HomeMy WebLinkAbout95-00917
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,
PENNSYLVANIA
HEALTHSOUTH OF MECHANICSBURG,
INC,
175 Lancaster Boulevard
Mechanicsburg, PA 17055
CIVIL ACTION - LAW
PLAINTIFF
DOCKET NO,
v,
(!-l--t4. L ,J (1 ".... W\.-
1!F 9/)
STATE FARM INSURANCE COMPANY
115 Limekiln Road
P,O, Box 257
New Cumberland, PA 17070
JURY TRIAL DEMANDED
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 an 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 y'u by the Court without further notice for any
money claimed in the Complaint or for any other claim or relief
requested by the plaintiff, You may lose money or property or
other rights important to you.
YOU 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:
COURT ADMINISTRATOR
CUMBERLAND CO COURTHOUSE 4th FLOOR
1 COURTHOUSE SQUARE
CARLISLE PA 17013 3387
(717) 240 6200
1
Illinois, and doing business in Pennsylvania with offices at 115
Limekiln Road, New Cumberland, Pennsylvania 17070-0257,
3, On or about July 14, 1991, Cindy Wendler was involved in
a motor vehicle accident,
4. Prior to July 14, 1991, Defendant issued a policy of
automobile insurance to Cindy Wendler, Said policy was in effect
on July 14, 1991, the date of the accident,
5, As a result of the accident, Cindy Wendler suffered
various injuries, including neck and back strain and sprain and
recurrent accident related symptoms,
6, As a further result of the aforementioned accident, Cindy
Wendler has been obliged to receive and undergo medical attention
and care and to expend various sums of money or to incur various
expenses for which medical benefits are payable,
7, Following the accident Cindy Wendler incurred reasonable
and necessary treatment from, among others, Plaintiff, for neck and
back pains and accident related injuries, The fair and reasonable
charges for this treatment are as set forth on a copy of the bill
which is attached hereto, made a part hereof and marked as Exhibit
"A",
B, The bills for Plaintiff I s services were submitted to
Defendant for payment,
9, Defendant, pursuant to Section 1797(b)(1) of the
Pennsylvania Motor Vehicle Financial Responsibility Law, as
amended, has contracted with a peer review organization, for the
purpose of allegedly confirming that such treatment, products,
2
services or accommodations conform to the professional standards of
performance and are medically necessary. The name and address of
the aforesaid peer review organization is Hoover Rehabilitation
Services, Inc.. A copy of the peer review report is attached
hereto as Exhibit "B",
10. Defendant has, in violation of Section l797(b)(1),
attempted to use said peer review organization to determine the
causal connection between the accident and the alleged injuries,
11, By letter dated August 7, 1992, the Defendant refused
payment for certain medical treatment, including the treatment
provided by the Plaintiff, based on the conclusions provided in
said peer review report,
12, It is averred that all medical bills incurred both before
and after the peer review and reconsideration are fair and
reasonable and that said treatment was medically necessary and
related to the accident, Moreover, pursuant to Section 1797 (a),
all bills were to be paid unless submitted to peer review within 30
days,
13, Defendant has refused to pay the balance due under the
terms and conditions of the policy of insurance and the Pa.MVFRL,
As a result of the aforesaid, Plaintiff was required to hire the
services of an attorney to collect the medical bills due.
14, It is averred that the Defendant has acted in an
unreasonable manner by refusing payment of Plaintiff's invoices,
Pursuant to Section 1716 of the Pa,MVFRL, Plaintiff is entitled to
attorney's fees plus interest at the rate of twelve percent.
3
15, Cindy Wendler assigned to MRS the right to receive monies
otherwise to be paid to the patient under any insurance plan and to
pursue her claims for such monies,
16, It is further averred that the Defendant has acted with
no reasonable foundation,
Pursuant to Section 1798 of the
pa.MVFRL, Defendant is liable for attorney's fees for such actions,
17. Defendant has undertaken a course of action which has
been designed to unilaterally, and without justification, refuse
claims for medical benefits arising out of motor vehicle accidents
and for which the Defendant has contracted to provide insurance
coverage,
WHEREFORE, Plaintiff demands payment of the full medical bills
due in the amount of $3,521,44 plus reasonable attorney's fees,
costs and interest on said overdue benefits,
COUNT II - BAD FAITH
AND INTERFERENCE WITH CONTRACTUAL RELATIONS
10. The foregoing paragraphs are incorporated herein by
reference as though set forth in full,
19, All treatment was provided to Plaintiff after the
effective date of Section 8371 of the Judicial Code, 42 P,S,
Section 8371, effective July 1, 1990.
20. It is believed and, therefore, averred that the Defendant
has employed said peer review organization in bad faith in that
said peer review organization does a substantial amount of peer
review work for Defendant and has a financial interest in provident
to Defendant a biased peer review report,
4
21. Moreover, said peer review organization has, or may have,
continuously been providing negative peer review reports to this
Defendant and other insurance companies repeating the same language
for the purpose of maintaining a steady source of business, thereby
showing a pattern of abuse of the peer review process,
22. It is believed and therefore averred that the Defendant
i,
~
I'
regularly refers claims to peer review organizations for review
without a basis to do so,
23, In addition, said peer review organization gave its
opinion that the injuries were not related to the accident, instead
of determining "medical necessity" or "conformance to standards",
all in violation of section l797(b)(1),
24, In addition, it is believed that the Defendant had no
reason to believe that Plaintiff I s treatment was not medically
necessary, but instead was intentionally trying to simply "cut off"
medical coverage for which Plaintiff paid a significant premium,
25. It is believed and, therefore, averred that based on the
allegations set forth above, Defendant is guilty of bad faith,
26, Defendant's unlawful, malicious, unreasonable and
unjustified conduct has interfered with Plaintiff's contractual
relations with its patients by making it more expensive and
burdensome for Plaintiff to perform its contractual obligations and
has deprived Plaintiff of the benefit of its contracts, thereby
causing losses to Plaintiff,
5
WHEREFORE, Plaintiff demands judgment in its favor in an
amount representing appropriate damages pursuant to section 8371,
including interest, punitive damages, court costs and attorney's
fees.
Respectfully submitted,
Date
Richard Oare, Esquire
Attorney ID 18631
1776 South Queen Street
York, Pennsylvania 17403
(717) 846-3000
Date
re
Plaintiff
\mra\wondlor\aLatoCar.cpl
6
..~L
1 71.. ~,
h(uii. .:.,..:lt1
()
H.
'<J ./ III f(.
I.,;, .,11.\'. ; . Jfl J.. \,
.. ~ "I'C". -Jl'.. ,
!.: \. ft.., I .l':'~ J po. U to \J' ,1.
. II \~, .,...... T : ~ -
-
, ,
STATEMENT OAtE
, .
~L~
\ :,/1 'l"1-Jlt,;
, '
,r
, -'
PATIENT NAME
PATIENT NUMBER
MEDICAL RECORDS NO.
,IHAN ...u
elMUl f'l'Pf
_. l~ f . h .1) L... ..
'J .'.j 7t,;"
')lJft7tJ~-.....;~l
,;
, ..
DATE OF BIRTH
,7/l II'. J
IAl U i
NIlVllfll
ATIENOINO DOCTOR
'0'
"
. J i ~ ':.11 '. '"
, ,
. -
j.
. / I t, .~ I I"
"JL:.tr
~ ., h
.... .
i'UL 1; I
t.' ., . ~I
UNllY ne~Il)Ld
dJn r;U~rt..r.~T oT
l..A~L!:i l...: I'..
17"1]
H ,~
I It,Y U
:., , .. ll: r. ",1 ti .
.\Ght': ,,.'1 &. 71 l ,., .; l
.1 U 0" 73.. t! \:
DESCRIPTION OF HOSPITAL SERVICE
, PAIlENI
I AMOUNT
<J7t~5 PT (,VAL l/~ HK 1 ~]701/)1\1 "U,9, 8U, !'J
'1HZb u.S. ~INliLc 1 ~370~lU() ~7,~,> 'I7,d~
'J7U1U HUT/MYiJRC P~CK 1 ~]70l7(;U lll, ,:. lb,"
'1HZ.. MA)$14G!: 1 ..37U3~OU ~~,lU .. 't. 10
'1712'1 MASS..Ll: 1 'IJ70350U "~,I.O 1,',,1 U
'Jlllb J.,) . ~ lfiliL l: L ~ HUt lUlJ 47. J, ~7, :I',
'J II JI.. 'J7UllJ t10 T IlIllJol U I' ,IC,," L 4J7U~7L\J lb, 'J, lu.~~
Ii 3iJl .,1Ub U. J . Sl"LL.: L 4J71ll10U .. 7, ~, lt7.d~
'J J I Jl ~7d~ HuT/HYu~(j P~C.... L .. J70l701.' lb.~j In,?:>
\.3111 11L~I, :1~))~L~ L 4J7UJ,OlJ ~',,1 J 1,", LU
v'll ~i '17126 u.,). ~lI,liLc L 4J70llvl, ~7,o'} 47. d,
04/0~ <J 7L ll.. HUT/M~Il~G i' >l(,.. 1 ~J7uL10(j t/), '>, ltJ.~'
U4/lJ~ nli.~ i'.AS St.lJ~ t 4J 7:; 3,01J .. I, .Ll) ~.:.. La
1;4/U<.. 'i 1l2tl u.). J l!'vL..t 1 4 HCdut; 47,0' ,.7.".,
C 41 U:J '17 ~ 1 v "UT IHYlJ;~1.. I'~CK L ',J7uOOlJ Lo,;; LL. ;J'j
'17 l.L " 1114.:) ~..l...lc. L ~J1IjJr)o,) ..~,LU 4t,. Lv
'JI L lL Pi 11 ~ t1~: 1 .371;)"lU 'It.: ,co 'ib. UtJ
l' 't I l..!l -471.~h U..1 . ., I IH,L: L ..jlli~tl.'J ..7.",> it; . .:~ ~j
'v~1~7 'J7vlu HUf/ltl,,<l.. r.,L" 1 4 J 11..0:: lU;, 10, ,'} 1.,. -j ~
u../lJ7 .. -; L,:.. j'!AS '::'uul' 1 '1 j 7 C j ~l\)!) ~" .llJ 'f It. l (.J
0"/07 ;711w I' r tl ~ ", 1 .. J 7 '.: j" 1,) 9t,OO 'It. ,rl"
, C "
u41 Lv .; 7 12. I) U.j. } 1 ~I',L:" . ~HCHU') ~ 7 . d~' '17. '., ~
1
U't/l.. ) 7lJ l'J Htlr/t1~GJG Pl,t." . .J7/J/.71)0] lb,;? 1. ~1 . ,.,
a",/lu n.2't ,1.\ ) '1,.\, t. 1 't 17C j')~l.j 4'1,LO it Jt. t lJ
U'/13 '17.. i.b u..) . o l',I.L= 1 " i 'Ie:.:: ill') ~1,~) 4'" ~ I.,
I. ...
(j.1 1 J 'J'/;,:; l\.. MurlHYU,L ~I "l-.'\ 1 I1Ji(,~7v'J Lb.,? 10. "':J
U 41 t J ,711.1, 11 ~:i j0-4i.;L 1 't J 7 '. J: 01) 44.L.I 'tIt. L C
o ~I .1" '17 1 ~ (; ~. ..i. ) 1 ~lllL.l.: 1 ~J 7ltdul) ~7,1>~ .. 7, ,')
04/1.. 171j tv M,jf/HIl..-J I' \!;~ l 4j7::~71.;.J lb,''> l r: . ~l :,
(; 41 1 ~ J 7 t l't ~" .) :':. \'L 1 tt ,t 7;.. j IHlt} It't. L (J "t". t J
, , TOTAL~'
PLEASE REFER TO PATIENT 'lUMOER
ON ,ALlIUQUIRES AND
CORIlESPONOCUCE
NOT POSTED WHEN THIS DILL WAS PREPARED. on IF INSURANCE
CARRIERS DO NOT PAY ANY PAnT OF THE AMOUNTS SHOWN,
I
,
,
lED
I
I
u"l h
1,)"1 III
u ~/1"
U4/1"
G"/lll
0'" ~~
O"UV
Ihl !l'
04/!1
lJ"nl
0"/<1
(jai' ~l
04/1.j
/J I" a! j
U "I LJ
O"U7
04/~7
0'" ,; 7
v"ti7
0"/211
o "I ~ rt
O"/~~
04/1v
Q../lV
041 JO
0'" Co,
05/C~
U."O"
O~/O~
O~/C"
STATEMENT DATE
;. '....11~1.. i '" J" t,;, l: . i: n" It J l J:.
.' J 11\),\ ~UL[)
'ltt,;ttt&U IL Sl,U~\J; p~ ! 7~~~
17l710'/1-1700
,,: \.1 i t ~'r: t1..to U
r..I\...L \..or/L",",!
.'ll._
-' , "
, -'
PATIENT NUMBER MEDICAL RECORDS NO. ',N.lH '"
CLAI" ""
~'J ,j 7 t;' )1) 1/L ')-.:. 'J~ L J U
DATE OF BIRTH LA u , ATTENDING DOCTOR
Ntll,lll[n
1)7/17/LJ 11~L"'(.i..'~~ "vLT1, LHdll
PATIENT NAME
L. :1\..' .,tldJL ,"..\
UJ/,.~/\t, l~ \L 1.'1/J!../'}
CHilJ y ~cfIlJLl:~
oj" 'j'jq,,~,,'~T 'iT
l:~~I.I~L. P..
