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Home My WebLink About95-03062 MEDICAL SERVICE ASSOCIATION OF PENNSYLVANIA d/b/a PENNSYLVANIA BLUE SHIELD, IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA v. I I plaintiff I I I I civil Action--Law GERALD D. STAYER, Defendont No. 'lj " (1 .. t J .,,>t'ft.~ _ ,t 11\, \..1 ~_H-' II 0 TIC Il 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) doys after this complaint and Notice are served1 by entering a written appearance personally or by attorney and f ling in writing with the Court your defenses or objections to the claims set forth ogainst you. You are warned that if you fail to do so the oase may proceed without you and a judgment may be entered against you by the Court without further notice for any money claimed in the Complaint 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 TARE 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 county courthouse 1 Courthouse square--Fourth Floor carlisle, PA 17013 KEEFER, WOOD, ALLEN & RAHAL D.t.d, tiS !~S- R~A-f (J..i-!t. L -...~.., L-~ B~dford Dorrance I.D. #32147 210 Walnut Street P. O. Box 11963 Harrisburg, PA 17108-1963 (717) 255-8014 Attorneys for Plaintiff I. ....~ MEDICAL SERVICE ASSOCIATION OF PENNSYLVANIA d/b/a PENNSYLVANIA BLUE SHIELD, I IN THE COURT OF COMMON PLEAS OF I CUMBERLAND COUNTY, PENNSYLVANIA I plaintiff I v. civil Action--Law GERALD D. STAYER, Defendant No. CO.PLAIIIT 1. Plaintiff, Medical service Association of Pennsylvania d/b/a Pennsylvania Blue Shield ("Blue Shield"), is a nonprofit pennsylvania corporation with its registered office and principal place of business at 1800 center street, camp Hill, cumberland County, Pennsylvani~ 17089. 2. Defendant, Gerald D. stayer ("Stayer"), is an adult individual residing at 225 Linden court, Bensalem, Bucks county, Pennsylvania 19020-4616. COUIIT I - III cOnnOT 3. Blue Shield incorporates by reference herein paragraphs 1 through 2 above. 4. At all relevant times, stayer was a subscriber and/or third-party beneficiary under a group contract between Blue Shield and his employer, chorming Shoppes, Inc., of Bensalem. The contract is not currently available but contains standard terms and conditione, including Blue Shield's obligation to pay for certain medical eervices provided to its subscribers by Blue Shield participating doctors. 5. On or about January 20, 1994, Stephen J. Dante, M.D. of suite 252, 8th and spruce streets, Philadelphia, Pennsylvania, provided certain medical services to stayer. At that time, Dr. Dante was a Blue Shield participating provider, and provided his medical servicee to Stayer in consideration of Blue Shield's payment of $3,750.00. 6. Ae a participating provider, Dr. Dante agreed to accept Blue Shield's $3,750.00 payment os payment in full for services provided to Stayer on January 20, 1994. 7. Blue Shield forwarded payment to stayer on or about April 4, 1994. The payment was intended to satisfy Dr. Dante's bill for servicee provided to Stayer on January 20, 1994. 