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Filing # 140282691 E-Filed 12/13/2021 04:28:22 PM
IN THE CIRCUIT COURT OF THE FIFTEENTH JUDICIAL CIRCUIT
IN AND FOR PALM BEACH COUNTY, FLORIDA
CIRCUIT CIVIL AE
ELIZABETH HURLEY,
Case No. 502021CA011833XXXXMB
Plaintiff,
vs.
KIET TAN VAN,
Defendant.
/
PLAINTIFF’S NOTICE OF SERVING RESPONSE TO DEFENDANT, KIET TAN
VAN’S FIRST REQUEST FOR PRODUCTION
COMES NOW, the Plaintiff, ELIZABETH HURLEY, by and through her undersigned
counsel and pursuant to Fla.R.Civ.P. 1.350, hereby files this Notice of Serving her Response to
Defendant’s Request for Production propounded on November 16, 2021.
I HEREBY CERTIFY that a true and correct copy of the foregoing has been e-filed
with the Clerk of the above named Court and furnished via email to Steven K. Sorenson, Esq.,
Law Office of Robert J. Smith, 4443 Lyons Rd., Ste 206, Coconut Creek, FL 33073,
ftlauderdalelegal@allstate.com this 13" day of December, 2021.
SAMUEL M. YAFFA, P.A.
301 W. Atlantic Ave., Suite O-2
Delray Beach, Florida 33444
Telephone: 561/900-0739
Facsimile: 561/900-0238
Attorney for Plaintiff
By: s/Samuel M. Yaffa
SAMUEL M. YAFFA, ESQ.
Florida Bar No: 011584
sam@yaffalaw.com
*** FILED: PALM BEACH COUNTY, FL JOSEPH ABRUZZO, CLERK. 12/13/2021 04:28:22 PM ***1. Copies of all tax returns, W-2 Forms, or any other evidence of income for all years to
date, beginning with the three (3) years preceding the subject accident.
RESPONSE: Objection. This information is not relevant as there is no claim for wage loss
from injuries to Plaintiff.
2. Withholding statements, pay envelopes, deposit slips, or any other evidence of income
earned by Plaintiff for the current calendar year.
RESPONSE: Objection. This information is not relevant as there is no claim for wage loss
from injuries to Plaintiff.
3. Copies of any and all medical records, hospital records, emergency room records, and
records from any health care provider pertaining to the treatment of Plaintiff for any injuries
sustained in the subject accident.
RESPONSE: All responsive documents in Plaintiffs’ possession will be provided under
separate cover.
4. Copies of any and all medical records, hospital records, emergency room records, health
care provider records, X-ray films, CT films and MRI films pertaining to the treatment of
Plaintiff for any reason in the seven (7) years prior to the subject accident.
RESPONSE: Copies of medical records in Plaintiff's possession will be provided under
separate cover.
Plaintiff is in possession of the following diagnostic studies. If you would like copies of the
below referenced diagnostic studies, please submit payment pursuant to invoice provided
under separate cover and copies of the CD(s) will be mailed to you immediately upon
receipt of payment.
1) 11/12/18 C-spine X-ray; and
2) 11/12/18 C-spine MRI
5. Copies of any and all medical records, hospital records, emergency room records, health
care provider records, X-ray films, CT films and MRI films pertaining to the treatment of
Plaintiff for any reason since the subject accident.
RESPONSE: In addition to record provided in Response to Number 3, Plaintiff is in
possession of the following diagnostic studies. If you would like copies of the below
referenced diagnostic studies, please submit payment pursuant to invoice provided under
separate cover and copies of the CD(s) will be mailed to you immediately upon receipt of
payment.
1) 6/29/20 L/C-spine MRI; and
2) 8/27/20 Knee MRI6. Copies of any and all medical bills and/or statements for services rendered, paid or
unpaid, as a result of the subject accident, including any bills for drugs or other related expenses.
RESPONSE: All responsive documents in Plaintiffs’ possession will be provided under
separate cover.
7. Copies of bills and/or estimates for the repair of Plaintiff's vehicle and any other damaged
property. If the vehicle was not repairable, in addition, attach estimates of the value of the
vehicle on the date of the alleged incident and estimates and/or receipts concerning salvage
value.
