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HomeMy WebLinkAbout95-05095 ~] <11 31 ] ~' , I lJ f> I e \ <::D ~. J' : , It)/ ~! I '" I ..." \f) 'a- ! , i 'j 'I .~~ ,~ ,'-. ~.1 i '.~ :1 --"~ :j ~ :!;~ " .;.' 1 ~ 1 , j 1 , , :\ I ' '" j ~ ~ {; . . GERALD BROCHEY and ANDREA · IN THE COURT OF COMMON PLEAS BROCHEY, Individually and as Parents and · CUMBERLAND COUNTY, PENNSYL VANIA Natural Guardians of STEPHEN BROCHEY, · A Minor, · V"., f/'1S-if '17 J PlaintiffslPetitioners · NO,: f ,), l :-t ,l-t '--_ . '.(.'\..'W-- v, . · CIVIL ACTION - LAW ELIZABETH WILSON, CAROL WILSON, · and THOMAS WILSON, · DefendantslRespondents · PETITION TO SEITLE THE CLAIM OF A MINOR The Petitioners, Gerald Brochey and Andrea Brochey, individually and as parents and natural guardians of Stephen Brochey, a minor, respectfully represent: 1. The Petitioners, Gerald Brochey and Andrea Brochey are the parents and natural guardians of Stephen Brochey, a minor, The minor Plaintif( Stephen Brochey, resides with his father, Gerald Brochey, and they have a mailing address of P,O, Box 8, Walnut Bottom, PeMsylvania, 17266. 2. The minor Plaintiff, Stephen Brochey, is currently 16 years old, having been born on October 27, 1978. 3, The circumstances giving rise to the instant Petition occurred on June II, 1994 at the intersection of Park Drive and Petersburg Road in South Middleton Township, Cumberland County, PeMsylvania, 4. At that time and place, the minor Plaintiff was a passenger in a vehicle operated by Elizabeth Wtlson, when the Wilson vehicle pulled from a stop sign in front of another vehicle which caused impact with the passenger side of the Wilson vehicle, A copy of the police accident report is attached hereto as Exhibit "A", 5, On the date of the accident, the vehicle driven by Elizabeth Wilson was owned by her parents, Thomas Wtlson and Carol Wilson, and was insured through an automobile policy issued by the Allstate Insurance Company, 6, As a result of the subject motor vehicle accident, the minor Plaintiff. Stephen Brochey, sustained lacerations and contusions around the left eye, There was also an initial mention of a possible loss of consciousness and neck pain by Mr, Brochey at the Carlisle Hospital Emergency Room, however, there was no additional treatment for these complaints, Attached hereto as Exhibit "B" are copies of the pertinent medical records, 7, The minor Plaintiff, Stephen Brochey, sustained some scarring in the left eyebrow area, which scarring is thought to be pennanent, A copy of a photograph of Stephen Brochey taken April II, 1995 is attached hereto as Exhibit "C", 8, To settle this claim, the Petitioners and Allstate have agreed upon the sum of Eleven Thousand and 00/100 Dollars ($11,000,00) for the settlement of the claims of Stephen Brochey, a minor, 9, The Petitioners and the minor Plaintiff request that the sum of Four Thousand and 001100($4,000,00) be paid up front to the minor Plaintiff for the purchase of an automobile so that the minor Plaintiff has transportation for employment purposes, as he is no longer attending high school. 10, The Defendants do not oppose the foregoing request provided it meets with Court approval, II, The Petitioners believe that the settlement enumerated in this Petition is fair and equitable and in the best interest of the minor Plaintiff. The Petitioners are unrepresented, They understand and waive their right to obtain counsel to advise them regarding the appropriateness of the settlement. 12, The Defendants have offered to pay the sum set out in paragraph 8 above toward an amicable solution of the claim, and in exchange for Court approval, a Release of all claims, and a discontinuance of the above-captioned matter.. Attached hereto as Exhibit "D" is a copy of the proposed Release, 13, The Petitioners, the minor Plaintiff and the Defendants agree that the sum of Four Thousand and 00/100 Dollars ($4,000,00) be paid to the minor Plaintiff, Stephen Brochey, for the sole purpose outlined in paragraph 9 ofthis Petition, Further, the parties agree that the sum of Seven Thousand and 00/100 Dollars ($7,000,00) payable on behalf of Stephen Brochey, a minor, shall be deposited in a federally-insured savings bank in the name of the minor, with the provision that no withdrawals can be made from such account until the minor reaches his majority. except as authorized by a prior Order of this Court, WHEREFORE, it is respectfully requested