8. stayer, a third-party beneficiary and subscriber under the governing group contract, breached his obligatione by failing to forward the Blue Shield payment to Dr. Dante, and by retaining such funde for hie own use. 9. Blue Shield thereafter eatisfied Dr. Dante's bill by forwarding another $3,750.00 payment to the provider. 10. As a result of stayer's breaches and defaults, Blue Shield has been forced to pay twice for the same service 2 provided by Dr. Dante on January 20, 1994, and has thereby incurred an additional obligation of $3,750.00, which has been liquidated, due, and payable since April 4, 1994. 11. To date, despite repeated requests, stayer has breached his contractual obligations by failing to pay Blue Shield's claim, inclusive of six percent interest and costs. "Ialroal, plaintiff, Medical service Aesociation of pennsylvania d/b/a Pennsylvania Blue Shield, demands judgment in its favor and against Defendant, Gerald D. stoyer, in the amount of $4,208.00, representing the current principal omount of the claim ($3,750.00), interest ($262.50) accrued thereon from 4/4/94 through 6/4/95, current record costs of $195.50, together with continuing interest and costs pending disposition hereof. COUMT II - IMPLIID-IM-raCT CONTRACT 12. Blue Shield incorporotes by reference herein paragraphs 1 through 11 above. 13. In the alternative, ossuming there was no express written contraot as averred in Count I above, there existed an implied-in-fact contract between the porties based on their oral and written representations and conduct, course of dealing, and the circumstances surrounding Dr. Dante's provision of services and Blue Shield's payment to stoyer. 3 14. Under the implied-in-fact contract, stayer agreed to satisfy Dr. Dante's bill with the Blue Shield payment that was forwarded to him, or agreed to use his own funds to satisfy the obligation. 15. Under the implied-in-fact contract, stayer had implied obligations of good faith, fair dealing, and disclosure. 16. stayer breoched his implied obligations and promises to forward payment to Dr. Donte, and has defaulted on his obligations under the implied-in-fact contract, leaving a current balance of $3,750.00 due and owing since 4/4/94. .....ro.., Plaintiff demands jUdgment in its favor and against Defendant in an amount not to exceed $10,000.00 (excluyive of interest and costs), thus requiring referral to arbitration under local rule. COUMT III - OUAMTUM MIRUITJUNJUIT INRICHKINT 17. Blue Shield incorporates by reference herein paragraphs 1 through 16 above. lB. Alternatively, assuming Blue Shield foils to state a olaim for either on express or on implied contract as averred in Counts I ond II, respectively, Blue Shield alleges a cause of action based on the doctrine of unjust enrichment, seeking 4 restitution of the reasonable value of its payment forwarded to stayer (and intended for Dr. Dante). 19. The reasonable value of Blue Shield's payment to stayer was $3,750.00. 