
hy ti,e p.rty or hy his allor"ey; but, u"I... u'e ,ourt
.lliIrl.no Ihe Urne, a ,I.(.nd.nl sh.1I "ot be requi!'ed w
.e"e a".w.... lJ' ohJecUun. be(ure lhe .'piraUon o(
(urty.nve day'. anor seNke o( the orll!1n.1 proee.a
upon 111m If ohjeclion i. m.de, Ihe relllons ther.(or
.h.1I be .taled. The an"".r .h.1I .dmlt ur d.ny th.
maller. ur ..I (orth in detail lh. reuons why O1e
alllJwenng party rannul lrulh(Ullr do '0. A denial
.hall (airly m.el Ihe .ul,.tanee 0 lhe requeslod ad.
ml88lon, and when good (lilh r.qulres 01.1 . p.rty
qu~b(y his answ... or deny only a p.rt u( lh. matlor of
whlrh an adml..ion i. roque.l.d, he .hall .ped(y so
murh n( ,t ... i, Irue and qualify 0' deny Ih. remain-
dPr.. A" .nswennR party may not Ril'e lack n( In(or.
maUon lIr knowledRe as a reaMn (or (ailure 10 .dmlt
or d.ny unl... he 'UlU>' lhat he hR.' made ,euon.ble
Inquiry .",1 th.t Ih. in(onnallun known ur readily
ohll~nahl. hy turn I, In.urnelenl In enahle him 10
.dm,l 0' ,Ipny. A party who ,onslden thaI a matlor
o( whl,h an .drnl..lon hll heen r.queslod pr..enlll a
gemlln. i'A1IP (lIr lnol may nol, un that ground alon.,
ohJrrl lu Ihe ,.rl".,1 lie may, suhjert 10 lI,. prol'l.
"",,, o( lIule lOlllldl, ,I.ny Ihe mailer ur .el forth
tl1a.,IHltl!l why hp rannnl ;11"111 or rlen>" il
,'illl.
11u' tf'fpl\tl;ltlrnl.~ !If all all~"'f'r ilN' i'lH'nlt'd 11\, !hi! rule
Atilt fill I by flu!" "12~llbJ '
Ie) Th. party who h.. !,"luesl.,1 lhe adml..!on
may n1<I\', 10 rJelennl"e lh. .urnrieney o( the .n.wer
nr.ohj.euon I1nle" the rourt d.lemllnes lhal .n
obJ.el"'" " JU,lln.,1. II .h.1I order lhal an answ'er be
8f1n'f?lJ, If thf' court lif'tenninn that an anwWflr don
nol ,ompl)' w,lh Ihe r.'jlll,emenlo "r thi. rul., It m.y
nrd.r "III", Ih.t Ihe mall... " arhnllled Ill' thai an
RIllPlllltid RllfilWrt lip Ilflt'vert. llw ('f}urt ma)', in IlPII of
II.... "rdp"" dell'nnllw Ihat nnal di,!'"sltlon Ilf Ihe
r(l~,uf'f11 lit' ll1adt' at a pf"l~ II1KI ('onrerenre or at a
d"'~l'al('d tim. !,nllr to Inal
. Idl Any mall.'r admlllod onder lI"s ntle I. l'llnrlu,
!I\'ply f'R~Ahlill"Pfl ulllflllll the court IHI flIoUon Pfll"ll1it~
",IIId,allalor anll'nd",.1l1 or III. arhnlK,illn SuhJ.el
to It\ll IlrO\'lfllf)m~ or BuIll 212 j,!(JVf'l'IIII1/i( Iltfl.lnal ('01).
((lrPll{'f'R, Ih" l'ou,.t lliay 'lPnlllt Withdrawal or 3f1lPfllt.
m.nt wIll
"111 be .11
Ih. .dmi,
or .mem!
..tion or
party und
a,tion onl
olh.r I'ul']
olhPl' pro'
Adopted N
ApM112, III
May 9, 1961
1978; .01..
1989, .(Torl
l'no, 1\11
f.dlt.Clv./
The 'mer.
pr...nl I'"
III Th."
r>lrmlllRd ,
...I...nlma
.1lT..m.n~
..ilhln Ih. ,
Thl, Indud.
m.tl.tr, but
.ppli<JIllon ,
121 Th. '"
limited th. I
Irrve . requ
heen lerVfd
.erve I tel~U,
romnll!nred
131 Th. 1'1'
rnulladmill'
I' rls"n.d
,'.nt denial,
In'lu,1')' and,
to (Inlble hi"
f,dPl1lllul.
ohJl'fllonl mil
141 Th. (n,
Inl Itul. 102~'
ral,ly 01..1 I
when loud fA
deny only I
requnled, Ill'
qUlhry Df dr.
denial which \
be ,um,l,nl t,
1&1 IVh....
