Department File Number :	M19991421
Claim Number :	A96-17371-95
Date Submitted :	2/10/2000

Insurer Information
Insurer Name				Coverage Type
FIRST PROFESSIONALS INSURANCE COMPANY, INC				Primary
Insurer FEIN		Professional License Number
59-6614702
Insurer Contact Information
Type		Entity Name
Entity		FLORIDA PHYSICIANS INSURANCE COMPANY
Street Address
1000 Riverside Avenue
City				State	Zip
Jacksonville				FL	32204
Phone	Ext	Fax	E-Mail Address
(904) 354 - 5910	3047	(904) 358 - 6728	collins@fpic.com

Insured Information
Type	First Name		MI	Last Name
Individual	ALEJANDRO		F	VERGARA
Insurer Type		Street Address of Practice
Licensed		10113 Whippoorwill Lane, #416
City		State	Zip Code	County
Jacksonville		FL	32256	Duval
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
8108		$1,000,000		$3,000,000
Profession or Business			Other Profession or Business
Medical Doctor
License Number		Specialty Code & Classification		Certification Number
14818		Physciatry - Including Child		0000

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

Injured Person Information
First Name	MI	Last Name		Date of Birth
Street Address			Gender	County where Injury Occurred
			M	*NR
City			State	Zip Code
Location where injury occured		Other location where injury occured
Patient's Home
Name of Institution		Code
Location of Institutional Injury		Other Location of Institutional Injury
Date of Occurrence		Date Reported to Insurer
11/1/1995		6/10/1996

Diagnostic Information

Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition

Depression and suicidal ideations.

Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury

None

Diagnostic Code :

Misdiagnosis Made, If Any, Of Patient's Actual Condition

Alleged that patient's condition was more serious than diagnosed.

Principal Injury Giving Rise To The Claim

Patient committed suicide.

Severity Of Injury

Permanent: Death.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

Legal Information
Date of Suit	Circuit Court Case Number
2/23/1998	98-00982 CA
County Suit Filed in	Date of Final Disposition
Duval	11/2/1999
Other Defendants Involved in this Claim
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court Decision	Other
No Court Proceedings.
Arbitration
Claim not subject to Arbitration.
Date of Payment

Financial Information

Was there a settlement Resulting in payment to the Plaintiff?

Yes

Indemnity Paid by Insurer on behalf of Insured

$350,000

Loss Adjust Expense Paid to Defense Counsel

$33,063

All Other Loss Adjustment Expense Paid

$22,753

Injured Person's Total Non-Economic Loss

$350,000

Deductible

$0

Injured Person's Total Economic Loss

	Incurred to Date	Anticipated
Medical Expense	$0	$0
Wage Loss	$0	$0
Other Expenses	$0	$0

Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely

None

Updates

No updates found.