20. stayer has wrongfully secured or has passively received the benefit of Blue Shield's payment, which was intended to satisfy Blue shield'e and Stoyer's obligation to Dr. Dante. After repeated demands, stayer has failed to make restitution. .....ro.., Plaintiff demands judgment in its favor and against Defendant in an amount not to exceed $10,000.00 (exclusive of interest and costs), thus requiring referral to arbitration under local rule. Blue Shield requests such other relief as the Court may deem appropriate. Respectfully SUbmitted, KEEFER, WOOD, ALLEN , RAHAL Datedl b/~t.r BYI L1: - -tL~ <J L ~ ~ '. ~fo Dorrance 1. D. 32147 210 Walnut street P. O. Box 11963 Harrisburg, PA 17108-1963 (717) 255-8014 ATTORNEYS FOR PLAINTIFF 5 VIRIrICATIOM I, vincent T. DiFilippo, verify and state thatl 1. I am the Manager for Billing and collections for Pennsylvania Blue Shield, Plaintiff herein, and os such, am duly authorized to moke this verificotion. 2. The facts set forth in the foregoing complaint ore true and correct to the best of my knowledge, information and belief. 3. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. 54904, relating to unsworn falsification to authorities. Datedl ~pA( ~,7\ ~ ~ k ., . -, ~.;., <.-. $ rz~ \ --- " \ r'-) 0'''1 . ' .... ~ 0{ ~, ". -;:--. d I: ~t\ ';1' . .<.1 " ., N ... -.I """C, :;J: ~ ,-..'; . c' \' :.',1" , " " 0J LV ~~ ~. \'). '" ('~ ! l' ""__:-;"~"~_--~4 u-- ,)C - c.~~7 q{ ~L'- (/ )Jkte<-~ ,A.l'p1)\ In The Court ci C.:mmo:,j ple::s or C:"r..;:.:.:!t'\:md C.:JU:-i','Y, PaMnsyl'lc:ni::: , , Medical Service Association of Pennsylvania d/b/a Pcnnsylvania Uluc Hhield 'is. Ge~ald D. staye~ :-io. lll\_ 'lOr,) Civ.i.L..l'eDl1.,- :~.._- -----0 ~OW, .111nR 07. lqq~ :9---. I. S:~?..!.:~ o!'" C:'~r3Z?.!.A..'fD COL.,.,TY. ?A.. do !I=!ly d..-;:u= th= Sl='E 0/ lblrkR C~u:ty to ~":::".1tC ~ \Vrl:, =:s d.:pu::cn b:i:1t _...l_ u == ~ =d :-=..s.k of :.:e ?!:ili:::I. a ':/ /,~' ../ t' / r "-:;;l:f,,.,_.~~.t.: '/ ~ She..~ at C=!:e1Ucd C~untT. :':1. . Aiiidavit af Sem= ~OW, 'Q .. o'dea ~L 1C".n .- , .. . ~t!:!zs 1:1 'Jpolt ~l Or =c!!:st :.0 & c::pr oi ::a :]r.~....,1 ,. :md :=a.C8 bowu :0 == .:::u::::s :.~:::::i. So a.::.sw=. --. Shc:'.:i .1 CDWlt'l'. ?2. 3wcr:l .:md. r.lbsc:'J:d bdon: COSTS SE..1.""1CZ ~a:u:."'GZ A::IDA "'-11' J __ .L.:. c!3v of ---- , 19_ ---"'""'----. , f_ "---a HEATH L. ALLEN N. DAVID RAHAL WILLIAM I. MILLER. JR. CHARL.ES W. RUBENDALL II ROIIIAT L WILDON EUGENE [. PEPINSMY, JR THO"'AR E WOOD JOHN H. INOIIII GARY I. rRENCH DONNA. WILDON aRADrORD DORRANCE JErrAEY . ITO",EI ROBIAT R. CHURCH STEPHEN L. OROIE R. ICOTT IHIAIUR JErrRIY r. SMITH DONALD M. LIWIS III BRlDOIT .... WHITLEY ORETCHEN C. HANRAHAN KAREN .1. BROTHERS KEEFER, WOOD, ALLEN & RAHAL 210 WALNUT STREET MAILING ADDRESS. p, 0, BOX 11963 HARRISBURG. PA, 17106.1963 ESTABLISHED IN 111. HULL, LEIBY AND MITZOER Ilg<43.IDIUI) METZGER, HArER, MfErER, THOMAI AND WOOD IUIIllSoID77) IRS No 23-0718138 August 10, 1995 WILLIAM H. WOOD SA"'UEL C. HAARY or COUNIlL \ \ hIt \ rAK (71711515'80150 -\ \,/ r TI\.IPHONI 1?171115tHIOOO WRITI"'. DuneT DIAL: (717) 255-8014 Prothonotary cumberland county Courthouse 1 courthouse Square Carlisle, PA 17013 Attention I Ms. Jane H. sparling Rei Pennsylvania Blue Shield v. Gerald D. stayer cumberland Co. C.C.P. No. 95-3062 civil Term Dear Ms. sparlingl As we discussed on August 10, you are authorized and requested to amend and correct the default