III million 1m!
doe. hUt m.~p
mllter lit leI
Sanrtlun Itule
..'blan (h), J1"1J
Jnove that "-'fl,
Inrludi"l rOIll
lml'H.pd Ullon
.ul/JUIfIIl. Iml
1IItJtil'liutl.hle. J
:111
~j f;f~i~1 n~H ~u:~tliIH:!fHHilf Ullfl"fU ulI~lrfR
~ .j~l It rhr 111:i li'Wd;ijfl!"1 [nli/!! f! Hjl; tIll!
l~ !lh1fjj [~I'I!I! ,jiliH'; ~!lli.!.., 1',.1 h~!t!. fllt!. ,If !l!!:llli!~ jL[U1"
! i! ! "r 1 :1 f i ~! f 11. 1 .! f [~i sIt 1 . rt 5; It r n.l
HllH i!J;H i ~ 1!b!.IIIItd!!Udb'I!!lul..lh Ih ".1111
~!11 flj' H!!P! j il! PH: ;H!i! iill1iHfllW ii,iJjl
ih!~! 1{llt{; _" }jLhH !f!H! I ifi p~!nJfl fll
IH~['~~~ Vh!!; Ii - .' tUi!tllc~ ~.tfiii~ H.IlI!IIIl.I{n~!tijllt
!" tIlt ...sIt.r l- i I f lh It.~ ~Idcj !et J lIf', "j f 11
~ t'l~i!;~H1IH:~ It. ".! p,fulF ~ifj:!d'I'hlll.hl'lilfll!
~ . JfiHh !hHh illHH; ~IH!i~tHfdIi;;!jl:ij 1., Ji!I'h
~ 5-1" flH 't.: "I!pr 1P ...t '
~ Ih Ii ~ ~h!rll.. ili~ if~il ~! d! ~
~ iH i H [ tis I~. t II ! t ~ kP [i H) ~ I ~ li
11 ell i ~jl-, i~JUU E htj1ll! IE 1 ~.
1 f I ! ~ i ~ ~ ! 11 i t f f' H 1 Ii; ~ .1 11 Ii ~ 1 ~,d i ~ ~ 1 i i
ll~ :w u=~ ( .Iti .s[lt fIE 'I I qf! t~lll ( 11
..! I W " trill 'f", hll ft,l'lll III: iI j nt
IU f ! If'l! h j 11111 hf!. illl i .IH Ihi!i iltl!i !! t lIt
11 ~ · t11- i L l'Et .l~ lP tIt 1Hit liH 1 _~ -
~lt!; -i~~;;!i' l~ ~!tHn.il"i ,1pilLlht.~t If;Hfil::~ 111
~ Jt 1. !! 1l ~ ,! 'E H ~ ~ ~ It i.s tit i!E! 1 V 11 i :i~ II
- i.-It '. ... "t! 'il, HP 'I.... '! ,is! u't 11i~I'l. ~ 'I
~ !f'! ~!! IllIH~ I hiiH1iH i-Ii IUll1jllllj'fi Ii;:: I il
~ jt!tJ~~ ~flj!j~ ~Hi'lll,~ii&,~t.I'i',",;oI\'iflIJ)~j!,tt~ ~~t
'i~li, -lit.. -! I i_Ie! ~ UJ H":l- _ 1
'" -. -- '. F..
,.. oS...1 _.' - -J.. ... "'.
--..- ..... . ,- .-".. ~ .--;.- .- . - ----.. ~ ~
"",", -. -
..
"
,
..
,
,.;. "
...- .
.
.,
.,
,
.
..
, .
. '
I..
16 Pa.e.B.A. 11715
Hilt a
rean from tb. ""II u, lbe .ccuJrnl Lomplirt wIth
ttctiOI nUIIU'1 0' lb. Prlllll}lnm. Mulot
V,Iud. FlIIllIaal RtlptlOI.bdllJ LAw and \10111 be
.. \.
, ;~ " .
.
, .
, ~...
': ':';~~~"'-r"j"\'
. ","..c'':;'~~.'''' ....
I .', ....ffH ~
.:. ,,..:....'..It''a.....~ !~.
~ .... .. 'I;.~
-. . ..... ,.~. ""'~:''' ',\ , ..
" .. _ ,,:. ,'_' ~
.... ~ ~.
VEIIICLE~
'Un AM'n IIll
HY. 19tw
~o-'.ull beOt
JI} L1I)'1 &her It
rruon.bl, prov
U1llfnt II rill
I<nlly I... 01,
19i'
Met. in.un
.uru .,ttwI JC
f.ull benefit. ..
nlhllQ talllUt
, ;d 16l. II< f
PwuUvI dur.
~l.:1I0D .pur I
dlllD. SulolbJt
J!" r"SUplf. J,
P~rtlGI.
.. I...p _ It
JUt 01 nein !
poticyboldt., l
I.. 01., 41\ A,
lnlunllt It:
tOM bcadiu Wl
.!Ill paymenl ~
nOlWlthJLUdiDl
lump-IWD p.ymt
.-u "&IOMbl.
Kona Y. Nlber
I Ill. 1:3 p&Jut
~.:.I 192, 1M P
P'ylDUI or it.
~pelld IlpOI It
IllCh but it """"
ue "O\'Irdu..-
~:.I Ill, 120 P
Employ,., i.a
~nlnu from b1l
(ntllled 10 "IV'
~rnditllh.t ...r
16il1 aOI .om!ed
'~hlc.h bl time'"
~"mlf and for .
