M200114967

Insurer Information

Insurer Name				Coverage Type
PRONATIONAL INSURANCE COMPANY				Primary
Insurer FEIN		Professional License Number
38-2317569
Insurer Contact Information
Type	First Name		MI	Last Name
Individual	BETH			ROMINGER
Street Address
13919 Carrollwood Village Run, Suite A
City				State	Zip
Tampa				FL	33624
Phone	Ext	Fax	E-Mail Address
(813) 969 - 2010		(813) 969 - 2120	BRominger@ProNational.com

Insured Information

Type	First Name		MI	Last Name
Individual	MICHAEL		A	POLLACK, M.D.
Insurer Type		Street Address of Practice
Licensed		2800 SOUTH OSCEOLA AVENUE
City		State	Zip Code	County
ORLANDO		FL	32806	Orange
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
0213000		$250,000		$750,000
Profession or Business			Other Profession or Business
Medical Doctor
License Number		Specialty Code & Classification		Certification Number
0017327		Neurology - Including Child - No Surgery		00000

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
Prison		Physician's Office
Name of Institution		Code

Location of Institutional Injury		Other Location of Institutional Injury

Date of Occurrence		Date Reported to Insurer
12/16/1996		3/27/1998

Diagnostic Information

Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Epilepsy.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Failure to take seizure medication.
Diagnostic Code :
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None.
Principal Injury Giving Rise To The Claim
Seizure/death.
Severity Of Injury
Permanent: Death.

Legal Information

Date of Suit	Circuit Court Case Number
1/11/1999	CI98-10188
County Suit Filed in	Date of Final Disposition
Orange	1/17/2001
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

$32,500

Loss Adjust Expense Paid to Defense Counsel

$28,151

All Other Loss Adjustment Expense Paid

$45,375

Injured Person's Total Non-Economic Loss

$32,500

Deductible

Injured Person's Total Economic Loss

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

Insured has discussed case with insurance company personnel, medical experts and defense counsel.

Updates

No updates found.