HomeMy WebLinkAbout96-00786
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RELEASE
'or 1M .oIe Conllcl".tlon of
Six thousand dollars 3nd 00/100 c'!nts ------------------------------------------ Dollars,
the recalpt .nd .ultlclency whereof I. h.reby acknowledged. the under.lgned hereby rele.... and for.v.r dlacharges
Joseph D. ~ilgore and Carol M. Kilgore
..t,h ..I r jlelrl, executorl, admlnlltratorl, agentl and a~slgns, and all other perton., firms or corporations liable or,
who might be cl.lmed to ba liable, none of whom admit any liabilitY to the undersigned but all expressly deny any
liability, from any and ell claims, demend., demages, action., cause. of action or suits of dny kind or nature whatsoever,
and particularly on account of all Inlurles, known and unknown, both to person and properlY, which have resultad or
may In the future develop from an accident which occurred on or about the
17
day of February
, (year) 1994
at or near 13 Highland Ave.. Sh Ippensburq, PA
Thla rel.all e.prenly resarves all right. of the partie. released to pur.ue their legal ramedles. If any. agalnsl the
undersigned, their heirs, executors. agant. and as.lgns.
Under.lgned hereby declare. that tha terms of thl. .ettlement have bean completely read and are fully understood and
voluntarily acceptad for the purpose of making a full and final compromise adju.tment and settlament of any and all claim..
dlaputed or otherwise, on account of the Injuries and damages above mentioned, and for the ex preas purpose ot precluding
forever any further or additional claim. arising out of the aforasald accident.
Undersigned hereby accepts draft or drafts as final payment of the consideration set forth above.
ANY PERSON WHO KNOWINGLY AND WITH INTENT TO INJURE OR DEFRAUD ANY INSURER FILES AN APPLICATION OR
CLAIM CONTANING ANY FALSE, INCOMPLETI: OR MISLEADING INFORMATION SHALL, UPON CONVICTION, BE SUBJECT
TO IMPRISONMENT FOR UP TO SEVEN YEARS AND PAYMENT OF A FINE OF UP TO $15.000.
In WllMN Whereof,
(year)
have hereunto sat
hand(s) and seal(s) this
day of
In prasence of;
Signed X
Wit.,...
Signed X
....-
G li7P" Prlr\l..s In U.S,A,
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C.ntraland $2MO lo Carllal. Hospilal which repr.sents the l'u1I subropl.d amount due and owlnalo
lhese \nIurlllC. p\sna by the Pl4InlilTs.
8, The P\aintilTs pllll to utllizslhe said $6,000.00 plws $1,000.00 pravloual,y received to pay
lh. sbove altorney's fees In the lI\lount of $2,000.00 pluslhe total swn of $1.380.42 on unpaid medical
ellJllnses,
WHEREFORE, for all the above reSlons. the PlalntllTs, WWIam end Michelle Klusman, guardian
end natural p81'ents of Nicole K1uaman, minor. requests this Court to hold a hearin1l8lld, aner hearlnll.
spprove the compromise 81 set forth above.
Reepectfu1l,y submitted,
~ It Jkv
~W~-
,
Date
Ron Turn, Esquire
32 South Bedford Slreet
CarUele, PA 17013
(717) 245.9688
Atlorney for PlalnlllTs
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WILLIAM and MICHELLE
KIJl5MAN ,
auardlanll and natlU'al parente of
NICOLE KLUSMAN, a minor,
Plalntlfl'l,
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY, PENNSYLVANIA
NO. ~ ) Cf'?~,. 7 '6~'
v.
JOSEPH D. KILGORE,
Defendant
: CML ACTION-LAW
pRDER OF COURT
AND NOW thia
day of
, 1996, a hearina on the within
Petition Is ICheduJed for the
day of
. 1996, at
o'clock
.M. In COlU'troom No.
--
. Cumberland County CourthoUlle, Carllale, Pennaylvanla.
BY THE COURT:
J.
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State Farm Insurance Companies
lUll ,...
A
INUIUHCI
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Februar:t..,. 12, 1996
Ch.mb."bu,,, 5"vlo. Cln'"
1 134 K,nn,b,. D,lve
PO&eOOl
Ch,mber,bu'g, PA 11201
Ron Turo / Esq.
Law attic.. ot Ron Turo
32 south Bedtord str.et
carlisle, PA 17013
REI
Claim Number I
Date ot Loss:
Our Insured:
38-C312-228
February 17, 1994
Joseph D. Kilgore
Dear Ron:
This will confirm our agreement to settle the claim ot your
client Nicole Marie Klusman for $6,000 with a court approved
settlement in Cumberland county. ~ou should proceed to prepare
the necessary pleadings and file them.
Enclosed is a general release for $6,000 to be signed by William
A, Klusman and Michele M. Klusman. Our draft for $6,000 is also
enclosed for review by the Court. It is understood that any
subrogation liens are to paid by
you out of these proceeds and will not be paid by state Farm. I
would also remind you that we have paid $1,000 previously in
Medical Payments coverage benefits. That exhausts the limit
available for the coverage.
sincerely,
""[(J!iYl ,jl,
Ned Davis
Claim specialist
(717) 261-4810
state Farm Fire and Casualty ,company
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HOME OFFICES: BlOOMINGTON. IlliNOIS &1710-0001
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WILLIAM and MICHELLE
KLUSMAN ,
Guardians & Natural Parents
of NICOLE KLUSMAN, a minor
Plaintiffs
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
V.
JOSBPH D. KILGORE,
Defendants
NO. 96-786 CIVIL TERM
PETITION TO SETTLE MINOR'S ACTION
BEFORE SHEELY. P.J.
MEMORANDUM OPINION AND ORDER OF COUR~
The parente of Nicole Klusman are authorized to compromise
and settle the above-captioned claim for the sum of $6,000.00 in
full satisfaction of all claims and they are authorized to
execute any releases required by the Insurance Company.
I direct that the net funds passing to Nicole Klusman shall
be deposited in the name of Nicole Klusman in a Bank or Savings
and Loan Association insured by a Federal Governmental Agency.
The account as opened shall contain a provision that no
withdrawals shall be made from such account until Nicole attains
majority, unless authorized by an Order of Court.
I further direct that the check from State Farm will be
payable to Ron Turo, Esquire, as counsel, either alone or a.
payee with the parents.
It will be the responsibility of Attorney Turo to see that
the aforementioned account .\s opened as directed. Within ten
(10) days after this hearing, he shall file with the Court a copy
of the account as opened.
NO. 96-786 CIVIL TBRM
ORDBR
AND NOW, thi8 23rd day of FEBRUARY, 1996, a hearing i. set
for Friday, March 22, 1996, at 10100 a.m. in Courtroom * 1. The
foregoing is not the reque8ted order. However, in recent times
parents have received a check from tho Insurance company in their
own nameB and have taken tho fundB with the minor receiving
nothing. Therefore, the above order enBures that the minor will
receive the benefit of the settlement.
By the Court,
Ron Turo, Esquire
Attorney for plaintiffs
IBid
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