L7v13
I'.'
lJ Nt
" '
. . J
1- ",;,....
~ 1 ~ T t:.
!'4L,', t.
J.Jl)..!J't~1J
. I' l 7 I L '" (, 1
DESCRIPTION OF HOSPITAL SERVICE"
~ 7 LiO PT 11 l Hll 1 43703011' 'Je .CO 'lb.OO
'1712ti U.S. HNliLt: L 4)702 LllO "7.d; ,,7.dOj
'i7li 1u rlOT/hYlJPO P ~CK 1 4J70l70U 1(;.,~ 1t)."~
'.71l4 MA 5 5..01: L 43103'>01) It't . i') "". LO
'J71lO PT LIZ t,ll L " 3703b11; 'I t;. 0 () %.1l0
'/7121> lJ.:'. ~ lIlliLc 1 4310211.1U "7.tl~ "7.rJ;
'J70 LU hOT/HfUKO I' 4tl\.' 1 ..370l100 111.55 ltl.Oj5
'J 1l. 2. ~ .MAS';..G~ L 4370)0;01,) 4".10 "tit. La
',lLlb u..>. 51/.GI.., 1 4HOllon .. 7. tj.j 't 1. .,' '>
~ 1\1 LI. rlUl/hYO,..O I' ,\(;1\ 1 4J7C270U LtJ.'J'l 1'J.~)?
OJ HZ" riA ~ ~Alil: 1 "3103~UU it', .to '. h. l U
')71',; PT LI .. hk 1 4HO)/,OU 4d.OO ",..00
'l1LZb u. ~ . ) 1 i,lil.t; 1 4,17(,l101J 47. ri~ It 7. lJ ')
'/7V1l t1'lT 1t11u..L t1.:-l.:1<. 1 " .l70l7011 Lb.5~ LO.'f ~
'17101" l'ii\S SAlre t 4371J3'>OU 4.. .ll' "... 1 0
'J 7 l.!b U . ~ . ) hllll.:. L .. J7 Ol10') "7.d" It 7. ,,'j
Q45 ';.t, r!: j'l ~ ..I'I.U.. 1 " J70l..UIJ L9.70 1.~'. 10
',7l;tv HilT "1lIHIl ~ ,,<;... 1 4J7C.!7uU Lt.;5 It,.~,~
I~ 71 i It ,', ^:) J H1Jl: 1 ..]71)J501J .. ~. tll ...., 1 U
'; 70 1.. 11',1 T 1 ,,'f U~ L; I' ,<:,.. L "J7U0171.lu lc.~J L:,.\. ')::J
'/ i L.! "t "'I.:to.:) ~ M~I L. L 4 J7UJ~0') ",.... L!J .....10
',1L 1(, r T 11 ~ tHo 1 "J 1lJ jldlJ 'ib .1,0 l~". 0 u
';10 L.. "LT/HYlJ"U li;.';,-, 1 "J7U,;7U,; 11>.5 'J Lt.""
'17101.. .':...;) J ~\I;': L 4)1l::1'101) "".10 't it. l (J
,,71 't~ iJ r L/'t "" L 4 He )1101) "e .00 "" .1)0
17u 1l; rt '" r lf11 d" L: t' ..<;. L 437<..!700 10.55 Lu..,1j
; 1 ~ Lit d ..at;) ).,....~ 1 .. 171; j ~U,) ..".1 U 4, '-1'. 1U
,] 1"" r T L/'t " " 1 .. J7CJllG'J "b.GO -1~. GL
, ! t; I.. ~111 r It': f v'" U t" .IC."' 1 .. J 7,1<: 7U() t IJ. ,>'j 1. t,. ,':1
oJ] 1.~'" " .\,;;a :. ..'oj C L 't)7(J'}OI~ ~".1() ... It. 1 U
NOT POSTED WHEN THIS DILL WAS PREPARED, OR IF INSURANCE
CARRIERS 00 NOT PAY ANV PAnT OF THE AMOUNTS SHOWN,
PATIENT NAME
!. .:f.'i;~l....';""'." ..(.,.....\U )t'.lTr.... . A(iJrt ..r;,"'.lU t1G~t tr.IL
"" ,j( '..11"'" 0
'ir.l.h.\I. t,;').,: u": II, .' A l 7u" ~
,/l71 h''l-J1Lo,
..._ . " I ,_
PATIENT NUMBER
MEDICAL nEconDS NO.
'INAN PAt
1;1.-.111 "'"
STATEMENT DATE
I . "'1_
'j"/ l # ,', t..
,.1.....
:~ 1 01. r '"-l I. 0 L, ,.
'J '. ,,711 ~
'j 1..' ~t 1f,:J -, lJ IJ 1
.1 U
, ,
DATE OF BIRTH
I L U I
N ",nfH
ATIENDINO DOCTOR
I.J/..:1/" It! JL lJ11'..I~/'j
~! 7 / 1 71 td " 1< (l' 0 i ,,', ,
,.~L r l. ..:".\ i (i
t.:lI.UY .~"/(;L~~
I! j H 1'.O~.r"" l' S T
l.A;...liLt
17v13
I'll!
~T
t'ol
) T ., T"-
~Chl:
F ,\!f"' .U:.
'Jul '/l1"I':t
J.)t;4 7 J'ti~l.J
DESCfllPTIDN OF HOSPITAL SEflVICE '
mD
5tllVICE ' TOtAL'
CODE . CHAnOES
~.I"'il"""___1 "......,."..___,,,,...,,..,.,,,_
PAlIENT.
, AMOUNT
",t ~J I!: ~ '171~!:l PT 1/.. HI'. 1 ~J7CJoOu ..S.OO "iI.OO
t: '/';7 <j7U 10 HUT/HfUkO 1'.lell. 1 ~ nOVUl; lll." 11l.55
'J ~ I\..' '1711" MAS ~1I1;c 1 ~31C35UU ..~. 10 "',.lU
;1'>/07 '171.., P T 1/" .H, 1 ..J70JbUlJ "d.uO ..~.OO
1j~1t 1 '17c; 10 HOT IHHH.O I'ACI\ 1 ..J70l70lJ 10.55 lb. 55
""Ill 'i71.!" MA~ ~f,~l: L ,,3703~O0 .....10 "".10
v;1 tl. <j 71.. 5 I'T 1/ " HI< 1 ..J7lJ3000 "d.OO ..ij.OO
'j ~ / l, '1701t: HUT IhYlJKC t',,(.~ 1 .. HUt: 7l)'J 10.5' 10. ') 5
V "~I t, ',HZ" i1A~i5..loc 1 ..3703,0') "".LIl ..... 1"
J;/l , 'Ill..!:l I'T 11 .. tit< 1 ,,370Jt:OlJ "d.O(J ,,~.OO
C 'J/ t n ~7U 1" tlOT /hliH,l; I' ~C" t ..17(.270:; lo.55 lll. ~?
V ~il to '1712" MA~ ~1I('t: 1 "17uJ;Ov "".LO .... Lll
v ~/1c '1711(, P T Lll tit< 1 ..17LJhl'. 90.00 'Jb.OU
lJ ~ / l'l '17(, 10 HOT/hYU.O t"...l:"'. 1 .. 37Gl701) Ib.55 lb. 5'
v'.i/l! "12.. :1"'~ S~Gl: 1 "J7c;J50t.J "".10 "'.. 1 U
o 'j/l 'J '1711v fOr II <. h'-, I "37\;31:11' '/0.00 "b.OC
'J: 1 i I. '11(; 1(, HOr/hYLJ~L I' ~I,r. I ,37C~70'J lb.? !:l 10. ,:;
fJ ~II ,! .. Ii ll~, 1A:i ~.\'-,c L ,,37fj);O;1 .....lU "'..10
lo";' ~ ) 711" I'T l/2 "i. 1 "37CJol,.. '10.,,0 'in.00
U";/.!t.t '/(; 1lo HIlT Irq lJ' U I' ~C~ 1 ~ J7t21{)IJ lo.55 1 to. ')?
1.J~'';tJ " 71~.. ."A:'J~ut: 1 ..l7';J~O'J .....10 "... 1 (;
'J'JI ~t; .71"5 I' r l/ , nt. 1 "J7 C J oQf) .. B .liO ..,..OG
U':lltj 'j 7 J 1 (. tt,)f IHYlJ;.IJ t' ~C~, t ,.I7(;27UO 10.;~ t ll. '> 5
O':Jllh ',7 l<" "1.\.i :: A\,c. I .. 37.; J 'UoJ "..oll) "". 1 0
U"), '0 .71 lu I' r tl ~ nK 1 "J 70., l'J 911.UO 'I,,, 00
:JOI U1 .1(, 1 \I H.lr /tlrU~l. tI.'.c.:" 1 ..)7..~7vIJ 11l. 5 'i ltJ.'J5
Obi rJ1 ',71.," ."I.\;)..lM \It I. "171)~Qt) "~.IO It I,. l U
OO/'H .711\) I' I 11 i "to 1 "HI;)"I'J '11>.00 'IlJ.IH)
Ue/O, ' hI 1 c' 111; r It1YU~ l. t'..t,;", 1 ..37(.OU,) lb.55 10. "
Otl/GL J 71~" i~'" J ~ M' tt: I. ,,17'Jj :IV') .....10 't". 1 G
'TOTAL~
~"~
PLEASE REFER TO PATIENT r~UMBER
or, AllltlOUlRES ArlO
CORnr:SPOrmEtICE
NOT POStED WHEN THIS BilL WAS PREPARED, OR IF INSURANCE
CARRIERS DO NOT PAY ANY PART OF THE ...MOUNf8 SHOWN.
" YOUR PHYSICIAN WILL BILL YOU SEPARATELY FOR PROFESSIONAL SERVicES RENDERED TO Y\lU ,', '
STATEMlNT DATE
t' li'....L ("or. Il" ,',,:,
HI....
,tl,.t1A.1.t1l..J 1.l'<\1 1("1,..) .d...r
" d "ll \ lU tu
~IC~"A~l(SnU~(;. p~ 17~~~
1717' a'll-l7U'.)
.. .. L J r t. .: t: r ~ tt "1 lJ:. I' i : .. L.
~
, "'. . '
, _'"
, ,
PATIENT NAME
PATIENT NUMBER
MEDICAL RECORDS NO.
'IN"'" ""1
caul 1YPf
t:! (.L.. r ,'L I,UL;' \,0
') J d 1 r. 'J
'J i" 1 7 to 'J - ..; 'J ~ 1
.I U
OJ, ~ c I " 1 ~ 11 L' 11 iJ U 'j ,
DATE OF BIRTH
';7/17/I,j
ll. lJ I
N uorn
ATTENOING DOCTOR
l t. ti' ~U, I
'-loLL:, l"'Jdv
Cll,LlY "l:,~UL~~
bJu NU~TI1"I'~T
CA':l.l.Lc
17013
."
\UI' I,l
.
~T
PA
q~lt
~L..i:
,; ',t" l~ " i,,)
L:,'! 1I~.I'it
J",;'tlHl;U
DESCRlPTIO'N OF HOSPITAL SERVICE
rm~
(,01 UL 'j Hlli I'T 11l HI< 1 't370l111'J "0. i.:'J ?lI.OO
uIII Ud 'i7U1U HOT IHYUIlO Po\LK 1 'I 17U1700 itJ. ~ oj 16.~5
o tll 00 <j HZ't I1ASS"uE 1 't170)~0') Itlt.10 't".10
UII/I:Il '1 HIU I'T 11l HI< 1 It 3701610 '1t..OU 9b.00
Otd 111 nUI0 hOr/HYORO PACK 1 43702700 In. ~ ~ 10. ~5
011110 '17th MA S 5,11,1' 1 It370)50Ll ..".lll "It. 1 0
011/10 '11llu I' r III III< 1 4HOlll1') 'JlJ.OU '1...00
\Jallll '17L lu HIlT/HYllK(j I'/,CK 1 "370,70'J lb.? ~ Ib.'j~
Ob/lu 'J 1l. Z 't IH5S..';1: 1 " ]7CJ511'~ ..It.1U "'f. 1 U
U al 10 ':1711,) P T It.! H~ 1 'tHOlbl'J 'ib. uU 'it>.lIU
ub/~", 'l101u Hur/hYU~(J Pile" 1 ItHOZ70il tb.:l? lb.')5
OI,/U 'JHZIt MASSAG~ 1 "170l':iOLl 't '1.10 'I '.. 1 U
Obi ~~ 171 tu Pi 11l Hk L "nOJol-J 'i~.u(j 'ho.OO
Obi d '11iJ 10 ,WT/hYLlkO 1'..1,;/1. 1 't H Ool71") ltJ . t) ~ It>o ') 5
l;a/,j ':I1L.!'t ilolS ,.1 \>1: 1 "3703')01) It It 01 IJ 't~.lC
Obl2 J '171111 PT Ln t1k 1 ~J7tJlol':i ')0. CU 'lb.OO
Ob/l5 ... 7t. Lll HI).T II,T LJf< C I' AL/I. 1 It 170i7UI) 11>., " 10. ',,~
Ot,IZ5 " 1Lllt t1~~:'h4bt; 1 'tJ7()j'JO'i 'lit. L ,) ".. 1 0
CJb/l:l > 111v PT l/.! "" L 't J n j 0 1') 'It; .00 Cjll. UO
Ob/l'J 'i 7U L.. r1U r It1YII~ U I'..C/I. 1 'tJ7o.!70iJ 10., , It,. , ':i
Obi ~It.J nL21t j~Ai :l~\d: 1 4J7U,CJ 'tlt.l) '1". l \J
Obll'l ,711J p r tli r1k 1 ItJ70301.1 'i/;.OO 'Ill .'JO
071 C<: . 7 u tt t1UT IIQlJkU t' ..(,/1. L It J 7'.', 7U'J llJ.!oJ ~ i.'.l. !J;
07/0" 'II.':" "1.\ ~ :Jj' "-It: 1 'tJ7uJ':iOLi 'tlt.1U ,. it. ~ U
0710i. 17Ll'~ P T 1, " :1;" 1 'tHeJolJ 'ltJ.lJu "'lJ.tHJ
Ph) SIC.'L The 0( ~I'Y 51bl.'1') ~ L" 1. 'I ':i
Oltl J." HJ/'II i, 4'IJ\;)T,11I,T 1 ilOOO\llll 7 j bt . '.,h}_
O':i/H . r .>1 t to .t,P', ,v 1 OOOl'UOlt 1 fI j')....~-
II
NOT POSTED WilEN Hm~ DilL WAS PREPARED, on If INsUnAtlCE
CAnRIEns DO rial PAY ANY PAR' OF Hif AMOUNTS SHOWN,
.-: L ~'f "" l.
