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HomeMy WebLinkAbout95-00723 ( I , ,,~, \I) ~ . - ::7 ~ V) -1 ..5 '-~:~J ''''il <., A ..-{ ., , ~. .n 7 :.. ~ C Q.I aL. ~ o \ "-'- ': ,~. ~ J ", cY) r6 r- . o <: : :~'~ oj,; '" ')00. ~, l' " '" ~ ... ~ .,~. ~ .." !~ <7> - :Y: "'- ~ ".'\ ~ .~ .'-;,} <:i ... .,.; ".-, :)' :r- . ,. ,7) en .... ,~ (j Ul' 0<0< lilZ lil HZ I1<lil H t:3 \'l 11< ~ VI I-l ~ Z :J: lil 'tl .... III ... Ii o -0< ~ = . .... i! = ~~ ~~.:l RIO .... RI ~ N ... 0 'tl Z 8E51 oz = E-o = lil ~~~ ~~ fil Nfil '... ~ III r.. oz ~ ZP:: RI .... fil ~i is! r..CJOI fillll ..t III ~ ~' 0 I-lItlH P::~ 11< Ul ~ ~ ~~ ~E-oO\O< III fil 0 ~~H ~~ E-oZCJ I-l Q . CJ E-o ~~ ll: 0< 0< . ll: 0< I-l . PH OE-o . >z fil ~I Oll:.:lZ ,.,::: . P::o CJ 0'1: CJfill-l >< E-olll fill-l I-l r:l:: fil~~ P:: Ullil.... UlE-o E-o ~ P I-l~'" ~~ 0 ::: CJ ,., CJ :- Z E-oCJ :a~VI filCJ E-oO zr.. p::H.... . I-lUl 1-l0 r..fil.s:: > Ul .; ': LAW OFFICES HAROLD S. IR WIN. 11/ . . 4, On Fcbruary 19, 1993, at or about 3:58 p,m., Bradley C. Shover (hereinafter Shover) was operating a 1979 Volvo southbound on U.S. Route II, Carlisle Pike, in Middlesex Township, Cumberland County, Pennsylvania near the intersection of the exit ramp of the Pennsylvania Turnpikc with U.S. Route 11 South, Carlisle Pike. 5. At said time and place, solely due to the negligence and carelessness of Shover, the Shover vehicle collided with the plaintiffs' vehicle and pushed plaintiffs' vehicle into the truck in front of plaintiff as plaintiff was lawfully stopped for traffic in front of plaintiff. 6, As the direct result of Shover's negligence and carelessness as aforesaid and the collision that resulted therefrom, plaintiff Francis J. DeRenzo suffered serious personal injuries, including, but not limited to severe cervical, thoracic and lumbrosacral sprain and strain syndrome of his spine, and serious injury to his left knee. 7. As the direct result of Shover's negligence and carelessness as aforesaid and the collision that resulted therefrom, plaintiff Francis J, DeRenzo knee injuries ultimately required knee replacement surgery after all efforts at rehabilitation failed. 8. As the direct result of Shover's negligence and carelessness as aforesaid and the collision that resulted therefrom, plaintiff Francis J. DeRenzo's knee injuries and the resultant knee replacement are Iikcly to create the nccessity for future knee replacements, medical treatment, physical therapy, extended recuperation and medical expenses resulting therefrom, 9. As the direct result of the collision, plaintiff Francis J, DeRenzo incurred substantial medical expenses in excess of Thirty Thousand (530,000.00) Dollars for evaluation and treatment of his injuries, hospitalization, surgery and extended care and plaintiff will probably again, in the future, incur medical expenses due to future medical care related to the injuries incurred in the accident. 10, At the time of the accident as aforesaid, plaintiffs were the holder of an automobile insurance policy provided by United Services Automobile Association (hereinafter USAA) who is licensed to sell automobile insurance in the state of Pennsylvania and is subject to the laws of the State of Pennsylvania. 11. Defendant received timely notice of all of plaintiff Francis ], DeRenzo's medical bills from plaintiff's health care providers. 12, Defendant USAA has failed to pay for a substantial amount of these medical bills, the precise amount of which will become known by the time of trial, within 30 days of receiving proof of loss from plaintiff's health care providers. 13, Defendant has failed to pay plaintiff's medical bills despite the fact that plaintiff's primary treating physician has clearly demonstrated that the medical bills are a direct result and consequence of the accident which occurred on February 19, 1993. 