RESPONSE: All responsive documents in Plaintiffs’ possession will be provided under
separate cover.
8. Any and all statements, including, but not limited to, recorded telephone interviews,
tapes, written statements, whether signed or unsigned, of Defendant(s) or any of their agents,
servants or employees, and all witnesses to the subject accident relative to the subject matter of
this action and/or any witnesses having knowledge regarding any and all facts and issues in the
instant litigation.
RESPONSE: None at this time.
9. Any and all photographs, diagrams or sketches of the scene of the subject accident.
RESPONSE: All responsive documents in Plaintiffs’ possession will be provided under
separate cover.
10. Any and all photographs of the vehicles involved in the incident before and after the
subject accident.
RESPONSE: All responsive documents in Plaintiffs’ possession will be provided under
separate cover.
11. Any and all photographs of Plaintiff depicting injuries to Plaintiff sustained as a result of
the subject accident.
RESPONSE: None at this time
12. Any releases, "Mary Carter Agreements", and any other type of settlement agreements
between Plaintiff and any other party which may have been responsible for the damages claimed
by Plaintiff.
RESPONSE: None.
13. Any and all photographs, blow-ups, recordings, charts, graphs, sketches and any other
tangible items or documentary evidence which you intend to use during the trial of instant
litigation and which have not been produced in response to any of the preceding paragraphs.
RESPONSE: Any such documents that will be used during the trial will be disclosed as to
Plaintiff's Exhibit List pursuant to the Trial Order in this matter.14. All incident reports filed by Plaintiff for any purpose, including, but not limited to,
reports to employer and/or insurance company regarding the subject accident, if applicable,
and/or any other reports filled out by Plaintiff.
RESPONSE: No incident reports known of.
15. All documents, papers or evidence to be introduced at trial.
RESPONSE: Aside from medical records related to the treatment of injuries resulting
from the subject crash, any such documents that will be used during the trial will be
disclosed as to Plaintiff’s Exhibit List pursuant to the Trial Order in this matter.
16. All expert reports from any experts who will testify at trial.
RESPONSE: In addition to the medical records created by any and all healthcare
providers for injuries sustained in the subject crash, any such documents that will be used
during the trial will be disclosed as to Plaintiff's Exhibit List pursuant to the Trial Order in
this matter.
17. Copy of the front and back of Plaintiff's health insurance card.
RESPONSE: All responsive documents in Plaintiffs’ possession will be provided under
separate cover.
18. Copy of the front and back of Plaintiff's Medicare and/or Medicare Advantage Plan card.
RESPONSE: None.
19. Copy of the front and back of Plaintiff's Medicaid card.
RESPONSE: None.
20. Any and all documents, including a PIP log, evidencing insurance benefits paid for or on
behalf of Plaintiff as a result of the subject accident, including but not limited to insurance
payments, contractual adjustments and/or write-offs.
RESPONSE: All responsive documents in Plaintiffs’ possession will be provided under
separate cover.
21. — Any and all documents evidencing any and all liens, subrogated interests, and/or
collateral source subject to Florida Statute 768.76, being claimed as a result of the subject
accident, including but not limited to, written documentation from each designated insurer, lien
holder and/or their designated representatives, stating the exact amount of their lien and/or
subrogated interest.
RESPONSE: All responsive documents in Plaintiffs’ possession will be provided under
separate cover.22. Any and all documents evidencing any and all other expenses, including but not limited
to wage loss, mileage, prescriptions, co-pays, and/or non-medical out-of-pocket expenses alleged
to have been incurred by Plaintiff as a result of the subject accident.
RESPONSE: None at this time.
23. Copies of all monthly statements, bills, invoices, and records of all incoming and
outgoing calls and text messages, for any and all cellular phones and/or any kind of wireless
devices, notebooks, iPads, etc. you owned and/or you had on you and/or inside the subject
vehicle at the time of the crash, limited to the 24-hour period encompassing the date of the
subject accident.
RESPONSE: None in Plaintiff’s possession.
