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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