I'1lmblUWlIllaL
.\:.1 IU, lID p,
\IIb.lberDo.fI
JeoY\DI bca.DtI
IU10lllubtJ, ICQC
fl(t, pr.dlldiat
..-hllbu iAsund'
I' rill 0' "'p'
"It delaytd bt>
Jrflnrd by lbli W
Cl. ~U A.ZIt
L'ndu No.flU;'
}Il daY' aller Qg..'
d'lm for ,,"uk
hu hUJband UI .
due dill fur parr
tn &I IIle or I
thcrerOr1"'u Iv
Bahr" Allnl ~
~I'I P05upe., II
Inlunlll am-
'wn dut UlJ~
htn.f1L1wuk:rb.
tl~e )0 daY' &1\11
lIme llle dalmlf.
t ml, Paymenl of beneml
BeneftLl IIl'I oventul 11 not plld WIthin 30 dlY' wr thl l1ururer fI<llvlI fluOnAb
proof of IllI amount of thl ben,ftLl If fluonlbll proof II not ouppUed u III
benellLl, IllI poroon oupporttd by fluonabll proof II uVlntul1l not plld IVIth1n 30 dl
Iftu thl proof II .....wed by thl l1ururer, OvINUI ben.ftLl ,hall b.ar Intere,l 'I ~
nLl of 12' per annum fhlm Ill, date th, benlftLl becoml dUI, In Ill, ..lnL Ih, I1ur
II found III hlvl acted In an unnuonabll mlMtr In rWlaln. III PlY lllt blnlftll wh
dUI. thl l1ururer ahall P"Y, In addlUon III thl benlnll owed and thl Interell thlreon.
"uonAble IlwmlY fl. bu.d upon actual tlml uplndld.
I", rIb, 12, P,L. 2ft, No. \1, I 3, tlTecuvI Ol'l. \, llIlI4,
..
.nfntled
C 41h 426,
VEIllCLEl
Toner \' :-JIllonwult Inl Co, 110
19VI, amlmed 610 ^.!d H I
Noltl of Olelllone
IAtunl" tl1hut to pay btatlh. ..u aot
toOlblt IUI.- II ... bud upon l.f"mI 01
policy and mudtl.. of till' law lAd ..
uulUtr iJJd aol Wlr..tolllbly dea)' COvtl'111
..u Gol liabl, fur anome}' fecI OeMic:belt
Ene lIu. E.u:hanll, 561 A1d 1Z71. lIS PI.Su
m.I!!!
......., "" I
l/odI.... .... "'."ol. Ad
Il'I'Iql\Il "tIoI ., .....n.. l
L Aao...., Ittt
1111' Financial RllponslblufJ' Aullfled C1I.mu
ptu IPACP) II Dol tubJlct 10 U.blIJrY for Inor.
." Ita or 121\ iDtern1 penalty lUUMI MOlor
V,Iuct, Flauml R..~...bw" Uw (MvtllLi.
PAC!' . .., "lIUwu' 10' P:"f:":' 0' MVl'ltL
fI..lbfOUk v Rubbuu. 611 A:d 1~9. "16 Pa,5u-
pt. 141, 1m
II,tuI. aulboNlDI ....rd 0' OOW'lK1 ftn In
""II UlIUftf .. found to heu IC1td I!l unrtuon,
able ,,8ftft la reM1nlla pa, btndill .hen dUI
dotl nul apply 10 tJllpUlfI 1n\''UMnI CUUllUphlc
Wu tNtI lCAn fund. &tIlt)' y fin!u,").I
A.U 1:09. Cat_lOt. 1M.
Inlultd *u nOI 'nlllled 10 "lIum.~ ftu
I'IIMI Inlu,..,. IIohttl InJUlt" ..!fum III ,wHItI
f.Q\'''''' Ihuulh not oonvtnCUlI 10 "Olin. ..tI'
tnfanabl, In hlhl III lieu lit pnllf cun .llllJ
GUlne.. uf apphublt la.. Rlmpa ~ E. mint
lathaD!'. J90 A.:d 18-1, .&(J.4 h Super :8", Su,
pt..I99 .
Illuflr ~II hi held Uable IOllcuunabl. '"or.
n.~ ,'U lncuned by Ullurcd ..hen INUIU' lltl,
WI tu pat dl!m c;orultlultl unrulOD.bl, 1l.1
.tuc:b II c:lutt, conltl'" 10 lfl1TlI (JI PUlll..,. ..n~
It... Iltmra yElle In. EAchln,e. ~\lil":d '8.1
11M Ps5up" ;e1, 1991
Tn.1 court dllt nlll .thuu III JIl~HIll," In
Bndlnllhll ,"'urer. \Iohllh rellrJ ul"Ift !fpUIU III
iU UYt'n Jllt;!IIR in flu uf lwr""hrlnunl \;Llnll'l)"
tV1dcnu shu.I"1 Insuwh Illu.l nud 1m mn.
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Lnfhh
EDWIN DUFFUS,
I IN THE COURT OF COMMON PLEAS OF
I CUMBERLAND COUNTY, PENNSYLVANIA
I
I CIVIL ACTION - LAW
I
I NO. 94-3352
I
Vlaintiff
VI.
NATIONWIDE INSURANCE
COMPANIES,
Defendant
JURY TRIAL DEMANDED
TOI NATIONWIDE INSURANCE COMPANIES, DEFENDANT
1I0UEBT FOR ADMISSIONS
Purluant to Pa.R.civ.p. 4014, you are hereby reque.ted to
admit thl fOlloWing, within thirty (30) days of service of this
requeatl
1. You have paid First Party Income Loee benefitl to Edwin
Duttua tro. 5/12/9] to 12/12/9] at the rate of $70].1] per month.
