Preview
Mary ARENS MCBRIDE, Esq. (SBN: 282459)
ALEXANDRIA O. PAPPAS, ESQ. (SBN 326149)
THE ERSKINE LAW GROUP, PC.
1592 N. BATAVIA ST., SUITE 1A
ORANGE, CA 92867
TEL: (949) 777-6032
FAx: (714) 844-9035
eservice-ca@erskinelaw.com
apappas@erskinelaw.com
Attorneys for Defendant
GENERAL MOTORS LLC
SUPERIOR COURT OF THE STATE OF CALIFORNIA
FOR THE COUNTY OF KERN
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FERNANDO MACHUCA. ’ Case No. BCV-22-101117
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Plaintiff,
12 Hon. Thomas S. Clark
v Dept. 17
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GENERAL MOTORS LLC; and DOES 1 DECLARATION OF ALEXANDRIA
14 through 10, inclusive, PAPPAS IN SUPPORT OF GENERAL
MOTORS LLC’S OPPOSITION TO
15 Defendants. COUNSEL’S MOTION FOR
ATTORNEYS’ FEES
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Date: April 3, 2023
17 Time: 8:30 am.
Dept: 17
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DECLARATION OF ALEXANDRIA PAPPAS IN SUPPORT OF GM’S OPPOSITION TO COUNSEL’S
MOTION FOR ATTORNEYS’ FEES
DECLARATION OF ALEXANDRIA PAPPAS
J, ALEXANDRIA PAPPAS, declare as follows:
1 I am an attorney at law licensed to practice before all courts of the State of
California, and an attorney with the law firm of Erskine Law Group, APC, counsel of record for
General Motors LLC (“GM”), defendant in this litigation. I am familiar with the records and
pleadings on file in this action and if called as a witness, I could and would competently testify to
the matters set forth below.
2. Plaintiff bought a 2020 GMC Sierra 2500 in September 2020.
3 Approximately 20 months later, in May 2022, Plaintiff sued GM, asserting five
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Song-Beverly claims. In the Complaint, Plaintiff sought a repurchase, the maximum civil penalty,
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plus attorney fees and costs.
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4 GM filed its answer on June 22, 2022.
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5 On June 22, 2022, GM served its initial written discovery on Plaintiff. Plaintiff
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responded to GM’s written discovery on July 26, 2022 with templated objections—the same
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responses that that Counsel serves in every GM case. Compare Exhibit A, discovery responses in
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this case, with Exhibit B, discovery responses from another of Counsel’s Song-Beverly cases. Lead
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Counsel billed 3.7 hours ($1,905.50) for this cut-and-paste work. (Moore Decl. Ex. 23, p. 32).
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6. Counsel served its standard, template-based “set one” discovery July 28, 2022.
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Counsel IgSs «6, set one” discovery included form interrogatories, special interrogatories, requests for
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admission, and requests for production - the same requests that Counsel serves GM in every Song-
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Beverly matter that Counsel files against GM. (See e.g., attached hereto as Exhibit C, discovery
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requests from this case, and Exhibit D, discovery requests Counsel served in another GM case.)
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Counsel billed another 3.7 hours ($1,295) for “drafting” this discovery. (Moore Decl., Ex. 23, p.
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33.)
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7 Counsel also served a Notice of Deposition for GM’s Person Most Qualified
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DECLARATION OF ALEXANDRIA PAPPAS IN SUPPORT OF GM’S OPPOSITION TO COUNSEL’S
MOTION FOR ATTORNEYS’ FEES
(“PMQ”), unilaterally scheduling the deposition. See e.g., attached as Exhibit E, PMQ deposition
notice from this case, and Exhibit F, PMQ deposition notice served in another case.) GM timely
objected to the notice on September 15, 2022, stating that GM would be willing to produce its PMQ
at a mutually agreeable time and place on certain categories within the scope of the issues in
Plaintiff's case.
8 GM responded to Plaintiffs’ discovery requests on October 4, 2022. Neither
Plaintiffs’ requests nor GM’s responses to those requests were novel nor varied significantly from
prior cases. Indeed, Plaintiffs’ requests and GM’s responses vary so little from case-to-case that
Counsel can readily deploy fill-in-the-blank meet-and-confer letters. Attached as Exhibit G are
10 discovery responses from this case and Exhibit H, another GM case for comparison).
