Department File Number :	M200116079
Claim Number :	97M08588
Date Submitted :	4/25/2001

Insurer Information
Insurer Name				Coverage Type
FRONTIER INSURANCE COMPANY				Primary
Insurer FEIN		Professional License Number
13-2559805
Insurer Contact Information
Type	First Name		MI	Last Name
Individual	SHARON			LOCH
Street Address
195 Lake Louise Marie Road
City				State	Zip
Rock Hill				NY	12775
Phone	Ext	Fax	E-Mail Address
(914) 796 - 2300	5474	(914) 796 - 1801

Insured Information
Type	First Name		MI	Last Name
Individual	CLAUDE			MORAES
Insurer Type		Street Address of Practice
Licensed		10826 PINE BARK LANE
City		State	Zip Code	County
BOCA RATON		FL	33428	Palm Beach
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
CM0502987		$100,000		$300,000
Profession or Business			Other Profession or Business
Medical Doctor
License Number		Specialty Code & Classification		Certification Number
ME0021859		Internal Medicine - Minor Surgery		80284

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
			F	*NR
City			State	Zip Code
Location where injury occured		Other location where injury occured
Hospital Inpatient Facility
Name of Institution		Code
FLORIDA MEDICAL CENTER		100210
Location of Institutional Injury		Other Location of Institutional Injury
Patients' Room
Date of Occurrence		Date Reported to Insurer
5/28/1995		5/30/1997

Diagnostic Information
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Thombocytopenia and death
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
None
Diagnostic Code :	798.1
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Failure to diagnose thrombocytopenia
Principal Injury Giving Rise To The Claim
death
Severity Of Injury
Permanent: Death.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

Legal Information
Date of Suit	Circuit Court Case Number
10/16/1997	972987CAJ
County Suit Filed in	Date of Final Disposition
Bay	10/2/2000
Other Defendants Involved in this Claim
Stage of Legal System at which Settlement was Reached or Award Made
During trial, but before court verdict.
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

($8,750)

Loss Adjust Expense Paid to Defense Counsel

$5,880

All Other Loss Adjustment Expense Paid

$6,452

Injured Person's Total Non-Economic Loss

$0

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

The insured has consulted with defense counsel, medical experts and claims personel regarding this matter.

Updates

No updates found.