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HomeMy WebLinkAbout02-4418DOLORES FREDERICK, Individually and as Parent and Natural Guardian of JESSICA FREDERICK, a Minor, Plaintiff / Petitioner VS. PH1LLIP A. FREDERICK, Defendant / Respondent : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : No. -- ttctl PETITION TO OBTAIN COURT APPROVAL TO SETTLE THE CLAIMS OF A MINOR The Petitioner, Dolores Frederick, Individually and as Parent and Natural Guardian of Jessica Frederick, a Minor, respectfully represents: 1. The Petitioner, Dolores Frederick, is an adult individual who currently resides at 5136 Ravenwood Road, Mechanicsburg, Pennsylvania. 2. The Minor, Jessica Frederick, is currently 16 years old, having been born on February 3, 1986. She resides with her mother and father, Dolores Frederick and Phillip A. Frederick. 3. The Respondent, Phillip A. Frederick, an adult individual, who currently resides at 5136 Ravenwood Road, Mechanicsburg, Pennsylvania is the natural father of the Minor Plaintiff, Jessica Frederick. 4. The cimumstances giving rise to the instant Petition occurred on December 16, 2000 on Route 15 South in Freedom Township, Adams County, Pennsylvania. 5. At that time and place, the Minor Plaintiff was a passenger in a vehicle owned and operated by her father, Phillip A. Frederick. 6. This single vehicle accident occurred when Mr. Frederick struck an ice patch and began to slide. Mr. Frederick slid offthe roadway to the west side of the road and struck a guardrail with his right front fender. The vehicle traveled through the guardrail and came to rest on its wheels facing south in the drainage culvert. 7. At the time of the accident, the Minor Plaintiff was taken to the Gettysburg Hospital emergency room where she was diagnosed with an acute low back strain and minimal contusion to the lower left ribs. She followed up with her chiropractor, William K. Shaffer, D.C.. X-rays were taken, which showed misalignment of the L4 and L5 vertabrae. She was diagnosed with a strain of the lumbar spine, as well as thoracic and cervical subluxations. Her last visit to Dr. Shaffer was on June 13, 2001, at which time she was asymptomatic and dismissed from further care. Attached hereto as Exhibit "A" is a true and correct copy of Dr. Shaffer's Progress Report of June 13, 2001. 8. All medical bills to date have been paid. 9. On the date of the accident, Defendant, Phillip A. Frederick, was insured under an automobile liability policy issued by GEICO insurance company. 10. To settle the case, the parties have agreed that the sum of $5,000.00 will be paid on behalf of Jessica Frederick, a Minor, in exchange for a Release of All Claims. Attached hereto as Exhibit "B" is a true and correct copy of the proposed Release. 11. The Petitioner believes that the settlement enumerated in the Petition is fair and equitable and in the best interest of the Minor. 12. GEICO insurance company has offered to pay the sum set out in this Petition toward an amicable solution of the claims and in exchange for court approval and a Release of All Claims. GEICO will also pay all court costs and legal fees incurred with respect to the instant Petition for Court Approval. WHEREFORE, the Petitioner respectfully requests that this Court enter an Order approving the foregoing compromise settlement, directing the distribution of proceeds thereof as set forth above, and authorizing the Petitioner, upon payment of the aforesaid sum, to discontinue the action brought and to execute a full and final Release. CALDWELL & KEARNS By: -- 3631 North Front Street Harrisburg, Pennsylvania 17110-1533 (717) 232-7661 Date: ~)4 02-335/39758 WILLIAM K. SHAFFER, D.C. PROGRESS REPORT 5014 Cadisle Pike Mechanic~burg, PA 17055 Telephone: (717) 737-6770 To: Geico Patient: Jessica Frederick Date of injury: December 16, 2000 1. Date of first treatment: December 19, 2000 2. Updated diagnosis: E815, auto accident causing 739.2, 739.3 and 724.2. Claim # 001902078157 724.1, 3. Date of most recent: 6-13-01 4. Present subjective complaints: None 5. Present objective findings: Misalignments of T1 and C1 vertebra. Myofascial trigger point in the sternocleidomastoideus muscle on the right. Her active cervical range of motion was 91% of normal, with the lumbar spine at 94% normal. Ail paravertebral muscles were relaxed and balanced following treatment. 6. Interim aggravations: None 7. Current status: Dismissed from active care, June 13, 2001. 