11 9 Upon receiving GM’s responses to Plaintiffs’ discovery requests, Counsel sent GM
12 a templated letter masquerading as “meet and confer” correspondence complaining about GM’s
13 discovery responses. The letter is nearly identical to letters Counsel has sent in other cases and did
14 not aim to resolve any disputes; it simply listed so-called deficiencies in GM’s responses and
15 production making no effort to engage GM in good faith about the scope of discovery. (Compare
16 Exhibit I and Exhibit J.)
17 10. Plaintiff sent another email request on November 28, 2022, asking for deposition
18 dates for GM’s PMQ. The parties exchanged emails throughout December 2022, with GM
19 agreeing to seek a mutually agreeable time and place for the PMQ deposition.
20 ll. Despite GM GM’s willingness to produce its PMQ witness, Counsel went ahead
21 and filed his standard “cut and paste” Motion to Compel GM’s Person Most Qualified on February
22 29, 2023. Counsel’s motion and reply brief were not drafted from scratch; they are virtually
23 identical to motions that Counsel filed in scores of other cases against GM. (Compare Exhibit K
24 and Exhibit L.) The Court granted later granted the motion in part, but Plaintiffs motion
25 succeeded only in achieving what GM had already agreed to provide. Counsel “billed” 11.3 hours
26 ($3,955.00 ) related to this work (Moore Decl. Ex. 23, pp. 20-23, 25).
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DECLARATION OF ALEXANDRIA PAPPAS IN SUPPORT OF GM’S OPPOSITION TO COUNSEL’S
MOTION FOR ATTORNEYS’ FEES
12. On March 20, 2023, GM sent Plaintiff a Code-compliant Section 998 Offer,
proposing to settle this entire lawsuit by paying Plaintiff's $109,100.00, plus $10,000.00 for
attorney fees and costs (or fees by Motion). Plaintiff rejected the offer.
13. Beyond its basic canned discovery to GM, Counsel also served several “fill-in-the-
form” deposition subpoenas on a non-party dealership, Motor City Buick. In September 2022,
Plaintiffs served unilaterally scheduled deposition subpoenas on Motor City Buick’s person(s) most
qualified, and two separate dealership technicians. The dealer employees and representative were
non-party witnesses, not employed by GM, and separately represented, and GM made no attempt
to block those depositions. No depositions of Motor City Buick or its employees ever took place,
10 and therefore this work did nothing to advance Plaintiff's case. Nevertheless, Counsel “billed” 1.7
11 hours ($875.50) for this work. (Moore Dec. Ex. 23, p.32.)
12 14. Plaintiff deposed GM’s PMK in July 2023. Incredibly, Counsel claims that he
13 devoted 17.7 hours ($6,195.00) to prepare for and take this deposition. (Moore Decl. Ex. 23, pp.12-
14 16.)
15 15. The case settled January 16, 2024 after a Mandatory Settlement Conference, for
16 $80,000, with attorney fees to be decided by motion. The settlement agreement was signed in
17 January 2024.
18 16. Plaintiff filed his Memorandum of Costs on February 15, 2024. On March 1, 2024,
19 GM filed its Motion to Strike Counsel’s Memorandum of Costs, asserting that Counsel’s costs
20 should be reduced by $336.41 to $1,653.20 in costs.
21 17. Plaintiffs’ Counsel’s fee demand in this case is largely identical to fee motions
22 Counsel has recently filed in other Song-Beverly cases against GM. Attached as Exhibit M is
23 another fee motion that demonstrates the templated nature of the instant fee motion.
24 18. A substantial amount of Counsel’s work is dedicated to breach of warranty actions
25 under Song-Beverly, where the issues presented are virtually identical from case to case.
26 19. In my experience defending cases involving breach of warranty claims, the issues
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DECLARATION OF ALEXANDRIA PAPPAS IN SUPPORT OF GM’S OPPOSITION TO COUNSEL’S
MOTION FOR ATTORNEYS’ FEES
presented in this case were typical and the course of discovery, such as the written discovery, the
discovery disputes, and the depositions, was largely routine. This case did not raise complex or
novel procedural or substantive issues, and it settled within the statutory remedies for a Song-
Beverly claim.
I declare under penalty of perjury under the laws of the State of California that the foregoing
is true and correct.
Executed March 20, 2024, in Orange, California.
