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Julia V. Bender
-vs-
The Mayor & Town Council of
the borough of Newburg
Dr Monroe Schneier & Dorothy
Schneier Department of Transporation
of Commonwealth of Pennsylvania
In the Court of Common Pleas of
Cumberland County, Pennsylvania
No. 95-681 Civil Term
Summons in Civil Action Law
Michael E. Barrick, Deputy Sheriff who being duly sworn according to
to law, says on February 17, 1995 at 9:45 o'clock A.M.E.S.T., he served a
true copy of Summons in Civil Action Law, in the above entitled action
upon one of the within named defendants to wit: The Mayor & Town Council
of Borough of Newburg, by handing to Curt Cramer at 4 East Main Street.
NeWburg, Cumberland County, Pennsylvania, its contents and at the same
time handing to hilll personally the said true and attested copies of the
same.
Robert L. Fink, Deputy Sheriff who being duly sworn according to law,
says pn February 27, 1995 at 6:30 o'clock P.M.E.S.T., he served a true
copy of Summons in Civil Action Law, in the above entitled action upon
one of the within named defendants to wit: Dr Monroe Schneier and Dorothy
Schneier, by handing to Dr Monroe Schneier at 102 West Main Street, Newburg,
Cumberland County, Pennsylvania, its contents and at the same time handing
to himpersonally the said true and attested copies of the same
R. Thomas Kline, Sheriff who being duly sworn according to law, says
he made diligent search and inquiry for the within named defendants to'wit:
Department of Transporation of Commonwealth of Pennsylvania. He therefore
deputized the Sheriff of Dauphin County to serve the within Summons in Civil
Action law according to law.
Dauphin County Return:and now: February 10, 1995 at 9:20 A.M. served
the within Writ of Summons upon Attorney General by personally handing to
Gail Gastrock, Secy' and person in charge at time of service a true
and attested copy of the original Writ of Summons and making known unto
her the contents thereof at 16th Floor, Strawberry Square, Harrisburg,
Dauphin County, Penna.
and now: February 10, 1995 at 9:20 am served the within writ of
Summons upon Dept of Transporation by personally handing to Dorothy Williams
Secy' and person in charge at time of service a true and attested copy of
the original Writ of Summons and making known to her the contents thereof
at 909 Green Street, Harrisburg, Dauphin County, Penna.
So answers: William Livingston Sheriff
Dauphin County Return is hereto attached.
Sheriff's Costs:
Docketing
Service
Out of County
Surcharge
Dauphin County
48.00
23,52
9.00
12.00
28.50
S 121.02 pd. by
atty 3-9-95
So al1~,~.e~.$: p....:..t't.
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R.
Sworn and Subscribed To Before Me
This 1'1"":: Day of \.*,...............
B
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COMMONWEALTH OF PENNA:
COUNTY OF DAUPHIN:
SHERIFF'S RETURN
NO. 95-681
PAGE 55
AND NOW:
WITHIN
February 10
WRIT OF Sl>>K)NS
SER VED THE
UPON
19 95 .nt 9:20 AM.
Attorney General
HANDING TO Gail Gastrock,
,
BY PERSONALI,Y
Sec' y and person in charge at time of service
A TRUE ATTESTED COPY OF THE ORIGINAl. WRIT OF SUMMONS
AND MAKING KNOWN TO
Her
TilE CONTENTS THIlREOI' AT 16th Floor,
Strawberry Square, Harrisburg, Dauphin County, Penna.
And Now: February 10, 1995 at 9:20 AM served the within WRIT OF SlJ!oMlNS
upon Dept. of Transportation by personally handing to Dorothy Williams, Sec'y
and person in charge at time of service a true attested copy of original WRIT OF
SlJMolONS and making known to her the contents at 909 Green St., Harrisburg, Dauphin
County, Penna-;-'
SO If?~ II.. ~
Sworn and subser' cd to
15th da of Feb.
SHERIFF OF DAYP~~~~f~~~TY, PENNA
BY ~r11\;,'" ,~
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19 95
C!-. t aMnaJ
PROTHONOTARY
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ation
Commonwealth of Pennsylvania
County of Cumberland
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Julia V. Bender
VS.
The Mayor &. Town Council of the
Borough of Newburg
c/o Curt Craner
4 East Main Street, Newburg, PA 17240
Dr. Monroe Schneier &. Dorothy Schneier
102 West Main Street, Newburg, PA 17240
Court af Common PI....
No, m~-5-":.@L_C;j.Y..U_:r$l.t;)!)..m__u___ ~____
Deparbnent of Transportation of the
Commonwealth of Pennsylvania
521 Transportation Safety Building
Harrisburg, PA 17120
In _ ..civll.Acti.oo_Law _ _ __ _ u ___ _ ____u______
You are hereby notified that
Julia V. Bender
.------------------------------------------------.------------------------------------------------
the Plaintiff has commenced an action in uCiY.i1..Acti.oO.LaIll_______________________________uu
against you which you are required 10 defend or a default judgmenl may be entered against you,
(SEAL)
Lawrence E. Welker
....__._--_._._----p~~~~~~~--_._---_.._-------
[)ale ~~~~.~~_~_t~___.___________ 19.9_~
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
Julia V. Bender,
: Civil Action. Law
Plaintiff
vs.
The Mayor and Town Council of the Borough
of Newburg, Monroe Schneier, D.C. and
Dorothy Schneier, his wife, and
Department of Transportation of the
Commonwealth of Pennsylvania,
Defendants
No. qS-lo '81 c:....:....O T..Q,f\lt)
Legal Action
PRAECIPE FOR WRIT OF SUMMONS
To the Defendants:
The Mayor and Town Council of the
Borough of Newburg
clo Curt Cramer
4 East Main Street
Newburg, PA 17240
Department of Transportation
of the Commonwealth of
Pennsylvania
521 Transportation Safety Bldg.
Harrisburg, PA 17120
Dr. Monroe Schneier and Dorothy Schneier, his wife
102 West Main Street
Newburg, PA 17240
To Lawrence E. Welker, Prothonotary:
Issue a writ of summons directed to the defendants In the above captioned
cause notifying the defendants that the plaintiff has commenced an action against them
which they are required to defend or a default judgment may be entered against them.
- // /J
<~~/)
/
Commonwealth of Pennsylvania
County of Cumberland
Julia V. Bender
vs.
The Mayor & Town Council of the
Borough of Newburg
c/o Curt Craner
4 East Main street, Newburg, PA 17240
Dr. Monroe Schneier & Dorothy Schneier
102 West Main Street, Newburg, PA 17240
Court or Conunan Pleas
No. m~,:t':.~tl].___{;j.y.AL:r~IJ!!____m_____ ~----
Department of Transportation of the
Commonwealth of Pennsylvania
521 Transportation Safety Building
Harrisburg, PA 17120
In __.civllll..Hno...Law_______________________
Ta _!:I!l.Y..c:?!"__&_-'r~S9~_lls!,L~L!l~!:lFJ.lLP.E. Schneier & Dorothy Schneier: Dept. of Transport-
ation
You are hereby notified that
Julia V. Bender
.------------------------------------------------------------------------------------------------
the PlaintiH haS commenced an action in __Cjy.i.l..AcJ:iao..Law___________________________________
against you which yau are required to derend or a derault judgment may be entered againlt you,
(SEAL)
Lawrence E. Welker
.------------------p~d;~~~~;y------------------
Date .K~1?~~;X_.!l.tI1_______________ 19_J_!?
By m'h.0..'b:_D_rYl~9.na..,.~------
Deputy '~j
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COMMONWEALTH OF PENNSYLVANIA
OFFICE OF ATTORNEY GENERAL
February 16, 1995
Reply To:
ERNEST 0, PREATE. Jr,
ATTORNEY GENERAL
Torts Litigation section
15th Floor, Strawberry Sq.
Harrisburg, PA 17120
717-783-1683
FAX: 717-772-4526
Prothonotary
CUmberland County Courthouse
South Hanover Street
Carlisle, PA 17013
Re: Bender v. The Mavor & Town Council
p, of the Borouqh of Newburq. et al....
Dear Prothonotary:
~1 enclose herewith for filing my Entry of Appearance in the
above; matter, together with Praecipe for Rule to File Complaint.
~"8P.~hiBlf'oorrel3p6ridence'Fql';Ctrue'"Jand,'correct:llicoPY$.Q~athis;,.
t;dOJ;;~P,t]t,:_beingt,;forwarde4,1,!:-q{J~J,l,:90UI1Se.k;,O~;);'~tC1Q,r,4.J
.....
Thank you for your assistance.
Very truly yours,
~D~
Daniel R. Goodemote
Senior Deputy Attorney General
DRG: jmp
Encs.
C: DAVID C. CLEAVER, ESQUIRE
THE MAYOR & TOWN COUNCIL
OF THE BOROUGH OF NEWBURG
DR. MONROE SCHNEIER and
DOROTHY SCHNEIER
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JULIA V. BENDER,
Plaintiffs
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
v.
CIVIL ACTION - LAW
THE MAYOR & TOWN COUNCIL OF NO. 95-681 CIVIL TERM
THE BOROUGH OF NEWBURG, et al.,:
Defendants
PRAECIPE FOR ENTRY OF APPEARANCE
TO: Prothonotary, Court of Common Pleas of Cumberland County,
Pennsylvania:
Please enter our appearance as attorneys for Defendants The
Mayor and Town Council of the Borough of Newburg.
McNEES,
rg
. 23152
17108-1166
April '1' 1995
.
.
.
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY. PENNSYLVANIA
Julia V. Bender,
Plaintiff
Civil Action. Law
vs.
No. 1995.681
The Mayor and Town Council of
the Borough of Newburg, Monroe
Schneier, D.C. and Dorothy
Schneier, his wife, and
Department of Transportation of
the Commonwealth of Pennsylvania,
Defendants
Legal Action
NOTICE
You have been sued In court. If you wish to defend against the claims set forth in
the following pages, you must take action within twenty (20) days after this Complaint
and Notice are served, by entering a written appearance personally or by attorney and
filing in writing with the Court your defenses or objections to the claims set forth against
you. You are warned that if you fail to do so the case may proceed without you and a
judgment may be entered against you by the Court without further notice for any money
claimed in the complaint of for any other claims or relief requested by the Plaintiff. You
may lose money or property or other rights important to you.
YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU
DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE
THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL
HELP.
Legal Reference Service of
Franklin - Fulton Counties
Court House
157 Lincoln Way East
Chambersburg, PA 17201
(717) 261-3848
.,
.
.
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY. PENNSYLVANIA
Julia V. Bender,
Plaintiff
Civil Action - Law
vs.
No. 1995.681
The Mayor and Town Council of :
the Borough of Newburg, Monroe :
Schneier, D.C. and Dorothy
Schneier, his wife, and
Department of Transportation of
the Commonwealth of
Pennsylvania,
Defendants
Legal Action
COMPLAINT
NOW comes the Plaintiff, Julia V. Bender, by her attorney, David C.
Cleaver, and respectfully represents:
1.
The Plaintiff, Julia V. Bender, Is a sui juris adult, who lives and
resides at 2 Water Street, Box 416, Newburg, Cumberland County,
Pennsylvania 17240.
2.
The Defendants in this cause of action are as follow:
A. Monroe Schneier, D.C., and Dorothy Schneier, his wife, sui
juris adults who live and reside at 102 West Main Street, Newburg,
Cumberland County, Pennsylvania 17240.
B. The Mayor and Town Council of the Borough of Newburg, a
duly constituted municipality, organized under the Borough Code of the
Commonwealth of Pennsylvania, whose location and address Is located at
4 East Main Street, Newburg, Cumberland County, Pennsylvania 17240.
C. The Department of Transportation for the Commonwealth of
Pennsylvania, 521 Transportation Safety Building, Harrisburg, Dauphin
County, Pennsylvania 17120.
.-.
.
..
13.
The Pialntiff's fall was caused as a direct and proximate result of
the Defendants' negligent actions, which negligent acts or failure to act are
set forth more fully as follows:
A. In failing to remove the tree root which caused the concrete
slab to be broken and dislodged from the ground, causing said concrete to
protrude from the surface of the surrounding concrete slabs.
B. In failing to properly remove and/or replace the broken
concrete slab, half of which protruded above the surface of the
surrounding concrete slabs, which protrusion caused the Plaintiff to fall.
C. In falling to reset a new concrete slab or modify the existing
concrete slab to insure that pedestrians would not catch their toes In the
protruding crevice, thus failing, as in the Plaintiff's case.
D. In falling to erect signs or other markers or warning devices
to Insure that a pedestrian would notice the crevice and protrusion and
thus avoid walking In that area or, in the alternative, avoid stepping or
falling on the crevice or protrusion in which the Plaintiff fell.
E. In failing to inspect, maintain, fix and repair the sidewalk so
that pedestrians could safely travel upon the area of sidewalk.
14.
As a result of the aforegoing negligent acts or failure to act on the
part of the Defendants, Plaintiff fell upon the sidewalk and suffered the
Injuries herein set forth.
15.
As a result of the negligent acts and omissions of the Defendants
as above alleged, the Plaintiff has suffered great mental and physical pain
and suffering as herein set forth.
16.
The Plaintiff's injuries were caused by the acts and omissions of the
Defendants as herein set forth and said accident was in no part caused by
the Plaintiff.
WHEREFORE, the Plaintiff respectfully requests this Honorable
Court enter judgment in an amount in excess of $25,000.00, plus the costs
of court as allowed by law.
And she will every pray, etc.
..
.
..
COUNT II
Julia V. Bender,
Plaintiff
vs.
The Mayor and Town Council of
the Borough of Newburg,
Defendants
17.
Plaintiff incorporates by reference Paragraph 1 through 15 as
set therein.
18.
The Plaintiff fell within the Borough of Newburg, Cumberland
County, Pennsylvania.
19.
The Borough of Newburg Is a lawfully enacted municipality within
the Borough Code of the Commonwealth of Pennsylvania, and is
responsible for the maintenance and care of the sidewalks located within
the Borough of Newburg.
20.
The Borough of Newburg was negligent in its actions or failure to
act In failing to properly maintain sidewalks within the Borough as herein
set forth.
21.
The Plaintiff's fall was caused as a direct and proximate result of
the Defendants' negligent actions, which negligent acts or failure to act are
set forth more fully as follows:
A. In failing to remove the tree root which caused the concrete
slab to be broken and dislodged from the ground, causing said concrete to
protrude from the surface of the surrounding concrete slabs.
29.
The Department of Transportation of the Commonwealth of
Pennsylvania was negligent In Its actions or failure to act for the following
reasons:
The Plaintiff's fall was caused as a direct and proximate result of
the Defendants' negligent actions, which negligent acts or failure to act are
set forth more fully as follows:
A. In failing to remove the tree root which caused the concrete
slab to be broken and dislodged from the ground, causing said concrete to
protrude from the surface of the surrounding concrete slabs.
B. In failing to properly remove and/or replace the broken
concrete slab, half of which protruded above the surface of the
surrounding concrete slabs, which protrusion caused the Plaintiff to fall.
C. In falling to reset a new concrete slab or modify the existing
concrete slab to Insure that pedestrians would not catch their toes In the
protruding crevice, thus falling, as in the Plaintiff's case.
D. In failing to erect signs or other markers or warning devices
to insure that a pedestrian would notice the crevice and protrusion and
thus avoid walking In that area or, in the alternative, avoid stepping or
failing on the crevice or protrusion in which the Plaintiff fell.
E. In falling to inspect, maintain, fix and repair the sidewalk so
that pedestrians could safely travel upon the area of sidewalk.
30.
As a result of the aforegolng negligent acts or failure to act on the
part of the Defendant Department of Transportation, Plaintiff fell upon the
sidewalk and suffered the injuries herein set forth.
31.
As a result of the negligent acts and omissions of the Defendants
as above alleged, the Plaintiff has suffered great mental and physical pain
and suffering as herein set forth.
32.
The Plaintiff's injuries were caused by the acts and omissions of the
Defendant Department of Transportation as herein set forth and said
accident was In no part caused by the Plaintiff.
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'ENDER, JULIA V
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THIS IS NOT A BILL /
Explanatioll of Your Medicare Part B Benefits
JULIA V BENDER
2 WATER ST BOX 416
NEWBURG PA 11240
Summary uf .hi~ IInlh.'c tJah.-d I:,,'bru.u)' :!.l, ""J"
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BlueCross
BlueShield
FEDERAL
EMPLOYEE
PROGRAM
EXPLANATION
OF BENEFITS
BATCH 70126
DATES:
RECE I VED
PRDCESSED
PAID
PENNSVLVANIA BLUE SHIELD
PO BOX 890037 CAMP HILL PA 17089-0037
IF YOU HAVE QUESTIONS ABOUT YOUR
CLAIM PLEASE CALL 1-717-763-3608
05/09/94
05/13/94
05/18/94
JULIA
2 WATER ST
NEWBURG
BENDER
BOX 416
PA 17240
ID NUMBER
R02024129
SUBSCRIBER
JV BENDER
CLAIM NUMBER
64126091479
PATIENT NAME
JULIA BENDER
THIS IS NOT A BILL
We Ire pleased to provide you WIth a lecofd 01 your recenl claim transactions fills
nottce descnbeS beneht paymenls and denials under your rederal Employee "log ram
CCMllage
Ple~se te tillS nolle' for incolfM lax sel
Any felubmlUtoI1 01 eligible expenses must be fccetved no later than December 31
of lhe year tallowlng the dale of seMCCl. or 90 dly1lfom lhe d~te 01 the 101m,
Whichever ts latcr
Plene cont<<t us " II~ an uesl,ons,
CLAIM
$32.00
20.14
9.49
2.37
SUMMARV OF STANDARD OPTION BENEFITS ON THIS
TOTAL CHARGES SUBMITTED:
LESS DENIED CHARGES:
LESS MEDICARE PAVMENT:
TOTAL AMOUNT OF FEP BENEFITS PAID TO
PROVIDER OF SERVICE
BENEFITS COORDINATED WITH MEDICARE
BECAUSE YOU ARE ENROLLED IN MEDICARE THE COMBINED PAVMENTS TOTALLV SATISFV
YOUR RESPONSIBILITV FOR THESE CHARGES.
