Rule 1305.1 - Pleadings And Discovery(a)Small Claims. In all cases in which the amount in controversy is $12,000.00 or less, a simplified complaint shall be encouraged and a simplified answer shall be permitted. A standard form simplified complaint and simplified answer shall be approved by the Court and provided in sufficient quantities by the Prothonotary. (1) Discovery in cases in which the amount in controversy is $12,000.00 or less shall be permitted only by order of court. In the event that it is necessary to continue the arbitration pending discovery, the order permitting discovery shall provide for such continuance, and the Court Administrator shall reschedule the arbitration.(2) The Court Administrator shall design any necessary forms to facilitate appeals pursuant to Pa.M.D.J. 1002, and shall make the forms available in the magisterial districts and the Prothonotary.(b)Discovery in Personal Injury Cases. For any personal injury claim subject to compulsory arbitration, the plaintiff may serve arbitration discovery requests as set forth below. The requests may be served simultaneously with the complaint. (1) The defendant shall furnish the information sought in the discovery requests within thirty (30) days of receipt of the discovery requests.(2) Any defendant may serve arbitration discovery requests as set forth below either together with a copy of the answer served on the plaintiff or thereafter within the time limits for discovery.(3) The plaintiff shall furnish the information sought in the discovery requests within thirty (30) days of receipt of the discovery requests.(4) A party may not seek additional discovery through interrogatories or requests for production of documents until that party has sought discovery through the arbitration discovery requests described herein.(5) A party may not include any additional interrogatories or requests for production of documents in the arbitration discovery requests provided for in this local rule, absent leave of court.(6) This local rule applies to additional defendants.(7) The local rule does not apply to claims that do not exceed the sum of $12,000.00 (exclusive of interest and costs) wherein the parties may only seek discovery when permitted by the Court. PLAINTIFF'S ARBITRATION DISCOVERY REQUESTS FOR PERSONAL INJURY CLAIMS DIRECTED TO DEFENDANTS
These discovery requests are directed to Defendants,____________________.
Within thirty (30) days following receipt of these requests, you shall provide the information sought in these discovery requests to every other party to this lawsuit.
IDENTITY OF DEFENDANT(S)
1. Set forth your full name and address. INSURANCE
2.(a) Is there any insurance agreement that may provide coverage to you for this incident? Yes _________ No ____________ (b) If so, list the name of each company and the amount of protection that may be available. WITNESSES
3. List the names, present addresses and telephone numbers (if known) of any persons who witnessed the incident (including related events before and after the incident) and any relationship between the witness and you. STATEMENTS AND OTHER WRITINGS
4.(a) Do you have any written or oral statements from any witness, including any plaintiffs? Yes _______ No _________ (b) If you answered yes, attach copies of any written statements signed, adopted or approved by any witness, attach a written summary of any other statements (include oral statements), and identify any witness from whom you obtained a stenographic, mechanical, electrical or other recording that has not been transcribed. (This request does not cover a statement by a party to that party's attorney.) I have _________ have not ______ fully complied with request 4(b).
(c) Do you have any photographs, videotapes, surveillance tapes, maps, drawings, diagrams, etc. that you may seek to introduce at trial or that may otherwise pertain to alawsuit? Yes ___________ No ____ (d) If you answered yes, attach copies of each of these items. I have ________ have not ____ fully complied with request 4(c).
MEDICAL DOCUMENTS
5.(a) Do you have any medical documents relating to the plaintiff? Yes _____ No ____(b) If you answered yes, attach each of these documents. I have _______ have not ____ fully complied with request 5(b).
CRIMINAL CHARGES
6.(a) Were any felony or misdemeanor criminal charges filed against you or any of your agents which arise out of the incident that is the subject of this lawsuit? Yes ____ No ____(b) If you answered yes, list each felony or misdemeanor charge that is pending and each felony and misdemeanor conviction. IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY, PENNSYLVANIA
Plaintiff, | CIVIL DIVISION |
v. | NO.: |
Defendant. | |
DEFENDANT'S ARBITRATION DISCOVERY REQUESTS
These discovery requests are directed to the Plaintiff, ______________. Within thirty (30) days following receipt of these requests, you shall provide the information sought in these discovery requests to every other party to this lawsuit.