A lifandeinl? Pagpie:
y
10 : Alexandria Pappas, Esq.
Attorneys for Defendant
11 GENERAL MOTORS LLC
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DECLARATION OF ALEXANDRIA PAPPAS IN SUPPORT OF GM’S OPPOSITION TO COUNSEL’S
MOTION FOR ATTORNEYS’ FEES
PROOF OF SERVICE
I am employed in the County of Orange and my business address is 1592 N. Batavia St.,
Suite 1A, Orange, California 92867. I am over the age of 18 years and I am not a party to this
action. I am readily familiar with the practices of ERSKINE LAW GROUP for the collection and
processing of correspondence for mailing with the United States Postal Service. Such
orrespondence is deposited with the United States Postal Service the same day in the ordinary
course of business.
On March 20, 2024, I served the foregoing document(s), bearing the title(s)
DECLARATION OF ALEXANDRIA PAPPAS IN SUPPORT OF GENERAL MOTORS
LLC’S OPPOSITION TO COUNSEL’S MOTION FOR ATTORNEYS’ FEES on the
interested parties in the action as follows:
[Xx] by placing [] the original [ X] a true copy thereof enclosed in a sealed envelope
addressed as follows:
CONSUMER LAW EXPERTS, PC.
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800 Parkview Drive N
El Segundo, CA 90245
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Ph: 310-442-1410; Fx: 877-566-8828
12 ervice@nolemon.com
13 Ul (BY MAIL SERVICE) I placed such envelopes for collection and to be mailed on this
date following ordinary business practices.
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Q (BY PERSONAL SERVICE) I caused to be delivered such envelope by hand to the
15 office of the addressee.
16 0 (BY FACSIMILE) The document stated herein was transmitted by facsimile
transmission and the transmission was reported as complete and without error. A transmission
report was properly issued by the transmitting facsimile machine and a copy of said transmission
17 report is attached to the original proof of service indicating the time of transmission.
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i] (BY NEXT DAY DELIVERY) I caused to be delivered such envelope by hand to the
office of the addressee.
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20 [xX] (BY E-MAIL) I served the above-mentioned document via electronic transmission per
agreement of the parties.
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[X] (State) I declare under penalty of perjury under the laws of the State of California that the
foregoing is true and correct.
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a] (Federal) I declare under penalty of perjury that I am employed by a member of the Bar
of this Court, at whose direction this service is made.
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Executed on March 20, 2024, at Orange, CA.
Uh G5
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Signed: ————
26 Michael Chung, Paralegal
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DECLARATION OF ALEXANDRIA PAPPAS IN SUPPORT OF GM’S OPPOSITION TO COUNSEL’S
MOTION FOR ATTORNEYS’ FEES
Exhibit D
DISC-001
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address).
Benjeman Beck, SBN 268617; Nanzy Zhang SBN 294675; Matt Xie, SBN 317942
CONSUMER LAW EXPERTS, PC
5757 W. Century Blvd. Suite 500
Los Angel California 90045
TELEPHONE NO. (310) 442-1410
FAX NO. (Optional): (877) 566-8828
E-MAIL ADDRESS (Optiona): Matt@nolemon.com
ATTORNEY FOR (Name): Plaintiff, SELVIN R. TORRES
SUPERIOR COURT OF CALIFORNIA, COUNTY OF Los Angeles
600 E Broadway
Glendale, CA 91206
SHORT TITLE OF CASE:
TORRES V. GENERAL MOTORS LLC
FORM INTERROGATORIES—GENERAL CASE NUMBER,
Asking Party: Plaintiff 21GDCV00782
Answering Party: Defendant
Set No. One (1)
Sec. 1 Instructions to All Parties (c) Each answer must be as complete and straightforward
(a) Interrogatories are written questions prepared by a party as the information reasonably available to you, including the
to an action that are sent to any other party in the action to be information possessed by your attorneys or agents, permits. If
answered under oath. The interrogatories below are form an interrogatory cannot be answered completely, answer it to
interrogatories approved for use in civil cases, the extent possible.