14, Despite defendant's refusal to pay these medical bills, defendant has also failed to request a Peer Review Organization Review (PRO review) within 90 days after receiving proof of loss as required by the Pennsylvania Motor Vehicle Financial Responsibility Act. IS, Defendant is long overdue in their payment of Plaintilrs medical bills since the majority of these bills have not been paid for over one year after receiving proof of loss and this failure is an unreasonable and wanton act because defendant had the opportunity to challenge the necessity of the medical bills and eKpenses through a PRO review which would have determined the necessity ofthe medical bills and eKpenses and their causal relationship to the accident. 16, Defendant has unreasonably and wantonly denied payment of plaintiff's medical bills and eKpenses and have conducted defendant's own review of plaintiff DeRenzo's injury and treatment, which review is not permitted by and is outside the scope of the Pennsylvania Motor Vehicle Financial Responsibility Act. 17, Defendant has unreasonably and wantonly withheld payment ofplaintilrs medical bills and eKpenses for over one year, thereby denying plaintilrs medical providers oflawful payment for their services to plaintiff and seriously injuring plaintiffs' credit standing, WHEREFORE, plaintiffs demand judgment against the defendant in an amount equal to all outstanding medical bills as of the time of trial and for reimbursement for any future medical bills and eKpenses, plus interest at a rate of 12% per annum from the date the benefits became Francis J. DeRenzo and In the Court of Common Pleas of Elizabeth A. Derenzo his wife Cumberland County. Pennsylvania -vs- No. 95-723 Civil Term United Services Automobile Association Complaint in Assumpsit and Notice R. Thomas Kline. Sheriff who being duly sworn according to law, says he served the within Complaint in Assumpsit and Notice, in the above entitled action by mailing a certified letter return receipt requested to the defendant United Services Automobile Association on February 10. 1995 to their last known address being 9800 Fredricksburg Road, San Antonio. TeKas. The letter was received by United Services Automobile Association on February 14, 1995 the return receipt card signed by Dorothy Ziemba. The return receipt card is hereto attached. Sheriff's Costs: Docketing Surcharge Certified Mail 18.00 2.00 2.75 22.75 2-21-95 pd. by So answers: / ,./. < .~; ".",,</'/..;. ~. Thomas Kline, Sheriff $ atty Sworn and Subscribed To Before Me This .J.~~ Day of .J...t.l....u......y 1995. A.D.~y,~ D.)Il.;(L/lYfl}' Prothonotary .. y . , " '.c,"" Fit.. Com~1 i..... 1 ....10'-2101 Iddldonol "Mco,. t<, I'." Com.....,. hltftl 3. and 4, II b. 1 >.;' .v. . prfnt your nlme .nd add,... on lhI reverH of thi. 'orm 10 lh1t WI cln ~:- ,.cum tN, caret to you. r _ . . AttKh thai tonn to the front of the mlllplecl, or on the blCk If 'p'~ l' doll Mt permit. t' .J . Wri,,""ltumRec:liptR'QUll1td"onthtfNllplecebeloWthlartIc:..numblr 2. 0 Rlltricted D.llvery I "_. The R.u.m R.celpt wlhhow to whom lhurtidl w.. dlhtred and the dill I deny,red. Consult atm.lte, for fee. : ] 3, AlIlcle Addre..ed to: 48, AlIlcle Numbe, I t United Services Autanobile IIssOC Z 069 875 840 ! 'Ii 4b. Service Type I II 9800 F'redricksburg Rd. 0 Regl.tered Oln.ured I San Antonio, Texas 78288 'SC.IIIf1ed 'ilA9D o expre.. M.II [j ~u'n Rec.lpt fa, I .1.~;;:";loh to ,ocelve :he following IIMCII (fa, en exlfe ,..): 1, 0 Add......'. Addre.. . f Ii ! .;! f 7, D.te of ~~If' 1 ~ 19!\~ ~ .. 8, Add......'. Add.... IDnly II ..quilted 'I end f.. I. p.ldl ~ &, Slgn.tu.. lAgenll ! P5 F~rm . i , D.c.mber 1991 *U.8. GPO: ____.1'4 DOMESTIC RETURN RECEIPT .r , , " ~ : ., . ,., , ... .. 