,'1 LL.
Uti Il') I ",'
'It.;,,^;;(l j!-lJd, ';UH~ $.YSTl:11 .
Q ,..
" d .t lJ ,\1 L t; III" -. '
ltl.rtAl. .>U<v, ria 170~;
11 L 71 ,,'1t-17eu
AcurE ~e"~tl
o
BTAT[f.lUn OAtil
. .
, - .
PATIENT NUMBER MEDICAL RECORDS NO, """ ,..
Cl"'l TYPf
,UrlH', 'j0~7b5-l0H A 0
, , DATE OF BIRTH N 1,18 R ATTENOING DOCTOR
~71l7llJj ,LZt:I,~O'1 ~ULTl, C~t.t(j
PATIENT NAME
L 1,';1, Y ..c I,UL. - ,;
Ij J I .:. ~ll .;
L I. lL 'J 7 II) i I I
C 11>;0 Y \~" rWL <f<
ale! ~Of,ltil.~ H
CAKL.1:'L.L
17t; lJ
~T
I'M
ST"Tl: Fill.. I""
"'C"'E 001 7/L",r,L
JlllJ~73~8U
DESCRIPTION OF ~DSPITAL SERVICE
rm
"A1IlNI
.AMOUNt
~~/Jl AUMI~ MOJUSTM[~T
u~/)u AOM[~ AUJuSTMENT
U711.~ ADMIN AUJuSTMENT
Orlll AO~IN AOJUSTM~NT
1 00000107
1 00000207
1 00000207
1 00000207
271.71-
81t.H-
21').)1-
112.116-
TOTAL OF PAYMENTS ~ AOJS
11>"0.51-
TuTAL CGwRr.NT CH~R(jES
5101.Q5 Y;.Zl.~~
dALANCE FORhARO CHARGES
TO-DATE PMYMENT~ AOJ5.
11>~0.51-
la~O.~
OEUuCTInLE A~uU~TS
~CCuUNT rlAL.~NL!:-
J5Zl.~~
II I
'lOT POST EO WHEN TIllS BILL WAS PREPARED. OR IF INSURANCE
CARRIERS DO NDT PAY ANY PART OF THE AMOUNTS SHDWN.
HOOVER REHABILITATION SERVICES, INC.
HARRISBURG
AUG 6 1992
RECEIVED
August 4, 1992
Ms, Amy M, Wolfberg
state Farm Insurance Company
115 Limekiln Road
P, 0, Box R
New Cumberland, PA 17070-2423
Clients Name:
'lour File:
Insured Name:
Date of Injur
Our File No :
92 PRO
PEER REVIEW
Medical information on the above captioned file was submitted to
Ellis Friedman, M.O" Orthopedist, for a peer review, His report
is enclosed,
After reviewing the enclosed report, the following conclusions
can be drawn:
1, Initial care rendered was reasonable and necessary.
2, continued care is not necessary.
3, Maximum medical improvement was reached by 1/13/92.
4, The TNS Unit and Second course of PT beginning in
March, 1992 was not due to the 7/14/91 MVA.
5, Dr. Lupinacci's evaluation on 6/2/92 was not due
to injuries occurring on 7/14/91.
Thank you for allowing us to provide you with the above service,
If you have any questions, please feel free to call,
If a reconsideration is desired. please contact Joanne E, Frank.
R,N., in writinq within 30 davs from the dav the initial
determination is effected. Use the Camp Hill address,
Sincerely,
HOOVER REHABILITATION SERVICES, INC
.I""n~' Eo h.:ud".,e,,-
Joanne E. Frank, R.N" C.I.R,S,
JEF/jj
Encl.
Peer review report
Medical Records
205 HOUSE AVENUE' P,O. BOX 6672 . CAMP HILL. PENNSYLVANIA 1701108672 . Phon.: (717) T.I7,5004 . FAX (717) 73Hl967
LIBERTY S~UARE MEDICAL CENTER' SUITE 104' I71h ANO LIBERTY STREETS' ALLENTOWN. PENNSYLVANIA 16104 'Phon.: (215) no.l000' FAX (215) no.9934
EXTON PROFESSIONAL BUILDING' SUITE 305 .319 NORTH POTTSTOWN PIKE. EXTON. PA 19341 . Phon.: (215)52~08596 . FAX (215)524-7980
SUITE'06 . 400 McKNIGHT PARK DRIVE' PITTSBURGH. PENNSYLVANIA 15237 . Phon.: (412) 368.9120' FAX (412) 368-6315
,ELLIS F. FRIEDMAN, M, D.
ORTHOPAEDIC SURGERY
320 ABINGTON DRIVE
WYOMISSING. PENNSYL.VANIA 19610
TELEPHONE (21!l) 1578'4!l2!l
July 31, 1992
Joanne E, Frank, R.N,
Hoover Rehabilitation Services
205 House Avenue
Camp Hill, Pa, 17011
Re: Cindy Wendler
CH-16452-692 PRO
Dear Ms. Frank:
At your request, I reviewed medical records relating to the care
and treatment of Cindy Wendler. Your letter dated July 15, 1992
arrived in my office on July 17, 1992, From these records I
learned that the patient, three days short of her 28th birthday,
was a passenger sitting in a parked car which had a boat trailer
connected to it, The boat was being tied down to the trailer when
the trailer was struck in the rear by another vehicle. She was
evidently seen at UrgiCare in Erie, Pennsylvania but I did not have
those records available for review.
The accident occurred on July 14, 1991. Two weeks later, on July
29, the patient came under the care of a chiropractor, Thomas Boch.
On a pre-printed "consultation" form, the patient's "major
complaint" was handwritten as: "central pain - T2-3 area - fell
asleep - went to MD for this before. Previous D.C. 12 to 13 years
ago - skating," The patient indicated that she had first noticed
these symptoms two Ileeks earlier and then they had gone away for
a few days. Her symptoms were said to be worse in the evening and
were relieved by putting her arms down. The symptoms were said
to be constant. The chiropractor took x-rays and diagnosed a
"vertebral subluxation at T2" as well as wedging at T4-T5, The
patient was then subjected to 41 chiropractic treatments through
October 25.
The patient was also seen by Dr. Christopher Snyder, an osteopathic
family physician, on August 1, 1991. His handwritten office note
indicates that the pc.tient had not had any pain initially but that
the next day she had developed pain in the neck and shoulder going
to both arms, She also had left mid to lower paracervical pain
going to the occiput. She denied paresthesias and had no problems
with grasping, She r.ad some problems sleeping because of pain and
stiffness and noted that her work as a beautician aggravated her
pain, Dr. Snyder's physical examination showed there was
limitation of motion of the cervical spine, intact reflexes, normal
sensation and motor power and paraspinal tenderness in the cervical
and upper thoracic region. The patient was diagnosed as having
a cervical and thoraGic strain.
On October 22, 1991, the patient was examined by Dr. Craig Fultz,
page 2 - Cindy Wendler
an orthopaedic surgeon. I have reviewed all of his typewritten
office notes. He noted that the patient had been seen at the
Carlisle Hospital on October 17 at which time she had been referred
to him. His typewritten physical examination showed no
tenderness to palpation in the cervical spine and no paraspinal.
muscle spasm. There was tenderness in the thoracic spine from T2
to T5, There was no tenderness along the vertebral border of the
scapula. There was mild hyperkyphosis in the thoracic region
without scoliosis. There was no lumbar tenderness and neurologic
examination was normal.
In contrast to the chiropractor, Dr. Fultz reviewed x-rays of the
cervical spine and thoracic spine and felt that they were negative
showing only mild flattening of thoracic kyphosis - exactly the
opposite of what he had found on clinical examination.
Dr, Fultz diaynosed a cervical and thoracic ~prain and started the
patient on a course of physical therapy, This therapy was done
at the Rehab Hospital at Mechanicsburg. 1. have reviewed the
handwritten evaluations and progress note~. The patient did well
and on the office with Dr. Fultz on December 2, 1991 it was noted
that she was working at her regular job and complained only of
"achiness in her neck at the end of the day." The physical
examination at that time showed her cervical spine was non-tender
on palpation, had a good range of motion and there was no
tenderness along the scapular border,
On January 13, 1992, Dr. Fultz noted that th~ patient was doing
well, was not taking any medicine and was doing home exercises
regularly. She was working without difficulty and her physical
examination was entirely normal. She was discharged from his care
at that time,
Two months later, on March 24, 1992, the patient was again seen by
Dr. Fultz, A week earlier she had been at work, had turned,
twisted her upper back and had developed increasing discomfort in
the thoracic spine along the medial border of the scapula, She did
not have any radicular symptoms. Dr. Fultz I s physical examination
at that time showed tenderness only along the paraspinal muscles
in the upper thoracic region and the medial border of the scapula,
Passive range of motion of the arm also caused similar discomfort.
Neurologic exam was normal.
Dr. Fultz started the patient on a second program of physical
therapy at the Rehab Hospital of Mechanicsburg. The handwritten
initial assessment of March 26, 1992 indicates that two weeks
earlier the patient had "turned to reach for stool and heard a
I pop I in upper back wi th pain. Pain has remained constant "."
The patient was then begun on another course of physical therapy,
It was also recommended that she be fitted with a TENS unit. This
page 3 - Cindy Wendl~r
'was done and she continued using the TENS unit during the next four
months, She was rechecked by Dr. Fultz on April 13 when it was
noted that her neck symptoms were improved. She had mild
tenderness to palpation on physical exam.
On June 2, 1992, the patient was evaluated by Dr. Michael
Lupinacci, a specialist in rehabilitation medicine, He prepared
an exceptionally thorough and well-detailed three-page letter on
June 5, In his physical examination he noted "moderate left upper
thoracic paras pinal muscle tenderness in a very circumscribed area
approximately 1 cm. in diameter." He felt that her pain was
muscular, His neurologic examination was normal.
In summary, the patient was involved in a motor vehicle accident
as a result of which she developed upper thoracic pain. She had
a worthless course of chiropractic treatment based on diagnoses
which did not exist, She then had a course of orthopaedic
evaluation and physical therapy which resulted in complete
resolution of her symptoms after which she was asymptomatic for two
months.
She then had a new injury at work when she twisted and developed
pain similar to that which she had had eight months earlier,
Thus in answer to the questions contained in your letter of July
15, 1992 I can state the following:
#1 - I think that all of the care which the patient
received by Dr. Snyder, Dr. Fultz and the Rehab Hospital
at Mechanicsburg through January 13, 1992 was directly
related to the motor vehicle accident. I am recommending
reimbursement for all of the original treatment at the
Rehab Hospital of Mechanicsburg during October and
November 1991 despite the fact that the patient received
only passive modalities including ultra sound, hot packs,
massage and therapeutic exercises, It does not appear
that the patient was receiving stretching and
strengthening exercises using back exercise equipment.
I think that the care which the patient received
beginning in March 1992 was unrelated to the accident and
was due to a new incident. I do not believe that an area
can "unheal" after it has been asymptomatic for over two
months. I think this was a new injury of tissues which
had completely healed.
#2 - Continued care is no longer necessary as a result
of the motor vehicle accident.
#3 - Care could have been discontinued by January 13,
1992,
. - - -,.. . .~ ~. .
.~ ~ . .~..- o. _
VERIFICATION
I verify that the statements made in the foregoing pleading
are true and correct to the best of my knowledge, information and
belief, I understand that false statements herein are made subject
to the penalties of 18 Pa, C, S, 4904 relating to unsworn
falsification to a~thorities.
Date:
II,..../? ..
/11./L ,Ii ,:tL
Mark Smith
Chief Financial Officer
Healthsouth Rehab Hospital
, ,
SIIERI F'I" S RETURN
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
In the Court of Common Pleas of
Cumberland County, Pennsylvnaia
No, 95-917 civil Term
Complaint in Civil Action Law
and Notice
Healthsouth of Mechanicsburg, INc.
VS
state Farm Insurance Company
R. THOMAS KLINE, Sheriff, who being duly sworn according to law,
says, that he made
diligent search and inquiry for the within named
State Farm Insurance Company
defendant, to wit.
but was unable to locate
them
in his bailiwick. He therefore
deputized the sheriff of
York
County, Pennsylvania,
to serve the within
Complaint in Civil Action Law and Notice
On
March 10, 1995
, this office was in receipt of
the attached return from
York
County, Pennsylvania,
Sheriff's Costs.
