Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-2_22-cv-00504/USCOURTS-caed-2_22-cv-00504-5/pdf.json

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

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63324677.1 

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. THE LAST DAY TO HEAR DISPOSITIVE MOTIONS IS IN 

Case 2:22-cv-00504-KJM-AC Document 35 Filed 06/15/23 Page 1 of 7
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63324677.1 

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

NOVEMBER 2023. TRIAL WILL BE SET THEREAFTER. 

 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 TO NOTIFY AND COMPEL THE APPEARANCE OF THE BELOW 

NAMED INDIVIDUALS TO GIVE EVIDENCE/PRODUCE DOCUMENTS AND 

BE DEPOSED ACCORDING THE QUESTIONS STATED BELOW. 

 1. INDIVIDUALS, FACILITIES OR ENTITIES 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. +56 64 233 6824. 

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

31, 2014, even if the medical records have been produced after that period. 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, even if the medical records have been produced after that period. 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. 

Case 2:22-cv-00504-KJM-AC Document 35 Filed 06/15/23 Page 2 of 7
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63324677.1 

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

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

31, 2014, even if the medical records have been produced after that period. 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. 

 D. Dr. Cristián Santiago Pérez Rios Chilean Nationality, internist, 

national identification number 21.277.862-1. 

 Last known 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, even if the medical records have been produced 

after that period. 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 David Assef Pilichi. 

 Chilean Nationality, cardiologist, national identification number 12.887.810-6. 

 Last known address of witness to be served: Clínica 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, even if the medical records have been 

produced after that period. 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 

Case 2:22-cv-00504-KJM-AC Document 35 Filed 06/15/23 Page 3 of 7
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63324677.1 

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

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

 F. Dr. Daniela Andrea Loebel Salazar. 

 Chilean Nationality, general practitioner, national identification number 

15.284.477-8. 

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

December 7, 2014 through December 31, 2014, even if the medical records have been 

produced after that period. 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.

Case 2:22-cv-00504-KJM-AC Document 35 Filed 06/15/23 Page 4 of 7
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63324677.1 

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

 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 

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. 

Case 2:22-cv-00504-KJM-AC Document 35 Filed 06/15/23 Page 5 of 7
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63324677.1 

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

 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. 

 Defendants request that the discovery/depositions be taken under oath or 

promise to be trustful by a certified shorthand reporter authorized and further requests 

that the deposition be recorded or videotaped. Defendants intend to use the records or 

videotapes at the time of trial. 

Defendants request that the Judicial Authority in Chile could serve the 

discovery or depositions in any place where the entities and individuals may be 

located, according to the information that could be provided by the Chilean attorney 

Mr. Raimundo Moreno Cox or anyone that he could appoint to do so. 

 Defendants request that the Judicial Authority in Chile could admit the 

appearance of Chilean attorney Mr. Raimundo Moreno Cox (or anyone that he could 

appoint to do so) for any clarification or for providing the information of the address 

or current representatives of the entities and individuals stated above. Also request 

that Chilean attorney Mr. Raimundo Moreno Cox could appear on the discovery and 

witnesses’ hearings that should be scheduled. 

 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 

Case 2:22-cv-00504-KJM-AC Document 35 Filed 06/15/23 Page 6 of 7
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63324677.1 

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

same for you in a similar case when required. 

 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 14, 2023 

(SEAL OF COURT) 

Case 2:22-cv-00504-KJM-AC Document 35 Filed 06/15/23 Page 7 of 7