8. Prognosis: Good, since the patient made steady progress this month with no sy~tomatology. The patient appears to have fully recovered from the MVA of 12-16~00, and should not experience residual effects. 8. Conauents: Patient is doing well, may be dism/ssed on her next visit. William K. Shaffer, D.C. Date DOLORES FREDERICK, Individually and as Parent and Natural Guardian of JESSICA FREDERICK, a Minor, Plaintiff / Petitioner VS. PHILLIP A. FREDERICK, Defendant / Respondent IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA No. GENERAL RELEASE FOR AND IN CONSIDERATION OF the payment to us of the sum of Five Thousand ($5,000.00) Dollars, and other good and valuable consideration, we, being of lawful age, have released and discharged, and by these presents do for ourselves, our heirs, executors, administrators and assigns, release, acquit and forever discharge, PHILLIP A. FREDERICK, and GEICO insurance company and any and all other persons, firms and corporation, of and from any and all past, present and future actions, causes of action, claims, demands, damages, costs, loss of services, expenses compensation, third party actions, liens, subrogation, suits at law or in equity, including claims or suits for contribution and/or indemnity, of whatever way growing out of any and all personal injuries, and property damage resulting or to result from the accident that occurred on or about December 16, 2000, on Route 15 South in Freedom Township, Adams County, Pennsylvania. We hereby declare and represent that the injuries sustained may be permanent and progressive and that recovery therefrom is uncertain and indefinite, and in making this Release and agreement, it is understood and agreed that we rely wholly upon our own judgment, belief and knowledge of the nature, extent and duration of said injuries. We understand that this settlement is the compromise of a doubtful and disputed claim, and that the payment is not to be construed as an admission of liability on the part of the persons, firms and corporations hereby released by whom liability is expressly denied. It is understood and agreed that this Release is executed in connection with the settlement of the claims of the undersigned as set forth in a Civil Action entered to No. in the Court of Common Pleas of Cumberland County, Pennsylvania, which action is to be marked as discontinued and settled and withdrawn. IN WITNESS WHEREOF, we have hereunto set our hands and seals this day of ,2002, intending to be legally bound hereby. WITNESS: Dolores Frederick Individually and as Parent and Natural Guardian of Jessica Frederick, a Minor (SEAL) (SEAL) Jessica Frederick DOLORES FREDERICK, Individually and as Parent and Natural Guardian of JESSICA FREDERICK, a Minor, Plaintiff / Petitioner VS. PHILLIP A. FREDERICK, Defendant / Respondent : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA . :No. od- : .. : AND NOW, this Ordered that a hearing be ~ ' OD /1 ~a~in Courtroom No. Settle the Claims of a Minor. day of ,2002, it is hereby held on ~{f'f)~ ~0; __.~00 ~ at for the Court to consider the Petition to Distribution: 1) 2) BY THE COURT: Dolores Frederick 5136 Ravenwood Road Mechanicsburg, PA 17055 Jeffrey T. McGuire, Esquire CALDWELL & KEARNS 3631 North Front Street Harrisburg, PA 17110-1533 42-. DOLORES FREDERICK, Individually and as Parent and Natural Guardian of JESSICA FREDERICK, a Minor, Plaintiff / Petitioner VS. PHILLIP A. FREDERICK, Defendant / Respondent : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : : : No. 02-4418 Civil Term : : AND NOW, this 7~,~ day of ~, ., 2002, upon consideration of the petition to Settle the Claims of a Minor, IT IS HEREBY ORDERED AND DECREED that the settlement is approved. GEICO insurance company is directed to make payment of the sum of $5,000.00 to Dolores Frederick on behalf of Jessica Frederick, a Minor. Petitioner is authorized to execute a full and final Release on behalf of the Minor Plaintiff and to discontinue the instant action. BY THE COURT: DOLORES FREDERICK, Individually and as Parent and Natural Guardian of JESSICA FREDERICK, a Minor, Plaintiff / Petitioner VS. PHILLIP A. FREDERICK, Defendant / Respondent 1N THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA No. 02-4418 Civil Term PRAECIPE TO DISCONTINUE TO THE CUMBERLAND COUNTY PROTHONOTARY: PLEASE mark the above-captioned lawsuit settled, discontinued and ended. ~) s Frederic7 Individually and as Parent and Natural Guardian of Jessica Frederick, a Minor Dated: / o/.~o/o R