24. Copy of marriage certificate if a derivative claim is being made for loss of consortium,
loss of service, or any other claim by your spouse as a result of personal injury to yourself
alleged to be as a result of the subject accident.
RESPONSE: N/A
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Filing # 140282691 E-Filed 12/13/2021 04:28:22 PM IN THE CIRCUIT COURT OF THE FIFTEENTH JUDICIAL CIRCUIT IN AND FOR PALM BEACH COUNTY, FLORIDA CIRCUIT CIVIL AE ELIZABETH HURLEY, Case No. 502021CA011833XXXXMB Plaintiff, vs. KIET TAN VAN, Defendant. / PLAINTIFF’S NOTICE OF SERVING RESPONSE TO DEFENDANT, KIET TAN VAN’S FIRST REQUEST FOR PRODUCTION COMES NOW, the Plaintiff, ELIZABETH HURLEY, by and through her undersigned counsel and pursuant to Fla.R.Civ.P. 1.350, hereby files this Notice of Serving her Response to Defendant’s Request for Production propounded on November 16, 2021. I HEREBY CERTIFY that a true and correct copy of the foregoing has been e-filed with the Clerk of the above named Court and furnished via email to Steven K. Sorenson, Esq., Law Office of Robert J. Smith, 4443 Lyons Rd., Ste 206, Coconut Creek, FL 33073, ftlauderdalelegal@allstate.com this 13" day of December, 2021. SAMUEL M. YAFFA, P.A. 301 W. Atlantic Ave., Suite O-2 Delray Beach, Florida 33444 Telephone: 561/900-0739 Facsimile: 561/900-0238 Attorney for Plaintiff By: s/Samuel M. Yaffa SAMUEL M. YAFFA, ESQ. Florida Bar No: 011584 sam@yaffalaw.com *** FILED: PALM BEACH COUNTY, FL JOSEPH ABRUZZO, CLERK. 12/13/2021 04:28:22 PM ***1. Copies of all tax returns, W-2 Forms, or any other evidence of income for all years to date, beginning with the three (3) years preceding the subject accident. RESPONSE: Objection. This information is not relevant as there is no claim for wage loss from injuries to Plaintiff. 2. Withholding statements, pay envelopes, deposit slips, or any other evidence of income earned by Plaintiff for the current calendar year. RESPONSE: Objection. This information is not relevant as there is no claim for wage loss from injuries to Plaintiff. 3. Copies of any and all medical records, hospital records, emergency room records, and records from any health care provider pertaining to the treatment of Plaintiff for any injuries sustained in the subject accident. RESPONSE: All responsive documents in Plaintiffs’ possession will be provided under separate cover. 4. Copies of any and all medical records, hospital records, emergency room records, health care provider records, X-ray films, CT films and MRI films pertaining to the treatment of Plaintiff for any reason in the seven (7) years prior to the subject accident. RESPONSE: Copies of medical records in Plaintiff's possession will be provided under separate cover. Plaintiff is in possession of the following diagnostic studies. If you would like copies of the below referenced diagnostic studies, please submit payment pursuant to invoice provided under separate cover and copies of the CD(s) will be mailed to you immediately upon receipt of payment. 1) 11/12/18 C-spine X-ray; and 2) 11/12/18 C-spine MRI 5. Copies of any and all medical records, hospital records, emergency room records, health care provider records, X-ray films, CT films and MRI films pertaining to the treatment of Plaintiff for any reason since the subject accident. RESPONSE: In addition to record provided in Response to Number 3, Plaintiff is in possession of the following diagnostic studies. If you would like copies of the below referenced diagnostic studies, please submit payment pursuant to invoice provided under separate cover and copies of the CD(s) will be mailed to you immediately upon receipt of payment. 1) 6/29/20 L/C-spine MRI; and 2) 8/27/20 Knee MRI6. Copies of any and all medical bills and/or statements for services rendered, paid or unpaid, as a result of the subject accident, including any bills for drugs or other related expenses. RESPONSE: All responsive documents in Plaintiffs’ possession will be provided under separate cover. 7. Copies of bills and/or estimates for the repair of Plaintiff's vehicle and any other damaged property. If the vehicle was not repairable, in addition, attach estimates of the value of the vehicle on the date of the alleged incident and estimates and/or receipts concerning salvage value. RESPONSE: All responsive documents in Plaintiffs’ possession will be provided under separate cover. 