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HomeMy WebLinkAbout95-06204 -~.~.!,,;" <,T":' '..~''T ,.,.._,~~:.; ,....,,., .... . LISA KOCH and ROBERT KOCH, Parenti and Natural Guardians of TAYLOR KOCH, a Minor and LISA KOCH, Individually, Petitioners, IN THE COURT OF COMMON PLEAS CUMBERLAND couNTY, PENNSYLVANIA v. AMICABLE ACTION. IN TRESPASS NO. 95.6204 1995 CIVIL TERM ROBERT GORIL, Respondent WIDER AND NOW, this/iftltrtay of ~,~Eil . 1995, upon consideration of the Petition to Approve Compromise SetUement (Minor); IT IS HEREBY ORDERED AND DECREED that a hearing on this matter will be held Tut..Sa) 1JfL. ~ 19,~i- ~..()~ I? m. BY THE COURT: ~~c.~\~ "f: ".1, -~t ,<t . LISA KOCH and ROBERT KOCH, Parenta and Natural Guardians of TAYLOR KOCH, a Minor and LISA KOCH, Individually, Petitionen, IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA v. AMICABLE ACTION - IN TRESPASS NO. 1995 qt - 1,;)..0''1 C'-u,'l Kt2.,-.'} ROBERT GORIL, Respondent ORDER ...rr AND NOW, this1L- day of \\0 L.J,~ . 1995, upon consideration of the Petition to Approve Compromise Settlement (Minor)j IT IS HEREBY ORDERED AND DECREED that the settlement is approved and distribution is directed as follows: 1. The sum of FIVE THOUSAND DOLLARS ($5,000.00) payable to LISA KOCH and ROBERT KOCH for reimbursement of medical expenses, incurred and to be incurred on beltalfofTAYLOR KOCH, a minor. 2. The sum of ONE THOUSAND SIX HUNDRED SIXTY-SEVEN DOLLARS ($1,667.00) payable to LISA KOCH and ROBERT KOCH Parents and Natural Guardians of TAYLOR KOCH, a minor for the immediate benefit of TAYLOR KOCH, a minor. LISA KOCH and ROBERT KOCH, Parents and Natural Guardians of TAYLOR KOCH, a Minor and LISA KOCH, Individually, Petitioners, IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA v. AMICABLE ACTION - IN TRESPASS NO. 1995 9t - "';lOI.j C!.iui l Ur...., ROBERT GORIL, Respondent Pl!;l'l'flON TO APPROVE COMPROMISE SR'M'IiEPNT (MINOR) AND NOW, come Petitioners, LISA KOCH and ROBERT KOCH, Parents and Natural Guardians of TAYLOR KOCH, a Minor and LISA KOCH, Individually, by their attorneys, Mette, Evans & Woodside, who represents 88 follows: 1. Your Petitioners, LISA KOCH and ROBERT KOCH, Parents and Natural Guardians of TAYLOR KOCH, a Minor, are adult individuals residinl at 153 South Pitt Street, Carlisle, Cumberland County, Pennsylvania 17013. 2. Your Petitioner, LISA KOCH, Individually, is an adult individual residing at 153 South Pitt Street, Carlisle, Cumberland County, Pennsylvania 17013. 3. Your Petitioners are parente and natural guardians of TAYLOR KOCH, a Minor, bom May 13, 1983 who resides at the same address as Petitioners. 4. Petitioners' minor was iqjured in an auto/pedestrian accident that occurred on December 14,1994 in Carlisle, Cumberland County, Pennsylvania. 5. At the aforesaid time and place, Petitioners' minor was crossing Hanover Street in the crosswalk in front of Lamberton Grade School at approximately 7:40 a.m. at which time the Respondent, Robert Goril was traveling in the fast lane of Hanover Street and struck Petitioners' minor causing serious iqjury 88 hereinafter related. 6. AB a direct result of the crash, Petitioners' minor suffered fractures of both legs, requiring surgery with the placement of metal rods in both legs. 7. Immediately prior to the accident, Petitioner. Lisa Koch had dropped Petitioners' minor off for school and as Petitioners' minor was crossing the crosswalk, Petitioner, Lisa Koch heard the squeal of brakes and heard a loud "thud." Petitioner. Lisa Koch helped Petitioners' minor out of the street by - 2 - dragging him off tho streilt fearful that he would be hit by other vehicles. Petitioner, Lisa Koch was emotionally distraught from viewing this accident and accordingly has a cause of action on her own for negligent infliction of emotional distre88. au, J'letTv. Lasso, _ Pa. Super. _. 555 A.2d 1304 (1989). 8. As a direct result of the aforesaid accident, Petitioners' minor underwent surgery of both legs with a placement of metal rods; underwent physical therapy; was unable to participate in sporting activities; suffered a refracture in the AprillMay 1995 time period merely from twisting his leg; had surgery again in July 1995 to remove the metal rods from his leg; and, is presently undergoing physical therapy. 9. As a direct result of the aforesaid accident, Petitioners' minor has four (4) large sears on his leg from both surgeries which scarring condition is pennanent. 10. That while the Defendant has denied responsibility and liability for the accident, his liability insurance carrier, Pennsylvania National Insurance Company (PNn has agreed to pay a settlement on behalf of Petitioners' minor in the amount 0($100.000 which amount is the ResDOndent's oolicv 1i1Di... ofbia .3- ----.-;"'1"':.~ automobile insurance in exchange for a Joint Tortfoaaor Releaae whidh is attached hereto 88 Exhibit "A". Petitioner, Liaa Koch, individually. is not claiming any portion of the $100,000 settlement for her claim of negligent infliction of emotional distress or her claim for lost wages. These claims will be pursued against the underinsurance carrier, Erie Insurance. 11. As a direct result of the aforesaid accident, approximately $29,500 in medical bills were incurred for treatment of Petitioners's minor. Of the $29,500, $10,000 was paid by Petitioners' first Pllrty carrier, Erie Insurance. Of the remaining amount, approximately $18,000 has been submitted to the Petitioners' health care provider, Blue Cross/Bluo Shield. Of the amount of bills processed by Blue Cross/Blue Shield, $3,591.71 is owed directly by Petitioners. Recent bills have been submitted to Blue Cross/Blue Shield in an amount of $5.500 and Blue Cross/Blue Shield has not detennined how much of this amount will be covered by insurance. Therefore, it is possible that a POrtion of the $5,500 will be owed by Petitioners. Considering the amount that is now owed directly by Petitioners ($3,591.71) and amounts that may be owed in the near future, it is requested that a total of $5,000 of the settlement monies be paid to Petitioners for payment of medical billa for treatment of Petitioners' minor. . '-'" - 4 - automobile insurance in exchange for a Joint Tortfeasor Release which is attached hereto 81 Exhibit MA". Petitioner, Lisa Koch, individually, is not claiming any portion of the $100,000 settlement for her claim of negligent infliction of emotional distreN or her claim for lost wages. These claims will be pursued against the underinsurance carrier, Erie Insurance. 11. As a direct result of the aforesaid accident, approximately $29,600 in medical bills were incurred for treatment of Petitioners's minor. Of the $29,600, $10,000 was paid by Petitioners' first party carrier, Erie Insurance. Of the remaining amount, approximately $18,000 has been submitted to the Petitioners' health care provider, Blue CrosaIBlue Shield. Of the amount of bills processed by Blue CroaaIBlue Shield, $3,691.71 is owed directly by Petitioners. Recent bills have been submitted to Blue CroaaIBlue Shield in an amount of $5,600 and Blue CroaaIBlue Shield haa not determined how much of this amount will be covered by insurance. Therefore, it is possible that a portion of the $6,600 will be owed by Petitioners. Considering the amount that is now owed directly by Petitioners ($3,691.71) and amounts that may be owed in the near future, it is requested that a total of $6,000 of the settlement monies be paid to Petitioners for payment of medical bills for treatment of Petitioners' minor. .4. 