1\\\\ \ ~. - US MAil SERVICE PENALTY FOR P1WATE USE TO A\IOlD PAYMENT OF POSTAGE, $300 Print your name, eddress and ZIP Code here . . R. ThanBS Kline , Sheriff c:unberland COOJ:lty Courthouse One COUrthouse Square Carlisle, PA 17013 In' \\I",' I" "",ll" \I 1\,11 '" I"" I ,1"1,1111\,,,,11" 1\11 ". , . - - FRANCIS J. DeRENZO and : IN THE COURT OF COMMON PLEAS BLIZABBTH A. DeRENZO, his : CUMBERLAND COUNTY, PENNSYLVANIA ",i~e, . . . CIVIL ACTION - LAW . l'lainti~~ . . . No. 723 Civil 1995 . v. . . . . UNITED SERVICBS . . AUTOMOBILE ASSOCIATION, . . . . De~endant . JURY TRIAL DEMANDED . ENTRY OF APPEARANCB 7'0 THE PROTHONOTARY: Please enter my appearance for De~endant in the above- captioned case. POST .Ii SCHELL, 1'. C. ~~ Paul W. Grego, Es e I.D. NUmber: 39701 101 North Front Street Harrisburg, PA 17101 (717 232-5931 Counsel for Defendant Dated: J-- ~ '1 j- FRANCIS J, DeRENZO and ELIZABETH A. DeRENZO, Plaintiffs IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW v, NO, 95-723 CIVIL TERM UNITED SERVICES AUTOMOBILE ASSOCIATION, Defendant JURY TRIAL DEMANDED DEFENDANT'S ANSWER WITH NEW MATTER TO PLAINTIFF' S COMPLAINT AND NOW ONTO COURT, through undersigned counsel, comes the Defendant, United Services Automobile Association, who, in Answer to the Complaint of the Plaintiffs, respectfully represent that: 1-3. Admitted, 4. Denied. After reasonable investigation, answering Defendant lacks information or knowledge sufficient to form a basis to the belief as to the truth of the averments contained in this paragraph and same are therefore denied, strict proof being demanded at trial, if relevant, 5-6. Legal conclusions which require no Answer, Where an Answer is deemed to be required, after reasonable investigation, Answering Defendant lacks information or knowledge sufficient to form a belief as to the truth of the averments contained in this paragraph and same are therefore denied, strict proof being demanded at trial, if relevant, 7-9, Denied, After reasonable investigation, answering Defendant lacks information or knowledge sufficient to form a basis to the belief as to the truth of the averments contained in this paragraph and same are therefore denied, strict proof being demanded at trial, if relevant, 10, Admitted. 11-14, Denied. After reasonable investigation, answering Defendant lacks information or knowledge sufficient to form a basis to the belief as to the truth of the averments contained in this paragraph and same are therefore denied, strict proof being demanded at trial, if relevant, 15-17, Legal conclusion which requires no Answer. Where an Answer is deemed to be required, after reasonable investigation, Answering Defendant lacks information or knowledge sufficient to form a belief as to the truth of the averments contained in this paragraph and same are therefore denied, strict proof being demanded at trial, if relevant. NEW MATTER 18. The Plaintiffs may have failed to state a cause of action upon which relief can be granted. 19, The applicable Statute of Limitations may have expired prior to the institution of this action. 20. Answering Defendant has complied with all the applicable requirements of the Pennsylvania Motor Vehicle Financial Responsibility Act in the handling, processing, and evaluation of the Plaintiff's claim for medical benefits, 21, Answering Defendant has complied with all due requirements and conditions of the insurance contract that existed between the Defendant and the Plaintiff at the time of this incident. Any refusal on the part of the Answering Defendant to pay for medical expenses submitted by the Plaintiff was not the result of any unreasonable and/or wanton act on the part of the Answering Defendant. 22, The Answering Defendant has promptly paid all medical expenses that were reasonable and related to the Plaintiff's existing claim for medical benefits under his automobile insurance policy. 