8. Any and all statements, including, but not limited to, recorded telephone interviews, tapes, written statements, whether signed or unsigned, of Defendant(s) or any of their agents, servants or employees, and all witnesses to the subject accident relative to the subject matter of this action and/or any witnesses having knowledge regarding any and all facts and issues in the instant litigation. RESPONSE: None at this time. 9. Any and all photographs, diagrams or sketches of the scene of the subject accident. RESPONSE: All responsive documents in Plaintiffs’ possession will be provided under separate cover. 10. Any and all photographs of the vehicles involved in the incident before and after the subject accident. RESPONSE: All responsive documents in Plaintiffs’ possession will be provided under separate cover. 11. Any and all photographs of Plaintiff depicting injuries to Plaintiff sustained as a result of the subject accident. RESPONSE: None at this time 12. Any releases, "Mary Carter Agreements", and any other type of settlement agreements between Plaintiff and any other party which may have been responsible for the damages claimed by Plaintiff. RESPONSE: None. 13. Any and all photographs, blow-ups, recordings, charts, graphs, sketches and any other tangible items or documentary evidence which you intend to use during the trial of instant litigation and which have not been produced in response to any of the preceding paragraphs. RESPONSE: Any such documents that will be used during the trial will be disclosed as to Plaintiff's Exhibit List pursuant to the Trial Order in this matter.14. All incident reports filed by Plaintiff for any purpose, including, but not limited to, reports to employer and/or insurance company regarding the subject accident, if applicable, and/or any other reports filled out by Plaintiff. RESPONSE: No incident reports known of. 15. All documents, papers or evidence to be introduced at trial. RESPONSE: Aside from medical records related to the treatment of injuries resulting from the subject crash, any such documents that will be used during the trial will be disclosed as to Plaintiff’s Exhibit List pursuant to the Trial Order in this matter. 16. All expert reports from any experts who will testify at trial. RESPONSE: In addition to the medical records created by any and all healthcare providers for injuries sustained in the subject crash, any such documents that will be used during the trial will be disclosed as to Plaintiff's Exhibit List pursuant to the Trial Order in this matter. 17. Copy of the front and back of Plaintiff's health insurance card. RESPONSE: All responsive documents in Plaintiffs’ possession will be provided under separate cover. 18. Copy of the front and back of Plaintiff's Medicare and/or Medicare Advantage Plan card. RESPONSE: None. 19. Copy of the front and back of Plaintiff's Medicaid card. RESPONSE: None. 20. Any and all documents, including a PIP log, evidencing insurance benefits paid for or on behalf of Plaintiff as a result of the subject accident, including but not limited to insurance payments, contractual adjustments and/or write-offs. RESPONSE: All responsive documents in Plaintiffs’ possession will be provided under separate cover. 21. — Any and all documents evidencing any and all liens, subrogated interests, and/or collateral source subject to Florida Statute 768.76, being claimed as a result of the subject accident, including but not limited to, written documentation from each designated insurer, lien holder and/or their designated representatives, stating the exact amount of their lien and/or subrogated interest. RESPONSE: All responsive documents in Plaintiffs’ possession will be provided under separate cover.22. Any and all documents evidencing any and all other expenses, including but not limited to wage loss, mileage, prescriptions, co-pays, and/or non-medical out-of-pocket expenses alleged to have been incurred by Plaintiff as a result of the subject accident. RESPONSE: None at this time. 23. Copies of all monthly statements, bills, invoices, and records of all incoming and outgoing calls and text messages, for any and all cellular phones and/or any kind of wireless devices, notebooks, iPads, etc. you owned and/or you had on you and/or inside the subject vehicle at the time of the crash, limited to the 24-hour period encompassing the date of the subject accident. RESPONSE: None in Plaintiff’s possession. 24. Copy of marriage certificate if a derivative claim is being made for loss of consortium, loss of service, or any other claim by your spouse as a result of personal injury to yourself alleged to be as a result of the subject accident. RESPONSE: N/A