Docke ting
Out of County
Surcharge
York County
So answers.
18.00
9.00
2.00
31,60
60,60 pd. by
to before me
..,/''''".....,-/ /'--~
<' (-~....... ~ . /#~.
.-; ~,..-; r' .. -
I
R, THOMAS KLINE, Sheriff
atty 3-10-95
$
Sworn dnd subscribed
this
J~ S
day of 71Lt.A.J--
19 Q.(
, A.D,
C)-'ll ~ 0, I\L,...:~ , ~l'I.1
Prothonotary
I;' ii1='l Court cr C.::mmO;-l r:le:::s of
.... f t .1
I ......,-.:\~Il...............' .'u......."/
........-...... -"...."'..... "',1
Panr:zy IV::i: i:::
. "
Healthsouth of Mechanicsburg, Jnc,
'is,
State Farm Insurance Canpa.ny
:-io. <)';-<)17 C'h1i1 T"nn
---,
:~..._.-.
:-iow, Februarv 22. 1995
:9_ !. SEZ?..z::- 0: C:'~G:::?.!..A.'ID eOT.:!':'?, ?A.. co
==--b)r d:::uci:: :.::: .sn.::S oi
York
C-:ltL:ty :;) =.."':::".::: :is 'tV:::,
:.::.s d:;:u::::.cn ;:~ -.,.:.. :It == ::qu=t ::ci :-=..:k. of == ?!~a.
~,/, /,' ,/~
__~.4;:,,~1 " 'r ,," . ..:" 1';'~'~:"
l' -';'. . ',,' 'r,.,. '-1 ....e~,,~
She..~ at C"~er..:u::d C~u:t'1. ?:1.
'"
.L\Sdavit or Sem~
:Sow,
M;rrh Ii.
. --
~9 Qt;
o'dea
1.m
P '..r. 1:-.-=
. ..0
== Wlp...."
N:lt:ic:E am C'a1plalnt
~POQ I-mltlm..1th of ~, Irr.
u 115 LinEkiln R:J" P;O. Il::l< 257, Now C\JtI::er1arrl, PA 17070
by::u:db;:o
Karen H. B.Iry. Claim 9..{:Erlntati=nt fer State Farm Ins. C'a1p.
.. t:n.e an:! aLl:e,l=I
I,
o::~
at 115 Llrrekiln R:l.. ax 257 ,
l'I3I/ llm:enanJ. ffi 1 N IU .
,
cpr
ci :==
.md -~":. bawn :0
"- Lon tlJ
IJ_ 0"').
((i
~.r
. .,
:.:.: .::::t:::3 :'''':::=L
,"
=
0-
r-
o
'"
~ ::1~~" r)JOk ' If"
'''0 ;/V
:-..' >_ t^,.." '.t,.../d1
v IEUIY 9JEruFF Nevin Arnold
<:.)
,'\ ..~""l~~"":'~'~,,~
t't.~= I ---
~ c. Counrr. ?
:.",1 . ':~
C ld
,. I :.r:
~';: llJ
I ~...
So =-w=.
i;J I....
uO
UJUJ
0:<.:>
u..
u..
o
r--
'"
~
Swot: :me r~J::d ee:cn: ;I!'
=: .\,,: -; (. 6v oi /iU~f / ,
/U/l, , .
COSTS
::~i. V1C:;
~aU,AGr:
oS 18.00
11.60
2,00
!9..2j:-
NOTAlUAI,SEAL A:: ll) ;"IT
Y1~lllS ~I. RHINE, HolnlY PubllO
york, YOlk Counly, Punnc~lvanla
My Comn.,:;Ion E.<plr.. M.,ch 25, 1~.5
7r.Gr'---'
1- .--a
.
ROLF E. KROLL, ESQUIRE
Pa, Supreme Court I.D. No. 47243
REYNOLDS & HAVAS
A Profeseional corporation
101 Pine Street
Post Office Box 932
Harrieburg, Pennsylvania 17108-0932
Telephone I
Faxl
[717] 236-3200
[717] 236-6863
Attorney for Defendantl
STATE FARM INSURANCE COMPANY
HEALTHSOUTH OF MECHANICSBURG,
INC, ,
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
Plaintiff
v,
NO. 95-917
STATE FARM INSURANCE COMPANY,
Defendant
CIVIL ACTION - LAW
JURY TRIAL DEMANDED
PRELIMINARY OBJECTIONS OF DEFENDANT, STATE FARM INSURANCE
COMPANY. TO PLAINTIFF'S COMPLAINT
AND NOW, comes Defendant, state Farm Insurance company,
("State Farm") by and through their counsel Reynolds & Havas, A
Professional Corporation to preliminarily object to Plaintiff's
Complaint as follows:
I. Plaintiff LackB Standinq to Sue
1, This is a breach of contr~ct action between Cindy
Wendler and her insurance company, state Farm.
2, The dispute at issue arises over medical bills
that Cindy Wendler claims are owed pursuant to the State Farm
policy in question.
3, By the terms of Plaintiff's Complaint, a true and
correct copy of which is attached hereto as Exhibit "A", it is
clear that Plaintiff alleges this action arises from a motor
,
vehicle accident that occurred on JUly 14, 1991, involving Cindy
Wendler. See Plaintiff's Complaint at paragraph three,
4, Plaintiff's Complaint establishes without question
that Plaintiff has asserted a medical payment coverage (MPC)
claim on behalf of Cindy Wendler to State Farm, automobile
insurance company for injuries allegedly arising out of the use,
maintenance or operation of a motor vehicle in Pennsylvania.
5, Nowhere in Plaintiff's Complaint does Plaintiff
allege that it is an insured under State Farm's policy. In fact,
it is clear that a hospital such as Healthsouth cannot be an
insured under a motor vehicle accident policy as they are neither
natural persons nor capable of sustaining injuries arising from
the maintenance or use of a motor vehicle. Thus, as Healthsouth
is not a party to the contract, they have n~ standing to sue in
this breach of contract action.
6, In view of the foregoing, state Farm requests that
this Honorable Court enter an Order striking Plaintiff's
Complaint as Plaintiff lacks standing to sue in this case.
II. Plaintiff's Claims for Extra-Contraotual Liabi1itv ars
Barred bv ODeration of Law.
7. In the event that this Honorable Court refuses to
dismiss Plaintiff's Complaint on the basis that Plaintiff lacks
standing to sue, this Court should nevertheless dismiss
Plaintiff's claims for extra-contractual liability because such
- 2 -
claims are barred as a matter of law and are further barred by
operation of a class action settlement.
6. Recently, a class action suit entitled Maria
Brownell v. state Farm Automobile Insurance Companv et,al" slip
op No. 90-2224 (1992) ("class action") was commenced, A true and
correct copy of the Final Order is attached hereto as Exhibit
"B". The parameters of the class involved in the class action
was established by a Certification Order entered on July 31,
1992, A true and correct copy of the Certification Order is
attached hereto as Exhibit "C",
8, The class involved in the Brownell suit included
all state Farm policy holders and all others who asserted MPC
claims against state Farm from February 24, 1984, through May 4,
1993. ~ Exhibit "C".
9. The Brownell Final Order dismisses with prejudice
all claims for extra-contractual liability including those
asserted under 42 Pa. Cons, stat, S8371 and claims under the
Unfair Trade Practices and Consumer Protection Law, See Exhibit
liB".
10, In view of the foregoing, Plaintiff's bad faith
and consumer protection law claims are nothing more than an
attempt to individually litigate issues addressed, resolved and
precluded by the resolution of the Brownell class action suit,
- 3 -
11. Moreover, the superior Court has recently held
that claims for extra-contractual liability must be dismissed
when a peer review organization has been used to challenge the
reasonableness and necessity of care. See Barnum v, state Farm,
635 A.2d 155 (1993),
WHEREFORE, Defendant State Farm Insurance Company
requests that this Honorable Court enter an order striking all
Plaintiff's claims for extra-contractual liability or, in the
alternative, that Plaintiff be required to file a more specific
pleading setting forth the facts that support Plaintiff's claims
for bad faith damages, damages under the Consumer Protection Law
and/or attorneys fees,
Respectfully submitted,
& HAVAS
1 nal corporation
DATE:3/:Li4r
By:
#47243
Attorneys for Defendant,
STATE FARM MUTUAL AUTOMOBILE
INSURANCE COMPANY
101 Pine Street
Post Office Box 932
Harrisburg, PA 17108-0932
(717) 236-3200
304B/MISC20
- 4 -
Exhibit A
..1..."If<"........."I'...,I'..'"It"I.""'II.@
.
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,
PENNSYLVANIA
HEALTHSOUTH OF MECHANICSBURG,
INC.
175 Lancaster Boulevard
Mechanicsburg, PA 17055
PLAINTIFF
CIVIL ACTION - LAW
v,
DOCKET NO.
C(:i- 9/7 (Jt..(l~LJLLNL
by entering a written appearance personally or by an 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
..- - --,...., :'~.~mQr;ey ~.claiiiie.d1fi-:: tlie~cciiiijjlali1t or for any other' claim"'or Are!!ei.'" ,
~... ... .- -.... . .:......_..r.':.. . .. .. . -. .~:..~."':'!'-;_.;"._:..:'."':'. co'. '.-:.~:'.'.'~'. .
requested by the Plaintiff, You may lose money or property or
other rights important to you.
COURT ADMINISTRATOR
CUMBERLAND CO COURTHOUSE
1 COURTHOUSE SQUARE
CARLISLE PA 17013 3387
TRUe COPV FROM R~) 240 6200
In r.III,IOII,/ W IIlIll"e Un1\) SIt my_
and "" seal of at Isle, PI._
T :J. 0' .... 1I1?~ .'
. .
STATE FARM INSURANCE COMPANY
115 Limekiln Road
P.O. Box 257
New Cumberland, PA 17070
JURY TRIAL DE~ANDED
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,
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:
4 th FLOOR 'I
~ :.,
- ...
,.,. II
~.l. ' .
'''''I "",
",
LZ 93 J
-,
1
~ ,.:!JI)
.
..
,
......
.
,
A VTSO
USTED HA SIDO DEMANDADO EN LA CORTE, Si usted desea defenderse de las
quejas expuestas en las paginas siguientes, debe lomar accion dentro de veinte (20) dras a partir
de la recha en que reciblo la demanda y el aviso. Usted debe presentnr compareccncia escrita
en persona 0 par nbogado y presentnr en la Corte par escrito sus defensas 0 sus objeciones a las
demandas en su contra.
Se Ie avisa que si no se defiende, el cnso puede proccder sin usted y la Corte puede
decidlr en su contra sin mas aviso 0 notificacion par cualquier dlnero reclnmado en la demanda
o par cualquier otra queja 0 compensacion reclnmados par el Demnndnnte, USTED PUEDE
PERDER DINERO, 0 PROPIEDADES U OTROS DERECHOS IMPORTANTES PARA
USTED.
LLEVE ESTA DEMANDA A UN ABOGADO INMEDIATAMENTE.
SI USTED NO TlENE 0 NO CONOCE UN ABOGADO, VAYA 0 LLAME A LA
OFICINA EN LA DIRECCION ESCRITA ABAJO PARA A VERlGUAR DONDE
PUEDE OBTENER ASISTENCIA LEGAL,
Lawyer Referral Service of the
York County Bar Association
York County Bar Center
137 East Market Street
York, Pennsylvania 17401
Telefono No. (717) 854-8755
..,;)..
20.DAYS NOTICE TO DEFEND
CtVlL ACTION (4/93)
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,
PENNSYLVANIA
HEALTHSOUTH OF MECHANICSBURG,
INC,
175 Lancaster Boulevard
Mechanicsburg, PA 17055
CIVIL ACTION - LAW
PLAINTIFF
DOCKET NO.
v,
STATE FARM INSURANCE COMPANY
115 Limekiln Road
P.O. Box 257
New Cumberland, PA 17070
JURY TRIAL DEMANDED
COMPLAINT
Plaintiff, Heal thsouth of Mechanlcsburg,
Inc., d/b/a,
Mechanicsburg Rehab System, 175 Lancaster Boulevard, Mechanicsburg,
pennsylvania, 17055, by and through their attorneys, Oare & Briggs,
states the following claims against Defendant state Farm Insurance
company:
COUNT I - BREACH OF CONTRACT
1,
P laintif f
HealLhsouth
of
Mechanicsburg,
Inc, ,
(Healthsouth) d/b/a Mechanicsburg Rehab system (hereinafter "MRS"),
is a health care provider duly licensed and organized under the
laws of the Commonwealth of Pennsylvania, with a treatment facility
and place of business at 175 Lancaster Boulevard, Mechanicsburg,
Cumberland county, Pennsylvania 17055,
2. Defendant state Farm Insurance company (hereinafter
"State Farm") is a mutual insurance company existing under the laws
of the State of Illinois with its principal office in Bloomington,
:
,
, .
Illinois, and doing business in Pennsylvania with offices at 115
Limekiln Road, New Cumberland, pennsylvania 17070-0257,
J, On or about July 14, 1991, Cindy Wendler was involved in
a motor vehicle accident.
4. prior to July 14, 1991, Defendant issued a policY of
automobile insurance to Cindy Wendler, Said policy was in effect
on July 14, 1991, the date of the accident.
5. As a. result of the accident, Cindy Wendler suffered
various injuries, including neck and back strain and sprain and
recurrent accident related symptoms.
