Department File Number :	M200218986
Claim Number :	97M08626
Date Submitted :	2/1/2002

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	MERCEDES			BRITO
Insurer Type		Street Address of Practice
Licensed		6122 WEST CORPORATE OAKS DRIVE
City		State	Zip Code	County
CRYSTAL RIVER		FL	34429	Citrus
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
CM0501957		$1,000,000		$3,000,000
Profession or Business			Other Profession or Business
Dentistry
License Number		Specialty Code & Classification		Certification Number
Unknown		Physciatry - Including Child		80249

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
Hospital Outpatient Facility
Name of Institution		Code
SEVEN RIVERS COMMUNITY HOSPITAL		100249
Location of Institutional Injury		Other Location of Institutional Injury
Patients' Room
Date of Occurrence		Date Reported to Insurer
5/30/1995		7/19/1995

Diagnostic Information
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Failure to diagnose and treat depression led to suicide
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Failure to diagnose depression
Diagnostic Code :	789.1
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Failure to diagnose depression
Principal Injury Giving Rise To The Claim
failure to diagnose depression
Severity Of Injury
Permanent: Death.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

Legal Information
Date of Suit	Circuit Court Case Number
10/24/1997	972909CA
County Suit Filed in	Date of Final Disposition
Citrus	12/20/2001
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
Disposed of by Court
Court Decision	Other
Directed verdict for defendant.
Arbitration
Claim not subject to Arbitration.
Date of Payment

Financial Information

Was there a settlement Resulting in payment to the Plaintiff?

No

Indemnity Paid by Insurer on behalf of Insured

$0

Loss Adjust Expense Paid to Defense Counsel

$66,148

All Other Loss Adjustment Expense Paid

$28,446

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 consulted with medical experts, claims personnel and legal counsel regarding this matter.

Updates

No updates found.