(b) For time limitations, requirements for service on other (d) If you do not have enough personal knowledge to fully
parties, and other details, see Code of Civil Procedure answer an interrogatory, say so, but make a reasonable and
sections 2030.010—2030.410 and the cases construing those good faith effort to get the information by asking other persons
sections. or organizations, unless the information is equally available to
(c) These form interrogatories do not change existing law the asking party.
relating to interrogatories nor do they affect an answering (e) Whenever an interrogatory may be answered by
party’s right to assert any privilege or make any objection referring to a document, the document may be attached as an
exhibit to the response and referred to in the response. If the
Sec. 2. Instructions to the Asking Party document has more than one page, refer to the page and
(a) These interrogatories are designed for optional use by section where the answer to the interrogatory can be found.
parties in unlimited civil cases where the amount demanded
(f) Whenever an address and telephone number for the
exceeds $25,000, Separate interrogatories, Form
same person are requested in more than one interrogatory,
Interrogatories—Limited Civil Cases (Economic Litigation) you are required to furnish them in answering only the first
(form DISC-004), which have no subparts, are designed for
interrogatory asking for that information
use in limited civil cases where the amount demanded is
$25,000 or less; however, those interrogatories may also be (g) If you are asserting a privilege or making an objection to
an interrogatory, you must specifically assert the privilege or
used in unlimited civil cases.
state the objection in your written response.
(b) Check the box next to each interrogatory that you want
the answering party to answer. Use care in choosing those (h) Your answers to these interrogatories must be verified
interrogatories that are applicable to the case. dated, and signed. You may wish to use the following form at
(c) You may insert your own definition of INCIDENT in the end of your answers:
Section 4, but only where the action arises from a course of | declare under penalty of perjury under the laws of the
conduct or a series of events occurring over a period of time. State of California that the foregoing answers are true and
(d) The interrogatories in section 16,0, Defendant’ correct.
Contentions—Personal Injury, should not be used until the
defendant has had a reasonable opportunity to conduct an (DATE) (SIGNATURE)
investigation or discovery of plaintiff's injuries and damages.
(e) Additional interrogatories may be attached. Sec. 4. Definitions
Sec. 3. Instructions to the Answering Party Words in BOLDFACE CAPITALS in these interrogatories
(a) An answer or other appropriate response must be are defined as follows:
given to each interrogatory checked by the asking party. (a) (Check one of the following).
(b) As a general rule, within 30 days after you are served (1) INCIDENT includes the circumstances and
with these interrogatories, you must serve your responses on events surrounding the alleged accident, injury, or
the asking party and serve copies of your responses on all other occurrence or breach of contract giving rise to
other parties to the action who have appeared. See Code of this action or proceeding
Civil Procedure sections 2030.260—2030.270 for details.
Page 1 of 8
Form Approved for Optional Use Code of Civil Procedure,
Judicial Council of California FORM INTERROGATORIES—GENERAL §§ 2030.010-2030,410, 203.710,
DISC-001 [Rev January 1, 2008] www.courtinfo.ca.gov
DISC-001
oO (2) INCIDENT means (insert your definition here or 1.0 Identity of Persons Answering These Interrogatories
on a separate, attached sheet labeled “Sec. 1.1 State the name, ADDRESS, telephone number, and
4a) (2)’): relationship to you of each PERSON who prepared or
assisted in the preparation of the responses to these
interrogatories. (Do not identify anyone who simply typed or
reproduced the responses.)
2.0 General Background Information—individual
(b) YOU OR ANYONE ACTING ON YOUR BEHALF LD 2:1 state:
includes you, your agents, your employees, your insurance (a) your name;
companies, their agents, their employees, your attorneys, your (b) every name you have used in the past; and
accountants, your investigators, and anyone else acting on (c) the dates you used each name.
your behalf.
(c) PERSON includes a natural person, firm, association, oO 2.2 State the date and place of your birth.
organization, partnership, business, trust, limited liability
company, corporation, or public entity.
[J 2.3 At the time of the INCIDENT, did you have a driver's
license? If so state:
(d) DOCUMENT means a writing, as defined in Evidence (a) the state or other issuing entity;
Code section 250, and includes the original or a copy of (b) the license number and type;
handwriting, typewriting, printing, photostats, photographs, (c) the date of issuance; and
electronically stored information, and every other means of (d) all restrictions.
recording upon any tangible thing and form of communicating
2.4 At the time of the INCIDENT, did you have any other
or representation, including letters, words, pictures, sounds, or
permit or license for the operation of a motor vehicle? If so,
symbols, or combinations of them.
state:
(e) HEALTH CARE PROVIDER includes any PERSON (a) the state or other issuing entity;
referred to in Code of Civil Procedure section 667.7(e)(3). (b) the license number and type;
(c) the date of issuance; and
(f) ADDRESS means the street address, including the city, (d) all restrictions.
state, and zip code.