PRDVIDER
DETAILED EXPLANATION OF SUMMARV
BENEFITS COORDINATED WITH MEDICARE
SERVICES RENDERED BV PREFERRED PROVIDER
PLACE AND TVPE FROM AND TO COINS. PROVIDER COVERED
OF SERVICE SERVICE DATES X CHARGES CHARGES
20 XRAV 04/06 04/06/94 32.00 11.86
TOTALS: $32.00 $11.86
11. 86
9.49
2.37
DENIED COD
CHARGES
20.14 32
$20.14
CHAMBERS
TOTAL OF COVERED CHARGES:
LESS MEDICARE PAVMENT:
AMOUNT OF BENEFITS:
---------------------------------------------------------------------------------
EXPLANATION DF CDDES
320--BECAUSE OF THE PREFERRED PROVIDER AGREEMENT, THE PROVIDER HAS AGREED TO
REDUCE THE NORMAL CHARGE BV $20.14. YOU ARE NOT RESPDNSIBLE FOR THIS
DIFFERENCE.
SEE A BELOW.
FOR MORE INFORMATIDN, PLEASE READ THE FOLLOWING SECTIONCS) OF YOUR SERVICE BENEFI"
UROCHURE, WHICH IS THE OFFICIAL EXPLANATION OF YOUR COVERAGE.
A. ADDITIONAL BENEFITS
EXPLANATION OF PLACE OF SERVICE CODES:
20 HOSPITAL OUTPATIENT
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BlueCross
lllu~lli~l(l
FEDERAL
EMPLOYEE
PROGRAM
EXPLANATION
OF BENEFITS
BATCH
PENNSYLVANIA BLUE SIlIElD
PO BOX 8900H CAMP IlILL PA 17089-0037
IF YOU IlAVE QUESTIONS ABDUT YOUR
CLAIM PLEASE CALL 1-717-763-360B
70123
DA TE S:
RECE IVED
PRDCESSED
PAlO
05/09/94
05/13/94
05/13/94
ID NUMBER
R02024129
SUBSCRIBER
JV BENDER
CLAIM NUMBER
64126091221
PATIENT NAME
JULIA BENDER
CHECK NUMBER 50352087
THIS IS NOT A BILL
JULIA BENDER
2 WATER ST
BOX (016
NEWBURG PA 17240-0416
We ::uc plcOI$Cd 10 ~IOVIdc 'tOu With a recold 01 youlleccnl clalln Uitnsaclloulo I his
nollce de~f1bes bentha p.1ymcnlS and oelll~ls unOe' YOU' redclilllmployec fllUY'dl1l
covcr..ge
j)leiltc J:et tfll10 nut lee /1,)1 Incume tiJlI UI.IOStfl
Anv fcsubtlllSSWn 01 eligible c.pcnses must be .ccclvcd no l.llcl than December 31
of the ycarlollowmg lhe dale of service, QrlJU dil')'\o lrulIIlhe date at U1C IOIRl.
whtchCVCllS lale'
I'l~ilst! con'ild us,1 au tlJVC an uesllOns
SUMMARY OF STANDARD OPTION BENEFITS ON TillS CLAIM
TOTAL CIlARGES SUBMITTED:
LESS DENIED CIlARGES:
LESS MEDICARE PAYMENT:
TOTAL AMOUNT OF FEP BENEFITS ON TillS CLAIM
BENEFITS COORDINATED WITH MEDICARE
BENEFIT CIlECK ENCLDSED
$2.16 PLUS ANY MEDICARE PAYMENT YOU IlAVE RECEIVED FOR TillS CLAIM WILL
SATISFY YOUR RESPONSIBILITY FOR TIlESE CHARGES.
DETAILED EXPLANATION OF SUMMARY
BENEFITS CDORDINATED WITH MEDICARE
PROVIDER PLACE AND TYPE FROM AND TO COINS. PROVIDER
OF SERVICE SERVICE DATES y. CHARGES
CARDIOLO 20 DIAGNOSTIC TEST 04/06 04/06/94 21.00
TOTALS:
$21.00
TOTAL OF COVERED CHARGES:
LESS MEDICARE PAYMENT:
AMOUNT OF DENEFITS:
$21.00
10.20
8.6(,
2.16
COVERED
CHARGES
10.80
$10.80
10.80
8.64
2.16
DENIED CODI
CHARGES
10.20 36.
$10.20
---------------------------------------------------------------------------------.
FOR YOUR INFORMATION
BECAUSE THE PATIENT IS ENROLLED IN MEDICARE. WHICH IS PRIMARY. HE OR SHE IS
RECEIVING EITIlER 100 PERCENT OF THE USUAL, CUSTOMARY AND REASONABLE CHARGE II
THIS IS A PROFESSIONAL SERVICE OR 100 PERCENT OF THE INSTITUTIONAL CHARGE FOI
COVERED SERVICES ON TillS CLAIM AFTER MEDICARE'S PAYMENT.
SEE A BELOW.
TillS PAYMENT IS BEING MADE TO YOU BECAUSE THE PROVIDER IS NOT A PARTICIPATINI
DOCTOR. TilE DIFFERENCE BETWEEN THE DOCTORS CHARGE AND TilE BLUE SHIELD
ALLOWANCE IS YOUR RESPONSIBILITY.
EXPLANATION OF CODES
367 SINCE YOUR IlEALTIl CARE PROVIDER AGREED TO ACCEPT ASSIGNMENT OF MEDICARE
BENEFITS. YOUR COVERAGE CANNOT PAY FOR THE DIFFERENCE BETWEEN THE
(CONTINUED)
1906
'9'
BlueCross
BIueShield
FEDERAL
EMPLOYEE
PROGRAM
EXPLANATION
OF BENEFITS
BATCIt 70033
DA TE S :
RECEIVED
PROCESSED
PAID
05,'05/94
05/15/94
OS/25/94
PENNSYLVANIA BLUE SItIELD
PO BOX 890037 CAMP ItILL PA 17089-0037
IF YOU HAVE QUESTIONS ABOUT YOUR
CLAIM PLEASE CALL 1-717-763-3608
JULIA
2 WATER ST
NEWBURG
BENDER
BOX 416
PA 17240
III NUMBER
R02024129
SUBSCRIBER
JV BENDER
CLAIM NUMBER
64124092668
PATIENT NAME
JUlI A BENDER
THIS IS NOT A BILL
We ilC p1cned 10 prOVIde you WIth II lecoId of you, .eccnl claim l'OInUicllons tillS
notJce descflbc1 benefl' piymcnts and dCOIals undol your f edetal rmployec "Iogfam
CDYe. age
Pltilse l thiS 'JOllc., lor mcomt tat , ses
AnV lesubmlulOO aI chglble eapenw musl be IccelVed nQ 1,11llUlln December 31
Gllha )'e.uIOltowtng Iho dill of IervtCl, or YU d..W' Ilomlllc dille Dllhe 'orm,
whIChever IIlale,
'Ilene tootlet us II hlW an Utl/lOnl.
SUMMARY OF STANDARD OPTION BENEFITS ON
TOTAL CHARGES SUBMITTED:
LESS DENIED CHARGES:
LESS MEDICARE PAYMENT:
TOTAL AMOUNT OF FEP BENEFITS PAID TO
PROVIDER OF SERVICE
BENEFITS COORDINATED WITH MEDICARE
BECAUSE YOU ARE ENROLLED IN MEDICARE THE COMBINED PAYMENTS TOTALLY SATISFY
YOUR RESPONSIBILITY FOR THESE CHARGES.
TltIS CLAIM
$540.00
366.37
138.90
3(f.13
TOTAL OF COVERED CHARGES:
LESS MEDICARE PAYMENT:
AMOUNT OF BENEFITS:
DETAILED EXPLANATION OF SUMMARY
BENEFITS COORDINATED WITH MEDICARE
SERVICES RENDERED BY PREFERRED PROVIDER
PLACE AND TYPE FROM AND TO COINS. PROVIDER COVERED
OF SERVICE SERVICE DATES ~ CHARGES CHARGES
20 ANESTHESIA 04/14 04/14/94 540.00 173.63
TOTALS: $540.00 $173.63
173.63
138.90
34.73
DENIED COD
CHARGES
366.37 32
$366.37
PROVIDER
CHAMBERS
---------~-----------------------------------------------------------------------
EXPLANATION OF CODES
320--BECAUSE OF THE PREFERRED PROVIDER AGREEMENT, THE PROVIDER ItAS AGREED TO
REDUCE THE NORMAL CItARGE BY $366.37. YOU ARE NOT RESPONSIBLE FOR THIS
DIFFERENCE.
SEE A BELOW.
FOR MORE INFORMATION, PLEASE READ TItE FOLLOWING SECTIONCS) OF YOUR SERVICE BENEFI
BROCHURE, WHICH IS THE OFFICIAL EXPLANATION OF YOUR COVERAGE.
A. ADDITIONAL BENEFITS
EXPLANATION OF PLACE OF SERVICE CODES:
20 HOSPITAL OUTPATIENT
32801
86... "lA'
,,~, U
I. "
BlueCross
BlueShield
FEDERAL
EMPLOYEE
PROGRAM
EXPLANATION
OF BENEFITS
BATCH 00037
DATES:
RECEIVED 09/09/93
PROCESSED 09/15/93
PAID 09/22/93
PENNSYLVANIA BLUE SHIELD
PO BOX 890037 CAMP HILL PA 17089-0037
IF YOU HAVE QUESTIONS ABOUT YOUR
CLAIM PLEASE CALL 1-717-763-3608
10 NUMBER
R02024l29
SUBSCRIBER
JV BENDER
CLAIM NUMBER
63750090715
PATIENT NAME
JULIA BENDER
JV BENDER
2 WATER ST
BOX 416
NEWBURG
PA
17240-0416
THIS IS NOT A BILL
We are planed '0 prOVide you WIth. ,ecord 01 yom lecenl claim transactions This
noUee describe, benefit payments and denials Under you. reder.l Employee Program
COYe,age
PI",. t 1111' nOIIC' (or Income "If SlIIS
Any lesubmisslon of eligible ellpenses musl be leclrved no tallrlha" Oetember 31
oflhe yea, follOWIng the date of servtel. 01 90 da)" "om lhe dale ollho 101m.
whichever I' later.
PIe,s, cont,ct us it au IIIV. an ues/um,
SUMMARY OF STANDARD OPTION BENEFITS ON THIS CLAIM
TOTAL CHARGES SUBMITTEDI
LESS OTHER CHARGES:
LESS MEDICARE PAYMENT:
TOTAL AMOUNT OF FEP BENEFITS PAID TO
PROVIDER OF SERVICE
BENEFITS COORDINATED WITH MEDICARE
BECAUSE YOU ARE ENROLLED IN MEDICARE THE COMBINED PAYMENTS TOTALLY SATISFY
YUUR RESPONSIBILITY FOR THESE CHARGES.
$50.00
8.12
33.50
8.38
DETAILED EXPLANATION OF SUMMARY
BENEFITS COORDINATED WITH MEDICARE
SERVICES RENDERED BY PREFERRED PROVIDER
PROVIDER PLACE AND TYPE FROM AND TO COINS. PROVIDER COVERED
OF SERVICE SERVICE DATES Y. CHARGES CHARGES
CARDIOVA 30 MEDICAL CARE 08/16 08/16/93 50.00 41.88
TOTALS: $50.00 $41.88
OTHER COD
CHARGES
8.12 32
$8.12
TOTAL OF COVERED CHARGES:
LESS MEDICARE PAYMENT:
AMOUNT OF BENEFITS:
41.88
33.50
8.38
---------------------------------------------------------------------------------
EXPLANATION OF CODES
320--BECAUSE OF THE PARTICIPATING "FEP PREFERRED" PROVIDER AGREEMENT, THE PROVIDE
HAS AGREEED TO REDUCE THE NORMAL CHARGE BY $8.12. YOU ARE NOT
RESPONSIBLE FOR THIS DIFFERENCE.
SEE A BELOW.
FOR MORE INFORMATION, PLEASE READ THE FOLLOWING SECTIONlS) OF YOUR SERVICE BENEFI
BROCHURE, WHICH IS THE OFFICIAL EXPLANATION OF YOUR COVERAGE.
A. ADDITIONAL BENEFITS
lCONTINUED)
2'8535
a.,
81ueCross
BlueShield
FEDERAL
EMPLOYEE
PROGRAM
EXPLANATION
OF BENEFITS
BATCII 00027
DAlES:
RECEIVED 04/27/94
PROCESSED 05/01/94
PAID 05/11/94
10 NUHBER
R02024129
SUBSCRIBER
JV BENDER
CLAIH NUHBER
64116091764
PATIENT NAHE
JULIA BENDER
PENNSYLVANIA BLUE SHIELD
PO 80X 890037 CAHP IIILL PA 17089-0037
IF YOU IIAVE QUESTIONS ABOUT YOUR
CLAIH PLEASE CALL 1-717-763-3608
JULIA
2 WATER ST
BOX 416
NEWBURG
BENDER
PA
17240-0416
THIS IS NOT A BILL
We are pteased 10 ptCMde you WIth oJ .ecord of YOUllecen. c~lm tr,lnUCllORS 'hl$
notICe deKllbes belleflt p.tyments and denl.llls under you.' ederall mpluyec "'OQ'3m
coverigCl
Pie". t 'illS notlC.'OI ",eMlt ". ses
Any ,nubnuslm of 'Itg.bIe ..penMI musl be 1tf.llfYtd no lal.. Ihln nee.mbl, ] I
of lho yell lollowlAlIlhe d.lc of I4lMCCI, Of gO d.ys 110m the d.l. oIlh. loull.
wtuchever.s yle.
Plen, ronllel.,I,I 11M' IIltlllonl.
SUHHARY OF STANDARD OPTION BENEFITS ON TillS CLAIH
TOTAL CIIARGES SUBHITTED:
LESS DENIED CHARGES:
LESS HEDICARE PAYHENT:
TOTAL AHOUNT OF FEP BENEFITS PAID TO
PROVIDER OF SERVICE
BENEFITS COORDINATED WITH HEDICARE
BECAUSE YOU ARE ENROLLED IN HEDICARE TilE COHBINED PAYHENTS TOTALLY SATISFY
YOUR RESPONSIBILITY FOR THESE CHARGES.
$50.00
(t . 0 I
36.79
9.20
DETAILED EXPLANATION OF SUHHARY
BENEFITS COORDINATED WITII HEDICARE
SERVICES RENDERED BY PREFERRED PROVIDER
PROVIDER PLACE AND TYPE FROH AND TO COINS. PROVIDER COVERED DENIED COil
OF SERVICE SERVICE DATES n CHARGES CIIARGES CIIARGES
CARDIDVA 30 HEDICAL CARE 04/08 04/08/94 50.00 45.99 4,01 32
TOTALS: $50.00 '45.99 $4.01
TOTAL OF COVERED CHARGES:
LESS HEDICARE PAYHENT:
AHOUNT OF BENEFITS:
(,5.99
36.79
,}, 20
------------------------------------------------------------------------------.--
EXPLANATION OF CODES
320--BECAUSE OF THE PREFERRED PROVIDER AGREEHENT. THE PROVIDER liAS AGREED TO
REDUCE THE NORHAL CHARGE BY $4.01. YOU ARE NOT RESPONSIBLE FOR TillS
DIFFERENCE.
SEE A BELOW.
FOR HORE INFORHATION. PLEASE READ THE FOLLOWING SECTIDNISl OF YOUR SERVICE bENEFI
BROCHURE, WHICH IS THE OFFICIAL EXPLANATION OF YOUR COVERAGE.
A. ADDITIONAL BENEFITS
EXPLANATION OF PLACE OF SERVICE CODES:
30 PROVIDER'S OFFICE
;"'''11 ,
BlueCross
BlueShield
. ,
FEDERAL
EMPLOYEE
PROGRAM
EXPLANATION
OF BENEFITS
BATCH 00031
DATES:
RECEIVED 04/12/93
PROCESSED 04/21/93
PAID 04/28/93
10 NUMBER
R02024129
SUBSCRIBER
JV BENDER
CLAIM NUMBER
63102093244
PATIENT NAME
JULIA BENDER
PENNSYLVANIA BLUE SHIELD
PO BOX 890037 CAMP HILL PA 17089-0037
IF YOU HAVE QUESTIONS ABOUT YOUR
CLAIM PLEASE CALL 1-717-763-3608
JV BENDER
2 WATER ST
BOX 416
NEWBURG
PA
17240-0416
THIS IS NOT A BILL
We IIC ple.ued 10 prOVide)oW with' 'KOU' 01 your ,ecenl cl.llm lJansactlons 'his
nollce descllbes benelll ~ymenls and denl"s under your Federal Emp!oyee Program
coverage
Please te rillS notICe lor income lu u Stl
Any fesubmlsslon of eligible Cllpenscs musl be 'ecelVtd no lale, lha" December 31
of the year follOWIng (he dale 01 ICMet, 01 gO days 110m Ihe dale 01 the form,
whichever IS laIc.
Please contact us " au havp an uesllOns
SUMMARY OF STANDARD OPTION BENEFITS ON THIS
TOTAL CHARGES SUBMITTED:
LESS OTHER CHARGES:
LESS MEDICARE PAYMENT:
TOTAL AMOUNT OF FEP BENEFITS PAID TO
PROVIDER OF SERVICE
BENEFITS COORDINATED WITH MEDICARE
BECAUSE YOU ARE ENROLLED IN MEDICARE THE COMBINED PAYMENTS TOTALLY SATISFY
YOUR RESPONSIBILITY FOR THESE CHARGES.
CLAIM
$45.00
3.12
33.50
8.38
TOTAL OF COVERED CHARGES:
LESS MEDICARE PAYMENT:
AMOUNT OF BENEFITS:
DETAILED EXPLANATION OF SUMMARY
BENEFITS COORDINATED WITH MEDICARE
SERVICES RENDERED BY PREFERRED PROVIDER
PLACE AND TYPE FROM AND TO COINS. PROVIDER COVERED
OF SERVICE SERVICE DATES Yo CHARGES CHARGES
MEDICAL CARE 03/24 03/24/93 45.00 41.88
TOTALS: $45.00 $41.88
41.88
33.50
8.38
OTHER
CHARGES
3.12
$3.12
PROVIDER
CARDIOVA 30
---------------------------------------------------------------------------------
EXPLANATION OF CODES
320--BECAUSE OF THE PARTICIPATING "FEP PREFERRED" PROVIDER AGREEMENT. THE PROVIDE
HAS AGREEEO TO REDUCE THE NORMAL CHARGE BY $3.12. YOU ARE NOT
RESPONSIBLE FOR THIS DIFFERENCE.
SEE A BELOW.
FOR MORE INFORMATION. PLEASE READ THE FOLLOWING SECTION(S) OF YOUR SERVICE BENEFI
BROCHURE, WHICH IS THE OFFICIAL EXPLANATION OF YOUR COVERAGE.