6, As a further result of the aforementioned accident, Cindy
Wendler has been obliged to receive and undergo medical attention
and care and to expend various sums of money or to incur various
expenses for which medical benefits are payable,
7, Following the accident Cindy Wendler incurred reasonable
and necessary treatment from, among others, plaintiff, for neck and
back pains and accident related injuries, The fair and reasonable
charges for this treatment are as set forth on a copy of the bill
__ .---...------which'"1s' at.tached ftareto,' made a part hereof and marked as Exhibit
. - . .... ...- - ..... .....~..'., . .---.--...-- p' --- .
"A".
8, The bills for Plaintiff I s services were submitted to
Defendant for payment.
9. Defendant, pursuant to Section 1797(b)(I) of the
Pennsylvania Motor Vehicle Financial Responsibility Law, as
amended, has contracted with a peer review organization, for the
purpose of allegedly confirming that such treatment, products,
2
,
services or accommodations conform to the profeBsional standards of
performance and are medically necessary. The name and address of
the aforesaid peer review organization is Hoover Rehabilitation
Serv ices, Inc.,
A copy of the peer review report is attached
hereto as Exhibit "B".
10, Defendant has, in violation of Section 1797(b)(1),
attempted to use said peer review organization to determine the
causal connection between the accident and the alleged injuries,
11. By letter dated August 7, 1992, the Defendant refused
payment for certain medical treatment, including the treatment
provided by the plaintiff, based on,the conclusions provided in
said peer review report,
12, It is averred that all medical bills incurred both before
and after the peer review and reconsideration are fair and
reasonable and that said treatment was medically necessary and
related to the accident, Moreover, pursuant to section 1797 (a),
all bills were to be paid unless submitted to peer review within 30
days,
,.._ '._ _ ~_._' -"-"1J':-~'Ddi'eniia:nt has .refLlsed to pay the balance-due 'un';'il= the.-
.-.-., ...-:---:..........-. .,.-....,-........... ......' -..... -..-....---..,...--... ....-.. ._. ,- .-....-..... ..._----_._.~ ................-...--..'
--' .
terms and conditions of the policy of insurance and the pa.MVFRL,
As a result of the aforesaid, Plaintiff was required to hire the
services of an attorney to collect the medical bills due,
14, It is averred that the Defendant has acted in an
unreasonable manner by refusing payment of Plaintiff's invoices,
Pursuant to section 1716 of the pa,MVFRL, Plaintiff is entitled to
attorney's fees plus interest at the rate of twelve percent,
3
15, Cindy Wendler assigned to MRS the right to receive monies
othorwise to be paid to the patient under any insurance plan and to
pursue her claims for such monies,
16, It is further averred that the Defondant has acted with
no reasonable foundation,
pursuant to section 1798 of the
Pa,MVFRL, Defendant is liable for attorney's fees for such actions.
17, Defendant has undertaken a course of action which has
been designed to unilaterally, and without justification, refuse
claims for medical benefits arising out of motor vehicle accidents
and for which the Defendant has contracted to provide insurance
coverage,
WHEREFORE, plaintiff demands payment of the full medical bills
due in the amount of $3,521.44 plus reasonable attorney's fees,
costs and interest on said overdue benefits,
COUNT II - BAD FAITH
AND INTERFERENCE WITH CONTRACTUAL RELATIONS
18. The foregoing paragraphs are incorporated herein by
reference as though set forth in full.
19, All treatment was provided to Plaintiff after the
effectiver'dateIH'(j'Cse'ct1cin'-8371 of the Judicial 'Code;-42 P,S, ..
Section 8371, effective July 1, 1990.
20. It is believed and, therefore, averred that the Defendant
has employed said peer review organization in bad faith in that
said peer review organization does a substantial amount of peer
review work for Defendant and has a financial interest in provident
to Defendant a biased peer review report,
4
.
,
21, Moreover, said peer review organization has, or may have,
continuously been providing negative peer review reports to this
Defendant and other insurance companies repeating the same language
for the purpose of maintaining a steady source of business, thereby
showing a pattern of abuse of the peer review process.
22, It is believed and therefore averred that the Defendant
regularly refers claims to peer review organizations for review
without a basis to do so.
23. In addition, said peer review organization gave its
opinion that the injuries were not related to the accident, instead
of determining "medical necessity" or "conformance to standards",
all in violation of Section l797(b)(1),
24. In addition, it is believed that the Defendant had no
reason to believe that Plaintiff I s treatment was not medically
necessary, but instead was intentionally trying to simply "cut off"
medical coverage for which Plaintiff paid a significant premium,
25. It is believed and, therefore, averred that based on the
allegations set forth above, Defendant is guilty of bad faith,
,-- -'=--~--,""""""" ~'6 :----Ciefenuan t ...s-~ tiilla W fu 1
- .'. _.....,. .~_.-:....-......-...-- . .,' ,. "-,' "~_.""'."" .~.,-. ~ .
malicious, - - unreasonable ,~- and
. ,,,..... ...-....~_.--=-.~.~::::--"... ..-.- ., ..:;..-.
unjustified conduct has interfered with Plaintiff I s contractual
relations with its patients by making it more expensive and
burdensome for plaintiff to perform its contractual obligations and
has deprived Plaintiff of the benefit of its contracts, thereby
causing losses to Plaintiff.
5
,
WHEREFORE, Plaintiff demands judgment in its favor in an
amount representing appropriate damages pursuant to Section 8371,
including interest, punitive damages, court costs and attorney's
fees,
Respectfully submitted,
Date
Richard Oare, Esquire
Attorney ID 18631
1776 South Queen Street
York, Pennsylvania 17403
(717) 846-3000
Date
re
Plaintiff
t
I
I
I
. _,e. -=-:';..~'~ . _; __,;.,. .__..,~ ..._._ ..~..
.__......_~_..-..._._._.- ".-
. - --. -.
.,
- -,
. - '. .-.. .--.'. _.,-... .
...-.......".
\mrl\w.ndl.r\.~a~lf~r.cpl
6
...
".
5Unlr.ltNf DAlE
.~
~ I .. '. '..
.....
. --
, ,'.. 7 J
PATIENT NAME
,.1 .: "1.....
,. .
."I...'JI '..
,
. -
. 7 I tJ": I '
;
. .
1,,: tiu'1 nC 'llH...::t
1 # i' ,", t,; " r t ^ C J T J T
~~hL!~~~ I'~
t 71,L J
DESCnlpnDN OF HOSPITALSERVICE :
'I..w 'l7t~5 I'T E\'Al. III Hi(
..1/,.'.. 'l7lZb U.S. ~lN"L.=
~ :1 _~ ')11,1(. HeT /MYURC t'~CK
~~/..~ ~112~ "A~;N~~
II.!! II. 'J71.!~ IUS iN"!:
"'~/:\.. J1LL~ J.,). :LI,uLe
,II ;'_ ..7~1.. Hi.:T l"rU~U "AC"
dl I. .hL!I u.... )lNlIl.:
'JJI : 1 ~7d\' HuT Ih'fL.,,,'; I'~C;.
1,3/ :L-17L~" '~')~MGI:
vAil t.;, ...,7lZ6 u.3. .lll...;l.~
~"~' ~IL1L MeT/MTC~C ~.~;.
0,; "I \..;, ; 'Ill." :'. A :i 5 t. \.0 f:
1~~/~~ ~7~Zc u.~. ~it,~~=
~"/~M .,1~lu Ml.T/hY~~1.. t'.CK
'v ~, ~~ I~ . J 7 L .:: It ,1 A .i :. "I.. C
'.. ~, ..:; , , 1. L ~ OJ T L I": .1:-.
\,' 't I I~ : -4 -: .1, "'. 3. ~! : I ~I L_
.. .. I -.; i .j '7.~ 1 ~.. ,... J r I r. , L,." ~ l.. IJ., l.";'
. I.... I .. I . : .L I~ .. i"':' ~ ....1 , L:
~..,';;. ,.i'..-:~.:'J"r ;..,.:.: '..".
'..:'-/..~ .,7i.~1) \oJ..:. lI.Il.lI..~
~"Jl\' ;7vL'_ M,;r,,"\'-G 1'.(.,
:.:...1 :'..' .1.l', .,...) ~...'~C
v"/LJ
'J'11 t ~
..:.., 1,)
u'i,l,"
\)4,' l..
I. ..'l~
,,7., .:
'17 _1.
';Lt.'.
,/1':0
,7~h
u..). Jl',LL.:
,....jr:t'll';'L, p.",.\
.-:~:' :....~l
"'" . ~. J 1.':\.IL. L:.
,,';f/Mrl.-:, ,,\~,'
,7. ~ It
'"...;.vC
.c.... J &,'J
-
.P' ~l .. ,~ .
~ L 71..:'
. .
,,"1- J I~-
'. ," , 1_ ,.' L
PATIENT NUMBER
, .' ~ 7 ~"
DATE OF BIRTH
, 7 I L 11 t, J
()
,
'WAN .AI
c...... .....
MEDICAL RECORDS NO,
~u~7o~-~~:1
~
,
,
A TlENDING DOCTOR
i'ULT i, \,' M.V
,L.:.t:~';';:
lorAL
CI~"Rr.rs
00.9"
..7.~~
10.,,;
.....lU
"... l.O.
~ 7. J;
10.5,
.. 7. a'
10.5;
....o1J
~7..,.,
10.,5
.....11.)
47.05
10.;5
.... .1\)
ql:o CO
..7.Q'
10."
'i4.~O
<1l:o CU
...,. c!'
lb.;5
,,~.lO
..7.ri5
1b.!l"
.....lJ
"'7.05
lb.55
4".1(1
.
;. y,.Il: F ",/, ,
:o.GI.1: ,J." 71L",'Q
PLEASE ~EFER TO PATIENT NUMBER
ON ALL INOUIRES AND
CORRESPONDENCE,
mil"-
1 ..31010111
1 4 HOHun
1 "37Cl7CiO
t ..3703~OU
1 ..J70350U
1 4J7U~101J
1 .. J7Gt.7Citl
1 "37ClLC,,;
1 ~J7t)l701.'
1 ..l7llJ,u(}
1 ~ nOl LO(,
1 4 J7Gl70U
1 ~37~350\J
1 .. J7Cdlit:
1 ~j1~27U~
1 ,,]7';3':01)
1 ")7I;3,,l'J
L ., ,1CllI.J
1 ..J71....?u"
l 't j 7 C j ~I',) .~~
1 .. J 7 '. J " l ;
i. ~ j 7C': L U:l
. .. J 7'.l. 71)U
l ,,\7t;j';~u
1 'OJ71:':;',)')
L "J;:~~?lI'.1
1. ,,;7',J:Otj
1 "J7rJ~lOO
1 4J7::::7,;J
t .. l 7.. J ',Il11
1 I TOTAL!~
: u ~ ~ ; 3.. Ii \.
~'"'"11'.'.'~~''' _
__L........ .,..__."....... .,..---. "........,..-
80.1!l
"7'. a!i
Lo. 'J5
44.10
4".10
47. ~5
lu..,!i
~ 7.,1;
lb.;;,
4...1U
47.0"
10."
~...lC
.. 7. ",
l.tJ.-;;
"".lll
'~!J . \J II
";..": Ii
L!':.~!J
It 'f. tu
'1t'. ~.t.
.. 7. l,
It:. :;,
It". l U
It i. ..~
.Lo. r"
... '-t . l C
.. 7. J'
le.,;
...... t J
NOT POITIO WHIN THIS IIU W'" P""A"ID. 0" lP IHIURAHCI
CA"ftlll'l 00 ,..OT ,AY AHY 'A"T 0' THI AMOUNUlHOWH.
-
. ..1''''11',-. "" ...
.
5TA1E...EHr DArE
oJ
\ ~U 10
;l,UtJ\J,
0'11- J 7""
,.
N.
" i I"" 'J::
~ .:.
~ ..'-
'..., L I, 'f.!
It:'..:t
Ill; I
. ,
.' L L.
",
"'ECIC~L nECOACS 110,
.
c
. .
PA nENT NUMBER
PATIENT tlAME
,
flN_ ,.,.,
Cl..ul nH
.... ,-..' ,:.' IJ!...
,.... .11 t:-
J .J ~ 11. J -.:. ~ ~ L
;0 1""01 l.Il
MJUfI,A
ATTENDING DOCTOR
-uLTZ, L..:.lu
,,'
DATE OF BIRTH
'.
.,
..
'L
': 7'V~/"
': I, : 7 , L j
.. i. ~ t;... &. ,:., .
':i.talY ncftl)L~~
:Jr. I J:' r.,i"t' .,J r
....:....i.,.!:>>L__
17.13
) T
~..
.
OM ''OJ''' '''''''"
) T ~ r " " , "
, , . ,
,,~t,... c 'I 71 L 'I' t. 1 jj~... ~J.,r.t,
,DesCA1PTlDN OF HOSPITAL SERVICE
. lorAL
r."&RC[! .
r:m~
J T.t' .i." ~ 7L 1~ n 11 l HIl 1 'o3703b1l' 'IC. ~'j
J'" Lt; '17i.Zb u.'i. ;lLI<(jLc 1 '0 J70HLlU 47.~:-
:...., lc: ~ 7u 1" ""JTlhYU"O ~ ~CK L '0 J70l70U Lt:. ~ :,
\.I" ::, .h.!" ,1;, S S':'uc 1 'o31\!3'JOIl <<t Lt. L';
,:,,,, Lu 'J 11 iI.. ~ r 11l t'K l. ..3103bll: ~c.uO
v"t' ~\o -11.2.. U...>>. ~ lIniL:: 1 'ol7CZ1LlU ,,7.rl'"
v It, ~ ....' oj 7..1L' MuTinru,;(j t' ~(;I\ 1 ..311;.nOiJ Lb.:~
u", .L' 17,,:.... i1':':. 'JM~I:. 1 ..l7CJ'!uu .. It . 1. f..'
