Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-2_22-cv-00504/USCOURTS-caed-2_22-cv-00504-4/pdf.json

Parties Involved:
AGA Service Company
Defendant
Boris Antl
Plaintiff
Jefferson Insurance Company
Defendant

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63282706.1 

4657-3.5980 -1- 

REQUEST FOR INTERNATIONAL JUDICIAL ASSISTANCE (LETTER ROGATORY) 

Walsworth 

19900 MACARTHUR BLVD., SUITE 1150 

IRVINE, CALIFORNIA 92612-2445 

TEL (714) 634-2522 • FAX (714) 634-0686

HELEN M. LUETTO, State Bar No. 119478 

hluetto@wfbm.com MARLENE K. FLORES, State Bar No. 304302 

mflores@wfbm.com

WFBM, LLP 

Attorneys at Law 

19900 MacArthur Blvd., Suite 1150 

Irvine, California 92612-2445 

Telephone: (714) 634-2522 

Facsimile: (714) 634-0686 

Attorneys for Defendants, AGA 

SERVICE COMPANY and JEFFERSON 

INSURANCE COMPANY 

UNITED STATES DISTRICT COURT 

EASTERN DISTRICT OF CALIFORNIA 

BORIS ANTL, an individual, 

Plaintiff, 

v. 

AGA SERVICE COMPANY, a 

Virginia Corporation; JEFFERSON 

INSURANCE COMPANY, a Virginia 

Corporation, and DOES 1-10, inclusive, 

Defendants. 

 Case No. 2:22-cv-00504-KJM-AC 

REQUEST FOR INTERNATIONAL 

JUDICIAL ASSISTANCE (LETTER 

ROGATORY)

 THE UNITED STATES DISTRICT COURT FOR THE EASTERN 

DISTRICT OF CALIFORNIA PRESENTS ITS COMPLIMENTS TO THE 

JUDICIAL AUTHORITY OF CHILE, AND REQUESTS INTERNATIONAL 

JUDICIAL ASSISTANCE TO OBTAIN EVIDENCE IN THE FORM OF 

RECORDS AND OBTAIN EVIDENCE FROM WITNESSES TO BE USED IN A 

CIVIL PROCEEDING BEFORE THIS COURT IN THE ABOVE CAPTIONED 

MATTER. NO TRIAL IS CURRENTLY SCHEDULED BUT THE LAST DAY TO 

Case 2:22-cv-00504-KJM-AC Document 33 Filed 06/05/23 Page 1 of 7
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63282706.1 

4657-3.5980 -2- 

REQUEST FOR INTERNATIONAL JUDICIAL ASSISTANCE (LETTER ROGATORY) 

Walsworth 

19900 MACARTHUR BLVD., SUITE 1150 

IRVINE, CALIFORNIA 92612-2445 

TEL (714) 634-2522 • FAX (714) 634-0686

HEAR DISPOSITIVE MOTIONS IS IN NOVEMBER 2023. 

 THIS COURT REQUESTS THE ASSISTANCE DESCRIBED HEREIN AS 

NECESSARY IN THE INTERESTS OF JUSTICE. THE ASSISTANCE 

REQUESTED IS THAT THE APPROPRIATE JUDICIAL AUTHORITY OF 

CHILE COMPEL THE APPEARANCE OF THE BELOW NAMED 

INDIVIDUALS TO GIVE EVIDENCE/PRODUCE DOCUMENTS AND BE 

DEPOSED. 

 1. INDIVIDUALS/FACILITIES TO GIVE EVIDENCE/PRODUCE 

DOCUMENTS AND BE DEPOSED 

 A. Black River CESFAM Hornopiren (CESFAM Río Negro 

Hornopiren). Callen nueva s/n,, Hualaihue, Hualaihué, Los Lagos, Chile. 

rionegrohospital@gmail.com. +56642336824. 

 The medical records of Boris Antl from December 7, 2014 through December 

31, 2014. These records provide Mr. Antl's medical condition, testing, test results, 

medications, medical care and treatment, diagnoses, surgical procedures and medical 

transportation provided to Mr. Antl related to a heart attack suffered by Mr. Antl while 

traveling in Chile. 

 B. Hospital Puerto Montt. Los Aromos 65, Puerto Montt, Los Lagos, 

Chile. +56 65 236 2001. 

 The medical records of Boris Antl from December 7, 2014 through December 

31, 2014. These records provide Mr. Antl's medical condition, testing, test results, 

medications, medical care and treatment, diagnoses, surgical procedures and medical 

transportation provided to Mr. Antl related to a heart attack suffered by Mr. Antl while 

traveling in Chile. 