2. Aqricultural labor is not light duty work.
]. In a letter dated 12/1]/9] (attached hereto as Exhibit
A) to Thomal Green, M.D., who wae the PIaintiff'a treating
physician, Patricia B. Grier, Physical Therapist, reported that
Plaintiff had been participating in a work hardening program
.ince 11/2/93 that his current level of activities would be
graded as light duty, and that "...it seems appropriate to
suggest that ths patient be returned to light duty activitiee."
4. On 1/10/94, Plaintiff's counsel transmitted a copy of
MI. Grier's 12/13/93 report to you, along with his own cover
letter, a copy of which i. attached as Exhibit D.
5. On 2/10/94, Plaintiff's couneel transmitted to you
copies of treatment records from Rehab Medicine Associatea, P.C.,
who had begun caring for Plaintiff on 1/21/94. The recorda were
accompanied by a covar lattar, a copy of which is attachad harato
AI Exhibit C.
6. Amonq tha racord. from Rehab Madicine A..ociat.., P.c.
wa. a lattar dated 1/21/94 from J.J. Cho, M.D. to Thoma. Graen,
M.D., a copy of which is attached hereto as Exhibit D.
7. On 3/18/94 Plaintiff's counsel wrote you to inquire a.
to the .tatus of the income loss claim. A copy of that letter is
attached hereto a. Exhibit E.
e. On 6/8/94, Plaintiff'. counsel sent you a report dated
5/20/94 authored by J.J. Cho, M.D., of Rehab Medicine As.ociate.,
P.C., concerning Edwin Duffu., together with a cover letter, a
copy of which is attached hereto as Exhibit F.
I. In tha la.t paragraph of Dr. Cho'. report of 5/20/94, a
copy of which 18 attached a. Exhibit G, the doctor .tate..
"While I wa. providinq treatment in tha past four month., the
patient va. not able to return to vork a. a farm laborer nor did
I reco..and that he return to work."
GRIFFIE , ASSOCIATES
Attorneys for Plaintiff
.
L -c..-
8\': /, :c'?
Fr. H. He , E .
200 North Hanover Streat
Carlisla, PA 17013
(717) 243-5551
(
P'a'~.r 13. 1113
Thom.. Or..n. M.D.
H.dlc.l Art. luilding
220 P.rk.r Str..t
C.rll.l., PA 1701J
O..r Dr. ar..n,
kI. Edwln Duff..
Work Condltioning St.tu.
Your p.ti.nt, Edwin Duff.., h.. b..n partlcip.ting in a five tim.. p.r
w..k work conditioning program .inc. 11/2/9J. p.ti.nt con.i.t.ntly plac.. hi.
p.in l.v.l at 4/10 .t b..t .nd 8-9/10 .t wor.t. Du. to tr.n'port.tion diff1-
cultl.., th. p.ti.nt p.rtlcip.t.d only 1n a thr.. hour program which includ.d
20 minut.. of moi.t h..t at th. .nd of hi. ....ion.
P.tl.nt'. curr.nt llvll of activiti.. would b. grad.d at light duty.
p.ti.nt do.. not tol.r.t. 20 pound. con.i.tently for . two hand c.rry, but i.
u.ing 12.5 pound. for. on. h.nd c.rry. Pati.nt i. working tran.f.rring .mall
box.. we1ghing from five to t.n pound. for 15 minut.. of time. Pat1.nt 1.
11fting only and 11 pound buck.t from a low to a m~d l.vel. pati.nt 1. t.king
frequ.nt walk. on the tr..dmill, going only 10 minut.. time becau.. of caa-
plaint. of l.g pain. pati.nt i. tol.rating only 40 pounda on the abdomin.l
pr..., 40 pound. on the l.ti..imu. bar .nd 10 minut.. on the uppar body .rgom.-
t.r wlth 20 w.tt. of r..i.t.nc.. pati.nt will not tol.r.t. kn..ling for work
.ctiviti.. b.c.u.. of compl.int. of right kn.. p.in. Th. right kn.. p.in h..
only b..n . complaint ln th. l..t two w..k..
p.tl.nt'. .x.rci.. program h.. includ.d lumb.r .t.billzatlon .x.rci... ..
w.ll .. .tr.tching of th. h.m.tring., ga.trocnemiu. .nd lumbo..cr.l mu.cul.-
tur.. p.ti.nt will fr.quently unil.ter.lly d.cid. th.t h. i. un.bl. to parform
hi. 'p.cifi.d activiti... H. h.. r..i.t.d all .ffort. to incr.... h1. work
lo.d. w. h.ve be.n eble to adv.nc. him to ambulation without a can. with .
minim.l g.it deviation. p.tient will oft.n rev.rt beck to the c.n. wh.n h.
feel. he i. in pain, but bec.u.. of improp.r ue., thi. cau.e. a much more
.bnorm.l gait pattern. pati.nt ie frequ.ntly re-inetructed in proper po.tur.
.nd body mech.nic. and continu.. to r.quire m.ximum cu.. for correct perform-
.nc. of .imple .ctiviti...