12. From the settlement monies, it is requested that a payment of ONE THOUSAND SIX HUNDRED SIXTY.SEVEN DOLLARS ($1,667.00) be made immediately for the benefit of TAYLOR KOCH, a minor to be used to buy giftalpresents for the minor. 13. From the settlement monies, it is requested the sum of SIXTY THOUSAND DOLLARS ($60,000.00) payable to LISA KOCH and ROBERT KOCH, parents and natural guardians of TAYLOR KOCH, a minor, to be placed in a federally insured savings account or a federally insured savings certificate in the name of the minor, to be marked "not to be withdrawn unti1said minor reaches the age of eighteen (18), as upon the Order of Court of Competent Jurisdiction". 14. Petitioners' underinsurance carrier, Erie Insurance, has approved this settlement and release so that Petitioners can pursue underinsurance motorist benefits against Erie Insurance. There is $200.000 of potential benefits available to Petitioners' minor in underinsurance motorist benefits. .5. - -, prosecution of their claim. However, at this time, no costs are being a8se88l'd '1 ( ',-; lIIail18t Petitioner8 as a result of this settlement. ,i, WHEREFORE, your Petitioners respectfully request the prayer of this l Petition be granted. /flJ:L/t tJcl] LISA KOCH and ROBERT KOCH, Parents and Natural Guardians of TAYLOR KOCH, a Minor METrE, EVANS &: WOODSIDE BY:~~---- ANDREW H. DOWLING, ESQUIRE Supreme Court I. D. No. 39692 3401 North Front Street P. O. Box 5950 Harri8burg, PA 17110-0950 Telephone: (717) 232.5000 Attorneys for Petitioners DATED: pRO.RATA JOINT TOR'fFEASOR REI.RARE KNOW ALL MEN BY THESE PRESENTS: That we, LISA KOCH and ROBERT KOCH, Parents and Natural Guardians of TAYLOR KOCH, a Minor, LISA KOCH, Individually and ROBERT KOCH, Individually, (hereinafter collectively referred to as "Releasors"), for and in consideration of the payment of the sum of ONE HUNDRED THOUSAND AND 00/100 ($100,000.00) DOLLARS and other good and valuable consideration, paid by ROBERT GORIL and his insurer, PENNSYLVANIA NATIONAL INSURANCE COMPANY, (hereinafter collectively referred to as "Releasees" or "Payors"), the receipt whereof is hereby acknowledged, realizing that there is doubt and uncertainty as to the nature and extent of my losses, damages, injuries, and the liability of ROBERT GORIL and his insurer, PENNSYLVANIA NATIONAL INSURANCE COMPANY, and that such facts are in dispute, have released and discharged, and by these presents do for ourselves, our heirs, executors, administrators, successors and assigns, release and forever discharge Payors and their successors, assigns, servants. agents, and employees from any and all actions, causes of actions, suits, claims, demands, liabilities, contribution, indemnity and damages of any kind or nature whatsoever, and also to the extent of any liability of ROBERT GORIL and his insurer, PENNSYLVANIA NATIONAL INSURANCE COMPANY, their successors, assigns. servants, agents and employees. for contribution or indemnity to or with '" --..;....,-'--.. _...._.""j~...'_"~...'~r /-",1 any other person, party, corporation or other entity, arising out of any and all claims for all injuries, damages and losses, known or unknown, to Releasors ariainl out of, related or resulting from an accident which occurred on or about December 14, 1994 in Carlisle, Cumberland County, Pennsylvania. i " ~ In the event that any other persons, firms, corporations, or other entities, or joint tortfeasors, and/or their servants, agents, or employees, or other persons, firms, or corporations for whom they could be vicariously liable are responsible to LISA KOCH and ROBERT KOCH, Parents and Natural Guardians of TAYLOR KOCH, a Minor, LISA KOCH, Individually and ROBERT KOCH, Individually, for damages as a result of the aforesaid accident, the execution of this Release for the consideration paid shall operate as a satisfaction of all claims against such other person, firms, corporations, or other entities or tortfeasors to the extent of the relative pro rata share, or percentage share of common liability of ROBERT GORIL and his insurer. PENNSYLVANIA NATIONAL INSURANCE COMPANY, herein released, such share to be determined in accordance with applicable law, including the Uniform Contribution Among Tortfeasors Law as enacted in the Commonwealth of Pennsylvania, and as it may have been modified by the Pennsylvania Comparative Negligence Law, or construed by the Courta of the Commonwealth of Pennsylvania. .2. We further agree that any judgment entered against other alleged tortfeaaors in any action instituted to recover damages arising out of the above described accident, whether the liability of such other tortfeasors is based upon negligence, strict liability, warranty or otherwise, shall be reduced by the full proportional amount of the shares of the Releaaees attributed by the Court or Jury to the Releaaees, whether or not the Releasees was/were in fact a joint tortfeaaor(s). If it should appear to be adjudicated in any suit, action or proceeding, however, that the Releasees and others caused injuries to us by liability producing conduct established on any legal theory, in order to save the Releaaees harmless, we, aa further consideration for said payment, will satisfy any decree, judgment, or award in which there is such finding of adjudications involving the Releaaees on their behalf and to the extent of their liability for contribution and/or indemnity. Should Heleasees be joined in any future lawsuit or action, Releaaors are not obligated to provide a defense to Releasees in said suit; however, Releaaors shall immediately mark any judgment rendered against Releasees satisfied to the full extent of Releasees liability for their pro rata share or liability to others for contribution or indemnity. - 3 - We reserve all claims against any and every other person, association or corporation as a result of the occurrence mentioned above. We understand that the Releasees hereby admit no liability or any kind by reason of said accident and that said payment and settlement in compromise is made to avoid further inconvenience and expense of litigation. We further warrant hereby that we have not received heretofore any consideration whatever for, nor have we heretofore made any other prior settlement with or given any prior Release to any other alleged tortfeasor as a consequence of the above described accident and we agree to hold hannless and indemnify the Releasees from any loss, claim or liability for contribution or indemnity by any other alleged tortfeasor. This Joint Tortfeasor Release contains the ENTIRE AGREEMENT between the parties hereto, and the terms of this Release are contractual and not a mere recital. In making this settlement and in giving this Release, we do not rely on any statements or representations of any doctor, physician or any other person as to what our condition(s) was/were. is/are or may be in the future nor do we rely on any statements or representations of the Releasees or any person acting on their behalf. It is our intention that this Release be complete and shall cover all the aforesaid claims, damages and injuries; that it shan not be subject to any claim of - 4 - . . :! mistake of fact; that it expresses a FULL AND COMPLETE SETTLEMENT of a liability claimed and denied: and that regardless of the adequacy or inadequacy of the amount paid, it is intended to avoid litigation and to be final and complete. We further agree that (1) we have read this Release, and that there is