 C. Clinica Andes Salud Puerto Montt (aka Clinica de Los Andes).

Bellavista 123, Puerto Montt, Los Lagos, Chile. +56 600 401 2600. 

 The medical records of Boris Antl from December 7, 2014 through December 

31, 2014. These records provide Mr. Antl's medical condition, testing, test results, 

Case 2:22-cv-00504-KJM-AC Document 33 Filed 06/05/23 Page 2 of 7
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63282706.1 

4657-3.5980 -3- REQUEST FOR INTERNATIONAL JUDICIAL ASSISTANCE (LETTER ROGATORY) Walsworth 19900 MACARTHUR BLVD., SUITE 1150 IRVINE, CALIFORNIA 92612-2445 TEL (714) 634-2522 • FAX (714) 634-0686

medications, medical care and treatment, diagnoses, surgical procedures and medical 

transportation provided to Mr. Antl related to a heart attack suffered by Mr. Antl while 

traveling in Chile. 

 D. Dr. Cristian Perez 

 Chilean Nationality. 

 Address of witness to be served: Hospital Puerto Montt. Los Aromos 65, 

Puerto Montt, Los Lagos, Chile. +56 65 236 2001. 

 Dr. Perez is requested to produce medical records of Boris Antl from December 

7, 2014 through December 31, 2014. These records provide Mr. Antl's medical 

condition, testing, test results, medications, medical care and treatment, diagnoses, 

surgical procedures and medical transportation provided to Mr. Antl related to a heart 

attack suffered by Mr. Antl while traveling in Chile. Dr. Perez will also be deposed 

regarding his observations, diagnoses, care and treatment he provided to Mr. Antl. 

 E. Dr. Victor Assef Pilichi, Cardiologist. 

 Chilean Nationality. 

 Address of witness to be served: Clinica Andes Salud Puerto Montt (aka 

Clinica de Los Andes). Bellavista 123, Puerto Montt, Los Lagos, Chile. +56 600 

401 2600. 

 Dr. Assef Pilichi is requested to produce medical records of Boris Antl from 

December 7, 2014 through December 31, 2014. These records provide Mr. Antl's 

medical condition, testing, test results, medications, medical care and treatment, 

diagnoses, surgical procedures and medical transportation provided to Mr. Antl 

related to a heart attack suffered by Mr. Antl while traveling in Chile. Dr. Assef 

Pilichi will also be deposed regarding his observations, diagnoses, care and treatment 

he provided to Mr. Antl. 

 F. Dr. Daniela Andrea Loebel Salazar. 

 Chilean Nationality. 

 Address of witness to be served: Clinica Andes Salud Puerto Montt (aka 

Case 2:22-cv-00504-KJM-AC Document 33 Filed 06/05/23 Page 3 of 7
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63282706.1 

4657-3.5980 -4- 

REQUEST FOR INTERNATIONAL JUDICIAL ASSISTANCE (LETTER ROGATORY) 

Walsworth 

19900 MACARTHUR BLVD., SUITE 1150 

IRVINE, CALIFORNIA 92612-2445 

TEL (714) 634-2522 • FAX (714) 634-0686

Clinica de Los Andes). Bellavista 123, Puerto Montt, Los Lagos, Chile. +56 600 401 

2600. 

 Dr. Salazar is requested to produce medical records of Boris Antl from 

December 7, 2014 through December 31, 2014. These records provide Mr. Antl's 

medical condition, testing, test results, medications, medical care and treatment, 

diagnoses, surgical procedures and medical transportation provided to Mr. Antl 

related to a heart attack suffered by Mr. Antl while traveling in Chile. Dr. Salazar 

will also be deposed regarding his observations, diagnoses, care and treatment she 

provided to Mr. Antl. 

 2. PERTINENT FACTS 

 This action arises from Plaintiff Boris Antl's travel to Chile in 2014, and is 

based upon a policy of travel insurance which Mr. Antl purchased for that trip. 

During his travel, on December 7, 2014, Mr. Antl, then 69 years old, unfortunately 

suffered a heart attack while in a remote part of the country. He sought assistance at 

a family clinic in the village of Hornopiren before being transported to Puerto 

Montt. There, Hospital Puerto Montt was unable to accommodate his condition and 

arrangements were made for his transfer to a different hospital Clinica de Los 

Andes, Puerto Montt, where Mr. Antl received medical care. He was discharged on 

December 13, 2014 

 Now, more than seven years after the incident, Mr. Antl sues defendants AGA 

and JIC (who sold or underwrote the subject insurance policy) asserting claims for 

breach of contract, breach of the implied covenant of good faith and fair dealing, 

bad faith, intentional and negligent infliction of emotional distress. A copy of the 

operative second amended complaint is attached hereto as Exhibit A. 