1 do not f..l th.t thi. client i. achi.ving th. maximum b.nefit. of . work
conditioning program. Ther.for., 1 r.comm.nd th.t w. di.continu. thi. program
.t thi. point in tim.. You may wi.h to con.id.r . functional capacity .v.lua-
tion .t .om. point in the future to d.t.rmin. hi. r.turn to work .tatu.. It i.
difficult to .ift through thi. g.ntl.man'. many end v.riou. complaint.. H.
report. thet h. i. un.bl. to r.ed and .xpr..... l.ck of under.t.nding with m.ny
of our in.truction.. If there er. no .ignific.nt finding with the kn.. prob-
l.m, it e..m. .ppropri.t. to .ugg.et that the p.ti.nt be raturn.d to light duty
.ctiviti... If you have eny que.tion., reg.rding th... comm.nt., pl.... do not
h..it.t. to cont.ct m..
EXHIBIT "A"
.
'J'
Rdia6 Medkinc Associates, P.C.
"'CWJZIHQ IN '"VlICAL ""IDelHl AND ..(M,....,TAnoN
JAY J\.HJHO CHO, folD
HONOI,_MP
flUNK W. lDfIll. YO
512. E Tllndlt Road
Mtthlf>Clburg, PA 17055
Teltphont (717178&-7813
F.. 17 HI 785-,78.2
o 1110 N 71h 5,,"1. 5u,11 102
Cha""'"IDUlg, PA 1720 I
Telaphont(71711187-7738
Fa. 17171267'0508
January 21, 1994
Thomas areen, M,O.
Medical Arts BUilding
220 Wilson street
carlisle, PA 17013
REI Edwin H. DUffus
Initial Evaluation
Dear Tom:
This gentleman who complains pain in the back and both legs
with muscle cramps in both legs, worse on the left, was seen in
the office today.
According to the patient's history, this patient came to
this country from Jamaica in 1973 and has been working on farms
as a laborer. Patient is not able to read or write. When this
patient was riding his bicycle on May 7, 1993 and trying to cross
the road, an automobile hit him on the left side. This patient
fell down on the ground and injured his back, leg and testicle.
The patient went to the Carlisle Hospital and received treatment
by you and neurologist, Dr. Jurgensen. Patient had to have 1
testicle removed in Octob~r, 1993 and he reports receiving 7
epidural injections and/or trigger point injections by an
anesthesiologist in Carlisle. The last injection was on December
27, 1993 and he has another appointment again in a few days.
Patient states that the injection sometimes worked for about 2
weeks. Patient is taking a medication before sleep for
relaxation and anxiety which was given by the anesthesiologist in
Carlisle, but he does not recall the name of the medicine.
Patient received physical therapy treatment at Alexander
springs until December, 1993. Due to increased pain and muscle
cramps, especially in the left leg, this patient could not work
as a farm worker. This patient does not have his own vehicle or
transportation.
In his past history, patient states that he had hypertension
but he never saw a doctor to get medication. Patient was an
inpatient at the Hershey Medical center a couple of years ago due
to kidney problems. Patient has no known allergies,
EXIUBIT liD"
. .
..
Dr. Green
REI Edwin M. DuffuB
paqe 2
January 21, 1994
Physical exam: straiqht leq raisinq is neqative bilaterally
on sittinq and lyinq but there is a complaint of a lot of muscle
cramps in the hamstrinq. Patient needs support from both arms to
rise up to over 90 deqrees in lying position. Patient is able to
walk on heels and toes with limping on the left leg. Range or
motion of the lumbar spine is almost full but the patient is
doing it with support of the arms in all directions. Patient
complains of severe tenderness on both sides of the low L-S,
worse on left, and 51 joint. DTR symmetric 2+ in the lower
extremities. There is no focal muscle weakness. Patient
complains of some difficulty urinating with hesitation or
initiating urination since the testicle surgery.
Today, I got a copy of the MRI study of the lumbar spine
which was done at Magnetic Imaging Center on June 3, 1993. It
showed a small central disc herniation at L4-5.
On today' s physical exam, I cannot piCk up any obvious
neurologic impairnent. Patient may have a central herniated
disc Which miqht be causing some pressure and giving some bladder
symptoms. I am not sure whether the bladder symptoms are related
to the back unless the patient has a CMG test by an urologist.
However, in my findings today, his main complaint of pain in the
hamstring and back is more of a result of muscle ligament strain.
Today I advised patient as below:
1. I gave him samples of Naprosyn 500 mg. b.i.d. to try.
2. Therapeutic exercises as he can until we get approval for
further treatment.
3. We will contact the patient's lawyer regarding what
direction we can take to provide medical care for this
patient.
Patient will be back to see me in 4 weeks.
Sincsrely,
JJC/clw
Dietl 1-21-94
Transl 1-24-94
:}~.
Jjy J. Cho, H. D.
RefuW Mtdlcine Associates} P,C.
...CIAIJIIHQ "........:AI. MIDlClNI _",_UlAnoo.
JAY JlJNQHO CHQ, MD
HONG' ......IlO.