Sec. 5. Interrogatories
LL 25 state:
(a) your present residence ADDRESS;
The following interrogatories have been approved by the (b) your residence ADDRESSES for the past five years; and
Judicial Council under Code of Civil Procedure section 2033.710: (c) the dates you lived at each ADDRESS.
CONTENTS
J 26 state:
1.0 Identity of Persons Answering These Interrogatories (a) the name, ADDRESS, and telephone number of your
2.0 General Background Information—Individual present employer or place of self-employment; and
3.0 General Background Information—Business Entity
(b) the name, ADDRESS, dates of employment, job title,
4.0 Insurance
and nature of work for each employer or
5.0 [Reserved]
self-employment you have had from five years before
6.0 Physical, Mental, or Emotional Injuries
the INCIDENT until today.
7.0 Property Damage
8.0 Loss of Income or Earning Capacity 5 27 state:
9.0 Other Damages (a) the name and ADDRESS of each school or other
10.0 Medical History academic or vocational institution you have attended.
11,0 Other Claims and Previous Claims beginning with high school;
12.0 Investigation—General (b) the dates you attended;
13.0 Investigation—Surveillance (c) the highest grade level you have completed; and
14.0 Statutory or Regulatory Violations (d) the degrees received.
15.0 Denials and Special or Affirmative Defenses
16.0 Defendant's Contentions Personal Injury [JJ 2.8 Have you ever been convicted of a felony? If so, for
17.0 Responses to Request for Admissions each conviction state:
18.0 [Reserved] (a) the city and state where you were convicted;
19.0 [Reserved] (b) the date of conviction;
20.0 How the Incident Occurred—Motor Vehicle (c) the offense; and
25.0 [Reserved] (d) the court and case number.
30.0 [Reserved]
40.0 [Reserved] oO 2.9 Can you speak English with ease? If not, what
50.0 Contract language and dialect do you normally use?
60.0 [Reserved]
70.0 Unlawful Detainer [See separate form DISC-003] oO 2.10 Can you read and write English with ease? If not, what
101.0 Economic Litigation [See separate form DISC-004] language and dialect do you normally use?
200.0 Employment Law [See separate form DISC-002]
Family Law [See separate form FL-145]
DISC-007 (Rev. January 1, 2008) Page 2 of 8
FORM INTERROGATORIES—GENERAL
DISC-001
Oo 2.11 Atthe time of the INCIDENT were you acting as an oO 3.4 Are you a joint venture? If so, state:
agent or employee for any PERSON? If so, state: (a) the current joint venture name;
(a) the name, ADDRESS, and telephone number of that (b) all other names used by the joint venture during the
PERSON: and past 10 years and the dates each was used;
(b) a description of your duties. (c) the name and ADDRESS of each joint venturer; and
(d) the ADDRESS of the principal place of business.
2.12 At the time of the INCIDENT did you or any other
person have any physical, emotional, or mental disability or 3.5 Are you an unincorporated association?
condition that may have contributed to the occurrence of the If so, state:
INCIDENT? If so, for each person state: (a) the current unincorporated association name;
(a) the name, ADDRESS, and telephone number; (b) all other names used by the unincorporated association
(b) the nature of the disability or condition; and during the past 10 years and the dates each was used;
(c) the manner in which the disability or condition an
contributed to the occurrence of the INCIDENT. (c) the ADDRESS of the principal place of business.
2.13 Within 24 hours before the INCIDENT did you or any 3.6 Have you done business under a fictitious name during
person involved in the INCIDENT use or take any of the the past 10 years? If so, for each fictitious name state:
following substances: alcoholic beverage, marijuana, or (a) the name;
other drug or medication of any kind (prescription or not)? If (b) the dates each was used;
so, for each person state: (c) the state and county of each fictitious name filing; and
(a) the name, ADDRESS, and telephone number; (d) the ADDRESS of the principal place of business.