absolutely no agreement or reservation other than as clearly expressed herein: and (2) the consideration stated herein is all that we are ever to receive from or on behalf of the Releasees and is received with full knowledge that it covers all possible claims that could be presented against the Releasees by us or by any other person or party as a consequence of the above-described accident. We further declare and warrant that each and every underinaured motorist carrier or inaurance company or entity which has or may claim to have a lien on recovery by subrogation or otherwise is aware of this Release and Settlement Agreement and has consented to it and has told us that any lien or subrogation .5- haa been waived against Releasees and that we are authorized to so represent the lame to the parties released hereunder. This Release is not be construed as a Releaae of our claims agailUlt our underinsured motorist carriers. WITNESSETH, due to execution of here of this _ day of 1995. residing at LISA KOCH and ROBERT KOCH, Parents and Natural Guardians of TAYLOR KOCH, a Minor residing at LISA KOCH, Individually residing at ROBERT KOCH, Individually WITNESS: residing at - 6 - H&Mll'YW. MfOotoDe .....,. M. LONCt. ..ft.- ~ T. MOYCft .JIiM"'~ MCHNIO" WOOO V_-.,,~"I. ... -.,ct:...TM .IOMM r.IIlNIKCK ......1. L&MII ..IITVMUI~ ~""MCM- ......,,, A. &.UMOUN .UIC...M\HIILCT.,Jtt. .....TMNIM..YCM."ft. -..- DIMD..o'UAIW DNI'O O.1"IlMIO&U- c...-.. ". ,....,. ~,.,...,.....," "&M".""~."'- "MN ~D TO TIC ruMII....... h: DIlA/IW D_ HICHOLoM '~MAa" ,MNCtt DUotI ... OU~N.C""I: DONNA N.". C........ CHAM.&e C OUTaHAl.L WC1'tI:. ....,...L.EY PAUL". WQU:L.L ~ D. LQCI4INOUI ,,&Me It. fIU"L LOtti... M.cUte" IUMHJIL" AL8fItGH' "'OCL Y111e1"'UIIto P. ...CNKHC1. auaAM tI:. KHWM DUM". ,.C....,,"II 'OGO ".""'L.L JeNN,,.Cft N. McHUGH MNMtI:TH"-",OC1. ., CU.nn: 'lour Inlund: Cl.la 10. : D.t. of Loll: TJp./LOII : -.....,.':'.-.. _. ,,0-" , I I HIIOAD8 . SINON ATTORNEY. AT LAw DAU~HIN BANK Bun.DING TWEL.'TH FLOO" ONE SOUTH MA"KET SaUA"E P.O. 80X II.. H.......'..u..O, PA 17108-II"e 0" cou...." ,.........""".."'0" .I0...N C. OOWUNG PAUL H. ...OADIJ ,...,.,-" "OHN M. MU"'uu.N 1.'.''- CUL& ft ...CMO<<""O' ,....,-.0 TELE,.HONEI7171.:u,.a731 ,.AX NO.1 aENC"ALI 717..~..14.. MUNICIf'AL attOU~1 717..~'''.IO LITIGATION a"OU~1 717..~1".~" OlltlCT 0tA1. NO. '".& NO. 5339/01 November 28, 1995 Lill . Rob.rt Koch. P.r.ntl .nd .Itur.l Guardianl of T.y10r Koch. a Minor. and Lila Koch, Individually Robart Ind Lila Koch 010950041665 12/14/94 Auto/p.d..trian Accidlnt Honorable Harold E. Sheely cumberland County Courthouse 1 Courthouse square Carlisle, PA 17013 Dear Judge Sheely: I understand that a petition settlement from the Defendant tort feasor minor's personal injury olaim has been December 5, 1995, at 2:00 p.m. Since that hearing has been scheduled, we have managed to settle the underinsured motorist olaim on behalf of the minor plaintiff and will be filing a petition for approval within the next several days. I am aooordingly requesting that you hear both petitions on Tuesday, Deoember 5, as the faots, testimony, issues, etc. are identical. If this is agreeable, would you please have your seoretary phone my office. DBD/lgr.nm to approve a $100,000 on the above-referenoed soheduled for Tuesday, Very truly yours, RHOADS &: SINON B~v.-r'~~ David B. Dowling ~ LANCAaTER O"'ICE: ,. NORTH LIME. aTREtT.I-ANCAaTER. PA 17.0.. TELEPHONt 17171 387.11,,7. rAX 17171.3.'..'.7 A,.'ILIATED O,'ICEI IUITE 301. ...W. CANIHO OAADEN8 BLVD'I .OCA RATON.'L 33431.. TEUPHONE 1.07) 31........'AX 140'. 3......7 ..~_ _~~>...._._",..... . K, I "~~~_'_"k' -. , , ." LISA KOCH and ROBERT KOCH, · IN THE COURT OF COMMON PLEAS Parenll and Natural Guardians of · CUMBERLAND COUNTY, PENNSYL VANIA T A nOR KOCH, a Minor and LISA KOCH. · Individually, · Plaintiffs · AMICALBLE ACTION -IN TRESPASS . v. ROBERT GORIL, Defendant · No.: 95-6204 1995 Civil Teon . . ENTRY OF APPEARANCE TO THE PROTHONOTARY: PLEASE enter my appearance on behalf of Defendant with regard to the above-referenced maUer. By: CAL7 KEARNS Timothy J. M squire Attorney J.D. 7 8 3631 North Fro tree! Harrisburg, PA 17110 (717) 232-7661 Attorney for Defendant Robert Goril Dated: November 6. 1995 6llm -..,........t... .. _.,.__...._....;,.."'''''''v. ..,....- - . '1\ 1- ~, ,l" ..-"",, ]' t'~ , -' i." .. L, '~l ~RTIFICATE OF SERVICE ; ',~ , .,~ I hereby certify that I am this day serving a copy of the foregoing document upon the person(s) and in the manner indicated below. which service satisfies the requirements of the Pennsylvania Rules of Civil Procedure, by depositing a copy of same in the United States Mail, at Harrisburg, Pennsylvania, with first clllll8 postage prepaid, addressed as follows: .. Timothy l. Mark, Esquire Caldwell & Kearns 3631 N. Front Street Harrisburg, PA 17110 METTE, EVANS & WOODSIDE BY: ~ --> - ANDREW H. DOWLING, ESQUIRE Supreme Court l. D. No. 39692 3401 North Front Street P. O. Bolt 6960 Harrisburg, PA 17110.0960 Telephone: (717) 232-6000 Attorneys for Plaintiffs DATED: January 2, 1996 ll:l31101 \, , , II 1111 h,lll'" lilli' t"'11"'"'' 11111. I' " tl II" . Itoll" Illlllllll.llil'll 1'1.",\ ""1 ""i.' I ,Ill ,. '1,,1 ' , " . ''l d li II' P, ,I, "" I Ih 11' I"I.! II" . '111, I ( III"" ,(,I, II" "Ill Il' ,: (i,. ',11t I, I , '1 .1, I tl" ( III ..: . ! 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'-I!P", I" 1.1 1,1 lHHhlllk 1,.1I III , I"d ,lfi,1 " LISA KOCH and ROBERT KOCH, IN THE COURT OF COMMON PLEAS Parents and Natural Guardians of CUMBERLAND COUNTY, PENNSYLVANIA TAYLOR KOCH, a Minor and LISA KOCH, Individually, Plaintift8, AMICABLE ACTION. IN TRESPASS v. NO. 95.6204 1995 Civil Term ROBERT GORIL, Defendant ~ TO THE PROTHONOTARY: Please mark the docket in the above-captioned action settled, discontinued and ended. METTE, EVANS & WOODSIDE ~ ~ BY: ~-;,5 -~_ ANDREW H. DOWLING, ESQUIRE Supreme Court I. D. No. 39692 3401 North Front Street P. O. Box 5950 Harrisburg, PA 17110-0950 Telephone: (717) 232.5000 Attorneys for Plaintiffs DATED: January 22, 1996 " . . . -' . . CERTlFlCA.TE OF SERVlCIjj I hereby certify that I am this day serving a copy of the foregoing document upon the parlon(l) and in the manner indicated below, which service satisfies the requirements of the PelU18ylvania Rules of Civil Procedure, by depositing a copy of lame in the United States Mail, at Harrisburg, PelU18ylvania, with fint c1au postqe prepaid, addreued as follows: Timothy I. Mark, Esquire Caldwell & Kearns 3631 N. Front Street Harrisburg, PA 17110 METTE, EVANS &: WOODSIDE - ~ BY: - e ANDREW H. DOWLING, ESQUIRE Supreme Court I. D. No. 39892 3401 North Front Street P. O. BOI: 5950 Harrisburg, PA 17110-0950 Telephone: (717) 232-5000 Attorneys for P1aintift'a DATED: January 22, 1996 1148121 . ;'f":_'~;" . :"".f''l-..i...._~....~_.''''.,.'..~.'''_...''''l<.~H. I<t,.~ . l;' LISA KOCH and ROBERT KOCH, Parents and Natural Guardians of TAYLOR KOCH, a Minor and LISA KOCH, Individually, IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA Plaintiffs, AMICABLE ACTION - IN TRESPASS v. NO. 95-6204 1995 Civil Term . ,.,.., ROBERT GORIL, Defendant mmEB AND NOW this ~ay of ~'7(}.11. VV' , 1997, upon consideration of the Petition to Amend the Order of Court Approving Compromise Settlement (Minor) dated December 5, 1995; IT IS HEREBY ORDERED AND DECREED that the Petitioners are permitted to withdraw $7,707.00 from PNC Bank Account "Taylor Koch, Minor under Court Order dated December 5, 1995 Lisa and Robert Koch, Natural Guardians", Certificate No. 31700021856 and Reference No. 3700008756. The amount of Lt' $7,707.00 shall be payable to Lisa Koch and Robert Koch, Parents and Natural Guardians of Taylor Koch, a minor. f BY THE COURT: fL~)EJ~' I!J. . 