.:.; ~I ':.L ,,71.: il 5 L 1,\jL.'; L .. J7CllUii . .
.... . .I . "'..3':.1
1J..,:.~-~h,L.. O1....T'hYC"Li ~\C" L '0 J7CZ 7(Jll 10. ':.,
'J~ , d. .'7L.~ 1~")~,1vc 1 .. 37tlj~IJl) "4. L '.:
C.., ...l 'j7h!l ~T 11 '0 hK 1 .. HC J /JOU ltd.u;';
V"/.:J 'j 7i..! t: v.,J. ~l..\'L:: L ...IndO/) 47.,,";
.:; :" ~ J .,7" LL ("1:r/nru~:L ~ .t:~ 1 ...l70l.70Ll It.~j
~ ~/_- .;71,," ,'1:') J ~lJi: I 'o17'.)j5llLl 4'1... f..'
U.., ... i '171.::c ..;..:.. )l..LJI..:: 1 ..J70l10'J 'ti..:,
,-"'1_7 .::..:."..... r ~ .~ ..tit- ~ r \,,0 i. "Ho1.:41J'J 1 C; . i:J
'J:", .i ,,~ l... - ) T '"I I;,' U r .lC~. 1 "j no! 7uo.J It:.; ';
j,,1,~7 '~11......, ...\~~.."c 1 ~ ] ; i; .i '; lJ') .....1 'J
:.'.'~ I.:.,,;... -' '1...:,:" .. J... r , .""J.:'.!' l.. .f \~!.. L ,,;7(;.: 7\l\.l ~c.~'
, - ..1 :"'Jj].;)~oJ'J . .... ~ L .
',,' ". I ..... ..~ j, ...- :. ._.J.....,._..
V'11 ~:: , ; II \. . - 1/ .. 'or. L ~J7CJcli, (IC .1.0
,
..J't , L. ',' 71.. 1.. "'_ T /... T "".., U ,. .It,;, L ..HI:.; 7U.; LC. ~::
(j,.1 l~ .7..: '"' ..,)...M.u.: 1 .:,j7(;)~J:; 44. L\)
oJ.., j".; ,7...'; " r ~I 't .... 1 ..37C)l:OU ,. e. t: ')
I"", ',/ '='1 ... 7 \.. 11.. .. . r "~f..."'t.: r ...C~ 1 ..)i'..1.7011 10.''::
I;: 1 C ~ .;. ~~ .,t.,J }.."..: 1 .. ! ;1;J :u'J 4tlt..LJ
u."I:" , , ~.. ': " . II" .... 1 ..J7CJu(i1i ..1l.CO
~,~ 105 .1 ! \,; ~ . .. : r , ,.. f I", ... L., :" ~c., L 431.;,700 lb.50)
"':', t;; , ~ j,. ~.. ., ',,;. .....;: I ..) 7CJ ,'j': .....10
'. ITOTAL~
.'" ''''':''l~ ;'_ "",."j"
_.....0(........_-.".."......__""....0....'-
llb.Otl
..7.d~
lt3.:7!)
"". Ui
'lll.<lO
.. 7. ",
Lu. 55
4t't. l.C
It 1 . .~,
J.~. .;.,
44. L C
't..,. uG
47...')
LQ. ":
It,,. tC
47. , oj
..II. ; C
~... ~ ~
'to.. L ~
l~,.'j,
'.,~. :a-" -'-' -.--....,.-- .'~'
.,. ...- ....-.... ... '.'
'I". .I \.i
1.!': . ': 5
tt... 1 (oJ
4....0\J
La. ,~
't...lu
oi:..Gv
t::. ,~
.. oi. 1l.i
PLEASE REFER TO PATiENT NUMBER
ON ALL INOUIRES AND
CORRESPONDENCE,
HOT POSlED WHIN THII DIU WAI '''.PARID. eR IP IHlURAHCI
("",RIIRS DO HOT PAY ANY PART 0' THI AUOUHflIHOWH.
STATllolENf DAfE
. .' t... .;......
I ..... L c
~' 4',
l tV'"
. ,
" 'f"
.
o
"~
,,' I l . I ".
ICl".t,",.. .~':U"'lf ~A
I 'L71 "~ 1- J7u',
. _ .,., 1_ .
1 7u 'J 5
.l __
L
,
PATIENT NAME
P^ TIENT NUMBER
." ,1 lb 5
MECICAL RECORC9 NO,
~l!H 7u,-dl'J 1
...
cuu ......
,I. r .. L "OL. ~
A U
, ,
OA TE OF BIRTH
'J 1 , I 7 III J
f.j ue A
^ TTENCING DOCTOR
"
,"'
'. J I ... 01 "
Il J. dlt'!,..
'illb,,':,,5,
;." L r z, ~,~: (;
~lt,(Jy "t"(;L,,~
~jl1 ".ll~ rll..~ ST
~A"",L,L"
171) 13
H
1'4
~T..TE
"'C,"e
F ,QI" l~S
'jUl 7/1"'<; 1
hc" 7l"l!'J
OESCRlPTION OF HOSPITAL SERVICE,
rm~
IOIAL
r.IfAROES
_L....II.I..."'..__=:.~:::~;~:~:'.:.._,.lIn....,I"__
.. ,,;/':~ '171"" PT 1/" HI\ 1 '0 J7CHOU ..e.oo '08.00
': 'I'; i \17010 HOT/HrURO poleK 1 .. J1 02700 lb.5' lb .,55
'j:. 1 .... ; .,ilH :1AS~..I;E 1 ..37C3,OU ~~.10 '0".10
.;" I .... i' .,71..; PT l' ~ t11\ 1 'o3103bOIJ ..d.uO ..11.00
:~ :; I t l ';7Llli HOT/HfOl\O PACK. 1 .. 3102700 10. 5 ., lb.55
~ =, Lj,. 'l71.1~ ,'1A, ),,';c 1 ..)70350(' "'0.10 '0".10
" ;, I l. '17l. ~., I'r 11 ~ HI( 1 ~ .l7UJciOU ~d.OO "'ll.OO
. ", 1" oJ701l.; HOr'l1YlJkO ~..(;" 1 " 37unOu lb.55 lb.5,
.... ~'I i ~ _~71Z" i1A~5..uc. 1 ~ J7 C 3 501) '0".10 '0".11;
J ;, l" '/ jl"" PT 1,.. MK 1 .. J7 C 3 bOI) "8.00 "I!.OO
'.. "; I ~ n ~7Ul" nOT /hlilF." i' .1:" 1 ..17(;270:: lb. ., 5 lb. 55'
...":;., t:J '.llZ.. MA~~A"c 1 ..J7u350L' ..'0.10 '0....10
IJ ~/l C 0/7 1 Ll.. i'T LIZ t11< 1 ..37<;3bli.. 9b. 0 0 90.00
I... .\ I i. ~ ~ 7U1C HuT IhYuFQ .. .c.. 1 .. 31 C270U lb.55 l.a.,;
""...1 ... ',' ,I1Z.. :1.\) ~~Gi: 1 4J7C350': ..'0.10 "'o.lU
:. ~ I L~ '!711u /IT 1,.:. .,~, 1 ..37(;3011' It!:.OO 'io.OC
'. ; Ii... 11(..1~ t1tJT/I1Y~:1. ....H." 1 ,,37C,70') 11:.,5 1u,. :;5
'..I :./ ~ _ ,; ..~It "A:i ~"'Jc 1 "J7r;) ;OU "'o.lU ..".10
;",,:' Ii. .,7 11 ~ " T l' ~ ..., 1 "J7t:JoH' "0. \.IiJ '1o.uO
\...., ~~ · ;l.l~ MlJ'('/"tU:'li ~ .:1:" 1 ..i7(;Z7c..; lb.~5 lb.~5
";'1.' _.~ _I? .l.,,-'t. "IJ.l.J 1.......: , "j tt:~:.'c.J 4...1C ~'" 1 to
.
'J~/';:; ..,il.:.~ ~ r 1, ~ "" 1 4J7t:Jollrj '08.00 ..t,.OC
oj: I ''3 , i J l:.. ri'H 'HY~". ~ ..at.:~. 1 4J7C.nCO lb.:; 5 10. ';;
'J; I L b 1 7l L" i1;l ~:: Ahc. 1 ..37.;J;U\J "".10 .....10
.;, I &:.0 .7 L lu I'r 11 ~ ,.,'" 1 .. 3 7Ch1'j 9b.UO 9".1)0
',j1;1 ~ l. .7ub MJr lr1tu'...... ~ ',c(. 1 .. j 7...... 7UI) lb. 5 '; lb. 0;.;
ub/'Ji. ',7 ",'t .1.\) ...u.uL: 1 431050\.1 ..'o.l.0 "4.1U
Oa";! ,7l1;.. P T l' .: 011\ 1 ..J7CJiJl'J 9b.aO 9thUO
rJr:/ C~ ,7\Jh nt.;T't1rl;hL. ..~c. 1 ..!Hl70,) lb., ':I lb.;;
Lnll.., 17L~'t 'A. : . 1 4)7'jJ,e,) "'0.10 .....10
, .. J .. "Ie
".' TOTAL..,-------7-
~ PLEASE REFER TO PATiENY NUMBER
ON ALL INQUIRES AND
CORRESPONOENCE.
NOT POSTlD WHIH THII lULL WAS ,,,I'AftID. Oft I' INIURAHCI
CAIlfUlIIl 00 HOT PAY AH'f' PAlO' 0' 'HI AMOUNJllHOWN.
YOUR PHYSICIAN WII.LBIu.. YOU SEPARATELY FOR PROFESSIONAL'SERVICES RENCERED TO YOU .
, ,. . ,
fI!
.. - I......, .... ,
S'AU...tH. DA.[
,/ J ~LJ~ lulo
'II:~M' 'nU~(;, ~~
I 71 7 I D ~ \- ]7'';:;
.:. I .... j'_ II
, ~ I" ....l. \,. ,~ I lIlt . '"
. 1 L.. .
PA TIEtlT tlAME
PATIENT NUMBER
5Jd.c'J
~~hLtr 'L.L.IL."
~J,~c./' L~ 11 ..71UU"
OATE OF BIRTH
'J 7 , 1 7 ,t: j
ClhllY .t.'IUL~fl
~jo i';u~T"n,,~r
e..; I.I.Lc
17i: 13
)T
PA
r:m~
DESCRIPTION OF HOSPITAL SERVICE
"o/U, '1711(, fiT lie! Hfl 1 ..37CJol'J
vo'lo ~7ulu HOT/hYlIRO P~~K 1 'o37Cl700
Oo/Co ~71Z.. ~A$S~uE 1 'o370J50v
lio/!:e '171111 I'T 1/.! 11" 1 ..]703610
OLlie. ~701v har/HYlIRO flACK 1 'o370270~
:;c/lc '17Ll.. I1ASS.."E 1 ..37035011
lJo/lo 'J711\; f'T lu: HIl 1 'o370301~
uc/lo 'l7l1'J H,;r II1Y!iiU] f'1.CK 1 'o37C;:70')
i)0/Iu~7.2~ :HS$..':'i: 1 ,,]7CJ~u(;
lJo/lo -I711u PT II! Htl 1 'oJ703bloJ
~o/~~ 'l7Clu HUT/HYutlG flACK 1 ..3702700
Oh/_~ 'l71Zlt MASSAGE 1 'o3703~OLl
01.1::'0:. .711" n 11l Hk 1 'o31CJbl'J
~o/,J 17....1u HUr/HYu~O P~CI\ 1 ,,37Ul70Q
loliJ ~71Z~ ~~$S."t 1 'o37CJ'J00
Ut./'::J '1Hl" ~T llZ rlk 1..37C361-:'
ubI.!!; ',7(.11: 1'1':T'''lui<C f'~1.1\ 1 "J7L)l7UII
Oh/'::5 ~7lilt ,~~...vc 1 ..37CJ500
(,b/.:, ,11:.'. ~T 1/~ ,," 1 ..31(,~Dl':'
,.0".1_.' 011: I. ",'. r It. (IJ~:'; I' .:.CI\ I"! 7/)l701i
... ..-. -.,.. .
. ,-,iLJ, .:_....=.; l,~ "._.:: ~.I_.."".L..~._ ..._ _. _. ..J. .~~._t ~ 16) ,:;~G J
Ijb/~'t ~7LL ~r I/~""" 1 ~J7~jol.'
u7,C, '/l.L w'J;II.ru...... ..~C"" 1 ..J7':~70.J
07/u': ;;.~. 1.:.S..."i: 1 ~n~J'JO;j
li 7, C.. "1.. .. r I,.. ,1;" 1 '0 J H J c LJ
1 7i.. 5 ~
,'.
,
"'rClC~L RECORCS NO.
j '.. . 7 L 'J - .; 'J ~ I
,."""" ",.
Cu.u ,......
.I ~
M
) i _ r: ~ . "
i'<C,i;
, TOIAL
, CUARGn
'10. ~ loJ
lb.~-:'
.....1(,
"i/.;.;;U
10.~~
""ol\)
~u.QU
lb.~;
.... . ~ 'J
Ijb. uti
lb."