(b) the nature or description of each substance;
(c) the quantity of each substance used or taken; 3.7 Within the past five years has any public entity regis-
(d) the date and time of day when each substance was used tered or licensed your business? If so, for each license or
or taken; registration:
(e) the ADDRESS where each substance was used or
(a) identify the license or registration;
taken;
(b) state the name of the public entity; and
(f) the name, ADDRESS, and telephone number of each
(c) state the dates of issuance and expiration.
person who was present when each substance was used
or taken; and
4.0 Insurance
(g) the name, ADDRESS, and telephone number of any
HEALTH CARE PROVIDER who prescribed or furnished 4.1 Atthe time of the INCIDENT, was there in effect any
the substance and the condition for which it was policy of insurance through which you were or might be
prescribed or furnished. insured in any manner (for example, primary, pro-rata, or
excess liability coverage or medical expense coverage) for
3.0 General Background Information—Business Entity the damages, claims, or actions that have arisen out of the
3.1 Are you a corporation? If so, state: INCIDENT? If so, for each policy state:
(a) the name stated in the current articles of incorporation; (a) the kind of coverage;
(b) all other names used by the corporation during the past (b) the name and ADDRESS of the insurance company;
10 years and the dates each was used; (c) the name, ADDRESS, and telephone number of each
(c) the date and place of incorporation; named insured;
(d) the ADDRESS of the principal place of business; and (d) the policy number;
(e) whether you are qualified to do business in California. (e) the limits of coverage for each type of coverage con-
tained in the policy;
3.2 Are you a partnership? If so, state: (f) whether any reservation of rights or controversy or
(a) the current partnership name; overage dispute exists between you and the insurance
(b) all other names used by the partnership during the past company; and
10 years and the dates each was used; (g) the name, ADDRESS, and telephone numberof the
(c) whether you are a limited partnership and, if so, under custodian of the policy.
the laws of what jurisdiction;
(d) the name and ADDRESS of each general partner; and 4.2 Are you self-insured under any statute for the damages,
(e) the ADDRESS of the principal place of business. claims, or actions that have arisen out of the INCIDENT? If
so, specify the statute.
3.3 Are you a limited liability company? If so, state:
(a) the name stated in the current articles of organization; 5.0 [Reserved]
(b) all other names used by the company during the past 10
6.0 Physical, Mental, or Emotional Injuries
years and the date each was used;
(c) the date and place of filing of the articles of organization;
(d) the ADDRESS of the principal place of business; and
Oo 6.1 Do you attribute any physical, mental, or emotional
injuries to the INCIDENT? (/f your answer is “no,” do not
(e) whether you are qualified to do business in California. answer interrogatories 6.2 through 6.7).
CO 6.2 Identify each injury you attribute to the INCIDENT and
the area of your body affected.
DISC-001 (Rev. January 1, 2008] FORM INTERROGATORIES—GENERAL Page 3 of 8
DISC-001
Oo 6.3 Do you still have any complaints that you attribute to (c) state the amount of damage you are claiming for each
the INCIDENT? If so, for each complaint state: item of property and how the amount was calculated; and
(a) a description; (d) if the property was sold, state the name, ADDRESS, and
(b) whether the complaint is subsiding, remaining the same, telephone number of the seller, the date of sale, and the
or becoming worse; and sale price.
(c) the frequency and duration.
O 6.4 Did you receive any consultation or examination 7.2 Has a written estimate or evaluation been made for any
(except from expert witnesses covered by Code of Civil item of property referred to in your answer to the preceding
Procedure sections 2034.210—2034.310) or treatment from a interrogatory? If so, for each estimate or evaluation state:
HEALTH CARE PROVIDER for any injury you attribute to (a) the name, ADDRESS, and telephone number of the
the INCIDENT? If so, for each HEALTH CARE PROVIDER
PERSON who prepared it and the date prepared;
state:
(b) the name, ADDRESS, and telephone number of each
(a) the name, ADDRESS, and telephone number; PERSON who has a copy of it; and
(b) the type of consultation, examination, or treatment (c) the amount of damage stated.
provided;
(c) the dates you received consultation, examination, or
treatment; and 7.3 Has any item of property referred to in your answer to
(d) the charges to date. interrogatory 7.1 been repaired? If so, for each item state:
(a) the date repaired;
(b) a description of the repair;
[J 65 Have you taken any medication, prescribed or not, as a
result of injuries that you attribute to the INCIDENT? If so, (c) the repair cost;
for each medication state: (d) the name, ADDRESS, and telephone number of the
PERSON who repaired it;
(a) the name;
(b) the PERSON who prescribed or furnished it; (e) the name, ADDRESS, and telephone number of the
(c) the date it was prescribed or furnished; PERSON who paid for the repair.