that this Court enter an Order approving the foregoing compromise settlement, directing the distribution of proceeds thereof as set forth above, authorizing the Petitioners, upon payment ofthe aforesaid sums, to discontinue the action brought and to execute a good and sufficient Release of any and all claims arising from or as a result of the incident referred to above, By: Respectfully submitted. ~i&fE ,t (,..k), ( 1...0'-<" ~borah A, Ca c~ni, sq iry A~mey 1.0, #67900 3631 North Front Street Harrisburg. PA 17110 (717) 232-7661 Dated: .ssJ ,21 ! ~ C, S 51166 VERIFICATION I, Andrea Brochey, individually and as parent and natural guardian of Stephen Brochey, a minor, verifY that the avennents made in the foregoing document are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa, C,S,A, 4904 relating to unsworn falsification to authorities, Dated: 11169 t7d11 (} (lr /12,) Andrea Brochey Individually and as parent and natural guardian of Stephen Brochey, A Minor q //9 jq.'S , I FILE No. 366 04119 '95 13:01 lD:IU.STATE INS. Hbg,Pa. 717 541 8196 ~ 2 m.~' AMONWEAL TH OF PENNSYL V" , .." POUCE ACCIDENT REPORT'" " (iii)1(fCIIIOOYlI\U>V "00;1' ~EI'OlI1A1l.( I iij NON.I\[I'OIITAAE. n -.--- POLICI! INFORMATION ACClOENT LOCA11ON ,- I.=~",~ J\~\ol'\.~1..l :IO..:=s.).l ,I. '-,,^Lj ~\alllIi ~ ~..... '-',^II"~;''\.\ ~'''''',... "~:JI\.h ...., I~ ~ .::'Ie'!. I, _CINC' Q..t"I............. c>. r:: ., ~1IOI..;l (:) PRINCIPAL ROADWAY INFORMA TION I,~.C!.:OC v..... t~. ~\."",... =~A~' NllJ =~': \~ .....'(o\{,.U'Z. .~, oJ...... !.2:U- [I~lU, I _ iUiiA":'oo .. ' l.UT ~" ""_' 0 IJ,~:'DI\'ON \.r\\'Gu.. 1'....-... \\~'1 ,..JNTERSECTINGROAD:' ACCIDeNTINFORMAOON '"'::::,'::: U--.-\ -~\- U't"~ "~IO(HfL.._\ \ -G\\.L. \O~ .n_ II il1. UWT~ ~S p.:.c-.v & ~CQHTIlClo.~ 11, ~~ OF \, \ c;;. .z.~ oJ IF NOT A TlNTERSEC77ON: lUILW'n f. ~ ''':ilE'':' ,0 N o'l · =~~ II CClYEHCl(Hl\IE TOlE A(1oO/El 11,~llICl.E_5 [3J '\~I~ N SEW'"' FAQUIITl 'AOU_ICSHU o.1lOHl! 1M" I '" UNIT I UNn I 1.11C1fT >>05TNa WAS 0 0 r1l ,rf1 I.MOOliMTE r::;l ~ IolUSlJIED E~lSD V Qf.J H 0 v~ NO "'EVIl\[ INTI ~ I~ fU:TDI [Q) ~TAAFRC I'AK:IP'" MtAS(c:rJG ,", Q t""1f II, 0 m ZllHE 0 =.- ~ r=.>1 lIAn:-.1 ,. N Jl(J , _ATV' .. AI ~ ~ UNIT. , UNIT. 2 'X.=,.c;AI"'~~ .:H.l. "n. ~ -.._mJM~"'~Ti Ct.lml\\'V":.l..)C:::;' I.~ I~~~~vw 'A ":I~'2\~e.~\..~~\""~S ~~~~ftl \ 1 ",,\oJ 7i:CiWi&Ir~. ,~. \ l\~''''' ,,,_ (\ \ r. """,vv4!"~ ~ ...-, t.. '~I.. .., =~s ~ r, ~ A .. , ~\...... \ 4'. :'ss _ -., u:::.. .f\ , x~ "- ... ~~~E vn-\-.\j 0\'...... ~ " "\,~~ \I'JGIo< ...~.STAft. ..Ht'Ah..1 ~~MI")'J-. .\1\(15 43.""''' <:V\ 1'.~c..r~('.cL ~ d._~ ..~~ \ ~ 4S.=~::T O"YY'\V\', \\ I~O lHlO 'I=~::r \r.. .....,.... r~O NO .-0 ~= D<::: P'IMOE C ~.') ~ OlJ ::.I'USAGE 6 ~1lSH.;J ~=IlPAC'~ ~STATUS 0 ~I~":' l$ ~loII'olI:rl') :!.:~~ 0 II 45 ~ \' I II ~l Iq~ I .:-. II I ~I ...--:~ l. \~.:'I <( '" '1\ (,l..1~~ rW\ 0 ~ \ \co ~ ~ rc: ~::l f' ~ NAME t=-\ ~?,,_, .. n I D~ ~,...,., 11.:::11 \'\.. ,\ ~. 'C.:.:..., -.- \ '..~ ~ eMil,S\... ~ -I " -=:'ss ....:lnC; f'\, ...,u-.o ... c~n.IIIA~....,-\-. .Nod' .~- ~1'10.s 14~=r"h.\.. ~..,\. .<::'.rw.~\..rI'lU15 ""~::::=- ~,~~~C1I-(yj.(j-, ,77 1"M'TI.P{,~,."..jJ' .. IE\:: ~f\ \, ~ ,q;1... "~N~r=: r~" "~NVI~ r:: Q. ~ UI jf, " .. ' 11 1lOL\J ", 1M II~II II ;:.mfE & 10. usoor '. II~II _IS HalV,P_A" . ZlI'alllf rue. 10........'. ICC' ::.D_-&~ ~... -~- .- ~. I'UC . 1I cwa 9' MIld 11.~~ ""... ."'11 Ii "" " AIIIlQI:I ....Tl...... _ etr....tn.oa...OtftV'l! :;fJ.'I' " IlCI_ClI'cr'U:' ..nl! 0 " " ' - I '. :' e: . . . ' " - FILE No, 366 04/19 '95 13:01 ID:lUSTATE INS, H>g,Pa. 717 541 8196 poo; 3 I..n&...Ir""'..,...,..... ,"-,,,M.' :, Co, v-lrl_ \II' \. ~\-'~l~~. U, 1"'UJ'ul..... fl. \""'" ..3. -'.J.:.}~,... 't ,",u ""'OICAU":'''' Q.c....,,\.::."':'.\.~ ~ -~T!ll--,- -, ~ENTU"TE: C~L,\ II \ql/ ~~&.C ...FO"N.I,,* ..... . eoI' , 0 I~. - . AOOfll~S ,- tl I J tIC .. IroC , Ilyl/("I~'T 16 Ira:';"; \\r\ - . ^ LJ " ~I(I 1'1 I I 3It'1ll~I'::l, .J1'l~,.t.l..lrl"h lC'\l,^,^, \"<.(L,r ,A-:\M n..v l/. ( ~ (l tJ I I Ii IVIII$!~ ~ () '&~ (l'v19~t &Y",V'"^~,,~(j~..,,U:I.IAt".h\ I t.{ l_ _"; IJ I) ( I ..!!.E. !l!{P do (\ \ r....rf'-. I \.~ \eL \.,",11 II, ,. " .h. ,A""/" ;) Q. .J 1\ 0 I j' T p ~3 I r, ~111 1 2..' "0 'I .~ 3 :2. a I ~'U-1'Ol ~&'TlCR []] ... OIAOAAu ,,_ I _ l I , . : r l' !!) ~'tc"'so..tj v' \\Q ~ U\- lOIlSUllFACI I /t4' 0 (bQ\\'''';k 'S~1"~~ C .:l \'\-o.~. ~ ' fa, I'€NNs'Il.VNIA IOlOOI. OlSrlllCT II AI'tlI.ICAIl.C1 5 DEICM'lOlOF DAJ,lAC(O l'JlOll[A1't ,. ^ ". , :MN!R ..' .. ~ ,<l 1- I \lP\'It~nz } 9~ s.