860011 . LISA KOCH and ROBERT KOCH, Parents and Natural Guardiana of TAYLOR KOCH, a Minor and LISA KOCH, Individually, IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA Plaintiffs, AMICABLE ACTION. IN TRESPASS v. NO. 95-62041995 Civil Term ROBERT GORIL, Defendant AND NOW, comes Petitioners, Lisa Koch and Robert Koch, Parents and Natural Ouardiana of Taylor Koch, a Minor, by their attorneys, Mette, Evana &I Woodaide, who represent 88 follows: 1. On December 5, 1995, the Honorable Harold E. Sheely, President Judge, signed an Order approving a compromise settlement (minor). Order and Petition are attached 88 Exhibit MA". 2. The above-captioned matter was a settlement 88 a result of an auto/pedestrian accident that occurred on December 14, 1994 in which Petitioners' minor suffered serious injury including fractures of both legs. 3. In addition to a compromise settlement in the abovc-captioned case, Petitioners also settled an underinsurance motorist claim (UIM) with Erie Insurance Company. A copy of the Order of Court and Petition approving the compromisc settlement in the UIM case is attached &s Exhibit "B" for completencss. 4. pursuant to the Order of Court approving the compromise settlement (minor) attached 88 Exhibit "A" a sum of $60.000 was placed into an appropriate federally insured account marked "not to be withdrawn until said minor reaches the age of 18 or upon the Order of Court of Competent Jurisdiction". 6. Petitioner's minor is presently in nced of orthodontic treatment, co.t1D1 $4,800. Attached as Exhibit "C" is a report from G. Ronald Krajack, D.M.D., P.C. outlining the treatment and cost of the orthodontic treatment for Petitioner'. minor. 6. Petitioners also desire to purchase a computer for Petitioner'. minor that will cost $2,600.00 7. As a result of investment of the $60,000 referenced in the Order or Court approving the compromise settlement (minor) attached sa Exhibit "A", Petitioner's minor has incurred Federal income tax in the amount of *328.00 and Pennsylvania State income tax in the amount of $79.00 for the calendar year 1996. f ) -\~ ,r~,-..~...,-,'_r"---..' '_:""",_,'4<:.. -">"'-' ',---i"j;"-"':": ., 8. Petitioners request the Court sign an Order pennitting withdrawal of $7,707.00 for medical treabnent, a computer, and payment of taxes as outlined above. 9. The $60,000 was invested at PNC Bank as evidence by the Certificate of Deposit Account Verification attached as Exhibit "D". WHEREFORE, Petitioners request this Court to modify the Order of December 5, 1995 pennitting the withdrawal of $7,707.00 to cover expellBes for medical treatment, purchase of a computer, and payment of income tax. Respectfully submitted, METTE, EVANS &I WOODSIDE ~- BY: ANDREW H. DOWLING, ESQUIRE Supreme Court I. D. No. 39692 3401 North Front Street P. O. Box 5950 Harrisburg, PA 17110..0950 Telephone: (717) 232-5000 Attorneys for Plaintiffs DATED; March 25, 1997 .\I-ITAU.lIu.o. _"'''''f fill' ",onlo ~ " W . . . " ~ tl--"'-:'~:r.il-'''.~tt~~flHii~V .........ij,. "!liMA .......-. LISA KOCH and ROBERT KOCH, Parents and Natural Guardians of TAYLOR KOCH, a Minor and LISA KOCH, Individually, Petitioners, IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA AMICABLE ACTION - IN TRESPASS v. NO. 1995 9S - /,).6 J..j (2; 1.>I'l '----;;;12..111 ROBERT GORIL, Respondent ORDER AND NOW, this ~ day of -=o~ r' p..n"l J, E,:2... . 1995, upon consideration of the Petition to Approve Compromise Settlement (Minor); IT IS HEREBY ORDERED AND DECREED that the settlement is approved and distribution is directed as follows: 1. The sum of FIVE THOUSAND DOLLARS ($5,000.00) payable to LISA KOCH and ROBERT KOCH for reimbursement of medical expenses. incurred and to be incurred on behalf of TAYLOR KOCH, a minor. 2. The sum of ONE THOUSAND SIX HUNDRED SIXTY-SEVEN DOLLARS ($1,667.00) payable to LISA KOCH and ROBERT KOCH Parents and Natural Guardians of TAYLOR KOCH, a minor for the immediate benefit of TAYLOR KOCH. a minor. ~'i LISA KOCH and ROBERT KOCH, Parents and Natural Guardbns of TAYLOR KOCH, a Minor and LISA KOCH, Individually, Petitioners, IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY. PENNSYLVANIA v. AMICABLE ACTION - IN TRESPASS NO. 1995 9S"- (.,;16'1 ROBERT GORIL, Respondent pETITION TO APPROVE COMPROMISE SETTI.F.MENT (MINOR) AND NOW. come Petitioners, LISA KOCH and ROBERT KOCH, Parents and Natural Guardians of TAYLOR KOCH, a Minor and LISA KOCH, Individually, by their attorneys, Mette, Evans & Woodside. who represents as follows: 1. Your Petitioners, LISA KOCH and ROBERT KOCH, Parents and Natural Guardians of TAYLOR KOCH, a Minor, are adult individuals residing at 153 South Pitt Street, Carlisle, Cumberland County, Pennsylvania 17013. 2. Your Petitioner, LISA KOCH, Individually, is an adult individual residing at 153 South Pitt Street, Carlisle, Cumberland County, Pennsylvania 17013. " 3. Your Petitioners are parents and natural guardians of TAYLOR KOCH, a Minor, born May 13, 1983 who resides at the same address as Petitioners. 4. Petitioners' minor was injured in an auto/pedestrian accident that occurred on December 14, 1994 in Carlisle, Cumberland County, Pennsylvania. 5. At the aforesaid time and place, Petitioners' minor was crossing Hanover Street in the crosswalk in front of Lamberton Grade School at approximately 7:40 a.m. at which time the Respondent, Robert Goril was traveling in the fast lane of Hanover Street and struck Petitioners' minor causing serious injury as hereinafter related. 6. As a direct result of the crash, Petitioners' minor suffered fractures of both legs, requiring surgery with the placement of metal rods in both legs. 7. Immediately prior to the accident, Petitioner, Lisa Koch had dropped Petitioners' minor off for school and as Petitioners' minor was crossing the crosswalk, Petitioner, Lisa Koch heard the squeal of brakes and heard a loud -thud." Petitioner, Lisa Koch helped Petitioners' minor out of the street by - 2 - .' dragging him off the street fearful that he would be hit by other vehicles. Petitioner, Lisa Koch was emotionally distraught from viewing this accident and accordingly has a cause of action on her own for negligent infliction of emotional distress. Sn. JIlelfv. Lasso, _ Pa. Super. _.555 A.2d 1304 (1989). 8. As a direct result of the aforesaid accident, Petitioners' minor underwent surgery of both legs with a placement of metal rods; underwent physical therapy; was unable to participate in sporting activities; suffered a refracture in the ApriVMay 1995 time period merely from twisting his leg; had surgery again in July 1995 to remove the metal rods from his leg; and, is presently undergoing physical therapy. 9. As a direct result of the aforesaid accident, Petitioners' minor has four (4) large scars on his leg from both surgeries which scarring condition is permanent. 10. That while the Defendant has denied responsibility and liability for the accident. his liability insurance carrier, Pennsylvania National Insurance Company (PNIl has agreed to pay a settlement on behalf of Petitioners' minor in the amount of $100.000 which amount is the ResDondent's Dolicv limits of his .3. automobile insurance in exchange for a Joint Tortfeasor Release which is attacht!d hereto as Exhibit "A". Petitioner, Lisa Koch. individually, is not claiming any portion of the $100,000 settlement for her claim of negligent infliction of Amotional distress or her claim for lost wages. These claims will be pursued against the underinsurance carrier. Erie Insurance. 