23. The damages described in the Plaintiff's complaint may have been caused or contributed to by the plaintiff, 24. The Plaintiff may not have properly mitigated his damages. WHEREFORE, the Defendant united Services Automobile Association prays that the Complaint be dismissed, at the costs of Plaintiffs, Respectfully submitted, POST & SCHELL, P.C. Pt 6 JO n Flounlacker, Esquire 101 North Front Street Harrisburg, PA 17101 (717 232-5931 Counsel for Defendants, United services Automobile Association Dated: 3/61.9/?S" VERIFICATION I, John Flounlacker, Esquire, attorney for the Defendant, United Services Automobile Association, herein state that the facts as set forth in the forgoing Answer with New Matter to Plaintiffs' Complaint are true and correct to the best of my knowledge and belief, This Verification is not made by the party because of the timely nature of this document and the present unavailability of my client to sign this Verification. ~~\)4't4~~ J HN FLOUNLACKER, ESQUIRE DATE :~/ol1(" CERTIFICATE OF SERVICE I, Susan L, Horstick, an employee for the law firm Po~t & Schell, p,C" hereby state that a true and correct copy of the foregoing Defendant's Answer with New Matter to Plaintiff's Complaint was served upon all counsel of record by first class United States mail, postage prepaid, addressed as follows, on the date set forth below: Bv First Class U,S, Mail: Harold S, Irwin, III, Esquire 36 South pitt Street Carlisle, PA 17013 POST & SCHELL, P.C, ~~ Susan L, Horstick rJ [ I ! l I I I f I ; t ( i f I f i i I i I ! Dated: ~J~;I?~ ...,.. en - >-... "',- ..~ .- l.i"r;:;~ ~fJ~~~ {~ /::.:;;;: , ~T l!"1 <. ~ .,. ." ~"J;:'~ ,-,',,'JU .: :,~ r... '" ~<-') ~ .... N 9 &.n ... ... cz . ... Ill' '... ..e..e :- IIlZ ..::IZ X CO III !::l .. "'Ill P: ....co .. "'~1Il ,<:... ..., E-t ~i u Z ..eE-t 'tl ... Zl::l :a ~~ o ...::1 s:: ....... 011I ~>< ..::IE-t lllO.., H'tl I:! E-tIHH Nl::l E-tl::l ZP: OZ > III Oz.... ..eOJ 111111 ~~~ UPZH'" NIIlIII H'" f<<E-t oouffi ZP:rol UOJ 1IlE-t ~'f. i!2 ~~ f<<UH III OJ'" III 0 I:! I:!;j ~~ 0 E-t"'1Il P:I:! III III ~ ~ ~ ~ I:! UN III OJ UIIl ~I~I ~~~ E-tZ..er--..e I:!' H..e P:..e I ..e > ;~ ..~ P..::I..::ILOZ . P:1Il P:Z 000l: OP:HOlH ..,::: 111..::1 III ~ UIIl> E-t IIlH ~ ~ H . III III III III ~ ~ IIlffiUO H~ I:! 0 :a ::: Z U..e III X E-tU ZN E-t0 ..eH HE-t Zf<< P:..::I . ZP HO f<<1Il > p..e LAW OFFICES HAROLD S. IRWIN, III . IIAROLD S, IRY.lIN,III, ESQUIRE ATTORNEY ID NO, 29920 36 SOUTII PI'fT STREET CARLISLE I'A 17013 (717) 243-6090 A,,.ORNEY FOR PLAINTIFF 11RANCIS J. DeRENZO and ELIZABETH A. DeRENZO, his wife, Plaintiffs : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA : CIVIL ACTION - LAW vs. : No. 95 - 723 CIVIL TERM UNITED SERVICES AUTOMOBILE ASSOCIATION, Defendant : IN ASSUMPSIT ANSWER TO DEFENDANT'S NEW MATTER NOW, come the plaintiffs. by their attorney, Harold S. Irwin. III, Esquire, and respond to the dcfendant's ncw matter, representing as follows: 18. The averments of paragraph eighteen of the defendant's new matter are conclusions of law to which no response is required, However, if a response is required, those averments are specifically denied. Plaintiffs have obviously stated a cause of action against the dcfendant as is clear from a cursory reading of the complaint. Defendant's averments in this paragraph represent another arbitrary and capricious attempt to avoid payment of its obligations under the contract of insurance that it issued to plaintiffs. 19, The averments of paragraph nineteen of the defendant's new matter are conclusions of law to which no response is required, However, if a response is required, those averments are specifically denied. The applicable statute of limitations has obviously not expired as is clear from a cursory reading of the complaint. Defendant's averments in this paragraph represent another arbitrary and capricious attempt to avoid payment of its obligations under the contract of insurance that it issued to plaintiffs. 