\.c.P~I.s"" : ..'....'.., ;..........,D), ......, ..'.."T.... .. ' .....': ,... IOOAI<II 'HeN! ".IIARIlA1M: .IID/Tn 'AEClPI1ATlIICIlVEHfI. CAUlATIOI/ FACTOIlI, ~CllDCIEOI'EWl'n. _EM "AnllENla.AIIII _ AIlClIT_ . ".. ~ DftHllC;U F.-' "" ,_ ~rc-t&, ..L.....C.cL PBll",~~.rl,I~ I "ItPlMO' ~ \-r....\p ,'!Ok ..r \) dl (\~ fl ~ \ ~. a\ \A.,q rv.. ~ ..C'.~. c I i''' L...L. /)Irll JJ-t ,\..<h 'L. " " ""O,.,'^~Y.'2,\~, I ,.\I'.~,\ ..,\\' _I '~'l-th-~\r'k {)Q. ~",Ct. A ,..c.. \ ".~ ~'\ ~\.......,.l.. -+IA oV'ot'('.",~ ~\(lu (~ ll~:t.T~ I. \ ).CV..JII..~'...~,,- rvr. ,^ ~C1O\....\L\.\...l\...-\-~o.~C .,CL.\ \~" "161 J...i.f.d:.1 , 1.\ A.~ - . S \" 'I., .!:'r. """-n ~r",.1J_ l W ..\.t.." <:: r" .lJ, \.rv" ......a rLA4 r~ "\._\ ....\..- ,,. ~. rA......:.:L" , ,\.. \ ,:rl" ~ ~. \ ..., ~ I J.' :,1J, . y{( k? . \ '- r\.- '1 l ..':, \l ...~l r......... I 1'" ...... :~;- \.. '- r: I - _.u..,.'ar,..JI hP r""" i'l.c ....r...<. NJ . NCI~ \c't \"\S \ I \41 JoJl _'!. r_ l" ',~ I.. A cl \'\,+. lH.l ^ , \~ " I 1. ';..l:A.1 JJk "S.OlAV\\ ~ '^"- (\,...~ ~.~\l"li'V I.~ r! ' · '~o:k ~ ,...:,,. ....- 'rf1J. (\~yz.':h Q_\ 1 ,A 'S\..a. d,d\o"l.'~ s........ llY\,~2.' ,,^~..,<;llto'~J"~' I \~ ,. ~~-' ......~~' ..o'k~ .A~.\~\\__..(\ ('l....-\- "".=0.. -4-" ~< 'O/lMlllCH ~ \ \ <;;.1- A.. I TOI OQW~c~ ~a. Y\~ ~T ~\~JU~o;;'';)..\60b'''S~Ct I ~ ~CYh,,^\L _ . H~I'"'I.""'''''~ oQ[C #' ~\ ~~~j. w~....t "::.r. t~""J'(S ,\.l"t'.;u..4.l0'f IICTISSIS ~'-."4\ ,^^1"",,"W\l.t ~ ~l.r'l'r' ~ \~h1,t\It.~P.I'-oIM.c. :..;.:.;: .. VOOVollQolStIClCAlfD lIll~C1D"'U''''1f\'0.UlF~' '" 'C ..'C Ill' I,..\.....",., ~l'o.rt~ ~ U~t'~cJ. ~\~ ~c;, 3_~ Jd[1 or, ., 'Y\ ~ - - --,r[f ~,. iIJ"!Ilf III )ll5U.1S ~nlT ~ .,JIT~ 1m. }lE,..11 E ~nlf M.IHlItSTGATOo L5l ......TCSt r-- [J /lUus( ~ UK --,nr I'-' 1_ , ~lt""ll b IJ L _OJ. 0 \HI uc'ft (j P<Q' ~ 0__1/. 0 , .~.,'~~ ~ 0 !4-~ r...... II' ~~. ~- ,- r"A ,~ ~ ... . .__. ." L-' .~. ....."....,.. .' . ~ _I 1k....J.ey,stephen 11II1 051199 ""1 06/11/94 ... ~ .xii Il80CIlD CIlIa' CXIll'L1Ulfft ItJbx' whial. aca1dent. JID'1alI C1I -Mf 'IUMlfll 'lbill ~ JIll. WIllI a t'IIlIl' po' _ In a llOtal' wh1cle eoeid-1t today probably era of feur 1'--- _B in the car. He thiJla he vu war~ hill _t belt bit has no real .........A:Y of the ooll1e!cn, He lilY haw been uh......lI'lClQU5 bdeny. He was trouc;I1t fully imobUlzed by ~1C8 to t.he __.,.,ucy deplIrtIlent. At thl. t..I.IIle he 1e tully alert. IIIDICAL IDIIDCM'1CII rewaltl an alert ard <<!.ad, qen.4al1y hell1thy, large and tall, totdt. ale '"' was in no aaJt:a d1..t.. . 'lbIre i.e a large CXII1b...s area en the l.ett f\.1LodIl8lId with a 3 at lacerat1at In t.he latsral aspect. of the -1....-. '1beEw 1e IIldted 80ft tl-1It -11Jn:J am~' '1ba. Ja ncnal. 'lbce la no forel9" bldy. Ife hIUI a vague caplaint of .-:Ie paJn in the oecv1cal collar, tbEefcre L::~ wer:e ClbtaJned prl<< to rEIIOYinJ th1a dwiClll. 'DIe t'I!IIB.lnlia' of the lizatien dlIViOlW oould be~. III had no injury of the dw8t: or ~.. '!be pelvia .. norMI. 'lbIre WIllI a _11 CXlllblltal _ 01: the rl'~ht III1d thl'" wt. he _ Clb.1e to beIIr ""1cJlt; an:1 tbe hip vu painl_ with Ita ralllJ8 of JlDtion, therefore I falt no x-ra'fll wra lhUdal:ed, 'lhe knee was IlOIIlIIl, 'lbe lef~ eJ.b:lIII was .UghUy OCIltuMd ard egaJn no x-rey ""s InUcated. A cr IIC'8Il of the aJ:daDen was ...dt,nd ~ to the ~y 10811 an:1 this WIll nor- IIll In the radiologist'. qllnlon. OD:Vlcal spine series WIIU'8 nanIIll in lIlY cp1n1en ard the collar was relIOII'tld, '1be patient's ~ VBr8 sutured arter hie x-nylI an! he nllB1ned alert thro.Jghcqt th1a 1&"'; T. one i-.....lt. U........i.. with QJinephrine vas Wlltrated into t.he area lU:'CllII1d the WIn! erd it: WIll lrriqated with jet Alina t.-:IInl.que. 'lbe Wl:IInl at..s.d only cIcIwn 1nto the deep ~ toI_. IIId not: dClIIn to the pr:io.W"". It: WIll u.n olo8al in a a1rqla laywr of ~ 1'U'WIiI9 6-0 ....l.al 1IJture. 'ltIe patient vas ala't ard he WIll d1eaIIrged witla a pnecr1ptlon t<< '!y1mDl with ~fna. I caatJ.oned hie parwlt8 ~ injury ~ ani be .. tI01d to return in era week foc IaIture lOllll8l:Mlll. J'DAL ..---.wl MX<< wh.lcle IlCOidwlt: with f...... 1'" l-ciUen 1II.It:ured, Blunt: hIIIId tra~ an:1 8allp cont:uIlaw. OR::/_ D - 06/U/M 1911 T - 06/14/M OAILlILI IOftIftL IPIDQIIfCY 1l00ll UClORD ~-. DEPARTMENT OF RADIOLOGY Carlisle I-bipital' 248 Parker 51,..1 . p.a Boll 3 to. c...... ~ t70t3.o:J to. 1-800-34e-4780. (7171248.1212 r.