11. As a direct result of the aforesaid accident. approximately $29,500 in medical bills were incurred for treatment of Petitioners's minor. Of the $29,500, $10,000 was paid by Petitioners' first party carrier, Erie Insurance. Of the remaining amount, approximately $18.000 has been submitted to the Petitioners' health care provider, Blue CrossIBlue Shield. Ofthe amount of bills processed by Blue CrossIBlue Shield. $3,591.71 is owed directly by Petitioners. Recent bills have been submitted to Blue CrossIBlue Shield in an amount of $5,500 and Blue CrossIBlue Shield has not determined how much of this amount will be covered by insurance. Therefore, it is possible that a portion of the $5,500 will be owed by Petitioners. Considering the amount that is now owed directly by Petitioners ($3,591.71) and amounts that may be owed in the near future, it is requested that a total of $5,000 of the settlement monies be paid to Petitioners for payment of medical bills for treatment of Petitioners' minor. .4. . .,' ~..,..- ~-~ .-_.-' ,J ) 12. From the settlement monies, it is requested that a payment of ONE THOUSAND SIX HUNDRED SIXTY-SEVEN DOLLARS ($1,667.00) be made immediately for the benefit of TAYLOR KOCH, a minor to be used to buy gifts/presents for the minor. 13. From the settlement monies, it is requested the sum of SIXTY THOUSAND DOLLARS ($60,000.00) payable to LISA KOCH and ROBERT KOCH, parents and natural guardians of TAYLOR KOCH, a minor, to be placed in a federally insured savings account or a federally iruured savings certificate in the name of the minor, to be marked "not to be withdrawn until said minor reaches the age of eighteen (18), as upon the Order of Court of Competent Jurisdiction" . 14. Petitioners' underinsurance carrier, Erie Insurance, has approved this settlement and release so that Petitioners can pursue underinsurance motorist benefits against Erie Insurance. There is $200,000 of potential benefits available to Petitioners' minor in underinsurance motorist benefits. - 5 . '. PRO-RAT A .JOINT TORTFEASOR RELEASE KNOW ALL MEN BY TH.r:SE PRESENTS: That we. LISA KOCH and ROBERT KOCH, Parents and Natural Guardians ofT AYLOR KOCH, a Minor, LISA KOCH, Individually and ROBERT KOCH. Individually, (hereinafter collectively referred to as "Releasors"), for and in consideration of the payment of the sum of ONE HUNDRED THOUSAND AND 00/100 (SIOO,OOO.OO) DOLLARS and other good and valuable consideration, paid by ROBERT GORll.. and his insurer, PENNSYLVANIA NATIONAL INSURANCE COMPANY, (hereinafter collectively referred to as "Releasees" or "Payors"), the receipt whereof is hereby acknowledged, realizing that there is doubt and uncertainty as to the nature and eltlent of my losses, damages, injuries, and the liability of ROBERT GORll.. and his insurer, PENNSYLVANIA NATIONAL INSURANCE COMPANY, and that such filets are in dispute, have released and discharged, and by these presents do for ourselves, our heirs, executors, administrators, successors and assigns, release and forever discharge Payors and their successors, assigns, servants, agents, and employees from any and all actions, causes of actions, suits, claims, demands, liabilities, contribution, indemnity and damages ofany kind or nature whatsoever, and also to the eltlent of any liability of ROBERT GORll.. and his insurer, PENNSYLVANIA NATIONAL INSURANCE COMPANY, their successors, assigns, servants, agents and employees, for contribution or indemnity to or with any other person, party, corporation or other entity, arising out of any and all claims for all injuries, damages and losses, known or unknown, to Releasors arising out of, related or resulting from an accident which occurred on or about December 14, 1994 in Carlisle, Cumberland County, Pennsylvania. In the event that any other persons, firms, corporations, or other entities, or joint tonfeasors, andlor their servants, agents or employees, or other persons, firms or corporations for whom they could be vicariously liable are responsible to LISA KOCH and ROBERT KOCH, Parents and Natural .' Guardians of T AYLOR KOCH, a Minor, LISA KOCH, Individually and ROBERT KOCH, Individually, for damages as a result of the aforesaid accident, the execution of this Release for the consideration paid shall operate as a satisfaction of all claims against such other persons, firms, corporations, or other entities or tonfeasors to the e)(\ent of the relative pro rata share, or percentage share of common liability of ROBERT GORll.. and his insurer, PENNSYLVANIA NATIONAL INSURANCE corvlPANY, herein released, such share to be determined in accordance with applicable law, including the Uniform Contribution Among Tonfeasors Law as enacted in the Commonwealth of Pennsylvania, and as it may have been modified by the Pennsylvania Comparative Negligence law, or construed by the Couns of the Commonwealth of Pennsylvania. We further agree that any judgment entered against other alleged tortfeasors in any action instituted to recover damages arising out of the above described accident, whether the liability of such other tortfeasors is based upon negligence, strict liability, warranty or otherwise, shall be reduced by the full proportional amour.t of the shares of the Releasees attributed by the Court or Jury to the Releasees, whether or not the Releasees was/were in fact ajoint tortfeasor(s). If it should appear or be adjudicated in any suit, action or proceeding, however, that the Releasees and others caused injuries to us by liability producing conduct established on any legal theory, in order to save the Releasees harmless, we, as further consideration for said payment, will satisfY any decree, judgment, or award in which there is such finding of adjudications involving the Releasees on their behalf and to the extent of their liability for contribution andlor indemnity. Should Releasees be joined in any future lawsuit or action, Releasors are not obligated to provide a defense to Releasees in said suit; however, Releasors shall immediately mark any judgment r~ndered against Releasees satisfied to the full e)(\ent ofReleasees liability for their pro rata share or liability to others for contribution or indemnity. 2 . . We reserve all claims against any and every other person, association or corporation as a result of the occurrence mentioned above. We understand that the Releasees hereby admit no liability or any kind by reason of said accident and that said payment and settlement in compromise is made to avoid funher inconvenience and expense of litigation. We further warrant hereby that we have not received heretofore any consideration whatever for, nor have we heretofore made any other prior settlement with or given any prior Release to any other alleged tonfeasor as a consequence of the above described accident and we agree to hold harmless and indemnifY the Releasees from any loss, claim or liability for contribution or indemnity by any other alleged tortfeasor. This Joint Tortfeasor Release contains the ENTIRE AGREEMENT between the panies hereto, and the terms of this Release are contractual and not a mere recital. In making this settlement and in giving this Release, we do not rely on any statements or representations of any doctor, physician or any other person as to what our condition(s) was/were, is/are or may be in the future nor do we rely on any statements or representations of the Releasees or any person acting on their behalf. It is our intention that this Release be complete and shall cover all the aforesaid claims, damages and injuries; that it shall not be subject to any claim of mistake offact; that it expresses a FULL AND COMPLETE SETTLEMENT ofa liability claimed and denied; and that regardless of the adequacy or inadequacy of the amount paid, it is intended to avoid litigation and to be final and complete. We further agree that (I) we have read this Release, and that there is absolutely no agreement or reservation other than as clearly expressed herein; and (2) the consideration stated herein is all that we are ever to receive from or on behalf of the Releasees and is received with full knowledge that it 3 N.",.t"".