M200218989

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	HOWARD		A	GOLDMAN
Insurer Type		Street Address of Practice
Licensed		PO BOX 1200
City		State	Zip Code	County
TAMPA		FL	33601-1200	Hillsborough
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
WM0009585		$1,000,000		$3,000,000
Profession or Business			Other Profession or Business
Medical Doctor
License Number		Specialty Code & Classification		Certification Number
ME0032737		Physciatry - Including Child		80249

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 Inpatient Facility
Name of Institution		Code
MANATEE MEMORIAL HOSPITAL		100035
Location of Institutional Injury		Other Location of Institutional Injury
Patients' Room
Date of Occurrence		Date Reported to Insurer
4/15/1998		4/22/1999

Diagnostic Information

Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Improper management of medication regime caused death
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Improper performance of medication regime caused death
Diagnostic Code :	789.1
Misdiagnosis Made, If Any, Of Patient's Actual Condition
improper management of medication regime caused death
Principal Injury Giving Rise To The Claim
death
Severity Of Injury
Permanent: Death.

Legal Information

Date of Suit	Circuit Court Case Number
	*NR
County Suit Filed in	Date of Final Disposition
*NR	12/21/2001
Other Defendants Involved in this Claim
MANATEE MEMORIAL HOSPITAL
Stage of Legal System at which Settlement was Reached or Award Made
Within the pre-suit period as set forth in 766.106 (more than 90 days before suit is filed).
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?

Indemnity Paid by Insurer on behalf of Insured

Loss Adjust Expense Paid to Defense Counsel

$8,626

All Other Loss Adjustment Expense Paid

$4,499

Injured Person's Total Non-Economic Loss

Deductible

Injured Person's Total Economic Loss

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

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

Updates

No updates found.