^Rr.TRr.R TH"'AT"" ^"Rnr.'^TRR, r.c, BROCHIY, BTIPHIK P. (15) 20 IABr Br. ",pr. 9 HT, HOLLY SPRINGS, PA 06/11/94 101"0 DR. COYLI M.R. .0111199 CIRVICAL BPIRI - 5 VIBN8 ... cro.. table lateral view of the cervical Ipine was perfor.ed initlall,. Routine cervical .pine .tudy wa. perfor..d .ub.equentlr. the vertebral alivnment 1. norael. The vertebral bodiel, lDter.pace., and a..oelated appendave. .bow no abnormalltie.. the intervertebral foramina are within nor..l li.ita. The loft ti..ue. of the nick appear noraal and there are no cervical rlbl, IHPRISIIO..: ".vative cervical .plne. CKL/cc P-08/11/94 D-06l12/9" T-06/12/94 Char Ie, .. roO', ":1 1300 0942 1035 CfIMT ffIHYSlClI\N ~- ...... '-' - YELLOW BREECHES FAMILY PRACTICE CENTER Donald J. Kovacl, M.D. .~ad'o~ J. Woad, M.D. Ch~ilty N. Hoove~, C,R.N.P. 1358 Lu'.'own Road IOILINB IPRINBI, PA 17007 Wilt 8ho~e 717/.97-0001 Phone 711lee-H74 July 20. 199~ MI. Do~o'hV L. Ca~.on S'a'f Clai. Analy.t All.'ate In.urance Co.pany eat.way Corpo~ate C.nt.r &34S Flank Drive. Suite 1000 Harri.burg. PA 17112 Dear MI. Car.on, RE' STEPHEN P. BROCHEV Clai. No, ISSI&-49&1-4 BI4 I .aw Bteph.n BrochlY on Jun. 20, 199~, to re.ove .utur.. fro. a wound in hi. l.,t .y.brow. At that ti.., the wound wa. h.aling w.ll and the .uture. w.re r..oved. 1 do not hav. an opinion about the co...tic r..ult. of thil wound at thil ti... Th. .ca~ Ihould r.ach full .aturation In about & .onthl. 1 have no plan. to rlflr hi. for a .car .valuation, Thil"l wa. no evidlnce of anv a"ect an his prior .ar or ankle luralrv due to this accid.nt. Sinc....ly. ~~Yw] Donald J. Kovacl, M.D, .ld .., "." ,f ,., v""" .' c' ~., .-.... " exhibit c Claim no. 15516-4967-7 B14 Insured. Carol J. & Thomas R. Wilson Driver. Elizabeth Wilson- dauqher Photo # 1 Taken. 4/11/95 Subject. Stephen Brochev Scarring in the lower aspect of the left eyebrow and above the left eyebrow on the forehead as markee with the arrcws. , . ~ _:,' ::~.~ > 10 ;~~~~ -.~' '. .,. '. '. '''~',,,''', ',' ,':~-"'.'" "~':~:~~~'..\.tj~. .~., '~~~'" f:~~. ~ . ..... '. . "=', '..:~~ .._~ :.... I> Submitted by: Dorothy L. Carson 4/11/95 ......'llI'..,'.........<J:I.... {_..~I....io1(_".lI<I,............., ExhIbIt 0 I...' PARENTS' RELEASE AND INDEMNITY AGREEMENT CLAIM NO, 15516-4967-4 B14 In con81deration of the payment, W the under8igned. of the 8um of $,I,l,rOOO"OO............. the receipt of which 18 hereby acknowledged. the under81gned parents" ana guardian...... of ........,..........'.. ,S,te.phen..,Br,ochey" ,............., ...." a minor, do ..., forever relea8e. di8charge and covell ant to hold hlll'lnlllll8 ".E~i.zabet.h..,Wi1sQn,Caro~ J.,&...,Thomas,..R...,W,i~sQn and any other per80n, firm or corporlltion charged or chargeable with re8ponsibl1lty or llabl1lty, Ulelr helr8. administrator8, executor8, 8ucceS80r8 and aS8igns. from any and all c1nim8, demands. damage8. C08ts. expensea, los8 of ser\'lces, actiona and cnuses of aetion. belonging to the aald minor or to the undershmed arising uut of any net or occurrcnce up to the present time. and partlcu. larly on account of all per80nal injury, di8ablllty, property damage. 1088 or damages of any kind 8uatained or that may hereafter be austalned by the aald minor or by the underalgned, in couse- quence of an accident that occurred on or about the...l~,..thday of.....,.:Iune..,..,....,............,......., , 19..94,. at or near ...P..rk,*..P~t-er-sbur~,.,Roads" Ht .Holly Sprinqa,..Cumbe,r-l-and Co. Pa. The undersilflled do.., hereby bind, ....o.ursQ,lv.Qs......... .. ,..and..,o.ur,... heirs, administrators. executors, successors and assigns to rCIJay to the ~aid EI i,za beth ..W,ilson, ,C-ac,o-l...J....&..ThOlllBS..,R,....WH,"o/t... .,....,..........and to any other person, firm or corporation charged with responSibility 'or liability, their heirs. administrators, executors, succellSors ami assigns. any additional 8um of money that any of them may hereafter be compelled to pay on account of the Injuries to said minor because of the said accident. To procul'c the payment of the said sum. ...,w.Q..,......., hereby declare: that no represcntation" about the nature and extent of the aaid injuries, disabilities or damages made b)' any physician, attorney or a~ent of any party released, nor any representations regarding the nature and cxtenl of legal linbi1it~, or financial responsibility of any of the parties released. ha\'e induced.......... ............,............ , ..,....,~~.. ......,..,......,.............,...,..to make this release and indemnity agreement: that in determining the amount of the said sum there has becn tallen into consideration not onl\' the ascertained injuriea. diaabilities and damages, but also the possibility that the injuries sus- tained may be permanent and progressive and reco\'cry therefrom uncertain and indefinite, so that consequences not now anticipated may result from the said accident. The undersigned al(rel$... as a further consideration and inducement for this release and in- demnity agreement. that it shall apply to all unknown and unanticipated injuries and namas.res direct. ly and indirectly resultinll' from the Baid accident. as well as to thoge now disclosed, The undersigned understand..,,$ that the parties hereby released admit no liability of any sort by reason of said accident and that said payment in compromise is made to terminate further contro- veray respecting all claims for damages that said minor or the undersigned have herewfore asserted or might personally or through personal representati\'es hereafter assert because of SlIid accident. Signed and sealed thI8.........,day oL..................,....,...,.................................19.. In the presence of (SEAL) (SEAL) n STATE OF COUNTY OF . .. t SS ) o . . . . . ~ o On this day of . 19.. " before me personally appeare.1 , . to me known to be the peraon who executed th~ - , c foregoing In~trllml'nt, and arknowledJl'ed that 1''':t('lltpd the same as free act and dl'l'd ~ My ('ommi!>-:otiCln pxrir(l~ Notary Public 'i:' ..; .:,~ '3t'" , .. . :~~'.';':,:,'~~F-.:O:i:-;':~:F""~~ "~: . . \. ... , . "c" ~ .~ i." .}: '\' '0 e t~ .. Z II ~~ ~~ iz ..z zr ~ . ~I iOiI .!! "a: I ....,. ,'.. , "): ; I'" ' ~:;:I' Cia .' ',:,;",' :5' "''':~8 ~. ., II "~I ::;,1'.;,,.li .. ....;-.:: .~!.'. :': ~i ~ ";"I.. C ,.>(1' ~ .:. . , , -,"- -,', ',' ,', :". . '. . :~" .. . 1":i.. , _ ;=...~.':~Jlr"' ~-.,o;. }~"'~~ '.'"- .' i.\'" . . (j , , ..;; " GERALD BROCHEY and ANDREA · IN THE COURT OF COMMON PLEAS BROCHEY, Individually and as Parents and .CUMBERLAND COUNTY, PENNSYLVANIA Natu.ral Guardians of STEPHEN BROCHEY, · ,~ <'. .I' N, S'- /1 I)./] A Mmor, · No,: I J -)~. C I A.. ,~,\( ,) L-L-1"'- Plaintiffs/Petitioners · v, · CIVIL ACTION - LAW . ELIZABETH WILSON, CAROL WILSON, · and THOMAS WILSON. · DefendantsIRespondents · PRAECIPE FOR WRIT OF SUMMONS TO THE PROTHONOTARY: Please i55lle a Writ of Summons in the above-captioned action, DO NOT FORWARD THE WRIT. ATI'ACHED IS AN ACCEPTANCE OF SERVICE FORM SIGNED BY DEFENDANT'S A TIORNEY. 7) '> ' , e I Brochey (I ividually and as Parent and Natural Guardian of Stephen Brochey, A Minor a1r/u t( ,;/ ~/tc f ~ drea Brochey , Individually and as Parent and Natural Guardian of Stephen Brochey. A Minor Dated: '-':. ffl-t- , /(/ If"C /0 '\. J ~B1U '.t}, ;~' ~ _~~ r<..,';::"-;V " ~; .. l:, .:~'c' ' " "',-';' . - . . - .: --,~--.. -~--' >---:'~~~::.',~.~",; -~~r:~.\<' . -, ~ . "~~ rO;:3';~~~;;~~]d{~'~~~~~;.~( ~"f'4',",~;---h,-","\o""",,"'l\."l<'ri">;f- '~'-..-, '~. ~ ~r~:,~:ES;'~~~~~~3J; ,~- "'Ill. " ",""~' ",d,.,,",' YJ-J ~', 1;_ :-:~:s:yr~r~:Ft~-. _ ;_~. \).ir:;) N -"-,,,(:,,'~---"j-.qsy;:,-~-...,t ~. . . :c:<,. ~'~, /~~,~-..,~~":Jtr~~~;{~}r~.;~;~ :_~-~J ",., .,~:. ~F "it,: .~.",~,It{'-::->>q..'~,'), ~.. -4 /'.. ",.'~T;(~i;}l~~\;~ ~......~ '5 \.C:,:;~::~;~,,;<:,;. . .i'~)">--" 'J,-~, ~ \ . "~," '-'::~' '!f?',}/'-~-;;'~~',:16'i:'>;' ;\i'!'Y:;;~'':'' ~:.p4'l~{i"l-~f,'>_'1 V:'P;;~;,:)'1:t;l:~~:;r;;,;:~};, .', - ," ",," . ,'>". '.'-;""'~'.."-" ,,~:J...{, .;,,#;__...~. _ __ ' , ,,' ','~' '.~!~, ~_!~~- -1.'/~..j,~~~~~,;g~~Q~~';~~.\.:-. '_. . \A' ~" . ,~" ~.' :~-:.~,~~.':;~.~ '.\0",. '~\.';E~~~I;'~~..' , " .~-I~, ~& .t"i: '~"7' " 1.~ ,',;. ';j~~'~. ,."'''' ..."', >~:':~r.- "'." '" , ~ _ ./ '~~;,. 't;,"- t'~"O;~.~> ,'~~ .~{.....~"<'t.lf!{;:::f:,_,' , -. , _" ", .<:}:~r;,::~/,' ",' " '?:.'f:'7;,~':'..""" ' ~,,:.~Y,h;';" "<' . ,;'" .. ..~ ,,;",-.,., j,. -'.' , '..":~/p'r*;~1J~tf,~:t .~ .'.."'1\.," t ;"..>::1.. f! 11 ,,': Ii .. ~ .,,~ . .. :,)\t~':8: I'~ z ....,.jL:lfti .~ Zr ,"'lot i 'z ' . '::;..'.1:' ~.; ..!l-O 0 II: <~.Dtl: . ~ ~ " ""'~'. .~ ,It. ",:,' IL'. . !!I '.".,. .. c', It Ii: .'" . IIC ,.,. ~ C' , ... . SE.P 2. 'llnl: /of> ~ ';J;J,JI ,., ... , ~--;, 't-;, "--,,,..