~'" ........ 1..11 flKK.llI (i) s "" , EIlhIblII j~(!.41~W;U~i~7~""~1I' -'-q'"- -- ,~ I ,'.. .:ti.....,:'"'...-......",.. '- -'.,- ,. ,-". _ ' . .~r-~~~...A~,;.t:i<\;::.5 ,.....,.,-"'t ... --T:""-:~- , LISA KOCH and ROBERT KOCH, Parent. and Natural Guardians of TAYLOR KOCH, a Minor, and LISA KOCH, Individually, Petitioners IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA v. AMICABLE ACTION - IN TRESPASS NO. i 9 'I IS - 0' '8" q ?:> ERIE INSURANCE COMPANY, Respondent .. .. .. .. .. .. .. .. UNDER!NSURED MOTORIST CLAIM .Q.BMB AND NOW, this s::!..!:. day of Dc:- (" ';'" n." lYi I? , 1995, upon con8ideration of the petition to Approve Compromise Settlement (Minor) : 1. It is hereby Ordered and Decreed that the settlement, a8 described herein, is in the best interest of the minor, Taylor Koch. 2. Lis. Koch and Robert Koch, parents and natural guardian8 of Taylor Koch, are authorized to execute a release, releasing Erie Insurance Co., its agents, employees, servants and assigns from liability in return for the sum of $155,000.00. 3. The di8tribution of proceeds and fees, as set forth herein, i8 approved and that the settlement proceeds shall be distributed as follows: Attorney'. fee. 33 1/3'......,........,. For the purchase, by Erie Ins. Co., of a structured Annuity with . payments of approximately $25,000,00 each, with payment on May 2000, May 2001, May 2002 and May 2003, and a fifth payment of $23,809.00 on May 13, 2006................................ 51,666.66 90,000.00 Reimburse Lisa and Robert Koch for their direct and personal expen.e., including meals, travel and lo.t wage8.. . . . . . . . . . . . . . . . . . . . . . . . . 3,863.07 Payable to Lisa and Robert Koch on behalf of, and for the benefit of their minor son, Taylor Koch......... 9,.70.27 BY THE COURT: 1~/ J.-)o,..,,-f--J _ r. l \Jln.j- /J I ~J. TRUE COPY FROM RECORD 1:'1 Testimony whnof. I here unto set my hlUlCl ~nd tile ~I of said ~.a! Carll~le, Pu, _ 2 _~ T~:;~. ~ ~~...::-;1~,o~ PrrAtvJ~'J1!ry ~ UiOV05 11: 42 =717 231 6626 RIIOADS"l; SINON \ I 14I00~ 2. Petitioners are parents and natural guardians of TI (lor Koch, a Minor, born May 13, 1983 who resides at the same a.:.1ress as Petitioners. 3. Respondent, Erie Insurance Company, is the Ul" lerinsured motorist carrier for Petitioners, 4. Petitioners' minor son was injured in an auto/ p,!,lestrian accident that occurred on December 14, 1994 in the Bc:::ough of Carlisle, Cumberland County, Pennsylvania, 5. At the aforesaid time and place, Petitioners' minor SI:11 wae crossing Hanover Street in the crosswalk in front of LlI'lberton Grade School at approximately 7:40 A,M. at which time Rllllert Goril was traveling in the fast lane of Hanover Street and struck Petitioners' minor son causing serious personal injuries, as S(I: forth herein, 6. As a direct result of the aforesaid accident, Pe.: itioners' minor son underwent surgery to repair fracture. of be.:h legs, with a placement of metal rods, underwent physical tb' rapy, was unable to participate in sporting activities, suffered a :'efracture in May of 1995 merely from twisting his leg, had ;,,:< - 2 - 12/04185 J J: 42 0717 231 0628 ~008 RlIlIADS .. SINlIN s.:gery again in July 1995 to remove the metal rods from his leg; a:' I, additional physical therapy, 7. As a direct resul t of the aforesaid accident. PII:itioners' minor son has four (4) large permanent scars on his In! IS from both surgeries. e. Attached hereto as Exhibit "A" is a report dated N(l"ember 16, 1995 from David C. Baker, M,D" Taylor's treating ol:l.hopedic surgeon. The report states that Taylor has a 20t 1088 01: motion of the left leg, which will probably be permanent, and fUI.ther explains that he is at risk for limb lenqth inequality. 9, The Respondent, Erie Insurance Co., has denied li.!bility and responsibility, but has nevertheless agreed to pay on tt..! underinsured claim, a settlement on behalf of Petitioners' mi . or in the amount of $155,000.00 in exchange for a Joint Tc.. tfeasor Release, which is attached hereto as Exhibit liB". 10. The Plaintiffs believe that the proposed settlement an,; compromise with Erie Insurance Co" and the distribution of fe,;s is reasonable, fair and equitable and in the best interest of th,'ir minor son. ~ . , - 3 - \' .~ ....-,-,-~.. " "".,.".';';",,>',"..\~"":""" ~'~"'''' , '.~', ; Go RONAl.D KRAJACK, DoMoDo, P.Co 44 PITT STREET SOUTH, CARLISLE, PENNA. 17013 TELEPHONE: (717) 249-7373 February 13, 1997 Andrew Dowling, Esq. Mette, Evans, and Woodside 3401 N. Front Street P. O. Box 5950 Harrisburg, Pa 17001 REI Taylor Koch Dear Mr. Dowling, We have examined Taylor Koch and determined that he is in need of orthodontic treatment. He can be treated essentially aA a full treatment case, which would take approximately two years. The total fee for everything done in our office, including retainers, would bp. $4800.00. We could also do him in Phases, Phase I would be about six months and the initial cost would be $1500.00. Phase II would take about six months and the cost would approximately be the same. Phase III would probably take six months to one year and the cost would be determined based on what was left to be done. As you know, by doing him in phases the cost could escalate higher then the $4800.00 that we were quoting as a full treatment case based on todays fee' s. . Please advise as to how you would like us to treat him and what further info~on you may need from us. As always, please feel free t,~ cal. ....__ and Mrs. Koch , " . . Iotl \I."UItIoI",,:,_cu '."'... 'e" . . ..... D p-'rJII 3. In addition to a compromise settlement in the above-captioned case, Petitioners also settled an underinsurance motorist claim (UlM) with Erie Insurance Company. A copy of the Order of Court and Petition approving the compromise settlement in the UlM case is attached as Exhibit "B" for completeness. 4. Pursuant to the Order of Court approving the compromise settlement (minor) attached as Exhibit "A" a sum of $60,000 was placed into an appropriate federally insured account marked "not to be withdrawn until said minor reaches the age of 18 or upon the Order of Court of Competent Jurisdiction". 5. Petitioners tiled a Petition in March, 1997 seeking monies for payment of orthodontic treatments and taxes. The Court signed an order amending the Order of Court Approving Compromise Settlement. Petition and court order attached as Ezhibit "Co. 6, Petitioner's minor desires to purchase a computer printer ($500.00), a bicycle {$450.00l and spending money for a trip to Disney World ($200.00). 