P1IAHK W UlPU. OlD
5'2. E '"",,1. Road
MechI"clbUIlI, PA '7055
Telephan. (7 1 7) 78&-71143
Fe'17'7178S,78.2
lJ 120 N 71h 51'"1, Sotle 102
Chlrrbe,1bUI8, PA 17201
Tllephane (717) 2110773&
Fe' 17171267.0501
Hay 20, 1994
Fred H. Hait, Esquire
200 North Hanover street
carlisle, PA 17013
RBI Bdvin Duffua
Dear Hr. Haiti
This is in response to your letter dated April 26, 1994
regarding Hr. Edwin Duffus. Hr. Duffus wae initially evaluated in
my office on January 21, 1994 referred by an orthopedic surgeon in
Carlisle, Dr. Thomas Green, for his low back problem and pain in
both legs.
Accordinq to the patient'. bhtory, the patient had been
working on a farm as a laborer. Unfortunately, patient was
involved in an accident on Hay 7, 1993 while the patient was riding
his bike. When he tried to cross a road, his bike was hit in the
rear on the left by a car. He fell down and injured his low back,
legs and testicle. He went to the Carlisle Hospital and received
a full orthopedic evaluation and also seen by a neurologist.
Patient had to have one testicle removed in October, 1993 and he
stated that he received 7 epidural steroid injections in his low
back inclUding a trigger point injection at Carlisle Pain Clinic.
Unfortunately, the pain did not get any better. When I saw this
patient, he was taking Elavil for sleep to relax and relieve
anxiety. Patient received outpatient therapy at Alexander spring
outpatient physical therapy facility until December, 1993 with not
much improvement. Patient had EMG test which showed L5 nerve
damage and HRI of the lumbar spine on June 3, 1993 showed a small
central disc herniated at L4-5.
Based on my physical exam on January 21, 1994, I could not
pick up any neurological findings to indicate a pinched nerve. My
diagnosis was low back pain with contusion with muscle ligament
strain and herniated di&c at L4-5 without pinChed nerve. Also, the
patient is still SUffering with testicle contusion. I recommended
to this patient to tako nonsteroidal anti-inflammatory medication
and have outpatient thera~y at Alexander spring outpatient therapy
facility.
EXIlI BIT "G"
Hr. Hait
REI Edwin Duffus
Page 2
May 20, 1994
Patient was seen by me a\lain on February 21, 1994. My
impression was muscle ligament strain in the low back with chronic
low back pain syndrome.
Another visit was on March 21, 1994 and he still complained of
severe pain in the low back and leg cramps. Patient was still
ambulating with a cane. My impression was still severe low back
pain as a result of MVA on May 7, 1993 which damaged muscle
ligaments in the low back. I gave him an elastic corsst and
encouragsd him to stop using cane and do therapeutic exercises. He
was also to take Naprosyn.
His last visit was on May 9, 1994 and he still complained of
pain in the low back and cramps in both legs, worse on the right
with pins and needle feeling in both legs. My physical examination
did not indicate any new neurological findings but from muscle
ligament point, there is markedly limited range of motion in the
low back with complaint of tenderness in the low back muscles. Due
to poor improvement one year after injury, I recommended that the
patient repeat MRI scan of ths low back and that hs might need
psychological evaluation and repeat EMG test to see if there has
been any deterioration as a result of MVA on May 7, 1993.
Based on the above notes after following this patient tor 4
months in my office, the pain in the low back and legs did not
change at all in spite of medication and outpatient therapy. The
only objective pathological finding is central herniated disc at
L4-5. Also, EMG test showed L5 pinched nerve but clinical physical
exam did not support this. The primary diagnosis is still severe
muscle ligament strain in his low back with hsrniated disc at L4-5
without pinched nervs. While I was providing treatment in the past
4 months, the patient was not able to return to work as a farm
laborer nor did I recommend that he return to work. Patient is
scheduled to see me again after he has repeat L-S spine x-rays and
MRI to compare with the studies done a year ago. Patient may need
further work-up in his low back orthopedically, neurologicallr and
may be from psychological point to rule out any kind of anx ety,
frustration or depression. .
Sincerely,
I/J
J. Cho, M.D.
JJC/clw
Aba II 9 20 AK '9~
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Of H 1"1 :1:",,'1:,r,y
CHI, ,,' I'll ':'hiT
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EXPLANATION OF BENEFITS
DATE
05-24-93
OUR POLICYHOLDER
Robert Li htner
7 0
NATIONWIDE MUTUAL INSURANCE COMPANY
PO BOX 2655
HARRISBURG, PA 17105
1 -800-421-3535
Edwin Duffus
212A Northwest Street
Carlisle, PA 17013
r-
Attorney Fred H, Hait
200 North Hsnover Straet
Csrlisle, VA 17013
I
APPLICABLE TO PENNSYLVANIA ONLY:
For your proleclion, Pennsylvenla requires Ihe lollowing 10
appear on Ihls lorm Any person who knowingly and with
Inlenllo Inlura or aelraud any Insurer tiles an appllCallon or
claim conlallllng any lalse, Incomplale or mislaadlng inlorma.
lion shall. upon convlcllon, be sublecllo Impnsonmanllor up
10 seven yeers and paymenl 01 a line 01 up 10 $15,000.
L
.J
The forma indicsled below are to bR completed and returned promplly:
g APPLtCATION FOR BENEFITS: Complete all sections and sign where indicated,
g RECORDS AUTHORIZATION: Complele and sign where indicated
g AFFIDAVIT A: This form is required II you do not own a motor vehicle and do nol have relatives in your
household With eulomoblle insurance.
