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HomeMy WebLinkAbout96-00786 I,!' ' , , , ' I" ~. " ., " , I' " 'I ~ I ". ~ o (1/ - , , ,'11 j' , Ii ;,' '1 , I: , , i " ' " 11,1, '. , I I " , d 'j' " 'I I '1 ;1, '.' ,.-1) " ., '1 11- J )'1 ., " ,lI' " 'I I 'j 1 " , d I " " I' " 'I , " " :L I , ./ ,I ," . -- " -I,t' .'\,;';{ ,; )!, t, , II" " 'II I I ,,1 ii' 'I!' i , " , jj' , -j. , , , , " " il ! I' "I, ;1' " I, -7 ,',I I " I" II " " , ' ., I " I ,I , , "'I " ~ j - ')/. " I' " " 'j ,I " , " " 'I I I " i'I_' L 1,11 \, '-t , I' 'I , ' i,' i' I, \1' " ., ._," I', Ii, ., 'i' " , i,11 ! " " " " 'I ,1 " , " I I, ., I I', '1'1 " " 1'-1' "\ , ' " "I-! i'l ,.I, , , , I i '1' ,', 'I, 11 "f , I " .. ,'I I, I .,~..., /' '1\ , , , " " '" , I' " 'j, I I ,I '"~ " , " ~ J " H 'I . ,'; ., ,I 1'- I"j " '1 " 'I ,!!,'I ,I .. \- '. " I I, , , , 'j, " :1'1 I' , \ )1, ~I ! ' :t' ,)-, I" . \ ~ ,I , ., iI, ;1) , " , , , ,. '01 'I 1,1 'I' 'j \-1 'iI ,I, . , , , '11 'I, '. , 't,j" " " " , ,,; , " , ,I" " ~ Ii) 1"',1 I ., 'I J 00 r- , " , , I' , , " , '''t i,\,,',, , \' 'I' 'I I q' II I " I, 'II .. " '",; '" .., ,'I ., ,I,' I;, .-11 " , " , i , , .,,1_1\' , '.' " '" " "I ", ,I,' " ,1", ; , , " f, , q, '1'1 i, ,. ( ) 'I I': .I' \ '-I' , " ., 'f' "I I il ii \ " '" I, I_i " ,;1 '0\ , i", , ' -'-, l', il;'I: " , " , " , " , , , 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, \ I 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 f" " . [I"" , ' . ',' hi. ," .,!, y- 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. it , 'I' , " I " \ .ij ,j" ' , , State Farm Insurance Companies lUll ,... A INUIUHCI . 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 " , , HOME OFFICES: BlOOMINGTON. IlliNOIS &1710-0001 , " , , ,", , " i/ " , , , , " , , , ,,' " " , , " , , " " " Iii i'l " , , ' ,;1 " , " " , ," , , , " )" " , , , " , , , " " " " " " ;1 i! " , " ;! I ,,' , , !, ," , , " " , I, it, , ,,' " ,I'll .'1 " ~~ W,Q..j ~ ~ ~"l W , , , I., , , 'V , , " ,,, ;J il '.I " , " " " , , " to.. ~ FJ "R~ em,'1 ~'~ /:'~~ (,' \ c;'! _.'.. '- ~~J "- ; ':"", I,"" \ r.~(') '~J'"2;: ~ j ..... " ~ " " , , ' ,.r I "I - .. C';) - i;, -,I. '"I " Ii, IJ~' 1,)\ ;.'17 j'T') - (,,' 4,., - . ~-~' , \ ' I , &:;:~ , " (j 'II ';:1 ,i,;l~r:z ''I TJ " . , '.L o'j',..) '::~J '''/!-5 ~J"'i " .il ." " .~.~ 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 '\.. '--. H ' P.J. _ e,t~ f'",""dlL.,r ~,~,..J :~/~ 01('1". .J,f' , il , , , , , , !,