A. ADDITIONAL BENEFITS
(CONTINUED)
249
3lpV
Blue Cross '
Blue Shield,
F.EDER,AL
EMPLOYEE
PROGRAM
EXPLANATION
OF BENEFITS
BATCH 00003
DATES:
RECEIVED 06/29/94
PROCESSED 07/01/94
PAID 07/06/94
10 NUHBER
R02024129
SUBSCRIBER
JV BENDER
CLAIH NUHBER
0665602
PATIENT NAHE
JULIA BENDER
We Ire pleilS~d 10 ')lOYI(i;~I)U'~lll'II~~1 ,Ud (II vour ,(Ocrnl cl..m IrilnSilchons.
ThiS nolice desc'Ihe!> hl'lll"" .."" 'l"'''.tl~ "ndl" you, rede,.1 EnlploYl!o
Program cover.IlJf'
p,.~u IfHP thiS "O~C!'_'~" .11< ."l:, r." .."1',",'."---_
Any Ill'submlss'on ul r..glllh' I-'P-'"
Docombor 3t ollhD 'foal 101101\"'.. ",
d.lo of Iho 101m. wluch('"... ,.. I.,:,
Pko.utl conl.rc:' us II I'U" 'I.I'~'~:!.':I. -,
"<"'011'11 110 1..lrr Ihan
.. ," "CJ 11JV" Irorn 111"
TOTALS:
TOTAL OF COVERED CHARGES:
LESS HEDICARE PAYHENT:
AHOUNT OF BENEFITS:
SUHHARY OF STANDARD OPTION BENEFITS ON THIS CLAIH
TOTAL CHARGES SUBHITTED: $539.00
LESS HEDICARE PAYHENT: 431.20
TOTAL AHOUNT OF FEP BENEFITS PAID TO
PROVIDER OF SERVICE 107.80
BENEFITS COORDINATED WITH HEDICARE
BECAUSE YOU ARE ENROLLED IN HEDICARE THE COHBINED PAYHENTS TOTALLY SATISFY
YOUR RESPONSIBILITY FOR THESE CHARGES.
"
$539.00
CAPITAL BLUE CROSS
HARRISBURG, P.A. 17177
18001 344-5446
JULIA BENDER
2 WATER ST
NEWBURG PA 17240
DETAILED EXPLANATION OF SUHHARY
BENEFITS COORDINATED WITH HEDICARE
SERVICES RENDERED BY PREFERRED PROVIDER
PROVIDER PLACE AND TYPE FROH AND TO COINS. PROVIDER COVERED
OF SERVICE SERVICE DATES ~ CHARGES CHARGES
CHAHBERS 20 OCCUPATIONAL 05/02 OS/25/94 539.00 539.00
THERAPY
$539.00
539.00
431.20
107.80
--------------------------------------------------------------------------------~
FOR YOUR INFORHATION
OUTPATIENT VISITS FOR THERAPEUTIC TREATHENT ARE PROVIDED FOR UP TO 25 VISITS.
WITH THIS CLAIH. 4 VISITS HAVE BEEN ACCUHULATED TOWARDS THIS HAXIHUH FOR 1994.
EXPLANATION OF PLACE OF SERVICE CODES:
20 HOSPITAL OUTPATIENT
Itll: GOYlIUU,tUIIWIlJf: Sf:I~vICE DUn.1111'1 Ar4
CONfRAClon IUul' CIO"'" .,"d U.u~ Shield A.....ne..lhll.
T"l l"A~blH~HUR6 HOSPITAL
112 N~RTH SEVENTH STREET I
C"',~:,fl ~,i:LJ~(" flA 17201 ..
<71/l 2~~-~171
T'--~ I
, J
I, ,,:,.~,
,
... ~.; .., "
019753-3
1,;y",,',-..,,;,;., -.--
....1...'<,
2l-()~6~'I70
'<';OI~1
"'.
",."
,...
:H:,..L;" .II/I-,1A V
" WA TlK. 5T
:.J'_t'uRli, I'A
172
o j/.'~/n ,
~'._'."'" ~
..!oto"~~'U" .
!H"N ,
Ii OJ/jl/93jI9; 7 1
~.. .,~~:.l<.''''1 H_. r,', ",'~~~"''':''
,
,~ OllOIi/93
f.J4/?~/(J~
. ~.., ..
, i
. ,
, ,
'" I,' ,ltllll,. I ~.I'"''
1 ,,,...., -..,:'.~'
d',
20, 01, 04/C2l~3
,. . ,. '","~"..' ..
11 "ill 'JI';'~
JilL I. , :ll ~I)t:ll
.' ...,FI.: ~T
I'd :HJX 416
Id:"'!uf/(" I'A 17240
EI-. Ili.' . EI-.
,
.A,'",
.,,-
I
. ~" ,}t.
'"
.1. "...,
I
I
",',' 1"1"1'''.
,
4S!
I
I
1;CN-COV ,',',
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.",,1,
....
I'liYSI (AL TI1UIAPY-GE"NE'RAL
, .
j 420 I
. Olll
I
I
i
I
I
767.0u
767.%
IUlt.L (HARGES
"';i.:.\....
';""",-""\'.
'",',...liii;Fi,"i,q1jr;--- "'I;~Ii\i'-'
.
· HEOICAR"
· BLUE CROSS
c PIlUDft;T tAL
.\ '''~U''lh'. ',.""
.WI I'. 11((
""......I+I"~'I '....M',.,.,.
.BENuEK, JULIA V
.~ENDEH, JULIA V
cOiNULk, JuLIA V
;-,""i,1 1 .,.... '..'.1......'-.
F
F
f.
01 184124254A
01 H02024129
01 1199200
. -'ttw,ii..'i.jI-----
A ANO B
FEP 104
7
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I
., ,,'if,!t!'l".r1~l'H0Df.'" ~I . -..---. .
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: , I
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"
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j. I
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rhis' tilt,:,.;;.,! i.~n is provided in cnnll>lidt1Ce
Mi t t, l't.'tl~l!.ll vani ,) 's Act dr1. ~JO bAL/lNCE [S
)UL ,\1 1:"', II"r..~lter insurance vayment
is r~c~iv"':, ~~ ~ill till you und~r
se~dr~t~ (~J~er 10r arlY remaininq baldnce.
. '" ~.. " '.' F C 19
~_.
L.__.
'. ..,-
.... . "" '..r.......,,'..
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112 ~0Rlh 5E~l~lrl STPLET
CHAt:aL~~c~I'~1 ~A !7?o1
lI1n ?/J<,-;17l
-~I-;-'~,il4..t ..I-.'t;......- "-+-
,."'!..&~
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'7240
,
.
".~" lJ
..
PHY~ILAL THEkAPY-uf.Nf.kAL
420
3~
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TOTAL CHARuE~
unl
551 .00
" ....'tll
..
OlDUCI_1
., CO"SUlWifCI
" 1\1 N~MlIl."" aJ fWOli"A'M."" .. fll.A/oIQutIjlOUt
'M EO I C AR E
"BLUE CROSS
cPKlJOENT IAL
DUE FROM PATIENT ~
361
INS
Y
Y
Y
Y
Y
Y
at IJf$UlIIIO.'.......'
'tllNUEK, JuLl A V
"d ENOEI{, JULIA V
cdLNUtK, J 'JLI A V
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AI' ) Rlll"'t:.u HUMt.rtA~lr<
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f
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01 184124l54A
(\1 ~n2024129
01 11",920u 7
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"
...'" ~l ll1tll.l~'''''' .U1H .,
::I" .....,...=- It ...,_IUGt, 90"11(:
Ihls""rH"brm.:tt;un is provided in corllolidnce
wiJh f'enllsllVc1ldd'S Act c,t}. 'hI :)^LAr.Ci.:. IS
LI~ "r 1 MIS liMe. ~l tl'r ;1I<Llr~nce Pdyment
; s~ r ~ c e i v e \J, w t.' "" ill hill '1 u u un t.J (' r
se1)aratf! Cuv~r tvr any rto'lldill;n" tJdl,.Jnc~.
uno] HcrA.14~O .. C 1 r.
....11I "tll,lflU",IP
.,""lV II'
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t\ '('IIH'. ,...., I.., UIU"II..."IIIfS ,"" '''I "'.I"!.I A"''' 10 ...." '"I. ...11 .", ~.I" . ...., .., "'I ~
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"
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toed l,IlI.I, I ill! I :
11/1 nr;l i
CIIAlIl;I. cd I I' II' 144Ul
APrT OAI[' 09/01~?3
AI'I'llll'II'IO'OOn
1"U/~;IJHllI Hili' Oil
A[t;1I:ul' ,00
AIT r 'I'
Jill I i1 V
7 I.In III'
I~I 1.111111/1,
/ t:' '-4/.~
14611
IIf NI,! II
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I'll I,' II,I}
/.11.11
X-RIlYtl'
1,",11 '''1
PI~IMnllY IliSz MISC. COMMERCIAL IH~~
1'111 Iry II' IlllMIIIUtlrli:,
~.I rlllHHlfIY "~'" 111'1)) [nlll.
rill III II' 1 'Iii I ,"'I'"HI -----_. ----.-.-----,--..- .-
DESCRIPTION ~ CODE AMOUNT MISC
. -.-.--.---------------..
Olrlcf VISit. NCWflT LEVEL 1 9!l201
PHI 1'11(11) I P! Ii' III,' HWi!.1l J1~ .....- .......-......--- ..-- ..
orner VISIT. NfWPf lEVEl2 9!l202
M'I'I l'klJ~111i1 10 III1 .lIl1SSA IN ........ - ..,- .^--- --
OFfICE VISIT. NEW PT LEVEL 3 9!l203
-_..~. _.. ... - --.-----.--. -
OFFICE VISIT. NEW PT LEVEL4 9!l204
.- --., --"'-_. .--.-.--. ._-
OITICE VISI!. NEW PT LEVEL 5 9!l205
___n______' .__.___._.____
--.------
. PHVSICIAN OfFICE VISIT. EST. PT. LEVEL 1 99211
1 ROBERT RICHARDS MD OfFICE VISIT, EST. PT. LEVEL 2 99212 l.J^ (Jo:>
2 JOHN ASHBV MO OFFICE VISIT, EST. PT. LEVEL 3 99213
3 ROBT RICHAROS JR MD OFFICE VISIT. EST. PT. LEVEL 4 99214
. SUAOOAR HUSSAIN MO OfFICE VISIT, EST PT. LEVEL 5 9!l215
H____.' U ..____._ - ..
--..- .-. I.)(~..t, + ---_._.,,_._-_._---~--_._--
.LL> 11, Ih' orflCE CONSULT. lEVEL 1 99241
---- -.---_.._--
DIAGNOSIS OFfICE CONSULT, LEVEL 2 99242
./1 f., ..1 .. --. -- ...---
_()l'nC[(:<,:"~SUI.T, LEVEL 3 99243
OFrlC[ CONSULT, LEVEL 4 99244
-----------..---------.---
oFrlcr CONSULT. LEVEL 5 99245
LAST 01 nGNW, (S: 1132,Q -..-.-..-- - -.~.
... - ,,'-'---
DIAGNOSIS I PREGNANT CONI CONSULT, LEVEL 1 99271
--.-.. . ----
CODE YES [J NO II CONF CONSULT. LEVEL 2 99272
.. .--.-.. -.--.
X.RAVS CODE fEE CONf CONSULT. LEVEL 3 99273
__"'_ _ ___on' .
( 1 SHOULDER I 1 H JUNCTION CONf CONSULT, LEVEL 4 99274
-----_.....-
( 1 AC JOINT ( 1 LBS. .- - CONF CONSULT, LEVEL 5 99275
___._un___
( ) CLAVICLE ( ) HIP ..' ..'..--"-'--
( ) HUMERUS ( I HIP & PELVIS EXAM,\ nEPORT 90000
( ) ELBOW ( 1 PELVIS ARTIifIOCENTESIS MAJOR JOINHNJlASP 20610
( ) fOREARM ( 1 SACRO.COCCVX ARTHROCENTESIS SMALL JOINHNJlASP 20600
--.---".-
( 1 WRIST ( 1 fEMUR UNILATERAL WEDGING 28690
( ) HAND ( ) KNEE BILATERAL WEDGING 28691
( ) FINGER I I TlB& fiB CASTS
( ) CHEST ( 1 ANKLE T1iUMB SPICA 29085
I 1 RIBS ( ) OS CALCIS SHORT ARM CAST 29075
( ) SCOLIOSIS ( ) FOOT LONG ARM CAST 29065
: ( ) C.SPINE ( 1 TOE SHORT LEG CAST 29405
: ( ) T.SPINE ( 1 COPIES LONG LEG CAST 29345
( 1 L.SPINE ( ) SCANOGRAM LONG LEG CVLINDER 29365
( 1 ( ) FILM CHARGES SPLINTS
( ) FINGER SPLINT 29130
YES NO DATE CLAVICULAR SPLINT 99070
STILL DISABLED FRACTURES:
--.-.------
RETURN TO WORK ( _ .1 F_R.~.TlJ!lE CARE IN OFfiCE
SCHOOL ---_. ..-----.--
-
PHVSED MEDICAL SUPPLIES:
--...-..
RESTRICTION
h . _n~ .----.----
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..
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TELE '(71712&1.6211
ORTHOPAEDIC ASSOCIATES RCVD BV \-. ---.. .
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1 ROBERT RICHARDS MD
2 JOHN ASHBY MD
. 3 ROBT RICHARDS JR MD
..~._ ._~'IADDAR HUSSAIN MO
.00
.lIO
.--_.--+-- ,.-.,.-- ,.-. --..-.-.- -- ---- _. .'. ------ -_.---
_~Il~RIPTI~N.-u--.---- "______ __ ,/ I. ~ODE AMOUNT MISC,
OFfiCI: VISIT. NfW III t[VEl1 99201
,-.,._._,,- - ------- . --------."
Ol-nCE VISIl. NEW fiT lEVEl2 ~JfJm
-oFfl~..Evi~. Nf,W !"XEVEl3 ~____~ -99203 -----
Y!~I~.~VIS!.T,-~[~-!,!-~EYEl4 _ 99204
?FF1~E_VISIT.N[W ~!:.~E'yEl5 __ 99205
OFFICE VISIT. EST PT LEVEL \
OFFICE VISI1, EST PT LEVEl2
OFFICE VISIT, EST. PT LEVEL 3
OFFICE VISIT. EST PT. LEVEL 4
OFFICE VISIl. [51 PT. lEVEL 5
99211
99212
I. ::99:113 17:J... J'
gt:J214
99?15
-- ,,'.-- .-- .--...-' ---. ---
. 0-- _.'. '--0""._-' ~
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fl, Jt!ui.jt.f..d-u,Lr~ OfFICE CON,~.ULT,tEVIL 2
I ~~ICI CONS!:l.L_L~Evn 3
OFFICE CONSUl1. lEV[l4
OFFICE CONSUlT. LEVEL 5
--.,--..----.. -
9!J241
--- -- .. - -...
9!J242
.-- _.- -..-._-,..---~-
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-.-.....-.........-
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.( I WRIST ( I FEMUR
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( I CIiEST ( I ANKLE
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I
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: YES NO DATE
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1035 WAYNE AVE. CIIAMBEASBURG. PA 17201
._ n_ _ __ ___ -.
CONF CONSULT, LIVEL 1
CONF CONSULT. LEV[l2
CONF CONSULT. LIvn 3
------_. ---.
CONF CONSULT, LEVEL 4
CONF CO~SULT, LEVEL 5
-1--' --
__ _'!"2~_
99272
99273
99274
99275
EXAM & RE PORT
ARTHROCENTESIS MI'JOR JOINT.INJiASP
ARTHROCENTESIS SMALL JOINT-INJiASP
UNILATERAL WEDGING
BILATERAL WEDGING
CASTS:
THUMB SPICA
SHORT ~RM CAST
LONG ARM CAST
SHORT LEG CAST
LONG LEG CAST
LONG LEG CYLINDER
SPLINTS:
FINGER SPLINT
CLAVICULAR SPLINT
FRACTURES:
I I FRACTURE CARE IN OFFICE
90000
20610
20600
26690
26691
29085
29075
29065
29405
29345
29365
29\30
99070
MEDICAL SUPPLIES:
.1_1-- __h_ ..-- -
AM
PM
AUTH TO IlELEASE INFO' I AUTHORIZE
ORTHOPAEOIC ASSOC TO RELEASE ANY
INFO ACOUIIlED IN TOil' COURSE OF MY
EXAM OR THTMT
--------
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ACVU BY
\../ --,
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-----.----.---
J~~ 01 I Ill' il\/d3 X 1/(1\'1/' t, r", 1I~ ~l Cllnh'l,! ~J ( If' II: 116!;9
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.- .-. ---. --~---'- "--,,,-,----,-'-" -_... '___"__4
"1\1 "'liP) I III 11: 1111 1111','01111'1 .0' IICI VISIT. NEW PI lEVEL' .....!!~.!..-
.. .----.."-.---------.--.- .--- ---
._~)~ ~I~I~.~I.~~T~_~~_~_!_! lEVEL 2 99202
(11'1'1 I'IWIIIOI III Ill, .1111',';1111'1 .---"-
ornCE VISIT. NEW PI LEVEL 3 99203
-- _, . n___.._._.~____ ---. --
OfFICl VISIT. NEW PI LEVEL 4 99204
---.-- -. - '.--.'- -
orncr, VISIT, NEW PT LEVEL ~ 992O~
-----.----.---- ----""-'-----"- -
---------,_.._---
I, PHYSICIAN OFFICE VISIT. EST PT. lEVEl. 99211
. ROBERT RICHARDS MD OFFICE VISIT, EST. PT. LEVEl 2 992'2
12 JOHN ASHBY MD OFFICE VISIT, EST. PT. lEVEl 3 992.3
:3 ROBT RICHARDS JR MD OFFICE VISIT, EST. PT. LEVEl 4 992'4
L~c;HA~~_A HUSSAIN totO OFFICE VISIT, EST PT lEVEl ~ -- I- 9921~
-_.-- -~-_._.... --.. -...