20. The averments of paragraph twenty of the defendant's new matter are specifically denied. On the contrary, defendant has failed to comply with all the applicable requirements of the Pennsylvania Motor Vehicle Financial Responsibility Act in the handling, processing and evaluation of the plaintiffs' claim for medical benefits as more specifically averred in plaintiffs' complaint, the relevant portions of which are incorporated herein by reference, 21, The averments of paragraph twenty-one of the defendant's new matter are specifically denied. On the contrary, defendant has failed to comply with all due requirements and conditions of the insurance contract between the parties as more specifically averred in plaintiffs' complaint, the relevant portions of which are incorporated herein by reference. By way of further response, defendant's failure to so comply is the result of unreasonable and/or wanton acts on the part of defendant and repreSJ:lnt an arbitrary and capricious attempt to avoid payment of its obligations under the contract ofinsurance that it issued to plaintiffs, 22, The averments of paragraph twenty-two of the defendant's new matter are specifically denied. On the contrary, defendant has failed to promptly pay all medical expenses that were reasonable and related to plaintiffs' existing claim for medical benefits under the contract of insurance that it issued to plaintiffs, as more specifically averred in plaintiffs' complaint, the relevant portions of which are incorporated herein by reference, WHEREFORE, plaintiffs demand judgment against defendant as prayed for in their complaint. 23, The averments of paragraph twenty-three of the defendant's new matter are specifically denied. On the contrary, all of the damages described in plaintiffs' complaint were the direct result of the motor vehicle accident described in plaintiffs' complaint, the relevant portions of which are incorporated herein by reference. 24. The averments of paragraph twenty-four of the defendant's new matter are specifically denied, On the contrary, plaintiff properly mitigated his damages and proceeded with all medical care related to this accident as directed by his physician, April 5, 1995 / , , L ,. / " /, '/0 tt21c/1Z HAROLD S. IRtWIN, III Attorney for pla\ntiffs '. 36 South Pitt Street Carlisle, Pennsylvania 17013 (717) 243-6090 Supreme Court ID No, 29920 CERTIFICATE OF SERVICE 1 hereby certifY that a copy of the foregoing answer to new mailer was served this date by depositing same in the Post Office at Carlisle, PA, first class mail, postage prepaid, addressed as follows: JOHN FLOUNLACKER ESQ POST & SCHELL PC lOl N FRONT ST HARRISBURG PA 1710l April 5, 1995 &V01P~ HAROLD S, IRW ,III Attorney for plainti 36 South Pitt Street Carlisle, Pennsylvania 17013 (717) 243-6090 Supreme Court ID No, 29920 Ioi---.-_.--" lAW_ HAROLD S, IRWIN. or ATT9m.-y"T;l.AW "_I'fTT.-T CA....~IIll" ,,,,.- -- IIAROLD S, IRWIN, III, ESQUIRE ATTORNEY ID NO, 29920 36 SOUTII PITT STREET CARLISLE PA 17013 (717) 243-6090 ATTORNEY FOR PLAINTIFF FRANCIS J, DeRENZO and ELIZABETH A, DeRENZO, his wife, PlaintilTs : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA : CIVIL ACTION - LAW vs, : NO. 95-723 CIVIL TERM UNITED SERVICES AUTOMOBILE ASSSOCIATION Defendant :IN ASSUMPSIT To the Prothonotary: Please mark the above action satisfied. /dA52 HAROLD S. IRW 36 SOUTH PITT ST CARLISLE, PA 17013 April ,7- ,1996 ..,- t:~ 0 L , Ill;:' Q"l ; .... U'. ") c.2;; fA: ~, 'n/;=: 1,_ . ~~~ CJ "::':~ . " '..J r] ~ fa L~ c, ";" . . . -.-, w.: c.' 4~_ L. . <'-'. ...~ -: "- ,. t.!:) , , ~ :j, (. ) ~'O'