-. ,L':JI.:",__ ;-. '.,-< _'J ---j' ',-;,. . GERALD BROCHEY and ANDREA · IN THE COURT OF COMMON PLEAS BROCHEY, Individually and as Parents and · CUMBERLAND COUNTY, PENNSYL VANIA Natu.ra1 Guardians of STEPHEN BROCHEY, : I' _ j'" A Minor, 1S-JN1.J (llt'\..(~, {k'IY'- PlaintiffsIPetitioners · No,: ' v. · CIVIL ACTION - LAW . ELIZABETH WILSON. CAROL WILSON, · and THOMAS WILSON, · Defendants/Respondents · ACCEPTANCE OF SERVICE I accept service of the Complaint on behalf of Elizabeth Wilson, Carol Wilson and Thomas Wilson and certify that I am authorized to do so as their attorney in this case, By: ( CALDWELL & KE S' './,' l~t I \ pe60rah A. Cay .. s4~~' IAttorney I.D, #67900 ~-North Front Street Harrisburg, P A 17110 (717) 232-7661 ~ "' -",',- Dated: ' ,~. L-I ' \'-11~j , ~n".1 ,.t. ' TO', --,': ,',... "~ , - .~ " I? :,~~ '.\ 3 t ..:~* ';f~;t> - . i"i~~;f~,; ~. ;:;~;:~~;': -<./~'~, . ,. '. ~'~f-;i"~.illi";',;, _ __..L \l="~"'.,~:t,,,c,,u.;. . , ",-4. ',1 " ~ ~' I', <<'. ".,-. ,. ,,' , . "0'.< ..... " . ~, ~ [':g!. I " -r,' ~" ;" t"" ,..' I:'" '. I " fl' , . " -~, c,:~~~)~,s..' ,~:'Y~~'.;:::;~iti;;'r: .;;:" , ")J;~~>;<~~ ::: '-'-' ?~~.':~~~~~1~;j~~~:;~'!~"' , ','<;~'~i}{~' E ~J~1;.~..t:~~~zi:I~::~:'~:,:t ~. """'l.~li:l~,1! j .~~'~j->i}l(t;;~, >' '~i/~~:f:f-fll ,', ~;?'~j::it.l ~ ~ :;I':t ~ ~ i t\c:, = II 'U;C . , . . ;. .!A ,~~: '~,)~, ,~i~~i~~.~,\::-"~::' _'~: -;~;~.~~"~ tt,~~;f:~'; :~~ ,,:':< ::,,~;:~~~,.({;;:~. ;~~,y" "'" '~',~ ~ ~'~t\ -.,<:'-- -:';;, '. ',' , ... . ...ua......... .r.u . .......'WlllllWIIt t- " - - GERALD BROCHEY and ANDREA · IN THE COURT OF COMMON PLEAS BROCHEY, Individually and as Parents and .CUMBERLAND COUNTY, PENNSYLVANIA Natural Guardians of STEPHEN BROCHEY, · "to /, ('Ii L-- (l ,/' ) A Minor, · No,: 'IvJ rJ t-1,l.-tl VL'1I1'- PlaintilrsIPetitioners · v. · CIVIL ACTION - LAW . ELIZABETH WILSON, CAROL WILSON, · and THOMAS WILSON, · DefendantslRespondents · ORDER AND NOW, this ~ day of I) ':"/,-jb UL . 1995, it is hereby ordered that a hearingbeheldon Jc..f(d,uL. /tJ 1'f95at C;.()(j n./n. L,'iL<./z.JIi.'JJ,n1.1. , I for the Court to consider the Petition to Settle the Claim of a Minor, B~ TfIE CO.UR T;-- ,'XI J~ 0-..1 I - \.J----- 1, Distn'bution: 1) Mr, Gerald Brochey P,O, Box 8 Walnut Bottom, P A 17266 2) Andrea Brochey rJo Mr, Gerald Brochey P,O, Box 8 Walnut Bottom, PA 17266 3) Deborah A. Cavacini. Esquire CALDWELL & KEARNS 3631 North Front Street Harrisburg. PA 17110 ~UM ~u.,"-,,~l ,o/~/H ,.,S, t'. - - ,'"' .-........ ,- GERALD BROCHEY and ANDREA * IN THE COURT OF COMMON PLEAS BROCHEY. Individually and as Parents and *CUMBERLAND COUNTY, PENNSYLVANIA Natural Guardians of STEPHEN BROCHEY, * A Minor, * No,: 9~- S'O?S Plaintift'slPetitioners * v, * CIVIL ACTION - LAW * ELIZABETH WILSON, CAROL WILSON, * and THOMAS WILSON, * DefendantslRespondents * ORDER AND NOW, this (O~ay of tJ r tc. f3.e/'- . 1995, it is hereby Ordered and Decreed that the Petition to Settle the Claim of a Minor is approved, The Allstate Insurance Company is directed to make payment of Eleven Thousand and 00/100 Dollars ($11,000,00) to the parents, Gerald Brochey and Andrea Brochey, on behalf of Stephen Brochey, their minor son, It is further ordered that Four Thousand and 00/100 Dollars ($4,000,00) of that sum be paid up front for the purchase of an automobile for the minor Plaintiff to have transportation for employment purposes, as he is no longer attending high school. The remainder, the sum of Seven Thousand and 001100 Dollars ($7,000,00) shaI1 be deposited on behalf of Stephen Brochey, a minor, in a federally-insured savings account, with the provision that no withdrawals can be made from such account until the minor reaches his majority, except as authorized by prior Order of this Court, The Petitioners are directed to sign a Release in favor of Elizabeth Wdson. Carol Wilson. Thomas Wilson and the Allstate Insurance Company, Upon payment of the settlement sums, the Petitioners are directed to discontinue the action filed in Cumberland County, / 1)0 I 0 ~ 31 '.,,195 ~ -.-- .... r):, 'I 7.#- \ ,,' ~C iff' ~ CALDWELL & KEARNS A PRO'ES$IONAI. CORPORATION TMOMAS D. CALDW[LL. JR. RICMARD L. KEARNS CARL G. WAIl JAMES R. CLIPPINGER CMARLEI J. D[HAAT. III JAMES D. CAMPBELL. JR. JAMES L. GOLDSMITM TIMOTMY I. NARK JAMES G. NEALON. III M"TTMEW A, GOVEA DEBOAAM A. CAVACINI KEVIN D ELLIOTT ATTORNEYS AT LAW 3831 NORTH FRONT STREET HARRISBURG. PENNSYLVANI... 