I ..------------ - ..- --- _.-,---
._--'------~
~'AtiNS'!i.!.~..:u.[' if tl!rrul_(t.I~II..i . ornCE CONSVL T, LEVEL' 9924'
_._._- -~_. --
OFF ICE CONSULT, LEVEL 2 99242
--.-..-- -+_. - .---- ,-- -
, OFFICE CONSULT, LEVEL 3 99243
! ------ 1-
OFFICE CONSVLT, LEVEL 4 99244
1__.__._ _+_.--_ -
, I lI!j r or R[;Nnfil S I OFFICE CONSULT, LEVEL ~ 9924~
, Ul2 .0
--
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CODE -
YES I'J NOLl CONE CONSULT. LEVEl 2 99272
'.. --
X.RAYS CODE FEE CONE CONSULT, lEVEL J 99273
,~--~._-
I( I SHOULDER ( 1 f.L JUNCTION CONE CONSULT, LEVEl 4 99274
; ( I AC JOINT ( 1 LB.s. CONE CONSULT, LEVEL ~ 9927~
( I CLAVICLE I 1 HIP
1( ) HUMERUS I ) HIP & PELVIS EXAM & REPORT 90000
II 1 ElBOW I ) PElVIS ARTIlROCENTESIS MAJOR JOINT.INJlASP 206'0
, I 1 FOREARM I ) SACRO.COCCYX ARTHROCENTESIS SMALL JOINT.INJIASP 20600
I( 1 WRIST I ) FEMUR UNILATERAL WEDGING 28690
II I HAND I ) KNEE BILATERAL WEDGING 28691
: I I FINGER I ) TIB& FIO CASTS'
I THUMB SPICA
'I ) CHEST I ) ANKLE 2908~
! ( I RIBS I ) OS CAlCIS SHORT ARM CAST 2907~
: ( I SCOLIOSIS ( ) FOOT LONG ARM CAST 2906~
'( I C.SPINE ( ) TOE SHORT LEG CAST 2940~
( ) T.SPINE ( ) COPIES lONG lEG CAST 29345
( I L.SPINE ( ) SCANOGRAM LONG LEG CYLINDER 2936~
( I ( ) FILM CHARGES SPLINTS
( I FINGER SPLINT 29130
YES NO OATE CLAVICVLAR SPLINT 99070
STILL DISABLEO FRACTURES:
RETURN TO WORK I 1 FRACTURE CARE IN OFFICE
---
---- SCHOOL
PHYSED MEDICAL SUPPLIES:
RESTRICTION
-------.- -- --
_.. - . _._---~--
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ORTHOPAEDIC ASSOCIATES nCVD RY , --
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~---- .-.----..-..- -.-.--.-. -- --- ~.-
"1:1 1'1,'11111'" III Ilk 11I1"."tlt! --9~~~E...VISIT, NE.w PT LEVEL' 1l'J2!l~._
...OFFlCE VISIT.~~W PT.LEVEl2 1l'J202
111'1' , l'I'llll'''1 Ii' hi, ttil',~,H I N - -- ---
--9.~FlCE VISIT. NEW PT.LEVEl3 1l'J203 -----
OFfiCE VISIT. NEW PT. LEVEL4 99204 .---
-
OFfiCE VISIT. NEW PT. LEVElS 9920S
,--- - - ---------.._~ .- -... .-+-. .. -
,
;. PHYSICIAN OFfiCE VISIT, EST. PT. LEVEL' 99211
--. .-
' . HOBERT HICHAHDS MD OFFICE VISIT, EST. PT. LEVEL 2 992.2
,2 -
JOHN ASHBY MD OFfiCE VISIT, EST. PT,LEVEL3 99213
,3 HOBT RICHARDS JR MD OfFICE VISIT, EST. PT. LEVEl 4 99214
14 ---. ---
SHADOAn HUSSAIN MD OFfiCE VISIT, EST. PT. LEVElS 9921S "'''-
1--.----- -- --- -~---- ---- _n' -
, .. ..
:.~IA(;NOSI!;.. ._~(_1'--if tJ! "'/~J21..;:C~~ ,-----. .-
OffiCE CONSULT,LEVELl 99241
-. .- -
OffiCE CONSULT,LEVEL2 9924? ",.
-'-~--'" - - -.-
OffiCE CONSULT,LEVEL3 99243
. ---
, OffiCE CONSULT,LEVEL4 99244
I -- - .. - -~_._-- -- ---_.-- u -_.
OffiCE CONSULT, LEVELS 9924!i
I 1 n~; I II 1 II 'OIW 'i 1 fj: It -i;~ . i", a.n_ .. ... -
-----,----..- ~GNANT --- --:c:--'" ..<-. --
I DIAGNOSIS CONf CONSUL T,LEVEll 99271
----. . - .-
j coO(: CONf, CONSULT, LEVEl 2 99212
I-X~RAYS- - YES I : NO I J
CODE fEe CONF. CONSULT. LEVEL 3 99273
~'l )iHO~.LO(-R --
, ) HJUNCTlON CONf. CONSULT,LEVEl4 99274
_._--- --.---.
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.- ---_.. ...--- -.
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'f JHUMERUS I I'UP & PElVIS EXAM & IlEPORT 90000
--->.- ----
,I j elBOW I I PElVIS ARTHIlOCENTESIS MAJOH JOINT.IN.UASP 206.0
'I I FOIlEARM I I SACHO.COCCYX ARTIlROCENTESIS SMALL JOINT.IN.UASP 20600
._-,_.- -
'( I WRIST I ) fEMUR UNILATERAL WEDGING 28690
:1 I HAND ( ) KNEE BIlATEIlAl WEDGING 2869'
il ) flNGEH , ) TIB& fiB CASTS,
'I ) CHEST I ) ANKLE THUMB SPICA 2908S
!, ) RIBS I ) OS CAlCIS SHORT AHM CAST 2907S
'I ) SCOLIOSIS I I fOOT LONG AHM CAST 2906S
'I I C.SP1NE I I TOE SHOHTlEG CAST 29405
I I I T.SPINE ( I COPIES LONG LEG CAST 2934S
II IL.SPINE ( I SCANooRAM LONG LEG CYLINDER 29365
I I ( I fILM CHARGES SPLINTS,
'I ) fiNGER SPLINT 29130
-
YES NO DATE CLAVICULAR SPLINT 99070 ._---- -
STIll DISABLED FRACTURES:
_._- -. .-.
, RETlmN TO WOHK - ( I fRACTURE CARE IN OffiCE
-----_.--. u -_.~-
SCHOOL ....-- -
--- -
PIiYSEO MEDICAL SUPPLIES:
------ .-
RESTRICTION
....-.--
--..---..-.--. I A // - "-'-- .. --.-.-.-.
HHunN.' ".- t? AUTIf TO RELEASE INfO' I AUTHORIZE '. ')'-' \.; :\
u. -,__LO Iii Ijp_..... OHTllOPAEDIC ASSOC. TO RElEASE ANY BAL fWD .____--::.:__._ I
0'__-
-NEXT (' ..'!. ~ 02' If). AM. INfO ACOUlRED IN THE COURSE Of MY CHO, THIS VISIT :::;.;;..L
-. --
API" EXAM OR TRTMT
.-J-'.~_ __ AT _____ _____ :...'(..- .'?Pw\~ DATE AIotTPD . -.. -. ...- - '--.
J i_i
fro 10 '25.1201240 THE Wll17)i'(j4-6111 BAl. DUE -.. _..:.::a:.. l.~-
ORTHOPAEDIC ASSOCIATES (,/,' 11 HCVD BY u__ ,
"
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'llY
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29519
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BlueQooss
B1ueShield
FEDERAL
EMPLOYEE
PROGRAM
EXPLANATION
OF BENEFITS
BATCH 70093
DATES:
RECEIVED 05/13/94
PROCESSED OS/22/94
PAID 06/01/94
PENNSYLVANIA BLUE SHIELD
PO BOX 690037 CAMP HILL PA 17069-0037
IF YOU HAVE QUESTIONS ABOUT YOUR
CLAIM PLEASE CALL 1-717-763-3608
10 NUMBER
R02024129
SUBSCRIBER
JV BENDER
CLAIM NUMBER
64132091238
PA TIENT NAHE
JULIA BENDER
JULIA BENDER
2 WATER ST
BOX 416
NEWBURG PA 17240-0416
THIS IS NOT A BILL
We Ife pleiased 10 prlMde you 'Mln I ,ecexd of your recenl clilrn u.nuclions Ihl'
not.ce descllOO\ bl:ncflt p.1ymcnts and delll.t, under your redelll rmploycc l'rOQ,am
covelloe
"Ie.,., thl' nollC" lOf "IC~ In It'S
Any lelublmuKMI of eligible e.penHs musl be ,curved no Ii'et than December 31
of lho yell followlI'Ig the dlla of leMCe, or 90 dJys from lhe dlle Dllhe lorm.
wfuchcve, ",..llel
IJkJst'COA'~clul,f "Ne~n Ut'SIIOIII,
SUMMARY OF STANDARD OPTION BENEFITS ON
TOTAL CHARGES SUBHITTED:
LESS DENIEO CHARGES:
LESS HEDICARE PAYHENT:
TOTAL AMOUNT OF FEP BENEFITS PAID TO
PROVIDER OF SERVICE
BENEFITS COORDINATED WITH HEDICARE
BECAUSE YOU ARE ENROLLED IN MEDICARE THE COMBINED PAYHENTS TOTALLY SATISFY
YOUR RESPONSIBILITY FOR THESE CHARGES.
THIS CLAIM
$198.00
146.92
40.86
10.22
DETAILED EXPLANATION OF SUHHARY
BENEFITS COORDINATED WITH MEDICARE
SERVICES RENDERED BY PREFERRED PROVIDER
PROVIDER PLACE AND TYPE FROM AND TO COINS. PROVIDER COVERED
OF SERVICE SERVICE DATES % CHARGES CHARGES
KEYSTONE 20 LABORATORY 04/14 04/14/94 198.00 51.08
DENIED COOl
CHARGES
146.92 321
$146.92
TOTALS.
U 98.00
$51.08
51.08
40.86
10.22
TOTAL OF COVERED CHARGES:
LESS MEDICARE PAYMENT.
AMOUNT OF BENEFITS:
---------------------------------------------------------------------------------.
EXPLANATION OF CODES
320--BECAUSE OF THE PREFERRED PROVIDER AGREEHENT, THE PROVIDER HAS AGREED TO
REDUCE THE NORMAL CHARGE BY $146.92. YOU ARE NOT RESPONSIBLE FOR THIS
DIFFERENCE.
SEE A BELOW.
FOR MORE INFORMATION, PLEASE READ THE FOLLOWING SECTIONCS) OF YOUR SERVICE BENEFIl
BROCHURE, WHICH IS THE OFFICIAL EXPLANATION OF YOUR COVERAGE.
A. ADDITIONAL BENEFITS
EXPLANATION OF PLACE OF SERVICE CODES:
20 HOSPITAL OUTPATIENT
24143
'.,
81ueCross
B1ueShield
FEDERAL
EMPLOYEE
PROGRAM
EXPLANATION
OF BENEFITS
BATCH 70113
DA TE S :
RECEIVED 06/16/94
PROCESSED 06/22/94
PAID 06/29/94
ID NUHBER
R02024129
SUBSCRIBER
JV BENDER
CLAIH NUHBER
94167040412
PATIENT NAHE
JULIA BENDER
PENNSYLVANIA BLUE SHIELD
PO BOX 890037 CAHP HILL PA 17089-0037
IF YOU HAVE QUESTIONS ABOUT YOUR
CLAIH PLEASE CALL 1-717-763-3608
JULIA
2 WATER ST
BOX 416
NEWBURG
BENDER
PA
17240-0416
THIS IS NOT A BILL
We lie pleued 10 plOYIde you wtlh.1 record of YOU' recent clllm lIansxhoos 'hIS
noIKe descllbn bench1 p.Jyments Ind den"ls undt. YOU' r edeull rmploycc Program
CCMflgc
Pie", I: ''''I noIltf fOlI/K'CWM' In ,..
MY ,esubn"uion of eligIble expenws mUll be ,ecerved no later than December 31
of the year lallowlng lhe dale 01 MMCC, 01 90 dilY' 110m lhe date of the form.
wtuchew:r11 lale.
Plell' c:onlxl III d IlIW In UfI'IOOI.
SUHHARY OF STANDARD OPTION BENEFITS ON
TOTAL CHARGES SUBHITTED:
LESS DENIED CHARGES:
LESS HEDICARE PAYHENT:
TOTAL AHOUNT OF FEP BENEFITS PAID TO
PROVIDER OF SERVICE
BENEFITS COORDINATED WITH HEDICARE
BECAUSE YOU ARE ENROLLED IN HEDICARE THE COHBINED PAYHENTS TOTALLY SATISFY
YOUR RESPONSIBILITY FOR THESE CHARGES.
THIS CLAIH
$198.00
1'.6.92
(to.86
10.22
PROVIDER
DETAILED EXPLANATION OF SUHHARY
BENEFITS COORDINATED WITH HEDICARE
SERVICES RENDERED BY PREFERRED PROVIDER
PLACE AND TYPE FROH AND TO COINS. PROVIDER COVERED
OF SERVICE SERVICE DATES ~ CHARGES CHARGES
20 LABORATORY 04/04 04/04/94 198.00 51.08
TOTALS: $198.00 $51.08
51.08
40.86
10.22
DENIED
CHARGES
146.92
$146.92
KEYSTONE
TOTAL OF COVERED CHARGES:
LESS HEDICARE PAYHENT:
AHOUNT OF BENEFITS:
---------------------------------------------------------------------------------
EXPLANATION OF CODES
32o--BECAUSE OF THE PREFERRED PROVIDER AGREEHENT, THE PROVIDER HAS AGREED TO
REDUCE THE NORHAL CHARGE BY $146.92. YOU ARE NOT RESPONSIBLE FOR THIS
DIFFERENCE.
SEE A BELOW.
FOR HORE INFORHATION. PLEASE READ THE FDLLOWING SECTIONCS) OF YOUR SERVICE BENEFI
BROCHURE, WHICH IS THE OFFICIAL EXPLANATION OF YOUR COVERAGE.
A. ADDITIONAL BENEFITS
EXPLANATION OF PLACE OF SERVICE CODES:
20 HOSPITAL OUTPATIENT
..... Pt-nn.)h.nla HIUf'Sh'rld
.... ..._,___...c_.....'""'-...._
,...."IMl.r...I~....
...,.. _'"'. .,.,. ,'-', 'I...... _.... ..... .....,
KEEP FOR YOUR RECORDS
PENNSYLVANIA ILUE SHJELD
CUSTClllfl SERVICE
PCI ICIX ''''57
C,"P HILL PA 170.....57
Sub.criber. JULIA V lENDER
Patient. JULIA V lENDER
Provider. PETER G WALLICK HD
(000678804)
ID Nueber. R02024129
Claim Number, 95052047041
Pege. 1 of 1
Dete. 02125/95
PROCEDURE DESCRIPTICIN
PROCEDURE CClDE SERVICE PROVIDER'S ALLCIIIAHCE AIIDUNT PAlO AItlIUNT REHARl(S
lNUKBER Of SERVICES) DATE IS) CHARGE NCIT PAlO
IWlII SURGERY 11.11 '~/l"94 2"&.11 .11 .11 2~~&.1I' 5&027
26121
""RVE SURGERY 11111 '~/14/"" 1~?1.1I .11 .11 15?1.... nl?7
S5027
According to our records. the patient has HEDICARE coverage. After HEDICARE has
processed these .ervices. submit the EXPLANATION of HEDICARE 8ENEFITS to PO lOX
898845 for 65 Special, PO BOX 890062 for Hedical/Surgical claims. or PO BOX
898854 for FEP claims.
1",11I",1..1,1,1.,111..,11....1..1..,11,11,,11I11,11..1,,1,1
JULIA V BENDER
2 WATER ST BOX 416
NEWBURG PA 17240-0416
HAVE A QUESTION? PLEASE CALL (717) 763-3608.
(Service for the Deaf via TDD Equipment i. available at 1-800-345-3848.)
SP047625
II
810
'ii'
70125
EXPLANATION
OF BENEFITS
BATCH
FEDERAL
EMPLOYEE
PROGRAM
BlueCross
BlueShield
PENNSYLVANIA BLUE SHIELD
PO BOX 690037 CAHP HILL PA 17069-0037
IF YOU HAVE QUESTIONS ABDUT YOUR
CLAIH PLEASE CALL 1-717-763-3606
DATES:
RECEIVED 05/16/94
PROCESSED OS/25/94
PAID 06/01/94
ID NUHBER
R02024129
SUBSCRIBER
JV BENDER
CLAIH NUHBER
64137093255
PATIENT NAHE
JULIA BENDER
JULIA
2 WATER ST
NEWBURG
BENDER
BOX 416
PA 17240
THfS IS NOT A BILL
We iI'O plened to prOVIde you With... ,ecord of your recent claim Iransacllom Til" Any rnubnllSStOO of ellQlble elpen~ musl be lecelvcd no later Ulin December 31
notate descllbeS bendll ~ymenls and den.ills under your Federal Employee Program of lhe year followmg lhe d.lte of 5eMCC, 01 90 days tram lhe elite of the IOfm.
toVellge whichever IS later
P~ase I: Ifln t'IOlIce 'OIlncD~ t... , 1ft PIe,se cont~1 us,f au h~,n uesllons.
SUHHARY OF STANDARD OPTION BENEFITS ON THIS CLAIH
TDTAL CHARGES SUBHITTED:
LESS DENIED CHARGES:
LESS HEDICARE PAYHENT:
TOTAL AHOUNT OF FEP BENEFITS PAID TD
PROVIDER OF SERVICE
BENEFITS COORDINATED WITH HEDICARE
BECAUSE YOU ARE ENROLLED IN HEDICARE THE COHBINED PAYHENTS TOTALLY SATISFY
YOUR RESPONSIBILITY FOR THESE CHARGES.
$60.00
14.01
36.79
9.20
PROVIDER
DETAILED EXPLANATION OF SUHHARY
BENEFITS COORDINATED WITH HEDICARE
SERVICES RENDERED BY PREFERRED PROVIDER
PLACE AND TYPE FROH AND TO COINS. PROVIDER COVERED
OF SERVICE SERVICE DATES % CHARGES CHARGES
30 HEDICAL CARE 04/06 04/06/94 60.00 45.99
TOTALS: $60.00 $45.99
45.99
36.79
9.20
DENIED COD
CHARGES
14.01 32
$14.01
WALL ICK
TOTAL OF COVERED CHARGES:
LESS HEDICARE PAYHENT:
AHOUNT OF BENEFITS:
---------------------------------------------------------------------------------
EXPLANATION OF CODES
320--BECAUSE OF THE PREFERRED PROVIDER AGREEHENT, THE PROVIDER HAS AGREED TO
REDUCE THE NORHAL CHARGE BY $14.01. YOU ARE NOT RESPONSIBLE FOR THIS
DIFFERENCE.
SEE A BELOW.
FOR HORE INFORHATION, PLEASE READ THE FOLLOWING SECTIONCSl OF YOUR SERVICE BENEFI
BROCHURE, WHICH IS THE OFFICIAL EXPLANATION OF YOUR COVERAGE.