jUdgment papers filed today in the above matter. You informed me that your office does not include the record costs as part of the default judgment. Therefore, the judgment will be entered on Auguet 10, 1995 in favor of Pennsylvania Blue Shield and against Gerald D. Stayer in the amount of $4,012.50, representing the principal amount of Blue Shield's claim ($3,750.00) and accrued interest ($262.50). Thank you. BD/ral sincerely, KEEFER, WOOD, ALLEN . RAHAL By I ~b;~~rrance- " 0 . ,.. , . <II ;0 KlElEP'lE". Wooo, ALLIEN " RAHAL 110 lMUOUT .TIIIIT No\lU...-.....,O.lIo.ICll.U .....-..u... .... ".aa.i..a iii 't ", - ,.. '...,' ~"~';;~';;~'oa,:~'~'Ui;:t)iAA.~\Ot~'- '-"._.. " - . . t " .... MEDICAL SERVICE ASSOCIATION OF PENNSYLVANIA d/b/a PENNSYLVANIA BLUE SHIELD, plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA v. civil Action--Law GERALD D. STAYER, Defendant No. 95-3062 civil Term '1tAIex,. TO 11l'1'1. DIrAULT JUDGIIIIIT TO THE PROTHONOTARY I As appearing in Count I of the complaint, please enter a default judgment in favor of Plaintiff, Medical Service Aesociation of Pennsylvania d/b/a Pennsylvania Blue Shield, and against Defendant, Gerald D. stayer, in the amount of ~;~&rGe, $4,012.50 * representing the principal amount of Plaintiff's claim ($3,750.00), accrued interest ($262.50), and record costs. f<t~KUk. · Attached are copies of the following I a July 26, 1995 letter from Plaintiff's counsel to Defendant, and Plaintiff's advance notice of its intention to enter a default judgment, which are marked as EXhibits "A" and "B," respectively. Plaintiff's undersigned counsel certifies that such letter and notice were mailed to Defendant more than 10 days before the date of this filing. D.t.., ~!? '" &'~rd~ )~ '. ~ 1. D. No. 32147 KEEFER, WOOD, ALLEN & RAHAL 210 Walnut Street P. O. Box 11963 Harrisburg, PA 17108-1963 (717) 255-8014 ATTORNEYS FOR PLAINTIFF "--. · 8-10-95 Ptlr ttlltlphonu convursdt1on with tltty Orddfoni lbrrdnJNs @ @ ~ w ~ KEEFER, WOOD, ALLEN & RAHAL 210 WAL.NUT STREET MAIL.ING ADDRESS' POBOX 11963 HARRISBURG, PA 17106-1963 ~[l'GtA tlAttn MEErEn 'l'lOMAS "'1\10 wOOD I,uee 111111 .. EllABllllttO IN 1871 ."tAllt l ALLIN N OAIIIO hAI;At WILLIAM t MILLER JR CltAnLll W RUBENOAll II ROB[Al L 'Nfl nON lUGE",t l Pl P,"'!'"" ...In TIIOMA' [ WOOD .JOliN II (IIlOS III GARy t tn[I-4ClI DONNA '& W[, (10.... BRAOfORO (lonn.....el .JEttAr" 'i !!o10"f.~ ROBlRT R (IlURCIl ,'[PlnN l GROSE ,JEffRE' t SM,'II DONALD M L[WIS III BRIDG[T lot Wll,ll[T GRlTelUN C IlAt-jAAllAN "-AREN J 8ROTIl[Rli t'lUll. LEtBY AND ME1l01" Ilg"J Igeel IRS Nu .D 0116135 July 26, 1995 WILl'AM It WOOD 9"'MUll C ..ARAT Of (DuNSt 1 tAl 11.71 2e~ 80&0 llt[PUON[ 11171 '&&-8000 WR"IlA' 0,Ale1 D'AL (717) 255-8014 IY C.RTI~IID lMD I.OULAR NAIL Mr. Gerald D. Stayer 225 Linden Court Bensalem, PA 19020-4616 Rei Medical service Association of Pennsylvania d/b/a pennsylvania Blue Shield v. Gerald D. stayer Cumberland Co. C.C.P. No. 95-3062 civil Term Dear Mr. stayer I As you recall, our firm represents plaintiff, Pennsylvania Blue Shield, in the above litiqation. More than 20 days have paseed since you were eerved with