7, As a result of investment of the $60,000 referenced in the Order or Court approving the compromise settlement (minor) attached as Exhibit "A", Petitioner's minor has incurred Federal income tax, Pennsylvania State income tax and local tax in the amount of $800.00 for the calendar year 1997. 8. Petitioners request the Court sign an Order permitting withdrawal of $2,000.00 for computer printer, bicycle, spending money and payment of taxes 88 outlined above. 9. The $60,000 was invested at PNC Bank 88 evidence by the Certificate of Deposit Account Verification attached 88 Exhibit "D". WHEREFORE, Petitioners request this Court to modify the Order of December 5, 1995 permitting the withdrawal of $2,000.00 to cover various expelUles, Respectfully submitted, METTE, EVANS & WOODSIDE -,-_.~ BY: ~:;:::.:. ::..:--:~ -----=- ANDREW H, DOWLING, ESQUIRE Supreme Court I. D. No. 39692 3401 North Front Street P. O. Box 5950 Harrisburg, PA 17110.0950 Telephone: (717) 232.5000 Attorneys for Plaintiffs DATED: March 17, 1998 """."'",10&1. PI....'. to,1 Ilt~UO @ \ IWTI A ...... .I~ oil, r",;, p- . '\.-"-" ~ -~ ,...,' .;-.- LISA KOCH and ROBERT KOCH, Parents and Natural Guardians of TAYLOR KOCH, a Minor and LISA KOCH, Individually, Petitioners, IN THE COURT OF COMMON PLEAS cm.-mERLAND COUNTY, PENNSYLVANIA AMICABLE ACTION. IN TRESPASS NO. 1995 9s - t,:J.oLj C;u I'l klL~ v. ROBERT GORIL, Respondent ORDER AND NOW, this ..t'fl day of -=OS:; r.c n"l h E/:t. . 1995, upon consideration of the Petition to Approve Compromise Settlement (l'YIinor); 1T IS HEREBY ORDERED AND DECREED that the settlement is approved and distribution is directed as follows: 1. The sum of FIVE THOUSAND DOLLARS ($5,000.00) payable to LISA KOCH and ROBERT KOCH for reimbursement of medical expenses, incurred and to be incUITed on behalf of TAYLOR KOCH, a minor. 2. The sum of ONE THOUSAND SIX HUNDRED SIXTY-SEVEN DOLLARS ($1,667.00) payable to LISA KOCH and ROBERT KOCH Parents and Natural Guardians of TAYLOR KOCH, a minor for the immediate benefit of TAYLOR KOCH, a minor. .~11 ~M~"""''' .-. .~--"'- ,'~'''''''----'- --..', .~ 3. The sum of SDCl'Y THOUSAND DOLLARS ($60,000.00> payable to LISA KOCH and ROBERT KOCH, parents and natural ruardians of TAYLOR KOCH, a minor, to be placed in a federally insured savings account or a federally insured savings certificate in the name of the minor, to be marked Mnot tc be withdrawn until said minor reaches the age of eiihteen (18), or upon the Order of Court of Competent Jurisdiction-. 4. The sum of THIRTY. THREE THOUSAND THREE HUNDRED THIRTY-THREE DOLLARS ($33,333.00) payable to Mette, Evans & Woodside for professional services rendered. BY THE COURT: If )/o~~1 r S'R->J -, C"!11:': l~,-''"''"'I ..-0'. 1....,-_ W'-.":-; :-:-, llU ~I:C-" ~r', 0.. .... "II h '... .......1o?i . ,.1,. mJilY W ,fjrco:, I h:JI:lIJrolo tat my l:IllCl :;~~ ,hI: sezl 01 said Cw~at Cartlsft. T;;l~ .( d ot r. 19. PrDtIlonlltlty &0, "~".Ul~ ."'... U". IOtCU:utl (i' EllhIIlIII I , _~l~fiWij""Wi ..1'''''0'1'", .....,'.'1 ll'" "","lI11 (!) -.." Exhibit c ,_~i.' ~tt7"n._u:'''''t''---- "r='-;~ ~ r' ,\:j",~{.;:",.jd':~).w:;~;; LISA KOCH and ROBERT KOCH, Parents and Natural Guardians of TAYLOR KOCH, a Minor and LISA KOCH, Individually, Plaintiffa, IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA AMICABLE ACTION. IN TRESPASS NO. 95-6204 1995 Civil Term v. ROBERT GORIL, Defendant AND NOW, comes Petitioners, Lisa Koch and Robert Koch, Parents and Natural Guardians of Taylor Koch, a Minor, by their attorneys, Mette, Evans &: Woodside, who represent as follows: 1. On December 5, 1995, the Honorable Harold E. Sheely, President Judie, siiOed an Order approving a compromise settlement (minor). Order and Petition are attached as Exhibit MAW. 2. The above-captioned matter was a settlement as a result of an auto/pedestrian accident that occurred on December 14, 1994 in which Petitioners' minor suffered serious injury including fractures of both leg9. 3. In addition to a compromise settlement in the above-captioned case, Petitioners also settled an underinsurance motorist claim (UIM) with Erie Insurance Company. A copy of the Order of Court and Petition approving the compromise settlement in the UIM case is attached as Exhibit MSW for completeness. 4. Pursuant to the Order of Court approving the compromise settlement (minor) attached as Exhibit MAw a sum of $60,000 was placed into an appropriate federally insured account marked Mnot to be withdrawn until said minor reaches the age of 18 or upon the Order of Court of Competent Jurisdictionw. 5. Petitioner's minor is presently in need of orthodontic treatment, costing $4,800. Attached as Exhibit MCW is a report from G. Ronald Krlijack, D.M.D., P.C. outlining the treatment and cost of the orthodontic treatment for Petitioner's minor. 6. Petitioners also desire to purchase a computer for Petitioner's minor that will cost $2,500.00 7. As a result of investment ofthe $60,000 referenced in the Order or Court approving the compromise settlement (minor) attached as Exhibit MAW, Petitioner's minor has incurred Federal income tax in the amount of $328.00 and Pennsylvania State income tax in the amount of $79.00 for the calendar year 1996. "'.,u,.."..... .""1"" W" ....,"Hn @ . ..~~.," --......" ElchIbIt D :';"""'l~' ~'f!(t"...tWtldl- .t'"W"....- I'....i'l!"; I --' , ( , , ~ , -, - .. PNCBANK . . Certificate of Deposit Account Verification 'rAYLOP. !OCR. KINOR UNDEP. COUP.T OJDIP. DTD 12-05-85 LISA AllIl l\CilEP.'r !OCH, GIlNS 153 . ,m: 1'1' WLlSIol 'A 17013 " c.l1I umDe, 31700021856 1885 1986 UrcMM Dum ,60,000.00 'MC lank, 'aticnal A8acc1aticn '~ 5.00\ on aEAIlY ACCU8 CEl 1-800-537-2262 on. ;: Intereat Jlate 4,tzO' IUec:Uve Unt11 Mar. 2', 1'" ., "J ~. ,.i.", ~ .r ~I :~l :)J ;j. 'Ii '::L ;'1 i:rr': ~~,: FL ... d " !,", .. :1 ':J ,:j -- ~ j t~ '011I.........1 . ".... ... revers, aid' fat Accaum "g,..""m -----. USA KOCH and ROBERT KOCH, Parents and Natural Guardians of TAYLOR KOCH, a Minor and USA KOCH, Individually, Plaintiffs, IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA AMICABLE ACTION - IN TRESPASS v. NO. 95-6204 1995 Civil Term ROBERT GORIL, Defendant WWER AND NOW this -12- day of ~ , 1999, upon consideration of the Petition to Amend the Order of Court Approving Compromise Settlement (Minor) dated December 5, 1995; IT IS HEREBY ORDERED AND DECREED that the Petitioner, Lisa (Koch) Black, 18 permitted to withdraw $900.00 from PNC Bank Account MTaylor Koch, MInor under Court Order dated December 5, 1995 Lisa and Robert Koch, Natural Guardians", Certificate No. 31700021856 and Reference No. 3700008756. Tbe amount of $900.00 shall be payable to Lisa (Koch) Black, Parent and Natural Guardian of Taylor Koch, a minor. IIIlll3I J. (>kr~J Is, 3. In addition to a compromise settlement In the above-captloned case, Petitioners also settled an underinsurance motorist claim (UIM) with Erie Insurance Company. A copy of the Order of Court and Petition approving the compromise settlement In the UIM case Is attached as Exhibit "B" for completeness. 4. Pursuant to the Order of Court approving the compromise settlement (minor) attached as Exhibit "A" a sum of $60,000 was placed Into an appropriate federally Insured account marked "not to be withdrawn until said minor reaches the age of 18 or upon the Order of Court of Competent Jurisdiction". 6. Petitioners rued a Petltlon In March, 1997 seeklng monies for payment of orthodontic treatments and taxes. The Court signed an order amending the Order of Court Approving Compromise Settlement. Petltlon and court order attached as Exhibit "C". 