A. ADDITIONAL BENEFITS
EXPLANATION OF PLACE OF SERVICE CODES:
30 PROVIDER'S OFFICE
,
il
6001
'It"-
81ueOoss
B1ueShield
FEDERAL
EMPLOYEE
PROGRAM
EXPLANATION
OF BENEFITS
BATCH
7B 125
PENNSYLVANIA BLUE SHIELD
PO BOX 890037 CAMP HILL PA 17089-0037
IF YOU HAVE QUESTIONS ABOUT YOUR
CLAIM PLEASE CALL 1-717-763-3608
DA TE S:
RECEIVED
PROCESSED
PAID
05/18/94
OS/25/94
06/01/94
JULIA BENDER
2 WATER ST
BOX 416
NEWBURG PA 17240-0416
10 NUMBER
R02024129
SUBSCRIBER
JV BENDER
CLAIM NUMBER
64137093256
PATIENT NAME
JULIA BENDER
THIS IS NOT A BILL
We alo pleased to plCMde you WIlli II ,ecOId 01 your feeenl claim Uanuchons 'Ills
OOClCe describes bentflt ~yments and denlJls unde' YOU' Fede.al [m~ r,ogl<lm
coveUlge
Pleas, i thIs nollC~ lor Income 'J. lies
AllY lelublmUIOfI 01 ehgl~e expenses musl be received no later than December 31
of Ihe yelll fotlowmg lhe date 01 lef'Vlce, Of YU d..ys 110m lhe cUte 01 the 101m,
MllChevells ~Ie'
,Jlease conl.rl us II au h~ an utS/lonS.
SUMMARY OF STANDARD OPTION BENEFITS ON THIS CLAIM
TOTAL CHARGES SUBMITTED:
LESS DENIED CHARGES:
LESS MEDICARE PAYMENT:
TOTAL AMOUNT OF FEP BENEFITS PAID TO
PROVIDER OF SERVICE
BENEFITS COORDINATED WITH MEDICARE
BECAUSE YOU ARE ENROLLED IN MEDICARE THE COMBINED PAYMENTS TOTALLY SATISFY
YOUR RESPONSIBILITY FOR THESE CHARGES.
$60.00
14.01
36.79
9.20
TOTAL OF COVERED CHARGES:
LESS MEDICARE PAYMENT:
AMOUNT OF BENEFITS:
DETAILED EXPLANATION OF SUMMARY
BENEFITS COORDINATED WITH MEDICARE
SERVICES RENDERED BY PREFERRED PROVIDER
PLACE AND TYPE FROM AND TO COINS. PROVIDER COVERED
OF SERVICE SERVICE DATES Y. CHARGES CHARGES
30 MEDICAL CARE 03/22 03/22/94 60.00 45.99
TOTALS: $60.00 $45.99
45.99
36.79
9.20
DENIED COD'
CHARGES
14.01 37
$14.01
PROVIDER
WALLICK
---------------------------------------------------------------------------------.
EXPLANATION OF CODES
320--BECAUSE OF THE PREFERRED PROVIDER AGREEMENT, THE PROVIDER HAS AGREED TO
REDUCE THE NORMAL CHARGE BY $14.01. YOU ARE NOT RESPONSIBLE FOR THIS
DIFFERENCE.
SEE A BELOW.
FOR MORE INFORMATION. PLEASE READ THE FOLLOWING SECTIONCS) OF YOUR SERVICE BENEFI
BROCHURE, WHICH IS THE OFFICIAL EXPLANATION OF YOUR COVERAGE.
A. ADDITIONAL BENEFITS
EXPLANATION OF PLACE OF SERVICE CODES:
30 PROVIDER'S OFFICE
27542
.~,
BlueCross
BlueShield
FEDERAL'
EMPLOYEE
PROGRAM
EXPLANATION
OF BENEFITS
BATCH 00022
DATES:
RECEIVED 04/04/94
PROCESSED 04/12/94
PAID 04/20/94
10 NUMBER
R02024129
SUBSCRIBER
JV BENDER
CLAIM NUMBER
64090090889
PATIENT NAME
JULIA BENDER
PENNSYLVANIA BLUE SHIELD
PO BOX 890037 CAMP HILL PA 17089-0037
IF YOU HAVE QUESTIONS ABOUT YOUR
CLAIM PLEASE CALL 1-717-763-3608
JULIA
2 WATER ST
BOX 416
NEWBURG
BENDER
PA
17240-0416
We ilre pteased 10 PfOVlde you Wllh a record DC you, .ecenl claim l,anucUons This
oollce describes benefit ~ymenls ilnd demals under your federal fmployee rUJgram
Cweflgt
Ple,se I IhlS notICe IOIInCOf1fl tax uses
THIS IS NOT A BILL
Any resubnusston ot tltglble elpenses musl be receIved no lalcrlhiln December 31
of the year 'olloWlng the date 01 5eMCe, Of lJO days horn Ihe dale of Ihe IOfm.
whichever 1$ later
Please contact us It hiVe an ufstlOns.
SUMMARY OF STANDARD OPTION BENEFITS ON
TOTAL CHARGES SUBMITTED:
LESS DENIED CHARGES:
LESS MEDICARE PAYMENT:
TOTAL AMOUNT OF FEP BENEFITS PAID TO
PROVIDER OF SERVICE
BENEFITS COORDINATED WITH MEDICARE
BECAUSE YOU ARE ENROLLED IN MEDICARE THE COMBINED PAYMENTS TOTALLY SATISFY
YOUR RESPONSIBILITY FOR THESE CHARGES.
THIS CLAIM
$250.00
113.04
109.57
27.39
TOTAL OF COVERED CHARGES:
LESS MEDICARE PAYMENT:
AMOUNT OF BENEFITS:
DETAILED EXPLANATION OF SUMMARY
BENEFITS COORDINATED WITH MEDICARE
SERVICES RENDERED BY PREFERRED PROVIDER
PLACE AND TYPE FROM AND TO COINS. PROVIDER COVERED
OF SERVICE SERVICE DATES ~ CHARGES CHARGES
30 CONSULTATION 02/08 0~/08/94 250.00 136.96
TOTALS: $250.00 $136.96
136.96
109.57
27.39
DENIED COD
CHARGES
113.04 32
$113.04
PROVIDER
WALLICK
---------------------------------------------------------------------------------
EXPLANATION OF CODES
320--BECAUSE OF THE PREFERRED PROVIDER AGREEMENT. THE PROVIDER HAS AGREED TO
REDUCE THE NORMAL CHARGE BY $113.04. YOU ARE NOT RESPONSIBLE FOR THIS
DIFFERENCE.
SEE A BElOW.
FOR MORE INFORMATION. PLEASE READ THE FOLLOWING SECTIoN(S) OF YOUR SERVICE BENEFI
BROCHURE. WHICH IS THE OFFICIAL EXPLANATION OF YOUR COVERAGE.
A. ADDITIONAL BENEFITS
EXPLANATION OF PLACE OF SERVICE CODES:
30 PROVIDER'S OFFICE
"'''BII ,
BlueCross
BlueShie1d
FEDERAL
EMPLOYEE
PROGRAM
EXPLANATION
OF BENEFITS
BATCH 00030
DATES:
RECEIVED 04/26/94
PROCESSED 04/29194
PAID 05/04/94
10 NUHBER
R02024129
SU BSCR IBER
JV BENDER
CLAIH NUHBER
64115091791
PATIENT NAHE
JULIA BENDER
PENNSYLVANIA BLUE SHIELD
PO BOX 890037 CAHP HILL PA 17089-0037
IF YOU HAVE QUESTIONS ABOUT YOUR
CLAIH PLEASE CALL 1-717-763-3608
JULIA
2 WATER ST
BOX 416
NEWBURG
BENDER
PA
17240-0416
THIS IS NOT A BILL
We are pleased to ptovlde you With a ,ecoid 01 yoUllccent claim transactions ThiS Any f6ubm.sslOf1 01 eligible erpenses must be receIVed no late' than December 31
notiCe describes benefit payments and deOl;lIs under YOUI fede,al [mpkJyee Program or the yeal followmg tile dale of leMCe, or 90 days 110m the dale allhe form.
cMrage Whichever IS laler
P~aslf. this nolleelOf mcolflf lalt ur ses Please tontac' uS It "we an ufSllOns,
SUMHARY OF STANDARD OPTION BENEFITS ON
TOTAL CHARGES SUBMITTED:
LESS DENIED CHARGES:
LESS HEDICARE PAYHENT:
TOTAL AHOUNT OF FEP BENEFITS PAID TO
PROVIDER OF SERVICE
BENEFITS COORDINATED WITH HEDICARE
BECAUSE YOU ARE ENROLLED IN HEDICARE THE COHBINED PAYHENTS TOTALLY SATISFY
YOUR RESPONSIBILITY FOR THESE CHARGES.
THIS CLAIH
$500.00
269.35
184.52
46.13
PROVIDER
DETAILED EXPLANATION OF SUHHARY
BENEFITS COORDINATED WITH HEDICARE
SERVICES RENDERED BY PREFERRED PROVIDER
PLACE AND TYPE FROH AND TO COINS. PROVIDER COVERED
OF SERVICE SERVICE DATES Y. CHARGES CHARGES
30 HEDICAL CARE 02/16 02/16/94 500.00 230.65
TOTALS: $500.00 $230.65
230.65
184.52
46.13
DEN I ED COOl
CHARGES
269.35321
$;'!69.5!j
REHABHED
TOTAL OF COVERED CHARGES:
LESS HEDICARE PAYHENT:
AHOUNT OF BENEFITS:
---------------------------------------------------------------------------------
EXPLANATION OF CODES
320--BECAUSE OF THE PREFERRED PROVIDER AGREEHENT. THE PROVIDER HAS AGREED TO
REDUCE THE NORMAL CHARGE BY $269.35. YOU ARE NOT RESPONSIBLE FOR THIS
DIFFERENCE.
SEE A BELOW.
FOR HORE INFORHATION. PLEASE READ THE FOLLOWING SECTION(S) OF YOUR SERVICE BENEFI"
BROCHURE, WHICH IS THE OFFICIAL EXPLANATION OF YOUR COVERAGE.
A. ADDITIONAL BENEFITS
EXPLANATION OF PLACE OF SERVICE CODES:
30 PROVIDER'S OFFICE
EXPLANATION
OF BENEFITS
BATCH 00003
DATES:
RECEIVED 08/02/93
PROCESSED 08/05/93
PAID 08/06/93
10 NUMBER
R02024129
SUBSCRIBER
JV BENDER
CLAIM NUMBER
93214036305
PATIENT NAME
JULIA BENDER
CHECK NUMBF.R 501~96?4
THIS IS NOT A BILL
599
86~"'i; 1A '01
."~', ~
.~ l!I
BlueCross
BlueShield
FEDERAL
EMPLOYEE
PROGRAM
We ale pleased 10 plovlde you wllh a Iceoll' or your leeent claim transactio", ThiS
notice descllbes benehl paymenls and denials under your Fedelal Employee Plogram
coverage
Please kef:' thIS noll(f~ (01 mcome lax uses
Any ltsubmiulon 01 eligible e.pens~ must be ,ctoNed no latollhan December 31
ollhe yeallollowmg Ihe dale 01 leNlee, Of 90 days flam the dale 01 the 101m.
Whichever IS lalel
Please conlac' us ,t ollllJVf an uestions
THIS CLAIM
$390.00
137.20
202.24
50.56
SUMMARY OF STANDARD OPTION BENEFITS ON
TOTAL CHARGES SUBMITTED:
LESS OTHER CHARGES:
LESS MEDICARE PAYMENT:
TOTAL AMOUNT OF FEP BENEFITS ON THIS CLAIM
BENEFITS COORDINATED WITH MEDICARE
BENEFIT CHECK ENCLOSED
$50.56 PLUS ANY MEDICARE PAYMENT YOU HAVE RECEIVED FOR THIS CLAIM WILL
SATISFY YOUR RESPONSIBILITY FOR THESE CHARGES.
COVERED
C:1ARGES
126.40
126.40
OTHER
CHARGES
68.60
68.60
COOl
PENNSYLVANIA BLUE SHIELD
PO BOX 890037 CAMP HILL PA 17089-0037
IF YOU HAVE QUESTIONS ABOUT YOUR
CLAIM PLEASE CALL 1-717-763-3608
JV BENDER
2 WATER ST
BOX 416
NEWBURG
PA
17240-0416
36
36
$252.80
252.80
202.24
50.56
$137.20
PRDVIDER
DETAILED EXPLANATION OF SUMMARY
BENEFITS COORDINATED WITH MEDICARE
PLACE AND TYPE FROM AND TO COINS. PRDVIDER
OF SERVICE SERVICE DATES ~ CHARGES
DURABLE MED 05/07 06/06/93 195.00
EQUIP PURCHASE
DURABLE MED 06/07 07/06/93 195.00
EQUIP PURCHASE
---------------------------------------------------------------------------------.
LANDMARK 40
LANDMARK 40
TOTALS:
$390.00
TOTAL OF COVERED CHARGES:
LESS MEDICARE PAYMENT:
AMOUNT OF BENEFITS:
FOR YOUR INFORMATION
BECAUSE THE PATIENT IS ENROLLED IN MEDICARE, WHICH IS PRIMARY, HE OR SHE IS
RECEIVING EITHER 100 PERCENT OF THE USUAL. CUSTOMARY AND REASONABLE CHARGE II
THIS IS A PROFESSIONAL SERVICE OR 100 PERCENT OF THE INSTITUTIONAL CHARGE FOi
COVERED SERVICES ON THIS CLAIM AFTER MEDICARE'S PAYMENT.
SEE A BELOW.
THIS PAYMENT IS BEING HADE TO YOU BECAUSE THE PROVIDER IS NOT A PARTICIPATINI
DOCTOR. THE DIFFERENCE BETWEEN THE DOCTORS CHARGE AND THE BLUE SHIELD
ALLOWANCE IS YOUR RESPONSIBILITY.
(CONTINUED)
EXPLANATION
OF BENEFITS
BATCH 00003
DATESI
RECEIVED 07/27/93
PROCESSED 07/30/93
PAID 08/03/93
ID NUMBER
R02024129
SUBSCRIBER
JV BENDER
CLAIM NUMBER
63207090638
PATIENT NAME
JULIA BENDER
CHECK NUMBER 50186476
THIS IS NOT A BILL
687
'iI~
BlueCross
BlueShield
FEDERAL
EMPLOYEE
PROGRAM
PENNSYLVANIA BLUE SHIELD
PO BOX 890037 CAMP HILL PA 17089-0037
IF YOU HAVE QUESTIONS ABOUT YOUR
CLAIM PLEASE CALL 1-717-763-3608
JV BENDER
2 WATER ST
BOX 416
NEWBURG
PA
17240-0416
We ale plentd 10 provide you mth I ,eCOid 01 your recent clllm transactions This
nollCe describes bencht payments and denials under your federal Employee Program
coverage
P'tas~ te thIS notICe fOf Income lfllt u StS
Any Icsubmlssion 01 eligible e.penscs musl be received no later than December 3'
01 the yea' 'allOWlng the d.Jte of servICe. or 90 days from the date of tho 'Ofm.
whichever's laler
Please contact us d ou haw an ucsllOns
CLAIM
$85.00
39.79
36.17
9.04
SUMMARY OF STANDARD OPTION BENEFITS ON THIS
TOTAL CHARGES SUBMITTED I
LESS OTHER CHARGES I
LESS MEDICARE PAYMENT I
TOTAL AMOUNT OF FEP BENEFITS ON THIS CLAIM
BENEFITS COORDINATED WITH MEDICARE
BENEFIT CHECK ENCLOSED
$9.04 PLUS ANY MEDICARE PAYMENT YOU HAVE RECEIVED FOR THIS CLAIM WILL
SATISFY YOUR RESPONSIBILITY FOR THESE CHARGES.
DETAILED EXPLANATION OF SUMMARY
BENEFITS COORDINATED WITH MEDICARE
PROVIDER PLACE AND TYPE FROM AND TO COINS. PROVIDER
OF SERVICE SERVICE DATES ~ CHARGES
CUMBERLA 90 AMBULANCE 02/10 02/10/93 85.00
TOTALSI $85.00
TOTAL OF COVERED CHARGES:
LESS MEDICARE PAYMENT:
AMOUNT OF BENEFITS:
COVERED
CHARGES
45.21
$45.21
45.21
36.17
9.04
OTHER
CHARGES
39.79
$39.79
36
---------------------------------------------------------------------------------
FOR YOUR INFORMATION
BECAUSE THE PATIENT IS ENROLLED IN MEDICARE, WHICH IS PRIMARY, HE OR SHE IS
RECEIVING EITHER 100 PERCENT OF THE USUAL, CUSTOMARY AND REASONABLE CHARGE I
THIS IS A PROFESSIONAL SERVICE OR 100 PERCENT OF THE INSTITUTIONAL CHARGE FO
COVERED SERVICES ON THIS CLAIM AFTER MEDICARE'S PAYMENT.
SEE A BELOW.
THIS PAYMENT IS BEING MADE TO YOU BECAUSE THE PROVIDER IS NOT A PARTICIPATI~
DOCTOR. THE DIFFERENCE BETWEEN THE DOCTORS CHARGE AND THE BLUE SHIELD
ALLOWANCE IS YOUR RESPONSIBILITY.
EXPLANATION OF CODES
367 SINCE YOUR HEALTH CARE PROVIDER AGREED TO ACCEPT ASSIGNMENT OF MEDICARE
BENEFITS. YOUR COVERAGE CANNOT PAY FOR THE DIFFERENCE BETWEEN THE
(CONTINUED)
..
, .
----------------------------,
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THRIFTI
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WAITING ~WILL CALL_
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SHW:'L; !':.:;U~\;; COMMONS S,C.
300 SO\i; H f ",,[lIT STREET
SHIPPEN5BlIRG PA I 7'}~ 7
DATE RECEIVED
PATIENT
(3F/1/iX:/!' "Nt/In
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Generic Drugs can save you up to 50%
TRUST Ask your doctor to prescribe the generic
~ equivalent to your medicetlon. Generic
drugs can save you money because
they cost less than name brand drugs.
@ Another Rxtra service from
the Rxperts
PHONE
[] 3.d PARTY CARO I SAFETY CAP
[] CARO OK [] YES [] NO
[] 0
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OlY.
Dr.
Drug
(PRICE
RXl7<ib4011727 u[iCM .)0.(,:'".;..:"')' ,r, 0-
No.. FCoR:..U.1A {lENDER [",l[:',:.:i,'" -
f'ROf'OIYFHENE tlAF";\' W/APHF :o(lii;,r",M>..
OIY. DR. f{INE Q1Y::'5 rWl: .'" " .
F ' l(i. b3 SAVE[I BY SELECTlIlC. (,ENER II.
or
- YOUR t1iAlnffREASURY DRUG RECEipt
For
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Drug
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-: . Comp"'e MmI I endJot 2 for ....... ......