D AFFIDAVIT B This torm is required II you do nol own a molor vehicle
This Auto Policy Provld.. Firat pany Benellts as Shown Below:
1. Medical Benellls: $ 100,000 5, Combined Loss Benelits: $ 000.00
'2. Income Loss Benetits: $ 25,000 (may include beneflls from 1,2.3. and 4)
Monthly Maximum $ 1,500 (benelits limited to 3 years Irom Accldanl Date)
3. ACCidental Deatl1 Benelits $ 10,000 6. Exlraordinary Medical Benefits apply II indlcBted below
4. Funarat Beneflls: $ 1,500 0 EMB Coverage $1 M/$50,OOO year
'If e c1elm IS presenterj under Ihls coverege, a venflcallon torm will be mailed to your employer. Wage payments ere
mede on a monthly basiS dunng your disability penod up 10 Ihe lunlt 01 your Income Loss Benefits, However. peyment
Will not be made lor the IIrsl five WOlklng days atter Inlury We Will request your doctor to certlly your dlsebllity on a
monlhly baSIS. Please nollly us when you relurn to Walk
IMPORTANT NOTICE:
Pennsylveflla Aula Insurance Law. Act 6, specltically requues Ihal:
. Medical care proViders "may nol billlhe Insured dlreclly, but ml '51 bllllhe insurer for a deletITllnallon of Ihe amounl
payable" ThiS applies 10 all providers 01 medical care, rncludlng pharmaCies and suppliers 01 medical equipment.
. Medical care pmvlljers wllIlle lunltelj on the amounl 1I1ey can charge insurance compames tor services relaled to
auto accldenls
o Medical care providers may not" bill or otherwise atlemptlo collecllromlhe Insured, Ihe dlllerence between the
proVider's lull charge and the amountl paid by the insurer"
II you receive health calo lor an Ruto accldrmt relaled condition, please remind the proVider 10 bill us direclly Be
assUled Ihal we Will rrll,ko overy otlOlllo prOVide you wllh the requued prolecllon under the law up to the limits 01 your
policy mvolOge
From
Guy t1ln.
Telephone
(717) h57-6975
Please keep Ihls lorm tor your lalerence
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EDWIN DUFI"US / I IN THE COURT OF COMMON PLEAS OF
Plaint1tt I CUMBERLAND COUNTY, PENNSYINANIA
I
VI. I DOCKET NO I !14-JJ52
I
NATIONWIDE INSURANCE I CIVIL ACTION - LAW
COMPANIEB, I
Detendant I JURY TRIAL DEMANDED
COUHSIL rllB INCURlID BY PLAINTlrr
TO 11/7/14
6/7/94
6/13/94
6/29/94
SERVICE rIHI EXPENDED
Draft complaint 0.90 hr.
Conference with client 0.25
DAU
Receipt , return of sheriff
return 0.10
7/19/94
Telecon with client
REI status of lawsuit 0.10
7/19/94
7/20/94
Ilsue Default Notice to Defendant 0.10
7/25/94
Receipt , return of Nationwide
Answer and New Matter, Draft Reply
to New Matter, Draft Petition for
Appointment of Arbitrators 0.40
Review file, Letter to Nationwide
Attorney with Reply to New Matter,
Petition for Appointment of
Arbitrators, and medical records 0.50
Telecon with client REI Nationwide
lawluit 0.10
7/23/94
7/27/94
Letter to Dr. Cho for report
REI client disability status 0.10
7/28/94
7/29/94
Telecon with counsel for Nationwide 0.10
7/29/114
9/1/94
relecon with counsel for Nationwide
REI hi. rescinding Interrogatori.. 0.10
Draft Request For Admissions 0.80
t.ettsr to counsel for Nationwide
with Request For Admissions and
medical records
0.10
I~'J. .....
POWER or ATTORNEY AND CONTINGENT P1!:!I AGIU!:EHJ!NT
KNOW ALL KEN BY THESE PRESENTS that I, the underaiqned, do
hereby retain the Law Firm ot GaI7PIZ , ASSOCIATES as my attorney
tor me in my name and to institute and maintain an action against
~, /
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and/or any per.son, Firm, corporation, or other entity who may be
responsible to me tor damages which I sustainsd on or &bout the
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or to negotiate an amicable set~18ment ot the claim, in
acccrdancQ with the terms conditions herein set to~h:
1. I agree that in consideration ot the services to be
rendered by Griftie , Associates, I agree to pay Grittie ,
Associates tor protessional services rendered a sum THIRTY-THREE
AND ONE-THIRD (33 1/3"1 percent ot whatever is recovered as a
result ot settlement without suit, or ot any ncevery attained
atter suit is tiled or a trial is held.
2. It our claim, or any part thereot, arises eu,. ot the
maintenance or use ot a motor vehicle, I agree that any services
pertormed by Grittie , ASlociate. to cellect tirst party or no
hult insurance benetits shall be calculated and paid in
accordance with the Firm's hourly rates in ettect at the time the
work 11 pertormed, tor time expended working on the claim. I
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per hour
understand that the.e rat.. are currently
tor partner. and
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per hour for associates, and
these rates are subject to change at any time.