 Plaintiff asserts that due to alleged delays by defendants in approving medical 

care after he had the heart attack in Hornopiren, Chile, and as a result, he suffered 

permanent damage to his heart beyond that which he would have otherwise suffered 

from the heart attack alone. He claims that because of the delay and the attendant 

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63282706.1 

4657-3.5980 -5- REQUEST FOR INTERNATIONAL JUDICIAL ASSISTANCE (LETTER ROGATORY) Walsworth 19900 MACARTHUR BLVD., SUITE 1150 IRVINE, CALIFORNIA 92612-2445 TEL (714) 634-2522 • FAX (714) 634-0686

damage, his life expectancy is shortened and he is precluded from enjoying his 

favored athletic and active life style and from doing all of the things he would 

otherwise have been able to do. 

 Mr. Antl received medical care and treatment at the above health care 

facilities and was treated by the named physicians. 

 3. QUESTIONS FOR THE WITNESSES

1. Please describe Mr. Antl's medical condition upon arrival and thereafter during 

the period of time during which he was treated and cared for in your medical facility 

including any diagnoses and/or prognoses. 

2. Please describe any medical testing performed on Mr. Antl while in your 

facility and the results of such testing. 

3. Please describe any medications prescribed or administered to Mr. Antl while 

in your facility. 

4. Please describe any medical or surgical procedures performed on Mr. Antl 

while in your facility and the results and/or outcome of such. 

5. Please describe Mr. Antl's condition upon discharge and whether he was 

discharged with any medical orders or conditions. 

6. Please describe policies and/or procedures for addressing medical emergencies 

and whether Mr Antl would be provided with all emergency medical care required 

without guarantee of payment by an insurer. 

7. Please describe all communications which you had with Mr. Antl about his 

medical condition while he was a patient under your care. 

8. Please describe any communication of which you are aware with AGA Service 

Company and /or Allianz about Mr. Antl while he was under your care. 

 and the results of such testing. 

9. Was Mr. Antl ever refused emergency medical treatment while he was a patient 

at Clinica de Los Andes. 

/ / / 

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63282706.1 

4657-3.5980 -6- REQUEST FOR INTERNATIONAL JUDICIAL ASSISTANCE (LETTER ROGATORY) Walsworth 19900 MACARTHUR BLVD., SUITE 1150 IRVINE, CALIFORNIA 92612-2445 TEL (714) 634-2522 • FAX (714) 634-0686

 Defendants request that the evidence/depositions be taken by a certified 

shorthand reporter authorized to administer oaths and further requests that the 

deposition be videotaped. Defendants intend to use the videotapes at the time of trial. 

 Defendants further request that they be notified of the time and place for 

examination of witnesses and/or production of documents. 

4. RECIPROCITY 

 WE, THEREFORE, request that in furtherance of justice you will by the proper 

and usual process of your courts cause such witnesses to appear before you or some 

competent person by you for that purpose to be appointed and authorized at a precise 

time and place by you to be fixed and there to answer in their oaths and affirmations 

to the several interrogatories hereunto annexed; and that you will cause their 

depositions to be committed to writing and returned to us under cover duly closed and 

sealed up together with these presents. And we shall be ready and willing to do the 

same for you in a similar case when required. 

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63282706.1 

4657-3.5980 -7- REQUEST FOR INTERNATIONAL JUDICIAL ASSISTANCE (LETTER ROGATORY) Walsworth 19900 MACARTHUR BLVD., SUITE 1150 IRVINE, CALIFORNIA 92612-2445 TEL (714) 634-2522 • FAX (714) 634-0686

 5. REIMBURSEMENT FOR COSTS 

 The execution of the Letter of Request shall not give rise to any reimbursement 

of taxes or costs of any nature. Nevertheless, the State of execution has the right to 

require the State of origin to reimburse the fees paid to experts and interpreters and 

the costs occasioned by the use of a special procedure requested by the State of origin 

under Article 9, paragraph 2. The requested authority whose law obliges the parties 

themselves to secure evidence, and which is not able itself to execute the Letter, may, 

after having obtained the consent of the requesting authority, appoint a suitable person 

to do so. When seeking this consent the requested authority shall indicate the 

approximate costs which would result from this procedure. If the requesting authority 

gives its consent it shall reimburse any costs incurred; without such consent the 

requesting authority shall not be liable for the costs. 

Dated: June 2, 2023 

Case 2:22-cv-00504-KJM-AC Document 33 Filed 06/05/23 Page 7 of 7