17110-11533 ',7.23Z.7d81 "All 717-Z3Z.278e January 23, 1996 Honorable Harold E, Sheely, P.J, CUMBERLAND COUNTY COURTHOUSE 1 Courthouse Square Carlisle. PA 17013-3387 Re: Gerald Brochey and Andrea Brochey, Individually and as Parents and Natural Guardians of Stephen Brochey, A Minor v, Elizabeth Wilson, Carol Wilson and Thomas Wilson Dear Judge Sheely: On October 10, 1995, you signed an Order approving a bodily injury settlement on behalf of Stephen Brochey, a minor (age 17), I have enclosed a copy of the signed Order for your reference, At the time of the hearing, you asked that proof of deposit of $7,000 be supplied to the Court, I am writing to advise that I am unable to obtain the parents' cooperation in that regard, I have sent out three letters dated: November 10, 1995, December I, 1995 and January 5, 1996; wherein I asked that the parents provide proof of deposit in an appropriate account with a notation that no withdrawals can be made until age 18, In each letter, I also provided the parents with the Praecipe to Discontinue and asked that they sign and return the same to me. My most recent letter of January 5, 1996, was returned to my office with a stamp indicating the address for the Brocheys is unknown, I assume that my first two letters were delivered as they were not returned by the post office in this fashion, My purpose in writing this letter is to advise the Court of the reason for my failure to provide information regarding the bank account set up for Stephen, I would like to have the suit discontinued but I am not certain there is any procedure to do so without the parents signing a Praecipe. If you require any additional information, please advise. Otherwise, I will plan to shortly close out my file in this matter as I do not believe there is anything further I can do to obtain the parents' cooperation. GERALD BROCHEY and ANDREA · IN THE COURT OF COMMON PLEAS BROCHEY,lndividuaDy and u Parenta and .CUMBERLAND COUNTY, PENNSYLVANIA Natural Guardlana of'STEPHEN BROCHEY. : . q" _ _ A Minor, No.., .) 5 ~S PlaintiflilPetitionen · v. · CIVU. ACTION - LAW . . . . 'ELlZABBnI WILSON. CAROL WILSON, and mOMAS WILSON, Def'endanlllRespondenu ORDER AND NOW, tbis IO~ day of c::t>4:.",Yw ~ . 1995, it is hereby Ordered and Decreed that the Petition to Settle the Claim of a Minor is approved, The Allstate Insurance Company is directed to make payment of Eleven Thousand and 001100 Dollars (SII,ooo,oo) to the parents, Gerald Brochey and Andrea Brochey, on behalf of Stephen Brochey, their minor son, It is further ordered that Four Thousand and 00/100 Dollars (S4,ooo.00) of that sum be paid up front for the purchase of an automobile for the minor Plaintiff to have tnnsponation for employment purposes. as he is no longer attending high school. The remainder, the sum of Seven Thousand and 001100 Dollars ($7,000,00) sha11 be deposited on behalf of Stephen Brochey, a minor, in a federally-insured savings account, with the provision that no withdrawals can be made from such account until the minor reaches his majority, except u authorized by prior Order of this Coun, The Petitioners are directed to sign a Release in favor ofEli7JI~h Wdson, Carol Wilson, Thomu Wilson and the Allstate Insurance Company, Upon payment of the settlement sums, the Petitioners are directed to discontinue the action filed in Cumberland County, TRUE copy FROM RECORD In Teslimony whtr~, , hsr. unto ~I my M:1d and the seal of sa!d court &1 Carlisle, PI. Thi~day ol.Ccl:...-. '~ \ f): ~ N\b NVrV"\ ,....,..1 ProthollOWV BY 11IE COURT: IS( ~Q.~ ~ Sl~_ GERALD BROCHEY and ANDREA · IN THE COURT OF COMMON PLEAS BROCHEY, Individually and as Parents and .CUMBERLAND COUNTY, PENNSYL V ANlA Natural Guardians of STEPHEN BROCHEY, · A Minor, · No,; 95-5095 CIVIL TERM Plaintift's/Petitioners . v, · CIVIL ACTION - LAW . ELIZABETH wn.SON, CAROL wn.SON, · and THOMAS wn.SON, · DefendantslRespondenlS · Ii ~ER AND NOW, this 2 (;;tday of ~"'~996, upon consideration of the Motion for Discontinuance, it is hereby Ordered and Decreed that the case filed against Elizabeth Wilson, Carol Wilson, and Thomas Wilson, for purposes of obtaining Court approval of a settlement on behalf ofa minor be discontinued, This discontinuance is in compliance with the Coun's previous Order of October 10, 1995, which directed that the case be discontinued upon payment of the settlement sums and based upon proof that the settlement sums have been paid, BltCOURT Ii ,t <:t~( E-. -'---- J, 71488.1 , D' ~ --.;..... ~~ FllED-OFF1CE OF T\ ',r: '" ,{'11 ,!",c1TnW 06 JU;l "0' ~ ", ": lln . ~,(., ~ I' ,I \of CUI.'"'' J' h,i.