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or
J. I Iqr.. to b. responsible ~or all co.t. and expen... due
to perlons or .ntiti.s out. ide the Firm of Grittie , A..ociate.
including but not limited to tiling fees, travel, photocopy,
deposition transcripts, long distance telsphone charges, witn.ss
he., medical reports, investigation, etc., which :nay be
nece..a~1 in order to pursue the claim, and to reimburse Grittie
, As.ociates for any such expenditures which they may make on my
behal~. I understand that G~ifrie , Associates may request that
I make advance payments on a monthly basis to be held in escrow
~or paYlllent of costs to be incurred, and I agres to make .uch
advancs payments as Griffie' Associates, may request in ~riting
from time to time.
4. I agree not to settle or adjust the claim or any
proceeding. based thereon without the prior written consent o~
Griffi. , Associates.
5. Grittie' A.sociat.. reserves the right to withdraw it,
atter investigation, they d8te~ine that there is no merit to the
claim. I acknowledge that in the vent of withdrawal by Griffie ,
Associatls I will remain liable for payment of all costs as set
forth in Paragraph J ot this Agreement.
6. This Agreement doee not cover any services perfo~ed in
connection with any appeal trom a Court ot Common Plea., Federal
District Court, or Board at Arbitration in an
uninsured/under insured motorist proceeding.
7. I authorize Grittie , Associates to deduct trom my share
ot any recovery and pay directly to any doctor, hospital, or
other health care provider any unpaid balance due tor treatment
... .
or injuries relat.d to the claim.
8. I aqree that Griftie , A..ociat.. may employ a..ociate.
coun.el or special trial counsel for their discretion, and that
any counsel so employed may be designated to appear on my behalf
and/or undertake to reprasent me in this matter.
9. It payment ot this claim is made by a stl"Uctured
..tt:'ement, with or without trial, attorney's tee. will. be
compuud by taking the applicable percentage agned upon and
multiplying it times the present cash value ot the settlament, as
d.ter::uined by actuarial eKPe~s I said payment to be made out ot
any init:.al lump sum payment. :n lieu ot said method ot
calculation, Grif!ie & Associates may, at their option, elect to
receive tor their rees the applicable percentage of each
a.ttlamant payment a. it is received.
10. I acknowledge that I have the right to ter:ninate this
Agreement at any time by giving written notice to Grit!!e &
Anociat... In the vent I elect to ter:ninate this agnement,
Gri!tie , Associate. shall be entitled to reimbursement for any
and all cost, as sat fo~h in Paragraph 3, which the Fin
incurred prior to raceipt of written notice ot termination.
Gritfie , Associates ahall have no obligation to release the tile
to me or to any other attorney until such expenses have been
paid.
In the event of a settlement or award ot damages atter
termination, Griftie , Associates shall be entitled to payment
in proportion to the time which the Firm spend working on the
claim.
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COMMONWEALTH OF PHNNAI
COUNTY OF DAUPHIN I
BHBRIFF'B RBTURN
NO, 94-3352
PAGE 152
AND NOWt June 23,
19 94 ,at 1145 I'M,
BERVBD TIIB
UPON
WITHIN
alMPlAH(J' & NanCE
Nationwide Insurance Company BY PHRBONAI.LY
HANDING TO lheresa Harding, Legal Sec 'y and pel'son In charge at time of service
A TRUE ATTESTED COpy OF TilE ORIGINAl. alMPlAINT & N<JfICE
AND MAKING KNOWN TO
Hel' TilE CONTBNTB TIIEREOF AT 1000 Nationwide
Drive, llardsburg, Dauphin County, Penna.
80 ANBWBR~ . .
'2I'~.?f. ~
SHERIFF OF DAUPHIN COUNTYI PENNA
BY ~evv.J f '}tJJk/
Dlil'UTY BIIERIl'F
Sworn and subsoribed to
before me this 2 h day of June 1994
0tIfllfn) C!-. f ~
PROTHONOTARY
BHRRIFF'S COST $
f:j'IA
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Additionally, paragraph six (6) of Plaintiff's complaint sets
forth a conclusion of law to which no responsive pleading is
required. To the extent facts are deemed to be alleged, they are
denied.
7. Admitted.
8. After reasonable investigation, Defendant is without
knowledge or information sufficient to fonn a bel:\.ef as to the
truth or falsity of the allegations contained in paragraph eight
(8) of Plaintiff's Complaint. Therefore, the same are denied.
9. After reasonable investigation, Defendant is without
knowledge or information sufficient to fonn a belief as to the
truth or falsity of the allegations contained in paragraph nine
(9) of Plaintiff's Complaint. Therefore, the same are denied.
10. Admitted.
11. After reasonable investigation, Defendant is without
knowledge or information sufficient to fonn a belief as to the
truth or falsity of the allegations contained in paragraph eleven
(11) of Plaintiff's Complaint. Therefore, the same are denied.
12. After reasonable investigation, Defendant is without
knowledge or information sufficient to fonn a belief as to the
truth or falsity of the allegations contained in paragraph twelve
(12) of Plaintiff's Complaint. Therefore, the same are denied.
WHEREFORE, the Defendant respectfully prays this Honorable
Court to dismiss Plaintiff's Complaint, and to enter judgment
against the Plaintiffs and in favor of the Defendant.
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