, I' Comp'''' Itema 3. Iftd 4. . b.
\ . Print vour ,...". and ...... on the rtvtrH of tNe tonn 10 ttwt WI can
r.turn 1tu, card 10 you.
. . Anech t,"- 'arm to the front of thI meIIp6ea, or on the beck tf apece
dtH. not JMtmn.
:.J . Will.' 'R.h,," Receipt ...........' on the meIIp6ece below IhIIf1k:II numbtf
'e' The "1'IMn Rec.tpt WIIlhow to wwhom the.......1I dIIwwed Ind the dItt
J 0 ctehlred.
: 1 3. Arllele Add".ood 10:
: Dr. Honroe Schneier :.- .
I Dorothy Schneier
, 102 West Hain Street
,
1 Newburg, PA 17240 .
I
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loIlowlng lime.. 1I0r .n 'Xl"
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VS.
. IN THE COURT OF COMMON PLEAS
.
. OF CUMBERLAND COUNTY
.
: PENNSYLVANIA
:
. CIVIL ACTION - LAW
.
.
.
. NO. 1995-681
.
.
.
. LEGAL ACTION
.
.
.
.
.
JULIA V. BENDER,
Plaintiff
THE MAYOR AND TOWN COUNCIL
OF THE BOROUGH OF NEWBURG,
MONROE SCHNEIER, D.C. and
DOROTHY SCHNEIER, his wife,
and DEPARTMENT OF
TRANSPORTATION OF THE
COMMONWEALTH OF
PENNSYLVANIA,
Defendants
.
.
.
.
PRAECIPB
TO THE PROTHONOTARY:
Please enter our appearance as attorneys for defendants
Monroe Schneier, D.C. and Dorothy Schneier.
To LAWRENCE E. WELKER, Prothonotary
Date: /::p/py.s; I ??.s-
,
LANDIS, BLACK & SCHORPP
By: ~~/-
Edward L. S h rpp, Esq.
Attorney for Defendants
36 South Hanover Street
carlisle, PA 17013
(717) 243-3727
.....
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
Julia V. Bender, : Civil Action. Law
Plaintiff
.
v. : No. 1995- 681 Civil Law
The Mayor and Town Council of the Borough
of Newburg, Monroe Schneier, D.C. and
Dorothy Schneier, his wife and
Department of Transportation of the
Commonwealth of Pennsylvania
Defendants Legal Action
AFFIDAVIT OF SERVICE
COMMONWEALTH OF PENNSYLVANIA:
SS
COUNTY OF FRANKLIN
David C. Cleaver, Esquire being duly sworn according to the law, deposes and
says that he sent a true and correct copy of a Complaint and Notice by regular First.
class mail, postage prepaid on May 8, 1995, from the law office of David C. Cleaver &
Assoc., 1035 Wayne Ave., Chambersburg, PA 17201 to Daniel R. Goodemote, Senior
Deputy Attorney General, Torts Litigation Unit, Office of Attorney General, 15th Floor,
Strawberry Square, Harrisburg, PA 17120.
Sworn and subscribed to before
me this )fI',- day of JI'I~(.J 1995,
k2 J
~' /'), 01j, aA rl
Not ry Public '
No;.,,".,J Sool
.loA. Rc'dlOId, ~"'Y PUlIIo
Ct\.~r!'bJ:ti -,,;'I';>, Fr~1Jl~.n CCM.1f"IIY
M;; CorT\I'nC.S~11 i:r~"t:s;.p1l12. It.~7
JULIA V. BENDER,
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
v.
CIVIL ACTION - LAW
f'
THE MAYOR & TOWN COUNCIL OF THE
BOROUGH OF NEWBURG, DR. MONROE
SCHNEIER & DOROTHY SCHNEIER and
DEPARTMENT OF TRANSPORTATION OF
THE COMMONWEALTH OF
PENNSYLVANIA,
I
Defendants
NO. 95-681 CIVIL TERM
NOTICE TO PLEAD
TO ALL PARTIES:
YOU ARE HEREBY REQUIRED to respond to the within New Matter
within twenty (20) days of the date of service hereof or a default
judgment may be entered against you.
Respectfully submitted,
ERNEST D. PREATE, JR.
ATTORNEY GENERAL
By: A,.;Qf)/)rAi2D
~el k~~emote ID#30986
Senior Deputy Attorney General
Torts Litigation Section
15th Floor, Strawberry Square
Harrisburg, PA 17120
717-783-1683
DATED: June 13, 1995
JULIA V. BENDER,
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
v.
CIVIL ACTION - LAW
THE MAYOR & TOWN COUNCIL OF THE
BOROUGH OF NEWBURG, DR. MONROE
SCHNEIER & DOROTHY SCHNEIER and
DEPARTMENT OF TRANSPORTATION OF
THE COMMONWEALTH OF
PENNSYLVANIA,
Defendants
NO. 95-681 CIVIL TERM
ANSWER AND NEW MATTER FILED ON BEHALF OF
DEFENDANT COMMONWEALTH OF PENNSYLVANIA.
DEPARTMENT OF TRANSPORTATION TO PLAINTIFF'S COMPLAINT
Defendant, Commonwealth of Pennsylvania, Department of
Transportation (npennDOTn), by and through the Office of Attorney
General, files the following Answer to Plaintiff's Complaint:
1.
Denied.
After reasonable investigation, PennDOT is
without sufficient knowledge or information to form a belief as to
the truth of these averments.
2 (A). Denied. After reasonable investigation, PennDOT is
without sufficient knowledge or information to form a belief as to
the truth of these averments.
(B). Denied. After reasonable investigation, PennDOT is
without sufficient knowledge or information to form a belief as to
the truth of these averments.
(C). Admitted.
3.
Denied.
After reasonable investigation, PennDOT is
without sufficient knowledge or information to form a belief as to
the truth of these averments.
4. Denied. After reasonable investigation, PennDOT is
without sufficient knowledge or information to form a belief as to
the truth of these averments.
5. Denied. After reasonable investigation, PennDOT is
without sufficient knowledge or information to form a belief as to
the truth of these averments.
6. Denied. After reasonable investigation, PennDOT is
without sufficient knowledge or information to form a belief as to
the truth of these averments.
7. Denied. After reasonable investigation, PennDOT is
without sufficient knowledge or information to form a belief as to
the truth of these averments.
8. Denied. After reasonable investigation, PennDOT is
without sufficient knowledge or information to form a belief as to
the truth of these averments.
9. Denied. After reasonable investigation, PennDOT is
without sufficient knowledge or information to form a belief as to
the truth of these averments.
COUNT I
10-16. The averments of these paragraphs are directed to
other parties, and, accordingly, no response is required.
COUNT U
17-24. The averments of these paragraphs are directed to
other parties, and, accordingly, no response is required.
COUNT UI
25. Requires no answer.
2
26. Admitted that the sidewalk is within the right-of-way of
S. R. 696. After reasonable investigation, PennDOT is without
sufficient knowledge or information to form a belief as to the
truth of whether Plaintiff fell and whether the defects alleged in
the sidewalk existed and caused Plaintiff to fall.
27. Admitted that the sidewalk is within the fifty (SO) foot
right-of-way for S .R. 696. It is denied that the sidewalk was
within the exclusive care and control of PennDOT. To the contrary,
PennDOT has no duty to maintain outside the curb lines of a state
highway within a borough.
28. Admitted that the sidewalk is within right-of-way of
State Route 696. It is denied that PennDOT owed a duty to the
Plaintiff to ensure the sidewalk was fit for pedestrians to travel
upon without risk of injury. To the contrary, PennDOT has no duty
to maintain a state highway within a borough outside the curb
lines.
29. Denied. PennDOT did not negligently act or fail to act.
It is denied that Plaintiff's alleged fall was caused as a direct
and proximate result of PennDOT's negligent actions, which are
alleged as follows:
A. Admitted only that PennDOT did not remove a tree root
in the area. After reasonable investigation, PennDOT is without
sufficient knowledge or information to form a belief as to the
truth of the remaining averments. By way of further response I
PennDOT avers that it has no duty to maintain the sidewalk, trees
or any other condition outside the curb lines of State Route 696
3
within the Borough of Newburg.
B. Admitted only that PennDOT did not remove or replace
a broken concrete slab. After reasonable investigation, PennDOT is
without sufficient knowledge or information to form a belief as to
the truth of the remaining averments. By way of further answer,
PennDOT has no duty to maintain a state highway outside the curb
lines within a borough.
C. Admitted only that PennDOT did not reset a new
concrete slab or modify the existing slab. After reasonable
investigation, PennDOT is without sufficient knowledge or
information to form a belief as to the truth of the remaining
averments. By way of further answer, PennDOT has no duty to
maintain a state highway beyond the curb lines within a borough.
D. Admitted only that PennDOT did not erect signs or
warnings outside the curb lines. After reasonable investigation,
PennDOT is without sufficient knowledge or information to form a
belief as to the remaining averments. By way of further answer,
PennDOT has no duty to maintain a state highway beyond the curb
lines within a borough, nor does PennDOT have a duty to warn or to
erect signs.
E. Admitted only that PennDOT did not maintain, fix and
repair the sidewalk. It is specifically denied that PennDOT had a
duty to maintain, fix or repair the sidewalk. After reasonable
investigation, PennDOT is without sufficient knowledge or
information to form a belief as to the remaining averments. The
word "inspect" has been stricken from Paragraph 29E by stipulation.
4
30. It iB denied that PennDOT negligently acted or failed to
act as alleged. It iB denied that Plaintiff's injurieB, if they
occurred, were a reBult of any negligence by PennDOT.
31. It iB Bpecifically denied that PennDOT waB negligent in
any manner whatBoever. After reaBonable inveBtigation, PennDOT iB
without Bufficient knowledge or information to form a belief as to
whether Plaintiff haB Buffered great mental and phYBical pain and
Buffering.
32. It iB Bpecifically denied that PennDOT'B actB or
omiBBions cauBed the Plaintiff' B injurieB. After reasonable
inveBtigation, PennDOT iB without Bufficient knowledge or
information to form a belief aB to the caUBe of the accident or the
Plaintiff'B injurieB.
WHEREFORE, PennDOT reBpectfully requeBtB that judgment be
entered in itB favor and againBt all other partieB.
NEW MATTER
33. The pre Bent action iB controlled by the provisionB of 1
Pa. C.S. !i2310 and Act No. 1980-142, Bet forth in 42 Pa. C.S.
S!i8501, et Beq., which ActB are incorporated herein and pled by
reference. PennDOT aBBertB all the defenBeB contained therein.
34. PennDOT did not have notice, written or otherwiBe, of the
allegedly dangerouB condition, or in the alternative, if Baid
notice waB received, it waB not received in Bufficient time prior
to the alleged accident for PennDOT to have corrected or to have
warned the traveling public of the allegedly dangerous condition.
35. There iB no cause of action baBed upon a failure to
5
inspect or improper inspection in that sovereign immunity has not
been waived for such claims.
36. PennDOT is immune from suit pursuant to 1 Pa. C.S. 52310,
and this action is not within any of the exceptions to immunity as
set forth in 42 Pa. C.S. 58522, and therefore this action is
barred.
37. The location of the alleged accident is not under the
jurisdiction or control of PennDOT, and as such, PennDOT is not
responsible for said sidewalk.
38. The sidewalk was owned, possessed or controlled by the
Defendant municipality and/or private property owner who had the
duty to keep and maintain the sidewalk in a reasonably safe
condition.
39. In a borough, PennDOT has no duty to maintain beyond curb
lines.
40. Should liability be found on the part of PennDOT, the
amounts and types of damages recoverable in the present action are
limited and controlled by 42 Pa. C.S. 58528.
41. The Judicial code at 42 Pa. C.S. 55522(a), which section
is incorporated herein and pled by reference, provides that the
Commonwealth and the Attorney General must have received written
notice of intent to sue within six (6) months from the date the
cause of action accrues. In the absence of such notice, this
action is barred.
42. PennDOT may not be held responsible for injuries incurred
by third parties which were allegedly caused by the acts of
6
another.
43. Plaintiff waB contributorily negligent in that Bhe failed
to obBerve the condition of the Bidewalk which waB open and obviouB
to any pedeBtrian exerciBing reaBonable care.
44. Plaintiff knowingly and conBciouBly aBBumed the riBk
leading to hiB injurieB in accordance with that Bet forth above,
and iB therefore barred from recovery.
45. PennDOT haB no duty to warn.
46. PennDOT haB no duty to erect BignB. The authority to
erect signB iB discretionary under 75 Pa.C.S. 6122(a).
RULE 2252(d) NEW MATTER DIRECTED TO DEPENDANTS
THE MAYOR AND TOWN COUNCIL OP THE BOROUGH OF NEWBURG
AND MONROE SCHNEIER. D.C. AND DOROTHY SCHNEIER. HIS WIPE
47. The factual avermentB of the Plaintiff'B Complaint are
incorporated herein by reference aB if fully set forth at length
without admiBBion or adoption.
48. Liability on the part of PennDOT iB Bpecifically denied.
49. If the avermentB contained in the Plaintiff's Complaint
are eBtabliBhed, said avermentB being Bpecifically denied, as they
may relate to PennDOT, then the injurieB and damageB complained of
were cauBed Bolely by the DefendantB, the Mayor and Town Council of
the Borough of Newburg, Monroe Schneier, D.C. and Dorothy Schneier,
hiB wife.
SO. DefendantB, the Mayor and Town Council of the Borough of
Newburg, Monroe Schneier, D.C. and Dorothy Schneier, hiB wife, have
been joined herein to protect PennDOT' B right of indemnity and
contribution, and PennDOT averB that the above-Baid Defendants are
7
alone liable to the Plaintiff, or in the alternative, that the
above-said Defendants are liable over to PennDOT, or jointly and
severally liable on the Plaintiff's causes of action.
WHEREFORE, PennDOT respectfully requests that judgment be
entered in its favor and against all other parties.
Respectfully submitted,
ERNEST D. PREATE, JR.
ATTORNEY GENERAL
By:
~~(~)
-eaniel R. oodemote ID#30986
Senior Deputy Attorney General
Torts Litigation Section
15th Floor, Strawberry Square
Harrisburg, PA 17120
717-783-1683
DATED: June 13, 1995
8
vs.
: IN THE COURT OF COMMON PLEAS
: OF CUMBERLAND COUNTY
PENNSYLVANIA
: CIVIL ACTION - LAW
JULIA V. BENDER,
Plaintiff
THE MAYOR AND TOWN COUNCIL
OF THE BOROUGH OF NEWBURG, NO. 1995-681
MONROE SCHNEIER, D.C. and
DOLORES SCHNEIER, his wife, LEGAL ACTION
and DEPARTMENT OF
TRANSPORTATION OF THE
COMMONWEALTH OF
PENNSYLVANIA,
Defendants
REPLY OF DEFENDANTS SCHNEIER TO NEW MATTER OF
COMMONWEALTH OF PENNSYLVANIA
AND NOW COMES the defendants, Dr. Monroe Schneier and
Dolores SChneier, by and through their attorneys, Landis, Black &
Schorpp, who reply to the New Matter of defendant, Commonwealth
of Pennsylvania.
33. Denied. These averments are conclusions of law
requiring no answer herein.
34. Denied. After reasonable investigation, defendants are
without knowledge sufficient to form a belief as to the truth of
these averments.
35.-37.
Denied. These averments are conclusions of law
requiring no answer herein.
38. Denied. It is denied that the subject property was
owned, possessed or controlled by defendants Schneier. The
remaining averments of this paragraph are conclusions of law
requiring no answer herein.
39.-42.
Denied. These averments are conclusions of law
herein are made subject to the penalties of 18 pa.C.S.A. S4904,
relating to unsworn falsification to authorities.
72 .J;t~~EL. \
Dr. Monroe schneier
VERIFICATION
I verify that the answers and statements contained
herein are true and correct. I understand that false statements
~~..
~ A#t!. <L
: Sc neier L
-l>OL tW.E5
Dated:~htL-/h" If ~~-
JULIA V. BENDER,
Plaintiff
. IN THE COURT OF COMMON PLEAS
.
. OF CUMBERLAND COUNTY
.
. PENNSYLVANIA
.
.
.
CIVIL ACTION - LAW
. NO. 1995-681
.
:
. LEGAL ACTION
.
vs.
THE MAYOR AND TOWN COUNCIL
OF THE BOROUGH OF NEWBURG,
MONROE SCHNEIER, D.C. and
DOLORES SCHNEIER, his wife,
and DEPARTMENT OF
TRANSPORTATION OF THE
COMMONWEALTH OF
PENNSYLVANIA,
Defendants
.
.
.
.
CERTIFICATE OF SERVICE
I hereby certify that I am this day serving the foregoing
document upon the person(s) and in the manner indicated below:
FIRST CLASS MAIL. POSTAGE PREPAID. ADDRESSED AS FOLLOWS:
David C. Cleaver, Esq.
David C. Cleaver & Associates, P.C.
1035 wayne Avenue
Chambersburg, PA 17201
Harvey Freedenberg, Esq.
McNees, Wallace & Nurick
100 pine Street
P.O. Box 1166
Harrisburg, PA 17108-1166
Daniel R. Goodemote, Esq.
Senior Deputy Attorney General
Torts Litigation Section
15th Floor, strawberry square
Harrisburg, PA 17120
BY:~~~
Edward L. Schorpp, Esq.
LANDIS, BLACK & SCHORPP
36 South Hanover Street
Carlisle, PA 17013
(717) 243-3727
Date: ~~ ~ /77..s-"
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JULIA V. BENDER, . IN THE COURT OF COMMON PLEAS
.
Plaintiff . OF CUMBERLAND COUNTY
.
PENNSYLVANIA
vs. .
.
. CIVIL ACTION - LAW
.
THE MAYOR AND TOWN COUNCIL .
.
OF THE BOROUGH OF NEWBURG, NO. 1995-681
MONROE SCHNEIER, D.C. and .
.
DOLORES SCHNEIER, his wife, LEGAL ACTION
and DEPARTMENT OF .
.
TRANSPORTATION OF THE
COMMONWEALTH OF
PENNSYLVANIA, .
.
Defendants
NOTICE TO PLEAD
TO: Plaintiff JUlia V. Bender and Defendants the Mayor and Town
Council of the Borough of Newburg and Department of
Transportation of the Commonwealth of Pennsylvania, and
their respective counsel.
YOU ARE HEREBY NOTIFIED TO PLEAD TO THE ENCLOSED
NEW MATTER
WITHIN TWENTY (20) DAYS FROM SERVICE HEREOF, OR A
DEFAULT JUDGMENT MAY BE ENTERED AGAINST YOU.