-o_l ,.;' ,'. .,' _" "I p....'.l'- ;....\11" \. ,~' 1.:1'lI'i.:J i \-J;;lf';'i~ , , , , . . . -....... GERALD BROCHEY and ANDREA · IN THE COURT OF COMMON PLEAS BROCHEY, Individually and as Parents and .CUMBERLAND COUNTY, PENNSYL VANIA Natural Guardians of STEPHEN BROCHEY, · A Minor, · No,: 95-5095 CIVIL TERM PlaintilrslPetitioners . v, · CIVIL ACTION - LAW . ELIZABETH WILSON, CAROL WILSON, · and THOMAS WILSON, · DefendantslRespondents · MOTION FOR A DISCONTINUANCE I, FoUowing a hearing on October 10, 1995, the Honorable Harold E, Sheely signed an Order approving a bodily injury settlement on behalf of Stephen Brochey. a seventeen year old minor, 2, The Order provided, "Upon payment of the settlement sums, the Petitioners are directed to discontinue the action filed in Cumberland County," ~ Order attached hereto as Exhibit "AU. 3, The sum of$ll,ooo was paid to the parents, on behalf of the minor Plaintiff. as is evidenced by the canceled checks attached hereto as Exhibit "B", 4, A Praecipe to Discontinue was sent to the parents for signature on three occasions: November 10. 1995, December I, 1995 and January 5, 1996. The last letter was returned and stamped with the notation that the current address for the Brocheys was unknown, The parents failed to return the signed Praecipe to Discontinue, 4" .......r..... 5, The Postmaster was contacted via letter in an attempt to locate the current address for the Brocheys, The Postmaster advised that the address was unknown and that a current address could not be located, 6, Based on this Court's Order dated October 10, 1995, which specifically directed that the action be discontinued upon payment of the settlement sums and based on proof that the sums were paid via check and cashed, it is requested that this Court enter an Order discontinuing the lawsuit. 7, Defendants' rights will be prejudiced ifa lawsuit remains open against them, until the case is purged, WHEREFORE, it is respectfully requested that this Honorable Court issue an Order discontinuing the action filed solely for purposes of obtaining Court approval ofa minor's settlement, where the Court directed that the case be discontinued after payment of the settlement sums and such sums have been paid, ,~"b..m. itted. , C'Y-o;yziL & KE . . , By: Dated: June 14, 1996 71488 2 ___L...._.... . AU ,IA".,,,.... _UI..... 1/1" "~n,l/1 @ ...., ..... ....--- GERALD BROCHEY and ANDREA · IN THE COURT OF COMMON PLEAS BROCHEY,lndividually and u Parenu and 'CUMBERLAND COUNTY, PENNSYLVANIA Natural Ouardlw of STEPHEN BROCHEY, : ,q ... _ . MAinor, No.. . ,') 5 d1 S Plaintifti/Petitioners · v. · CIVIL ACTION. LAW . . . . 'ELlZABEm wasON, CAIlOL wasON, and mOMAS wn.soN, DefendanUlllespondenu ORDER AND NOW, this IO~ day of cx-~....Y"K';- . 1995, it is hereby Ordered and Decreed that the Petition to Settle the Claim of a Minor is approved, The Allstate lnJurance Company is directed to make payment of Eleven Thousand and 00/100 DoUm ($11,000,00) to the parents, Gerald Brochey and Andrea Brochey, on beha1fofStephen Brochey, their minor son. It is fimherordered that Four Thousand and 00/100 DoUars ($4,000.00) of that sum be paid up front for the purchase of an automob~e for the minor Plaintiff to have transportation for employment purposes, as he is no longer attending high school. The remainder, the sum of Seven Thousand and 00/100 DoUm ($7,000,00) shaD be deposited on beha1f of Stephen Brochey, a minor, in a federaUy-insured savings account, with the provision that no withdrawals can be made from such account unt~ the minor reaches his majority, except IS authorized by prior Order of this Court, The Petitioners are directed to sign a Rdeue in favor ofE1izabeth Wilson, Carol Wilson, Thomas Wilson and the Allstate Insurance Company, Upon payment of the settlement sums, the Petitioners are directed to discontinue the action filed in Cumberland County, TRUE COpy FROM RECORD In TestimonY w!\,r~l, , Mr. unto ~l my M:1d and thll suI 0' $.!:d Courl it CarlISle, Pas Thi~day ol.c:c.L-. \~ \ . ....1.1. r'i ~ ,",^" N'\t"W"V"\ II: PlolhonOlJtV BY THE COURT: IS! \-\ Q.~ ~ SJ~ ExhIbIt B "'~'''!I.LI~ ..m.', 'h" "I:'QIII @ , IIJ!i ll~ " uni II' ,,' ' '. - -i ' . . is ~, l"- i " d m ,@tj I.t) "'N ~ ;':.:D~ ;. o . 00, <0 0 ~ I.t) 0- oo::t :1'ld l'; en "'- l';, oo::t.M~ i C) II'~ 1'-._~l'1, r-./l~ , r- 11'0- !l'1: r- ",;! 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