IDENTITY OF PLAINTIFF(S)
1. Set forth your full name, address, age, employer, and type of employment. ANSWER:
WITNESSES
2. List the names, present addresses and telephone numbers (if known) of any persons who witnessed the incident (including related events before and after the incident) and any relationship between the witness and you. ANSWER:
STATEMENTS AND OTHER WITNESSES
3.(a) Do you have any written or oral statements from any witnesses, including any defendant? Yes __________ No _________
(b) If you answered yes, attach any copies of written statements signed, adopted or approved by any witness, attach a written summary of any other statements (including oral statements), and identify any witness from whom you obtained a stenographic, mechanical, electrical, or other recording that has not been transcribed. (This request does not cover a statement by a party to that party's attorney.)(c) Do you have any photographs, maps, drawings, diagrams, damage estimates, etc., that you may seek to introduce at trial or that may otherwise pertain to this lawsuit? Yes __________ No __________
(d) If you answered yes, attach each of these writings. I have ____________ have not ________ fully complied with request 3(c).
MEDICAL INFORMATION CONCERNING PERSONAL INJURY CLAIM
4.(a) Have you received any inpatient or outpatient treatment from any hospital for any injuries or other medical conditions for which you seek damages in this lawsuit? Yes _________ No __________
(b) If you answered yes, list the names of the hospitals, the names and addresses of the attending physicians, and the dates of the hospitalizations. ANSWER:
(c) Have you received any chiropractic treatment for any injuries or other medical conditions for which you seek damages in this lawsuit? Yes _________ No __________
(d) If you answered yes, list the name and address of each chiropractor and the dates of treatment. ANSWER:
(e) Have you received any other medical treatment for any injuries or other medical conditions for which you seek damages in this lawsuit? Yes _________ No __________
(f)If you answered yes, list the names and addresses of each physician.
ANSWER:
(g) Attach complete hospital and office records covering the injuries or other medical conditions for which you seek damages for each hospital, chiropractor, and other medical provider identified in 4(b), and 4(f) or authorizations for these records. I have __________ have not ___________ fully complied with request 4(g).
5.(a) List the name and address of your family physician for the period from five (5) years prior to this incident to the present date. ANSWER:
(b) Have you received inpatient or outpatient treatment for injuries or physical problems that are not part of your claim in this lawsuit from any hospital within the period from five (5) years prior to the incident to the present date? Yes _________ No __________
(c) If you answered yes, attach a separate sheet which lists the name of the hospital, the date of each treatment, the reason for the treatment, and the length of the hospitalization. ANSWER:
(d) Have you received chiropractic treatment for injuries or physical problems that are not part of your claim in this lawsuit within the period from five (5) years prior to the incident to the present date? Yes _________ No __________
(e) If you answered yes, attach a separate sheet which lists the dates of the treatment, the reasons for the treatment, and the chiropractor's name and address. ANSWER:
(f) Within the period from five (5) years prior to the incident to the present date, have you received any other medical treatment for injuries that are not part of your claim in this lawsuit? Yes _________ No __________
(g) If you answered yes, attach a separate sheet which lists the dates of treatment, the reasons for the treatment, and the name and address of the treatment provider. ANSWER:
I have ___________ have not ___________ fully complied with requests 5(b), 5(c), and 5(f).
WORK LOSS
6.(a) Have you sustained any injuries which resulted in work loss within the period from five (5) years prior to the incident in the present date? Yes _________ No __________
(b) If you answered yes, for each injury list the date of the injury, the nature of the injury, and the dates of the lost work. ANSWER:
7. If a claim is being made for lost income, state the name and address of your employer at the time of the incident, the name and address of your immediate supervisor at the time of the incident, your rate of pay, the dates of work loss due to the injuries from this accident, and the total amount of your work loss claim. ANSWER:
OTHER BENEFITS
8.(a) If you are raising a claim for medical benefits or lost income, have you received or are you eligible to receive benefits from workers' compensation or any program, group contract, or other arrangement for payment of benefits as defined by Title 75 P.S. § 1719(b)? Yes _________ No __________
(b) If you answered yes, set forth the type and amount of these benefits. ANSWER:
INSURANCE INFORMATION
9.(a) Are you subject to the "Limited Tort Option" or "Full Tort Option" as defined in Title 75 P.S. § 1785(a) and (b)? __________ Limited Tort Option (no claim is made for non-economic damages)
__________ Limited Tort Option (claim is made for nonmonetary damages because the injuries fall within the definition of serious injury or in 75 P.S. § 1705(d)(1)-(3) applies)
__________ Full Tort Option
(b) (Applicable only if you checked "Full Tort Option") Describe each vehicle (make, model, and year) in your household. ANSWER:
(c) (Applicable only if you checked "Full Tort Option") Attach a copy of the Declaration Sheet for the automobile insurance policy covering each automobile in your household. I have ___________ have not _______ fully complied with request 9(c).
Plaintiff verifies that the statements made herein are true and correct. Plaintiff understands that false statements herein are made subject to the penalties of 18 Pa. Con. Stat. §4904 relating to unsworn falsification to authorities.
Date: ___________ | _________________________ Plaintiff Respectfully submitted, _________________________ Counsel for Defendant |
Amended effective 1/1/2022