(d) the dates you began and stopped taking it; and
(e) the cost to date. 8.0 Loss of Income or Earning Capacity
8.1 Do you attribute any loss of income or earning capacity
[1 66 Ate there any other medical services necessitated by to the INCIDENT? (/f your answer is “no,” do not answer
the injuries that you attribute to the INCIDENT that were not interrogatories 8.2 through 8.8).
previously listed (for example, ambulance, nursing,
prosthetics)? If so, for each service state: 8.2 State:
(a) the nature;
(a) the nature of your work;
(b) the date; (b) your job title at the time of the INCIDENT; and
(c) the cost; and (c) the date your employment began.
(d) the name, ADDRESS, and telephone number
of each provider. 8.3 State the last date before the INCIDENT that you
worked for compensation.
O 6.7 Has any HEALTH CARE PROVIDER advised that you
may require future or additional treatment for any injuries 8.4 State your monthly income at the time of the INCIDENT
that you attribute to the INCIDENT? If so, for each injury and how the amount was calculated.
state:
(a) the name and ADDRESS of each HEALTH CARE 8.5 State the date you returned to work at each place of
PROVIDER; employment following the INCIDENT.
(b) the complaints for which the treatment was advised; and
(c) the nature, duration, and estimated cost of the 8.6 State the dates you did not work and for which you lost
treatment. income as a result of the INCIDENT.
7.0 Property Damage 8.7 State the total income you have lost to date as a result
O 7.1 Do you attribute any loss of or damage to a vehicle or of the INCIDENT and how the amount was calculated.
other property to the INCIDENT? If so, for each item of
property: 8.8 Will you lose income in the future as a result of the
(a) describe the property; INCIDENT? If so, state:
(b) describe the nature and location of the damage to the (a) the facts upon which you base this contention;
property; (b) an estimate of the amount;
(c) an estimate of how long you will be unable to work; and
(d) how the claim for future income is calculated.
DISC-001 (Rev. January 1, 2008} FORM INTERROGATORIES—GENERAL Page 4 of 8
DISC-001
9.0 Other Damages (c) the court, names of the parties, and case number of any
action filed;
Oo 9.1 Are there any other damages that you attribute to the
(d) the name, ADDRESS, and telephone number of any
INCIDENT? If so, for each item of damage state:
attorney representing you;
(a) the nature;
(b) the date it occurred; (e) whether the claim or action has been resolved or is
(c) the amount; and pending; and
(d) the name, ADDRESS, and telephone number of each (f) a description of the injury.
PERSON to whom an obligation was incurred.
11.2 In the past 10 years have you made a written claim or
demand for workers' compensation benefits? If so, for each
9.2 Do any DOCUMENTS support the existence or amount claim or demand state:
of any item of damages claimed in interrogatory 9.1? If so, (a) the date, time, and place of the INCIDENT giving rise to
describe each document and state the name, ADDRESS, the claim;
and telephone number of the PERSON who has each (b) the name, ADDRESS, and telephone number of your
DOCUMENT. employer at the time of the injury;
(c) the name, ADDRESS, and telephone number of the
workers’ compensation insurer and the claim number;
10.0 Medical History (d) the period of time during which you received workers’
Oo 10.1 At any time before the INCIDENT did you have com- compensation benefits;
plaints or injuries that involved the same part of your body (e) a description of the injury;
claimed to have been injured in the INCIDENT? If so, for (f) the name, ADDRESS, and telephone number of any
each state: HEALTH CARE PROVIDER who provided services; and
(a) a description of the complaint or injury; (g) the case number at the Workers’ Compensation Appeals
(b) the dates it began and ended; and Board,
(c) the name, ADDRESS, and telephone number of each
HEALTH CARE PROVIDER whom you consulted or 12.0 Investigation—General
who examined or treated you.
12.1 State the name, ADDRESS, and telephone number of
each individual
10.2 List all physical, mental, and emotional disabilities you (a) who witnessed the INCIDENT or the events occurring
had immediately before the INCIDENT. (You may omit immediately before or after the INCIDENT;
mental or emotional disabilities unless you attribute any (b) who made any statement at the scene of the INCIDENT;
mental or emotional injury to the INCIDENT.)