'0',.10
'I t; . iJ 'J
lb. ~ S
....ol(J
'10.~(J
lb. ~:,
"It .1.j
r~t:. . J 1.1
lb. ~,
"......~
"it. ~~.i
lo.~,
.....11l
"l(.;.uJ
1.'1. ~ UII
~tJ"nFR
A TTENOING OOCTOR
l ~ C'" ~ I}."
l"'LLr:, l..;.~\I
'"
~ ,
.
.
) ~ ,;" 7 J" f. ~
, .
~- .
71.~,'iL
"'11 1111" ~'~" _ ~
~""'I"l,,__I".oI"II""_~-".""'.""-~
')o.UO
16.55
.....10
90.00
La.;;
'0".10
'1...00
10.;;
'04. 1 U
9b.llC
Lb.';S
"',.10
'lo.OU
J.D.;;
..-.1(;
'1o.UO
1':l.'J';
",. L C
IJe.. vO
Lt;'.:'
'1"t.Tu
'Jb..'JC...._........ ',.
1o.'J;
It It. ~ U
'ic..DO
r~1 ~l'~.\L Thc'<~f'Y
Hbl.'1'; Hul."!;
1;'" J'. _JI" ii', ~dJ"~ T,111.T
U~l',!l .)r~r: r...'.,'"
1 JOOC~ ZO 7
1 OOO('...O~ I
, . TOTAL~'
pl.EJose REFER TO PATIENT NUMBER
ON Al.L INOUIRES .AND
COR~ESPONDeNCe.
30,.99-
~.d". ,5-
.
Nor POITIO WHIH rH11 DILL WU P""A"IO. 0" I' IHIUMHCI
CARAIIAS 00 NOT PAY ANY 'A"T or THI ~MOUNfI '"OWN,
I
lid. i
~
..--...-".;(.,;.;: ...
. ., " ,
, p :lTATCloIlNT OAfE I' .J 11..~\.'LtJ .- "! 0
rL......L. I)" Il'} ,', ~ II:Lr ~~U~C, "0\ 17055
,ILL. IlL 7 I ",1- )7I;U
. . , , , - . J
PATIENT NAME PATIENT NUMBER MEDICAl. RECORCS NO, ,..
"'- .....
l. ~ "u '( ue f'~Ul. '" ..' ,url7l.5 501l7b5-l0~1 A 0
.
.
.
OATE OF BIRTH
Ll7'17/oJ 51lbulO'Jl
ATTENOING nOCTOR
FUL TZ. !;~t.1G
'~~'~!,I'. L': H 'J7'U~'~'
clll;OY Ill:NULck
lbd ~Of,TH..t:~T
CAI'\Ll~LI:
17013
Sf
p-,
STt.rl: F ~/I INS
NONE 001 7/1~/r,1
Jl:lb..7J'o8U
OESCRIPYIDN OF HOSPITAL SERVICE
r:m~
IU.AL . I ':0111,11111 UIIrI'UMIlJoc:l '
. rttaRI1P'; I'" (0_1"&(01 ,',UU)WIMIILf 1'1lI [OllHllloI
l~ . ~' "'''''~'''': ~I
: .., , .
l7,t:.;7'l.-
. c ,:a'~'.::rR;"
2.'l.ij~h.-
b~;tib,..
I~, ,
..
0~,JL AOMI~ "OJUSTMENT
u..,Jv AUHI~ AOJUSTMENT
u~,.:~ -,OMIN ADJUSTMENT
0r'LJ -,U~IN AOJUSTM~NT
1 OOOOOlO 7
1 00000207
1 00000207
1 OOOOOZU 7
.'," ,'.
TOTAL OF PAYMENTS ~ AOJS
..~\:;.:.>:
.,.~..,... t
lb ~O;'5L-
.: '.~; ''; .
TLlTt.L Cl..~RcNr Ch~RGE5
5161.95 3Hl.V.
dAL~NCE FURhAKO ChAKGES
TO-O..TE' P"YMEr.r~ oIOJS.
OI:UuCTI~LI: A~uu~TS
16"0.51-
1
~CcuuNT rlAL:.t.LE
3511.'o'o
_ _a ,.....~ . .... .t'.~_
.... -.".----... .- ,"
.....
':'011.,.::.-' "
.:i'\'/l;~v .
,~ ,,'.'
~'~'~~:\'
i;;::...' ,
. I . .
~: '~'
. . ~ '
-~.: -.'!'..
. '.-,
..
, ,TOT^L~
PLEASE REFER TO PATIENT NUUDEA
ON .AlL INOUIRes ,lNO
CORRESPONDENCE,
NOT ~nn WHlH rHla ILL WAa ".,.,AMD, 0" I' IHlUfUJtCI.
CAJUUUI DO HOT ,.., AHY ,.AIIT 0' ntI,AMOUHTllHOWN,
1
HOOVER REHABILITATION SERVICES. INC.
HARRISBURG
AUG 6 1992
REC~IVED
August 4/ 1992
Ms. Amy M. Wolfberg
state Farm Insurance company
115 Limekiln Road
P. O. Box R
New cumberland, PA 17070-2423
Clients Name:
Your File:
Insured Name:
Date of Inj
Our File No :
92 PRO
PEER REVIEW
Medical information on the above captioned file was submitted to
Ellis Friedman, M.D., orthopedist, for a peer review. His report
is enclosed.
After reviewing the enclosed report, the following conclusions
can be drawn:
1. Initial care rendered was reasonable and necessary.
2. continued care is not necessary.
3. Maximum medical imprcvement was reached by 1/13/92.
4. The TNS unit and Second course of PT beginning in
March, 1992 was not due to the 7/14/91 MVA.
5. Dr. Lupinacci's evaluation on 6/2/92 was not due
to injuries occurring on 7/14/91.
Thank you for allowing us to provide you with the above service.
If you have any questions, please feel free to call.
If a recons~deratio~ i~ desired. ~lease contact Joan~e E. Frank.
B;N.. in writi~a w~thln 30 davs ~~om the day ne inltial
determ!nat!on ;s ef~ected. Use the Camn Hill address.
Sincerely,
HOOVER REHABILITATION SERVICES, INe
.1_"" Eo hatIJ:. ~~
Joanne E. Frank, R.N., C.I.R.S.
JEF/jj
Encl.
Peer review report
Medical Records
205 HOUSE AVENUE' PO. BOX 8872 . CWP HIll. PENNSYWANIA 17011-8872 . Phone: (7171 m.5004 . F~ (717) 7:ll~
UBERTY SCUARE MEDICAL CENTEq . SUITE 104' lMANC UBERTY STREETS' ,o.UfllTOWN, PENNSYLVANIA lB104. Phone: 1215) Tro-IOOO' F~(2151
EXTON PROFESSIONAL BUILCING . SUITE l05 . l19 NORTH POTTSTOWN PIKE' EXTON, PA 19341 . Pilon.: (215) 524.a5ge . F~ (215) 5240796
SUITE 403 . 400 McKNIGHT PARK cRIVE . prrrSBURGH. PENNSYLVANIA 152:17 . Phon.: (4121 36e-9120 . F~ 141213Mo6J15
ELLIS F. FRIEDM, . M. D.
~. -
-
ORTHOPAEOIC SURGERY 320 ABINGTON I
WYOMISSING, PENNSYLVANIA
TELEPHONE (21!l1 67B
July 31, 1992
Joanne E. Frank, R.N,
Hoover Rehabilitation Services
205 House Avenue
Camp Hill, Pa. 17011
Re: Cindy Wendler
CH-164s2-692 PRO
Dear Ms. Frank:
At your request, I reviewed medical records relating to the care
and treatmen~ of Cindy Wendler. Your letter dated July 15, 1992
arrived in my office on July T 7, 1992. From these records I
learned that the patient, three days short of her 28th birthday,
was a passenger sitting in a parked car which had a boat trailer
connected to it. The boat was being tied down to the trailer when
the trailer was struck in the rear by another vehicle. She was
evidently seen at UrgiCare in Erie, Pennsylvania but I did not have
those records available for review.
The accident occurred on July 14, 1991, Two weeks later, on July
29, the patient came under the care of a chiropractor, Thomas Boch.
On a pre-printed "consultation" form, the patient's "major
complaint" was handwritten as: "central pain - T2-3 area - fell
asleep - went to MD for this before. Previous D.C. 12 to 13 years
ago - skating." The patient indicated that she had first noticed
these symptoms two Ileeks earlier and then they had gone away for
a few days. Her symptoms were said to be worse in the evening and
were relieved by putting her arms down. The symptoms were said
to be constant. The chiropractor took x-rays and diagnosed a
"vertebral subluxation at T2" as well as wedging at T4-Ts. The,
patient was then subjected to 41 chiropractic treatments through
October 25.
The patient was also seen by Dr. Christopher Snyder, an osteopathic
family physician, on August 1, 1991. His handwritten office note
indicates that the pCltient had not had any pain initially but that
the next day she had developed pain in the neck and shoulder going
to both arms. She also had left mid to lower paracervical pain
going to the occiput. She denied paresthesias and had no problems
with grasping. She r.ad some problems sleeping because of pain and
stiffness and noted that her work as a beautician aggravated her
pain. Dr. Snyder's physical examination showed there was
limitation of motion of the cervical spine, intact reflexes, normal
sensation and motor power and paraspinal tenderness in the cervical
and upper thoracic region. The patient was diagnosed as having
a cervical and thorar.ic strain.
On October
~~
M_'
1991, the patient was examined by Dr. Craig Fultz,
,
page 2 - Cindy Wendler
an orthopaedic surgeon. I have reviewed all of his typewritten
office notes, He noted that the patient had been seen at the
Carlisle Hospi talon October 17 at which time she had been referred
to him. His typewritten physical examination showed no
tenderness to palpation in the cervical spine and no paraspinal
muscle spasm. There was tenderness in the thoracic spine from T2
to TS. There was no tenderness along the vertebral border of the
scapula. There was mild hyperkyphosis in the thoracic region
without scoliosis. There was no lumbar tenderness and neurologic
examination was normal.
In contrast to the chiropractor, Dr. Fultz reviewed x-rays of the
cervical spine and thoracic spine and felt that they were negative
showing only mild flattening of thoracic kyphosis - exactly the
opposite of what he had found on clinical examination.
Dr. Fultz diagnosed a cervical and thoracic sprain and started the
patient on a course of physical therapy. This therapy was done
at the Rehab Hospital at Mechanicsburg. I have reviewed the
handwritten evaluations and progress notes. The patient did well
and on the office with Dr. Fultz on December 2, 1991 it was noted
that she was working at her regular job and complained only of
"achiness in her neck at the end of the day." The physical
examination at that time showed her cervical spine was non-tender
on palpation, had a good range of motion and there was no
tenderness along the scapular border.
On January 13, 1992, Dr. Fultz noted that the patient was doing
well, was not taking any medicine and was doing home exercises
regularly. She was working without difficulty and her physical
examination was entirely normal. She was discharged from his care
at that time.
Two months later, on March 24, 1992, the patient was again seen by
Dr. Ful tz . A week earlier she had been at work, had turned,
twisted her upper back and had developed increasing discomfort in
the thoracic spine along the medial border of the scapula. She did
not have any radicular symptoms. Dr. Fultz's physical examination
at that time showed tenderness only along the paraspinal muscles
in the upper thoracic region and the medial border of the scapula.
Passive range of motion of the arm also caused similar discomfort.
Neurologic exam was normal.
Dr. Fultz started the patient on a second program of physical
therapy at the Rehab Hospital of Mechanicsburg. The handwritten
initial assessment of March 26, 1992 indicates that two weeks
earlier the patient had "turned to reach for stool and heard a
'pop' in upper back with pain. Pain has remained constant ..."
The patient was then begun on another course of physical therapy.
It was also recommended that she be fitted with a TENS unit. This
~
page 3 - Cindy Wendl~r
'was done and she continued using the TENS unit during the next four
months. She was rechecked by Dr. Fultz on April 13 when it was
noted that her neck symptoms were improved. She had mild
tenderness to palpation on physical exam.
On June 2, 1992, the patient was evaluated by Dr. Michael
Lupinacci, a specialist in rehabilitation medicine. He prepared
an exceptionally thorough and well-detailed three-page letter on
June 5. In his physical examination he noted "moderate left: upper
thoracic paraspinal muscle tenderness in a very circumscribed area
approximately 1 cm. in diameter." He felt that her pain was
muscular. His neurologic examination was normal.
In summary, the patient was involved in a motor vehicle accident
as a result of which she developed upper thoracic pain. She had
a worthless course of chiropractic treatment based on diagnoses
which did not exist. She then had a course of orthopaedic
evaluation and physical therapy .which resulted in complete
resolution of her symptoms after which she was asymptomatic for two
months.
She then had a new 1nJury at work when she twisted and developed
pain similar to that which she had had eight months earlier.
Thus in answer to the questions contained in your letter of July
15, 1992 I can state the following:
#1 - I think that all of the care which the patient
received by Dr. Snyder, Dr. Fultz and the Rehab Hospital
at Mechanicsburg through January 13, 1992 was directly
related to the motor vehicle accident. I am recommending
reimbursement for all of the original treatment at the
Rehab Hospital of Mechanicsburg during October and
November 1991 despite the fact that the patient received
only passive modalities including ultra sound, hot packs,
massage and therapeutic exercises. It does not appear
that the patient was receiving stretching and
strengthening exercises using back exercise equipment.
I think that the care which the patient received
beginning in March 1992 was unrelated to the accident and
was due to a new incident. I do not believe that an area
can "unheal" after it has been asymptomatic for over two
months. I think this was a new injury of tissues which
had completely healed.