LANDIS, BLACK & SCHORPP
Date:
6 - ~;;-9's
BY~~~~~
Edward L. Schor p, Esq.
36 South Hanover Street
CarliSle, PA 17013
(717) 243-3727
JULIA V. BENDER, . IN THE COURT OF COMMON PLEAS
.
plaintiff . OF CUMBERLAND COUNTY
.
PENNSYLVANIA
vs. .
.
. CIVIL ACTION - LAW
.
THE MAYOR AND TOWN COUNCIL .
.
OF THE BOROUGH OF NEWBURG, NO. 1995-681
MONROE SCHNEIER, D.C. and
DOLORES SCHNEIER, his wife, LEGAL ACTION
and DEPARTMENT OF
TRANSPORTATION OF THE
COMMONWEALTH OF .
.
PENNSYLVANIA,
Defendants .
.
ANSWER WITH NEW MATTER
NOW, COMES the defendants Monroe Schneier, D.C. and Dolores
Schneier, husband and wife, by and through their attorneys,
Landis, Black & Schorpp, who answer the complaint of plaintiffs
as follows:
1. Admitted.
2. Admitted in part and denied in part. It is admitted
that defendant wife, whose correct name is Dolores Schneier,
resides at 102 West Main Street, Newburg, Cumberland County,
Pennsylvania; it is denied that Monroe Schneier is or should be a
defendant in this action. After reasonable investigation
defendants are without knowledge or information sufficient to
form a belief as to the truth of the remaining averments of this
paragraph and the same are therefore denied.
3.-4.
The averments of these paragraphs are denied
pursuant to Pa.R.C.P. 1029(e)(1).
5. Denied. Defendant Monroe Schneier, D.C., is not an
owner of any premises in the vicinity of the area alleged by
plaintiff. As he does not own the premises, he should not be a
party to this action. It is specifically denied that defendant
Dolores Schneier is the owner of the land upon which the subject
concrete sidewalk exists. Defendants believe, and therefore
aver, that the concrete sidewalk is owned by others. The
remaining averments of the paragraph are denied pursuant to
Pa.R.C.P. 1029(e) (1).
6.-9. The averments of these paragraphs are denied
pursuant to Pa.R.C.P. 1029(e)(1).
COUNT I
BENDER vs. DEFENDANTS SCHNEIER
10. Defendants incorporate by reference their answers to
paragraphs 1. through 9. of this Answer as more fully set forth
herein.
11. Denied. Defendant Monroe Schneier, D.C., is not an
owner of premises located at 102 West Main Street, Newburg,
Cumberland County, Pennsylvania. Defendant Dolores Schneier does
own the premises at 102 West Main street, Newburg, Cumberland
County, Pennsylvania; however, she believes, and therefore avers,
that the subject sidewalk is outside the boundaries of defendant
Dolores Schneier's premises.
12. Denied. The averments of paragraph 11. of this answer
are incorporated herein by reference. The remaining averments of
this paragraph are denied pursuant to Pa.R.C.P. 1029(e) (1).
Further, this averment contains conclusions of law which require
no answer herein.
13.-16.
Denied. This averments are conclusions of law
which require no answer herein. Additionally, the averments of
these paragraphs are denied pursuant to Pa.R.C.P. 1029(e)(1).
WHEREFORE, defendants Schneier respectfully request that
plaintiff's complaint be dismissed.
COUNT II
BENDER VB. NEWBURG
17.-24.
These averments are not applicable to answering
defendants.
25.-32.
COUNT III
BENDER VB. COMMONWEALTH
These averments are not applicable to answering
defendants.
NEW MATTER
33. Defendant Monroe Schneier, D.C., does not own, possess
or control the premises and sidewalk in question and should not
be a party to this action.
34. Defendants believe, and therefore aver, that the
sidewalk upon which plaintiff allegedly fell is not located on
land owned, possessed or controlled by defendant Dolores
Schneier.
35. Defendants believe, and therefore aver, that plaintiff
walked this sidewalk on a frequent basis, was very familiar with
the sidewalk conditions there and then existing on or about
February 10, 1993, and had knowledge, prior to the accident, of
the specific conditions upon which she claims caused her to fall.
36. Plaintiff's complaint fails to state a cause of action
and/or claims upon which relief can be granted against additional
defendant.
37. Plaintiff's claims are barred by the applicable statute
of limitations and/or by the substantive law of the Commonwealth
of Pennsylvania.
38. Plaintiff failed to mitigate her damages, injuries or
losses as alleged in her complaint.
39. Answering defendants give notice that they intend to
rely upon such other and further affirmative defenses which may
become available or apparent during discovery proceedings, or
during the course of trial of this action and hereby reserve the
right to assert any such affirmative defenses, as well as any of
the affirmative and new matter defenses which may have been or
which may be asserted by any other party to this action, which
are incorporated herein by reference as though set forth fully
herein at length.
NEW MATTER
CROSS CLAIM OF DEFENDANTS SCHNEIER
AGAINST THE MAYOR AND TOWN COUNCIL
OF THE BOROUGH OF NEWBURG (BOROUGH OF NEWBURG)
PURSUANT TO Pa.R.C.P. 1052(41
40. In the event the allegations of plaintiff's complaint
are proven true and correct at the time of trial (said
allegations being incorporated herein by reference only for the
purpose of this cross claim, but which have heretofore been
specifically denied) then, and in that event, the injuries,
losses and/or damages alleged therein were caused in whole or in
Ii
,
,
l
I'
41. The averments of paragraphs 1.-9. and 17.-24. of
plaintiff's complaint are incorporated herein for the purpose of
this cross claim (but which have heretofore been specifically
denied by answering defendants).
42. As a result of the actions or inactions on the part of
the Mayor and Town Council of the Borough of Newburg and their
agents, servants and employees, and as further specifically
identified during the course of trial, defendants Mayor and Town
Council of the Borough of Newburg and the Borough of Newburg are
solely and alone liable to the plaintiff, and/or jointly and
severally liable with or liable over to answering defendants
herein for contribution and/or indemnification, in the event that
liability which has heretofore been specifically denied is also
found against answering defendants.
WHEREFORE, defendants Monroe Schneier and Dolores Schneier
hereby respectfully request This Honorable Court to find
defendants Mayor and Town Council of the Borough of Newburg and
the Borough of Newburg, its servants, agents and employees,
solely and alone liable to the plaintiff, jointly and/or
severally liable with or liable over to answering defendants
part by the negligence, carelessness and/or recklessness or
defendants Mayor and Town Council of the Borough of Newburg, and
their agents, servants and employees, acting individually and/or
jointly or others over whom answering defendants had no legal
responsibility or control, thus, answering defendants herein
cannot be held liable.
herein for contribution and/or indemnification, including
reasonable attorneys fees, costs and expenses with regard to the
matters proven at trial.
NEW MATTBR
CROSS CLAIM OP DBPBNDANTS SCHNEIBR
AGAINST DBPARTMENT OP TRANSPORTATION
OP THB COMMONWEALTH OP PBNNSYLVANIA
PURSUANT TO Pa.R.C.P. 1052(4)
43. In the event the allegations of plaintiff's complaint
are proven true and correct at the time of trial (said
allegations being incorporated herein by reference only for the
purpose of this cross claim, but which have heretofore been
specifically denied) then, and in that event, the injuries,
losses and/or damages alleged therein were caused in whole or in
part by the negligence, carelessness and/or recklessness of
defendant Department of Transportation of the Commonwealth of
Pennsylvania, its agents, servants and employees, acting
individually and/or jointly or others over whom answering
defendants had no legal responsibility or control, thus,
answering defendants herein cannot be held liable.
44. The averments of paragraphs 1.-9. and 25.-32. of
plaintiff's complaint are incorporated herein for the purpose of
this cross claim (but which have heretofore been specifically
denied by answering defendants).
45. As a result of the actions or inactions on the part of
the Department of Transportation of the Commonwealth of
pennsylvania, its agents, servants and employees, and as further
specifically identified during the course of trial, defendant
Department of Transportation of the Commonwealth of Pennsylvania
is solely and alone liable to the plaintiff, and/or jointly and
severally liable with or liable over to answering defendants
herein for contribution and/or indemnification, in the event that
liability which has heretofore been specifically denied is also
found against answering defendants.
WHEREFORE, defendants Monroe Schneier and Dolores Schneier
hereby respectfully request This Honorable Court to find
defendant Department of Transportation of the Commonwealth of
Pennsylvania, its servants, agents and employees, solely and
alone liable to the plaintiff, jointly and/or severally liable
with or liable over to answering defendants herein for
contribution and/or indemnification, including reasonable
attorneys fees, costs and expenses with regard to the matters
proven at trial.
WHEREFORE, defendants demand that plaintiff's complaint be
dismissed.
Respectfully submitted,
LANDIS, BLACK & SCHORPP
~~~
36 South Hanover street
Carlisle, Pennsylvania 17013
(717) 243-3727
VERIPICATION BASED UPON PERSON KNOWLEDGE
AND INFORMATION SUPPLIED BY COUNSEL
We verify that we are the Defendant(s) in the foregoing
action, and that the attached Answer with New Matter is based
upon the information which has been gathered by my counsel in
preparation of the defense of this lawsuit. The language of the
Answer with New Matter is that of counsel and not ours. We have
read the Answer with New Matter and, to the extent that it is
based upon information which we have given to our counsel, it is
true and correct to the best of our knowledge, information, and
belief. To the extent that the contents of the Answer with New
Matter is that of counsel, we have relied upon counsel in making
this Verification.
We understand that intentional false statements herein are
made subject to the penalties of 18 Pa, C.S.A. ~ 4904 relating to
unsworn falsifications to authorities.
/1 "1 '/
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Mo roe Schneier, D.C.
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Dolores Schne1er
Dated:
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JULIA V. BENDER,
Plaintiff
IN THE COURT OF COMMON PLEAS
: OF CUMBERLAND COUNTY
: PENNSYLVANIA
vs.
.
.
THE MAYOR AND TOWN COUNCIL
OF THE BOROUGH OF NEWBURG,
MONROE SCHNEIER, D.C. and
DOLORES SCHNEIER, his wife,
and DEPARTMENT OF
TRANSPORTATION OF THE
COMMONWEALTH OF
PENNSYLVANIA,
Defendants
: CIVIL ACTION - LAW
.
.
NO. 1995-681
LEGAL ACTION
.
.
CERTIFICATE OF SERVICE
I, EDWARD L. SCHORPP, ESQUIRE, hereby certify that I have,
on the below date, caused a true and correct copy of the
foregoing Answer with New Matter to be served upon the person and
in the manner indicated below:
FIRST CLASS MAIL. POSTAGE PREPAID. ADDRESSED AS FOLLOWS:
David C. Cleaver, Esq.
1035 Wayne Avenue
Chambersburg, PA 17201
Harvey Freedenberg, Esq.
McNees, Wallace & Nurick
100 Pine Street
P.O. Box 1166
Harrisburg, PA 17108-1166
Daniel R. Goodemote, Esq.
Senior Deputy Attorney General
Torts Litigation Section
15th Floor, Strawberry square
Harrisburg, PA 17120
By: ~~P/? //----
Edward L. ~q.
LANDIS, BLACK & SCHORPP
36 South Hanover Street
Carlisle, PA 17013
(717) 243-3727
Date:
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JULIA V. BENDER,
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
v.
CIVIL ACTION - LAW
THE MAYOR & TOWN COUNCIL OF THE
BOROUGH OF NEWBURG, DR. MONROE
SCHNEIER & DOROTHY SCHNEIER and
DEPARTMENT OF TRANSPORTATION OF
THE COMMONWEALTH OF
PENNSYLVANIA,
DefendantB
NO. 95-681 CIVIL TERM
PENNDOT'S RESPONSE TO
DEPENDANTS SCHNEIER NEW MATTER CROSS CLAIM
AND NOW, comeB the Commonwealth of PennBylvania, Department of
TranBportation (UPennDOTU) and fileB the following AnBwer to the
New Matter CrOBB Claim filed by DefendantB Monroe Schneier, D.C.
and DoloreB Schneier:
43. Denied that PennDOT waB negligent in any manner
whatBoever. The remainder of the allegationB of Paragraph 43 are
concluBionB of law to which no reBponBive pleading iB required.
44. PennDOT' B AnBwer and New Matter are incorporated by
reference for purpoBeB of reBponding to thiB CrOBB Claim.
45. Denied that PennDOT iB Bolely or jointly and Beverally
liable for Plaintiff'B injurieB. The allegationB of Paragraph 45
conBtitute concluBionB of law to which no reBponBive pleading iB
required.
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
Julia V. Bender,
: Civil Action. Law
Plaintiff
vs.
No. 1995.681
The Mayor and Town Council of the Borough
of Newburg, Monroe Schneier, D.C. and
Dorothy Schneier, his wife, and
Department of Transportation of the
Commonwealth of Pennsylvania,
Defendants Legal Action
ORDER OF COURT
NOW, Iru-h S' ~ .1995, the within Stipulation of Counsel
having been read, c nsidered, and Ordered to be filed, it is hereby Ordered that
paragraph 8 of the plaintiff's Complaint shall be deemed amended as set forth in the
within Stipulation and the Exhibits attached to plaintiffs original Complaint shell be
deemed deleted.
BY THE COURT,
J.
JUl 6 9 33 AH '95
tf fit;[
Ci ',. _ ; "ON~i .\k)
;!~"'l,:~r''--".1tO ~r';~lY
:':,:_li~'~ 'f'_" }." ,'A'
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
Julia V. Bender,
Plaintiff
: Civil Action. Law
vs.
The Mayor and Town Council of the Borough
of Newburg, Monroe Schneier, D.C. and
Dorothy Schneier, his wife, and
Department of Transportation of the
Commonwealth of Pennsylvania,
Defendants Legal Action
No. 1995. 681
STIPULATION OF COUNSEL RE AMENDMENT OF COMPLAINT
Now, this ,;}9~' day of May, 1995, the It Is hereby stipulated and agreed by
and between David C. Cleaver, attorney for the plaintiff, Edward L. SChorpp, attorney
for defendants Monroe Schneier, D.C. and Dorothy Schneier, his wife, and Harvey
Freedenberg, Esquire, attorney for the Mayor and Town Council of the Borough of
Newburg, and Daniel R. Goodemote, attorney for the Department of Transportation of
the Commonwealth of Pennsylvania, that the plaintiff may amend the plaintiff's
complaint flied In the above captioned matter, and that the said complaint may be
deemed amended as follows:
1. It Is stipulated and agreed that paragraph 8 of the plaintiff's complaint may
be amended to read as follows:
8.
As a result of the fall and the injuries which the plaintiff suffered as heretofore set
forth, the plaintiff was required to undergo treatment, and to be treated for her Injuries by
Shabbar Hussain, M.D. of Orthopaedic Associates, Chambersburg, Pennsylvania, and
Peter Wallick, M.D., of Chambersburg, Pennsylvania, and was also required to undergo
treatment at the Chambersburg Hospital located In Chambersburg, Pennsylvania, as a
result of which the plaintiff Incurred liability for payment for services rendered by the said
health care providers.
" .
2. It Is stipulated and agree.d by counsel that the Exhibits attached to the
plaintiffs original complaint shall be deemed to be deleted and shall not be
considered a part of the pleadings.
IN WITNESS WHEREOF, the respective counsel for the parties In the above
captioned matter have hereunto affixed their hands and seals the day and the year first
above written.
Daniel R. Goodemote
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,
PENNSYLVANIA
1')
Julia V. Bender,
Plaintiff
Civil Action . Law
vs.
No. 1995.681
'--
~
The Mayor and Town Council of the
Borough of Newburg, Monroe Schneier
D.C. and Dorothy Schneier, his wife,
and Department of Transportation
of the Commonwealth of
Pennsylvania,
Defendants
'"
Legal Action
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REPLY TO NEW MATTER BY PLAINTIFF JUUA BENDER
NOW comes the Plaintiff, by her attorney, David C. Cleaver, and replies to
Defendants Schneiers' New Matter and says:
33. Denied. After reasonable Investigation, Plaintiff is unable to form an
opinion as to the truth of these allegations and proof is therefore demanded.
34. Denied. After reasonable investigation, Plaintiff Is unable to form an
opinion as to the truth of these allegations and proof is therefore demanded.
35. Denied. On the contrary, Plaintiff did not walk the sidewalk on a
frequent basis, was not familiar with the sidewalk conditions, and had no
knowledge of the specific conditions prior to her fall.
36. Denied. On the contrary, Plaintiff's complaint does state a cause of
action against the Defendant.
37. Denied. On the contrary, Plaintiff's cause of action was flied within the
applicable statute of limitations and Is not barred.
38. Denied. Plaintiff has undertaken all reasonable necessary medical
treatment and has mitigated her damages to the extent necessary.
39. Denied. After reasonable investigation, Plaintiff Is unable to form an
opinion as to the truth of these allegations and proof Is therefore demanded.
David C. Cleaver
Attorney for Plaintiff
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,
39. Denied. Plaintiff, after reasonable Investigation, cannot form an opinion as to
the truth of the allegations of this paragraph and proof thereof is therefore demanded.
40. Admitted.
41. Admitted as to the law, but Plaintiff did give notice to the Attorney General
within six months of the date of the accrual of the cause of action. Accordingly,
plaintiff's claim is not barred by this section.
42. Admitted.
43. Denied. On the contrary, plaintiff was not negligent.
44. Denied. On the contrary, plaintiff assumed no known risk.
45. Conclusion of law to which no answer Is required.
46. Admitted.
WHEREFORE, plaintiff requests judgment be entered for plaintiff and against the
defendant.
D vld C. Cleaver -
Attorney for Plaintiff
.
I verify that the statements made In the foregoing document are true and
correct. I understand that false statements herein are made subject to the
penalties of perjury contained in 18 Pa. C.S. Section 4904, relating to unsworn
falsification to authorities.
Date:
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Julia V. Bender
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McNEES. WALL.ACI: lk NURICt(
lOa PINE STReET
,., o. aOlll 111111
HARRI9nVrIO. PA 17'00
JULIA V. BENDER.
plaintiff
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
v.
CIVIL ACTION - LAW
THE MAYOR & TOWN COUNCIL OF NO, 95-681 CIVIL TERM
THE BOROUGH OF NEWBURG, et al.,:
Defendants
NEWBURG'S RESPONSE TO CROSS-CLAIM
OF DEFENDANT PENNDOT
Defendants, Mayor and Town Council of Borough of Newburg
(hereinafter "Newburg" or the "Newburg Defendants"), by and
through their counsel, McNees, Wallace & Nurick, file the
following Answer to Cross-Claim of PennDOT:
47. The responses of Defendant Newburg to Plaintiff's
Complaint (Paragraphs 1-32) are hereby incorporated by reference
as if fully set forth.