6. Petitioner rued a Petition In March, 1998 seeklng money for payment for taxes and other miscellaneous Items. The Court signed an Order amending the Order of Court Approving Compromise Settlement, a copy of which Is attached as Exhibit "0". 7. Petitioner's minor desires to purchase a calculator and a musical Instrument costing a total of $400.00. 8. As a result of Investment of the $60,000 referenced In the Order or Court approving the compromise settlement (minor) attached as Exhibit" A", Petitioner's minor has Incurred Federal Income tax, Pennsylvania State Income tax and local tax In the amount of $500.00 for the calendar year 1998. 9. Pelllloners request the Court sign an Order permlttlngwtthdrawal of $900.00 for calculator, musical Instrument and payment of taxes as outlined above. 10. Tbe $60,000 was Invested at PNC Bank as evidence by the Certificate of Deposit Account Verlflcallon attached as Exhibit "E". -, i " . ~ ~ ~ WHEREFORE, Petitioners request tbls Court to modify tbe Order of December 6, 1995 permlttlngtbe wltbdrawal of $900.00 to cover various expenses. '.i ,',j ~t . Respectfully submitted, METTE, EVANS & WOODSIDE BY: -, ---<---<~ --=-- c.--' ~--- ANDREW H. DOWLING, ESQUIRE Supreme Court I. D. No. 39692 3401 Nortb Front Street P. O. Box 5950 Harrisburg, PA 1711().()950 Telepbone: (717) 232-5000 Attorneys for Plaintiffs DATED: Apm 14, 1999 llU-II.,.'U.... ..-..... lOll IIIC.cu. (i) ....... A ,'... .......L,.. ,.... ,..; .,.,... ~... ...~~H'.... A~..IJ.,'.~-...... LISA KOCH and ROBERT KOCH, Parents and Natural Guardians of TAYLOR KOCH, a l'YIinor and LISA KOCH, Individually, Petitioners, IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY. PENNSYLVANIA v. AMICABLE ACTION. IN TRESPASS NO. 1995 qs- /,:loLl C.;UI.t "'--Fi1L~ ROBERT GORIL, Respondent QRDER AND NOW, this ~ day of -=.dJ 0;; r t: n"l b (./:2... . 1995, upon consideration of the Petition to Approve Compromi~tl Settlement (l'Ylinor)j IT IS HEREBY ORDERED AND DECREED that the settlement is approved and distribution is directed as follows: 1. The sum of FIVE THOUSAJ.'ID DOLLARS ($5,000.00> payable to LISA KOCH and ROBERT KOCH for reimbursement of medical expenses, incurred and to be incurred on behalf of TAYLOR KOCH, a minor. 2. The sum of ONE THOUSAND SIX HUNDRED SIXTY-SEVEN DOLLARS ($1,667.00) payable to LISA KOCH and ROBERT KOCH Parents and Natural Guardians of TAYLOR KOCH, a minor for the immediate benefit of TAYLOR KOCH, a minor. .",.---.~'-- ~----..- ---- ----..-.--- ~ _. . . 3. The sum of SIXTY THOUSAND DOLLARS ($60,000.00) payable to LISA KOCH and ROBERT KOCH, parents and natural ruardians of TAYLOR KOCH, a minor, to be placed in a federally insured savinis account or a federally insured savinis certificate in the name of the minor, to be marked Mnot to be withdrawn until said minor reaches the &Ie of eiihteen (18), or upon the Order of Court of Competent Jurisdictionw. 4. The sum of THIRTY-THREE THOUSAND THREE HUNDRED THIRTY.THREE DOLLARS ($33,333.00) payable to Mette, Evans &: Woodside for professional services rendered. BY THE COURT: ,0/ )/n~~J r '~'~~c1 T::",l i':: ,."-. c.... I ..- A , ..-- -..'", i :-riO,,,1 p,CC'" ~t". . I.. '9"""11' .- Vf"".-.r ~_; .I:. i:Dilj' \IIm:rL~:. I h~r:J uroto tat my I:ancl ":'~ ,hI: sezt at sa:d Ci)~l1t CarllslI' T;;l~.. .( d of r ,19 . EllhIIlIII .~. f' "'\,'UU.'ftOoOl ...m... tU., .....'0.10 (i) , ~1'"I,.,tl~ _Pt... 10" "'['(llll @ ;\ IEJchlbIt C \_1. ~~ te1AR 2 6 199Ji7 '" ,. I~".. ,:t., LISA KOCH and ROBERT KOCH, Parenta and Natural Guardians of TAYLOR KOCH, a Minor and LISA KOCH, Individually, Plaintifti, IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA AMICABLE ACTION. IN TRESPASS v. NO. 95.62041995 Civil Term ROBERT GORIL, Defendant mmEB AND NOW this ~ day of '-nllL,,-,.L , 1997, upon consideration of the Petition to Amend the Order of Court Approving Compromise Settlement (Minor) dated December 5, 1995; IT IS HEREBY ORDERED AND DECREED that the Petitioners are permitted to withdraw $7,707.00 from PNC Bank Account Mfaylor Koch, Minor under Court Order dated December 5, 1995 Lisa and Robert Koch, Natural Guardiansw, Certificate No. 31700021856 and Reference No. 3700008756. The amount of $7,707.00 shall be payable to Lisa Koch and Robert Koch, Parents and Natural Guardians of Taylor Koch, a minor. TRUE COpy FROM RECORD In Tt:it:rllc,I', ".h,t'I'd, I hilr~ ~"t, 3lIt my hltl1d and lho :~al 01 lO!J ::c'Jrt 01 Carlislo, Pa. Thll.....I..~:.:.. day of.....an.~...., 19..1.:7 ~ L("1' """""'" .. "l:r-~;':C~~~ BY THE COURT: l.sl'1-Ir-0.4t,( E. JJi..~ P,;r. HOO11 LISA KOCH and ROBERT KOCH, Parente and Natural Guardians of TAYLOR KOCH, a Minor and LISA KOCH, Individually, IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA Plaintiffs, AMICABLE ACTION - IN TRESPASS NO. 95-6204 1995 Civil Term v. ROBERT GORIL, Defendant ." "' , I , .1 , " " ,,' .... AND NOW, comes Petitioners, Lisa Koch and Robert Koch, Parents and Natural Guardians of Taylor Koch, a Minor, by their attorneys, Mette, Evans & Woodside, who represent as follows: 1. On December 5, 1995, the Honorable Harold E. Sheely, President Juqe, siiOed an Order approving a compromise settlement (minor). Order and Petition are attached as Exhibit MAW. 2. The above-captioned matter was a settlement as a result of an auto/pedestrian accident that occurred on December 14, 1994 in which Petitioners' minor suffered serious irijury including fractures of both legs. 3. In addition to a compromise settlement in the above-captioned case, Petitioners aIao settled an underinsurance motorist claim (UIM) with Erie Insurance Company. A copy of the Order of Court and Petition approving the compromise settlement in the UIM case is attached as Exhibit MBW for completeness. 4. Pursuant to the Order of Court approving the compromise settlement (minor) attached as Exhibit MA" a sum of $60,000 was placed into an appropriate federally insured account marked Mnot to be withdrawn until said minor reaches the lIIe of 18 or upon the Order of Court of Competent Jurisdictionw. 5. Petitioner's minor is presently in need of orthodontic treatment, costini $4,800. Attached as Exhibit MCW is a report from G. Ronald Krajack, D.M.D., P.C. outlining the treatment and cost of the orthodontic treatment for Petitioner's minor. 6. Petitioners aIao desire to purchase a computer for Petitioner's minor that will cost $2,500.00 7. As a result of investment of the $60,000 referenced in the Order or Court approving the compromise settlement (minor) attached as Exhibit MA", Petitioner's minor has incurred Federal income tax in the amount of $328.00 and Pennsylvania State income tax in the amount of $79.00 for tht' calendar year 1996. . . .'..'-..........-.... 8. Petitioners request the Court silO an Order permitting withdrawal of 87,707.00 for medical treatment, a computer, and payment of taxes as outlined above. 9. The $60,000 was invest"ld at PNC Bank as evidence by the Certificate of Deposit Account Verification attached as Exhibit MDw. WHEREFORE, Petitioners request this Court to modify the Order of December 5, 1995 permitting the withdrawal of $7,707.00 to cover expenses for medical treatment, purchlllle of a computer, and payment of income tu. Respectfully .mbmitted, METTE, EVANS Be WOODSIDE ~- BY: ANDREW H. DOWLING, ESQUIRE Supreme Court 1. D. No. 39692 3401 North Front Street P. O. Box 5950 Harrisburg, PA 17110-0950 Telephone: (717) 232.5000 Attorneys for Plaintiffs DATED: March 25, 1997 "'1"''''""., _......,. "'" "'('ClIO ('i) ~~~jlir~.ri~]l~f\ EllhlbIt D ~..:':>".' ..);". -'._,,,,.".., ',-' '",,,,< '--