#2 - Continued care is no longer necessary as a result
of the motor vehicle accident.
#3 - Care could have been discontinued by January 13,
1992.
" '
~
page 4 - Cindy Wendlur
~
#4 - Not applicable.
#5 _ I do not think that the second course of physical
therapy beginning in March 1992 is related to the
accident nor do I think that Dr. Lupinacci's excellent
and thorough,evBluation is related to the motor vehicle
accident either.
I hope this information is helpful for you. If you have any
questions, please do not hesitate to contact me.
~'-4fJ
"'is F. F~' M.D.
Board Certified by the American
'Board of Orthopaedic Surgery
EFF/cbs
encl.
f
."fA y
,
. ,
~':ll'-=-
.,....-.
:~l :HE: :"-:II':'!:: S':'AT::S ::STRIC:: ~=t,"'R'I'
FOR ':HE EAST!.'Ul CISTRIC= OF pENNSYLVANU
:-!ARIA EROWNELL
CIVIL Acr:ON
'I.
, , i 0 O(
.. ,,' . 1
i'll.-"'" "
STATE: FARM MUTUAL ^UTOMOBIL~
INSURANCE COMPANY, ee al.
.
.
NO. 90-2224
ORDER
AND NOW, this 4th day of May, 1993, pursuane to this
court's order of July 31, 1992, and after a hearing thae began 0
April 23, 1993 and adjourned May 3, 1993, to consider the
par~ies' j~ine ~oeion to approve see~lemene of ~~~s cLass aceion
and to approve the peeition of class counsel tor attorney fees
and costs, and the Court tinding tttat:
1. The class is so numerous thae joinder of all
members is impracticable, there are questions ot lall or tact
common to the class, the claims or detenses ot the representativ,
party, Maria Brownell, are typical ot the claims or defenses ot
the class, and the representative party, Maria Brownell, has
tairly and adequately protected the interese of ~~e class within
the meaning ot Fed.R.Civ.P. 23(a) i
2. The questions ot law or face cOlDlllon to the members
ot the class predominate over any questions atteceinq only
individual members, and a class action is superior to other
available methods tor the tair and efticiene adjudication ot the
controversy within the meaning of Fed.R.civ.P. 23(b)(3)i
3. The class represeneaei ve, Maria Brownell, and clasl
counsel, the law fir.: of Smolow & Landis, have adequately
~ecresen~aci ~~B c~~ss:
. -. ,--- --
o 'J I - ,;. 0 0,
l.l. L,., \ '_. ,
-
...; . _- C_"
- ,
- ~
._--, ,,"'-,-'._,
--,,-
~. :~~S C~3SS ~c~~=n ~~ :3~: ~na :aascn~clQ r.3Vlnq
taken ineo ccnslderac:.cn, :..~~e~~:
a. ~~a c=cplox~e/' Bxpense and l~~oly duraeion
the li:iqile:.on;
b. The !avorable reac~ion ot the class to ene
see~lament as evidenced by tho rbmarxably small number ot opt-
outS and ene absence ot any objection1
c. The staqe ot the procaedinqs and the amount
discovery comploted1
d. Thu r isxs ot 'jlJl:llbl.ishinq liabili tv 1
o. The risxs ot establishing damaqas1
!. The risxs ot maintaininqthe class action
through the tria11
q. The ability at ene detendants to withstand a
qreatU' judqment1
5. Detendants attordad enemail and published notice
to the class in accordanca with ena tarma ot the settloment
Agreement and this CO~'s Order ot 3uly J1. 1992:
~. 6. Notice to the claas was !llir. adequate and
reasonable; and
7. Class counsel's request !or attorney toes and
costs. totalling S22~,OOO.oo, is !air and reasonable. taking
taxan into consideration class counsel's hourly rates. the time
class counsel davotad to this Cllse, and th& costs incurred by
class counse11
It is there!ore ORDERED thae:
.
.
- .
:he tOl:=~lr.g =13ss ~s r.erecy CL~T:::!O pur~uane :0
:~a =~:~:~:~~: ~~~~~&n~~~:
F~=~ February =~, :984 ~= t~e daee of ~~nal
order. all perscns and ene~:ies (oeher ehan
defendanes. :heir subsidiar~es. parenes and
af:iliaeed ccmpanies) insured by a Staee Far.:
moeor vehicle insurance policy issued for a
moeor vehicle reglseered in pennsylvania.
and/or including any person who submitted a
Medical paymene coverage claim ("MPC claim")
eo State Farm for injuries arising out ot the
use. operation or maintenance ot a motor
vehicle in pennsylvania;
2. The class action settlement set forth in the
Set~lement ~greement daeed ;uly 23. 1992 is APPROVED;
J. Those persons who are identified on Exhibit "A"
attached hereto shall be EXCLUDED from the class;
4. Class counsel'S petition for attorney fees and
costs is APPROVED;
5. Detendants arc DIRECTED to pay class counsel the
sum ot S225,OOO.OO in accordance with the provisions ot , 10 of
the Settlement Agreement;
6. In accordance with " 1J(f) and 15 of the
settle.ant Agreement, the Court DISMISSES WITH PREJUDICE all
claims' by any members of the class which were or could have bean
at issue and/or asserted. includinq, without limitation, any
statutory or common law claim for fraud, misrepresentation,
violation of the Motor Vehicle Financial Responsibility Law
(IIMVFRL"), Act 6, 42 Fa. cons. Stat. 5 8J71. the pennsylvania
consumer protection Law, the pennsylvania Unfair Insurance
practices Act and the federal Racketeer Influenced and corrupt
:?c~.."NE:: ':. ~-:',~,Tl:"
":"~C'"
, ,.4".
(')p"'_"'l'T'~
Bobby, Oaniel E.
(no address supplied)
policy No. B16-1018-608-38
Boris, Ronald and Donna
177 p1newood Orive
Levittown, PA
(no policy supplied)
conroy, William P.
921 N. Main street
Bethlehem, PA 18018
policy No. A08-5686-E05-38A
OeCostanza, Joan and Theresa
c/o Thomas Pit~, III, ~sq.
107 S. Church Street
West Chaster, PA 19382
(no policy supplied)
DeMarCO, Joseph L.
397 W. ACademy street
Wilkes Barre, PA 18702
policy NoS.: 6168-126-A18-38K; 6529-680-F18-38B; 704-1977-B13-31
DeVita, Louis N.
R.D. #1, 48 Woodhill Drive
Cheswick, PA 15024
(no policy supplied)
Dzuqan, Peter R. and Donna M.
116 Alden Mt.
Nanticoxe, PA 18634
polic:Y~os.: 697-7840-023-38; S90-1683-C18-38G; 638-7263-P27-38I
Feyertaq, Liselotte
2118 strahle Streee, Apt. A
Philadelphia, PA 19152
(no policy supplied)
Frederick, Beverly J.
(no address or policy supplied)
Golombosxi, Arthur R. and Mary Jo
620 Gary Lane
Norristown, PA 19401
(no policy supplied)
,
:.
=ROWNE~~ ~PT-~r~s
par;e ~
Lovejoy, carole
7618 Langdon streee, ~se floor
philadelphia, PA 19111
(no policy supplied)
Mankin, E!rem
3551 pose Road
Huneingdon Valley, PA 19006
(no policy supplied)
Phillips, Betty
328 parx Avenue
Wilklls Barre, PA 18702
(no policy supplied)
piontak, Stanley
46 Burket Streee
plains, PA 18705
(no policy supplied)
prlltt, Fred
R.O. No.4, Box 60
New castle, PA 16101
(no policy supplied)
Resnick, Paul Robert
The White House At
4144 Arnold Avenue [~J
Brae Burn, PA 15016
pOlicy No. B07 2603-8-01-38B
Romber,.qF, Richard
R.O. 1, Box 150
Pine Grove, PA 17963
(no policy supplied)
scott, James W., Jr.
(no address or policy supplied)
schrader, James and Caroline
1210 Michley Road
Whitehllll, PA 18052
(no policy supplied)
silvey, catherine E.
4034 Warrilow Road
Brookhaven, PA ~9015
?oli=y ~o. 31~-a150-F06-!aA
=ROWNEt~ :p~-~~~
PAGE: "
Thomas, carol Hott:an
Policy No. J95-5459-E21-J80
(no address supplied)
Wagner, Chris~ian T. and Olivares, Ines C.
1621 Wins~on Road
Gladwyna,PA 19035
Policy Nos.: 398 6894-012-38A; 398 6894-012-388
Walkowiak, Bernard
1913 St. paul street
Pittsburqh, PA 15203
(no policy supplied)
Welker, Gaorqe L.
(no address or policy supplied)
~ .
AI. "..."'..'...A....",'
Exhibit C
'....m/A'.
''''''''C1t1lU@
I,j 1;*\ ,
,"~.tO l. a 1~2
..
( ~7J
/""
sD
........
IN THE mlITED STATES DISTRICT ~C~RT
FOR THE EASTERN DISTRICT OF PElllIS'lLVlItIIA
~ . .. ... :'" ~'
.. -- \,.'.: '-
" ~ -
- . .
MARIA BROWNELL
CIVIL ACTION
.
.
V.
STATE FARM MUTUAL AUTOMOBILE
INSURANCE COMPANY and
WORLDWIDE AUDITING SERVICES, INC.
NO. 90-2224
ORDER
AND NOW,
I>y
this '>
day of
J~(7
Approve
, 1992, upon
And Issue Notice Of
consideration of the Joint Motion To
proposed Class Action settlement, it is hereby ORDERED and DECREED
that:
1. The following settlement class is certified and Maria
Brownell is designated as class representative:
From February 24, 1984 to the date of final
order, all persons and entities (other than
defendants, their subsidiaries, parents and
affiliated companies) insured by a State Farm
motor vehicle insurance policy issued for a
motor vehicle registered in pennsylvania,
and/or including those who submitted a Medical
payment coverage claim ("MPC claim") to State
Farm for injuries arising out of the use,
operation or maintenance of a motor vehicle in
Pennsylvania.
2. A hearing is scheduled for Friday, April 23, 1993 at 2:00
p.m. to determine the reasonablenesD, adequacy and fairness of the
.
proposed settlement of this class action and whether it should be
approved by the court, and to determine whether to ~pprove class
counsel's request for ~ttcr~ayt~ ~~05 ~~C =~~~~~~~~Q~t o~ CC3t~
and expenses.
,
3. The court hereby approves the notices attached as Exhibits
"A" and "B" to the proposed settlement Agreement and directs the
parties to issue the notice and proceed to implement the terms of
the settlement Agreement as required therein. The court finds that
the issuance of these notices is appropriate and sufficient to
protect the interests of the settlement class and the parties.
4. Any member of the settlement class may exclude themselves
from the settlement class and this action in the manner and with
the consequences described in the notices.
All requests for
exclusion must be filed with the court and delivered to the
respective counsel for the parties no later than twenty-eight days
after mailing and/or publication to the class member of notice of
the scheduled date of the settlement hearing.
5. Objections by any member of the settlement class to the
proposed Settlement Agreement or any part of it or to the judgment
to be entered as a result of its approval and effectuation must
show cause and state the specific reasons for objection, and must
be in writing filed with the court and delivered to the respective
counsel for the parties no later than twenty-eight days after
mailing and/or publication to the class member of notice of the
.
scheduled date of the settlement hearing.
6. No person shall be entitled to contest the Rpproval of the
terms and conditions of the proposed Settlement Agreement or the
judgment to be entered thereon except by filing and serving written
objections in accordance with paragraph 5 of ,this order, and if the
court approves the Settlement Agreement, any member of the
settlement class who fails to exclude themselves shall be deemed to
have waived and shall be foreclosed forever from raising objections
to the settlement, and shall be deemed to have consented to the
judgment to be entered and given the release provided for under
paragraph 15 of the proposed Settlement Agreement.
7. Class counsel is directed to file their fee petition
pursuant to paragraph 10 of the Settlement Agreement within forty-
five days of the date of this Order.
BY THE COURT:
A~~
STEWART DALZELL,
c:\wp\brownell\order
~NTERED: __ f -. 3 :i_~ ~....
CLERI\ OF WURT
"
CERTIFICATE OF SERVICE
I HEREBY CERTIFY that I have served a true and correct
copy of the
record this
foregoing document upon all counsel and parties of
01STday of M.CU..CAr\ , 1995, by placing the
John D. Briggs, Esquire
Richard Oare & Associates
1776 South Queen Street
York, Pennsylvania 17403
same in the United States First Class Mail, postage prepaid, at
Harrisburg, Pennsylvania, addressed as follows:
~~~
Debora L. Hamm
-
~
=
C>_
<Tl
:r
('oJ
I"~ ,
c:' ~'
L._ ~_l
.
," r
..
,"
,; ~
,"
t_"?
-
:r-
=>
-,
.~"
~
~~~
O:t~
@~i:i
:t~2
uti~
~ ~
,
..
CERTIFICATE OF SERVICE
I, John D. BriggB, Esquire, hereby certify that I have this
15th day of June, 1995. sent a true and correct copy of the
foregoing documents: PRAECIPE TO SETTLE, DISCONTINUE AND END to
the fOllowing individual, via United States Mail, postage paid,
addressed as follows:
Rolf E. Kroll, Esq.
Reynolds & Havas
101 pine Street
P.O. BOX 932
Harrisburg, PA. 17108-0932
D.
orney ID: 5
76 South Qu
York, PA 17403
(717) 846"3000
Attorney for Plaintiff