plaintiff's complaint, and you have failed to file any answer or other pleadinq with the Prothonotary's Office. Therefore, I encloeo plaintiff's advance notice of its intention to enter a default judqment. If you do not file an answer or other pleadinq within 10 days after the date of this letter, plaintiff sholl enter a default judgment against you in the amount requested in the complaint. I am .endin9 a copy of this letter and its enclosure to you by certified and re9ular mail so that you will be certain to receive advance notice of this default judqment. Sincerely, KEEFER, WOOD, ALLEN & RAHAL By: Bradford Dorrance BD/ral enclosurs ~:Khlhlt "A" .. . IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA MEDICAL SERVICE ASSOCIATION OF PENNSYLVANIA d/b/a PENNSYLVANIA BLUE SHIELD, plaintiff : I civil Action--Law I : I Defendant I No. 95-3062 civil Term v. GERALD D. STAYER, TOI Defendant, Gerald D. Stayer Date of Notice: July 26, 1995 IN'O.TAM! MOTIC. YOU ARE IN DEFAULT BECAUSE YOU HAVE FAILED TO ENTER A WRITTEN APPEARANCE PERSONALLY OR BY ATTORNEY AND FILE IN WRITING WITH THE COURT YOUR DEFENSES OR OBJECTIONS TO THE CLAIMS SET FORTH AGAINST YOU. UNLESS YOU ACT WITHIN TEN DAYS FROM THE DATE OF THIS NOTICE, A JUDGMENT MAY BE ENTERED AGAINST YOU WITHOUT A HEARING AND YOU MAY LOSE YOUR PROPERTY on OTHER IMPORTANT RIGHTS. YOU SHOULD TAKE THIS NOTICE TO A LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE FOLLOWING OFFICE TO FIND OUT WHERE YOU CAN GET LEGAL HELP: Court Administrator cumberland county Courthouse 1 courthouse Square--Fourth Floor Carlisle, PA 17013 (717) 240-6200 I, tbe undlr.i9ned ettornlY, clrtiry tbat, above-rererenoed date (~., .orl tbln aD day. arter co.p1aint vas servedl, tbis noticl vas .ai1ed to the rlsidenoe by oertified and rl9u1ar .ail. KEEFER, WOOD, ALLEN' RAHAL on tbe the Dlfendant's EKhthtt "II" ft..61~ QJ... )~-- ~~~~~d Dorrance 1.0. No. 32147 210 Walnut Street P. o. Box 11963 Harrisburg, PA 17108-1963 (717) 255-8014 ATTORNEYS FOR PLAINTIFF - ...... MEDICAL SERVICE ASSOCIATION OF PENNSYLVANIA d/b/a PENNSYLVANIA BLUE SHIELD, Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA v. civil Action--Law GERALD D. STAYER, Defendant No. 95-3062 civil Term TO: Gerald D. Stayer, Defendant i 4,/\/) "J"{' You are hereby notH ied that on August'-&, 1995, a . $4,208.00 default judgment was entered against you and in favor of Plaintiff, Medical Service Association of Pennsylvania d/b/a Pennsylvania Blue Shield, in the above-captioned coset Date: ~~., ;it,IL,;y pro.)~~~~~ary/ I ( ~)/~I I hereby certify that the nam~and the address of the person to receive this notice is: D. /n t) ~- f proper Gerald D. Stayer 225 Linden Court Bensolem, PA 19020-4616 Dated: 'o/,,/yr I /-,~~,~.~.. ~ KEEFER, WOOD, ALLEN & RAHAL 210 Walnut Street P. O. Box 11963 Harrisburg, PA 17108-1963 (717) 255-8014 ATTORNEYS FOR PLAINTIFF , .......... 'f- Y/{i 9l f1t. {/,/ {t {.' {r /' "II \ ( "., I" I, ;./ C II \ III , '.J {3 I ,1 ,.. (r I .( I)r I 1/1 ( I' ( )f/,. r::. \\ '-.u "" .::' ""I-..?\. ~ . '1- -J '-. 1-'0 '1 '~ .~ ,"" i ~' ~ l...' I c., '-J V) , ~ ~ ---\ - ~ " '-. " i' u\ I " ,- ~ '- I' .. L!.i WI