48. Paragraph 48 avers a conclusion of law to which no
response is required. Should a response be deemed necessary,
Paragraphs 45-47 of Newburg's Cross-Claim against PennDOT are
hereby incorporated by reference as if fully set forth.
49. Paragraph 49 avers conclusions of law to which no
response is required. Should a response be deemed necessary, the
averments of Paragraph 49 with respect to Defendant Newburg are
denied. It is specifically denied that the injuries or damages
complained of by Plaintiff were caused in any manner by Defendant
Newburg. By way of further answer, Paragraphs 1-50 of
CERTIFICATE OF SERVICE
The undersigned hereby certifies that on this date a true
and correct copy of the foregoing Newburg's Response to Cross-
Claim of PennDOT was served by first class mail, postage prepaid,
upon the following:
David C. Cleaver, Esquire
David C. Cleaver & Associates, P.C.
1035 Wayne Avenue
Chambersburg, PA 17201
Edward L. Schorpp, Esquire
Landis, Black & Schorpp
36 South Hanover Street
Carlisle, PA 17013
Daniel R. Goodemote, Esquire
Senior Deputy Attorney General
Torts Litigation Section
15th Floor, Strawberry Square
Harrisburg, PA 17120
Dated: 1)~1\1r-
rJ--,u.ILf
1 JamesfW. Kutz
Of Counsel for Defendants The
Mayor & Town Council of the
Borough of Newburg
- 3 -
JULIA V. BENDER,
Plaintiff
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
v.
CIVIL ACTION - LAW
THE MAYOR & TOWN COUNCIL OF NO. 95-681 CIVIL TERM
THE BOROUGH OF NEWBURG, et al.,:
Defendants
NEWBURG'S RESPONSE TO CROSS-CLAIM
OF MONROE AND DOROTHY SCHNEIER
Defendants, Mayor and Town Council of Borough of Newburg
(hereinafter "Newburg" or the "Newburg Defendants"), by and
through their counsel, McNees, Wallace & Nurick, file the
following Answer to Defendants Monroe and Dorothy Schneier's
Cross-Claim:
40. Denied Paragraph 40 avers conclusions of law to which
no response is required. To the extent a response is deemed
necessary, the same are denied. It is specifically denied that
Newburg has caused any damages to plaintiff whatsoever, or was
negligent, careless, or reckless in any manner whatsoever with
regard to the averments of the Complaint. By way of further
answer, Paragraphs 1-50 of Newburg's Answer and New Matter are
hereby incorporated by reference as if fully set forth.
41. Denied. Newburg's responses to Paragraphs 1-9 and 17-
24 of Plaintiff's Complaint are incorporated by reference.
42. Denied. Paragraph 42 avers conclusions of law to which
no response is required. To the extent a response is deemed
necessary, the same are denied. It is specifically denied that
any actions or ir.actions on the part of Newburg were in any way
responsible for the alleged harm as set forth in Plaintiff's
Complaint. It is further denied that Defendant Newburg is
liable, either solely or jointly, with any of the other answering
Defendants. By way of further answer, Paragraphs 1-50 of
Newburg's Answer and New Matter are hereby incorporated by
reference as if fully set forth.
WHEREFORE, Defendant Newburg requests that this Honorable
Court dismiss Plaintiff's Complaint and/or enter judgment against
Defendants Monroe and Dorothy Schneier solely or jointly with the
other answering Defendants.
Respectfully submitted,
McNEES, WALLACE & NURICK
\ ,\ '\ r
Dated: "1\). 1\
By ~~~i~~~~g23'52
James W. Kutz
Attorney I.D. No. 47245
100 pine Street
P.O. Box 1166
Harrisburg, PA 17108-1166
(717) 237-5267
- 2 -
VERIFICATION
Subject to the penalties of 18 Pa. C.S.A. S4904 relating to
unsworn falsification to authorities, I hereby certify that I am
William Spencer, Sr., Borough Council, Roadmaster, and that the
facts set forth in the foregoing document are true and correct to
the best of my information and belief.
W~trl(U~~1 ~
William - encer, S .
Date:
,
CERTIFICATE OF SERVICE
The undersigned hereby certifies that on this date a true
and correct copy of the foregoing Newburg's Response to Cross-
Claim of Defendants Monroe and Dorothy Schneier was served by
first class mail, postage prepaid, upon the following:
David C. Cleaver, Esquire
David C. Cleaver & Associates, P.C.
1035 Wayne Avenue
Chambersburg, PA 17201
Edward L. Schorpp, Esquire
Landis, Black & Schorpp
36 South Hanover Street
Carlisle, PA 17013
Daniel R. Goodemote, Esquire
Senior Deputy Attorney General
Torts Litigation Section
15th Floor, Strawberry Square
Harrisburg, PA 17120
~m~j ~"
Dated: 11).1\,r
Of Counsel for Defendants The
Mayor & Town Council of the
Borough of Newburg
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McNEES. WALLAce llo NURICK
100 PINE STRCET
fl. " .Ok 11111I1
JtARRI5DURCi. PA 17100
JULIA V. BENDER,
Plaintiff
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
v.
CIVIL ACTION - LAW
THE MAYOR & TOWN COUNCIL OF NO. 95-681 CIVIL TERM
THE BOROUGH OF NEWBURG, et al.,:
Defendants
To: Monroe and Dorothy Schneier
and their counsel, Edward L. Schorpp, Esquire
Landis, Black & Schorpp
YOU ARE HEREBY NOTIFIED TO FILE A WRITTEN RESPONSE TO THE
ENCLOSED CROSS-CLAIM WITHIN TWENTY (20) DAYS OF SERVICE HEREOF OR
A JUDGMENT MAY BE ENTERED AGAINST YOU.
Dated: 1)'>-1\9)
::N~~~:-ti.~URICK
Attorney I.D. No. 47245
100 pine Street
P. O. Box 1166
Harrisburg, PA 17108-1166
(717) 237-5441
Counsel for Defendants
JULIA V. BENDER,
Plaint if f
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
v.
CIVIL ACTION - LAW
THE MAYOR & TOWN COUNCIL OF : NO. 95-681 CIVIL TERM
THE BOROUGH OF NEWBURG, et al.,:
Defendants
To: Pennsylvania Department of Transportation
and its counsel, Daniel R. Goodemote, Esquire
YOU ARE HEREBY NOTIFIED TO FILE A WRITTEN RESPONSE TO THE
ENCLOSED CROSS-CLAIM WITHIN TWENTY (20) DAYS OF SERVICE HEREOF OR
A JUDGMENT MAY BE ENTERED AGAINST YOU.
Dated:
11~1\1}
McNEES, WALLACE & NURICK
By J;;w.~j If
Attorney I.D. No. 47245
100 Pine Street
P. O. Box 1166
Harrisburg, PA 17108-1166
(717) 237-5441
Counsel for Defendants
JULIA V. BENDER,
Plaintiff
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
v.
CIVIL ACTION - LAW
THE MAYOR & TOWN COUNCIL OF NO. 95-681 CIVIL TERM
THE BOROUGH OF NEWBURG, et al.,:
Defendants
To: Julia V. Bender
and her counsel, David C. Cleaver, Esquire
David Cleaver & Associates, P.C.
YOU ARE HEREBY NOTIFIED TO FILE A WRITTEN RESPONSE TO THE
ENCLOSED NEW MATTER WITHIN TWENTY (20) DAYS OF SERVICE HEREOF OR
A JUDGMENT MAY BE ENTERED AGAINST YOU.
Dated: 1 }).1 \1>'
McNEES, WALLACE & NURICK
By t- fit). If bf
VJames W. IKutz
1 Attorney I.D. No. 47245
100 Pine Street
P. O. Box 1166
Harrisburg, PA 17108-1166
(717) 237-5441
Counsel for Defendants
3. Denied. After reasonable investigation, Newburg is
without sufficient knowledge or information to form a belief as
to the truth of the averments of Paragraph 3. Consequently, the
same are denied.
4. Denied. After reasonable investigation, Newburg is
without sufficient knowledge or information to form a belief as
to the truth of the averments of Paragraph 4. Consequently, the
same are denied.
5. Denied. After reasonable investigation, Newburg is
without sufficient knowledge or information to form a belief as
to the truth of the averments of Paragraph 5. Consequently, the
same are denied.
6. Denied. After reasonable investigation, Newburg is
without sufficient knowledge or information to form a belief as
to the truth of the averments of Paragraph 6. Consequently, the
same are denied.
7.a-e. Denied. After reasonable investigation, Newburg is
without sufficient knowledge or information to form a belief as
to the truth of the averments of Paragraphs 7a-e. Consequently,
the same are denied.
8. Denied. After reasonable investigation, Newburg is
without sufficient knowledge or information to form a belief as
- 2 -
to the truth of the averments of Paragraph 8. Consequently, the
same are denied.
9. Denied. After reasonable investigation, Newburg is
without sufficient knowledge or information to form a belief as
to the truth of the averments of Paragraph 9. Consequently, the
same are denied.
COUNT I
10-16. The averments of Paragraph 10-16 are directed to
parties other than answering Defendant, and accordingly, no
response is required.
COUNT II
17. Answering Defendant incorporates by reference
Paragraphs 1-16 above as though fully set forth.
18. Denied. After reasonable investigation, Newburg is
without sufficient knowledge or information to form a belief as
to the truth of the averments of Paragraph 18. Consequently, the
same are denied.
19. Admitted in part and denied in part. It is admitted
that the Borough of Newburg is a lawfully enacted municipality
within the Borough Code of the Commonwealth of Pennsylvania. It
is denied that the Borough of Newburg is "responsible for the
maintenance and care of the sidewalks located within the Borough
of Newburg." By way of further answer, it is specifically denied
- 3 -
Newburg is in any manner responsible for the maintenance or care
of the sidewalk referenced in Plaintiff's Complaint. Indeed,
Newburg has no ownership interest or right-of-way in said
sidewalk, and thus has no duty to maintain or repair said
sidewalk.
20. Denied. Paragraph 20 avers conclusions of law to which
no response is required. To the extent a response is deemed
necessary, the averments of Paragraph 20 are denied. It is
specifically denied that Newburg was negligent in any manner with
regard to the sidewalks within the Borough. By way of further
answer, Paragraph 19 above is hereby incorporated by reference as
if fully set forth.
21. (a)-(e) Denied. By way of further answer, Paragraph
19 above and Paragraphs 33-44 below are hereby incorporated by
reference.
22. Paragraph 22 avers conclusions of law to which no
response is required. To the extent a response is deemed
necessary, the averments of Paragraph 22 are denied. By way of
further answer, Paragraphs 19-21 above are hereby incorporated by
reference.
23. Paragraph 23 avers conclusions of law to which no
response is required. To the extent a response is deemed
necessary, the averments of Paragraph 23 are denied. By way of
- 4 -
further answer, Paragraphs 19-21 above are hereby incorporated by
reference. By way of further answer, Defendant Newburg is
without sufficient knowledge as to any alleged mental or physical
pain which mayor may not have been suffered by Plaintiff to
either admit or deny these averments. Consequently, the same are
denied.
24. Paragraph 24 avers conclusions of law to which no
response is required. To the extent a response is deemed
necessary, the averments of Paragraph 24 are denied. By way of
further answer, Paragraphs 19-21 above are hereby incorporated by
reference. By way of further answer, as more fully set forth in
New Matter below, to the extent the accident was "caused" by
anyone, it was not caused by Defendant Newburg, but rather was
caused either by Plaintiff, or Additional Defendants Monroe and
Dorothy Schneier or PennDOT.
WHEREFORE, Defendant Newburg respectfully requests this
Honorable Court to dismiss Plaintiff's Complaint and enter
judgment in favor of Defendant Newburg.
COUNT I II
25-32. Paragraphs 25-32 are directed to Defendants other
than answering Defendant and require no response.
- 5 -
WHEREFORE, Defendants Mayor and Town Council of Borough of
Newburg request that this Plaintiff's claim be dismissed, and
judgment entered on behalf of Defendants.
NEW MATTER
33. As a municipality, the Borough of Newburg and its
officials are covered by the Political Subdivision Tort Claims
Act (42 Pa. C.S. S8541, et seq.).
34. The Newburg Defendants are immune from suit from tort
claims except as provided for by the Political Subdivision Tort
Claims Act.
35. Plaintiff has failed to plead an applicable exception
to the Newburg Defendants' immunity.
36. The Newburg Defendants are immune from the claims
raised by Plaintiff in her Complaint.
37. The sidewalk referenced in Plaintiff's Complaint is not
owned, possessed, or controlled by Newburg, nor is the sidewalk
within the right-of-way of any street owned by Newburg, and as
such, Newburg is not responsible for said sidewalk.
38. The sidewalk referenced in Plaintiff's Complaint is
owned or controlled by either PennDOT or the private property
owner who had a duty to maintain the sidewalk in a reasonably
safe condition.
- 6 -
46. If the averments contained in Plaintiff's Complaint are
proven true, which averments are specifically denied as they
relate to Defendant Newburg, then the injuries and damages set
forth in Plaintiff's Complaint were caused solely by the
Defendant Department of Transportation.
47. As a result of such actions or inactions on the part of
the Department of Transportation, and its agents, servants and
employees, Defendant Department of Transportation is solely
liable to the Plaintiff and/or jointly and severally liable with
or liable over to answering Defendants herein for contribution
and/or indemnification.
WHEREFORE, Defendant Newburg respectfully requests this
Honorable Court to enter judgment on behalf of Defendant Newburg,
and against all other parties.
NEW MATTER DIRECTED TO DEFENDANTS
MONROE AND DOROTHY SCHNEIER
PURSUANT TO RULE 2552(dl
48. Defendant Newburg hereby incorporates by reference the
averments of Plaintiff's Complaint, as amended, as if fully set
forth, without admission or adoption of same.
49. If the averments contained in Plaintiff's Complaint are
proven true, which averments are specifically denied as they
relate to Defendant Newburg, then the injuries and damages set
- 8 -
forth in Plaintiff's Complaint were caused solely by Defendants
Monroe and Dorothy Schneier.
50. As a result of such actions or inactions on the part of
Defendants Schneier, and its agents, servants and employees,
Defendants Monroe and Dorothy Schneier are solely liable to the
Plaintiff and/or jointly and severally liable with or liable over
to answering Defendants herein for contribution and/or
indemnification.
WHEREFORE, Defendant Newburg respectfully requests this
Honorable Court to enter judgment on behalf of Defendant Newburg,
and against all other parties.
Respectfully submitted,
McNEES, WALLACE & NURICK
By
arvey ee enberg
Attorne I.D. No. 23152
James W. Kutz
Attorney I.D. No. 47245
100 pine Street
P.O. Box 1166
Harrisburg, PA 17108-1166
(717) 237-5267
Dated: 111-1\4>'
- 9 -
.
..
JULIA V. BENDER,
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
v.
CIVIL ACTION - LAW
THE MAYOR & TOWN COUNCIL OF THE
BOROUGH OF NEWBURG, DR. MONROE
SCHNEIER & DOROTHY SCHNEIER and
DEPARTMENT OF TRANSPORTATION OF
THE COMMONWEALTH OF
PENNSYLVANIA,
Defendants
NO. 95-681 CIVIL TERM
PENNDOT'S RESPONSE TO
RULE 2552ldl NEW MATTER PILED BY
DEPENDANTS THE MAYOR & THE TOWN COUNCIL OP NEWBURG
45.
Requires no answer.
PennDOT's answer to Plaintiff's
Complaint is incorporated by reference as if more fully set forth
herein.
46. Denied. The allegation constitutes a conclusion of law
to which no responsive pleading is required. By way of further
answer, it is denied that PennDOT caused the injuries and damages
set forth in Plaintiff's Complaint.
47. Denied. The allegation constitutes a conclusion of law
to which no responsive pleading is required. By way of further
answer, PennDOT denies that it is liable to the Plaintiff or
jointly and severally liable with or liable over to the answering
Defendants for contribution or indemnification.
JULIA V. BENDER,
plaintiff
: IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY
PENNSYLVANIA
vs.
CIVIL ACTION - LAW
THE MAYOR AND TOWN COUNCIL
OF THE BOROUGH OF NEWBURG,
MONROE SCHNEIER, D.C. and
DOLORES SCHNEIER, his wife,
Defendants
NO. 95-681
.
.
SCHNEIERS' REPLY TO
CROSS-CLAIM OP DEFENDANT NEWBURG
NOW, COMES the defendants Monroe Schneier, D.C. and Dolores
Schneier, husband and wife, by and through their attorneys,
Landis, Black & Schorpp, who reply to the cross-claim of
defendant Newburg as follows:
48. Defendants Schneier hereby incorporate by reference the
averments of their answer as if fully set forth herein.
49. Paragraph 49 avers conclusions of law which require no
answer herein. Should a response be necessary, the averments of
Paragraph 49 with respect to defendants Schneier are denied. It
is specifically denied that the injuries or damages complained of
by plaintiff were caused in any manner by either defendant
Schneier. By way of further answer, Paragraphs 1 through 45 of
defendants's Schneier answer is incorporated herein by reference.
50. Paragraph 50 avers conclusions of law to which no
response is required. To the extent a response is deemed
necessary, the averments of paragraph 50 with respect to
defendants Schneier are denied. It is specifically denied that
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
Julia V. Bender,
Plaintiff
vs.
The Mayor and Town Council of the Borough
of Newburg, Monroe Schneier, D.C. and
Dorothy Schneier, his wife, and
Department of Transportation of the
Commonwealth of Pennsylvania,
Defendants
Civil Action - Law
No. 1995 - 681
Legal Action
PRAECIPE FOR DISCONTINUANCE
To Lawrence E. Welker, Prothonotary:
Please mark the above captioned action settled and discontinued.
It ) ~~~--,
Attorney or Plaintiff
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY
PENNSVL VANIA
Julia V. Bender,
Plaintiff
: Civil Action - Law
v.
No. 1995-681
The Mayor and Town Council of the :
Borough of Newberg, Monroe Schneier, :
D.C. and Dolores Schneier, his :
wife, and Department of Transportation
of the Commonwealth of Pennsylvania,
Defendants Legal Action
ANSWER TO REQUEST FOR PRODUCTION OF DOCUMENTS
I. Xerox copies of all photographs are attached.
2. There are no diagrams, sketches, etc.
3. There are no statements In plaintiff's possession.
4. The only expert opiniol1s are those opinions of the health care providers.
There are no expert reports per se but only medical records. They have been supplied.
5. None.
6. None.
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Chambersburg, PA 17201
717-264-1110