Department File Number :	M200221517
Claim Number :	95M04966
Date Submitted :	9/9/2002

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 Rd
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	GARY		S	MAGID
Insurer Type		Street Address of Practice
Licensed		SUITE C-107 2699 STIRLING ROAD
City		State	Zip Code	County
FORT LAUDERDALE		FL	33312	Broward
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
CM0504376		$1,000,000		$3,000,000
Profession or Business			Other Profession or Business
Medical Doctor
License Number		Specialty Code & Classification		Certification Number
ME0031178		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
			F	*NR
City			State	Zip Code
Location where injury occured		Other location where injury occured
Hospital Inpatient Facility
Name of Institution		Code
MEMORIAL REGIONAL HOSPITAL(HOLLYWOOD)		100038
Location of Institutional Injury		Other Location of Institutional Injury
Patients' Room
Date of Occurrence		Date Reported to Insurer
2/28/1994		11/27/1995

Diagnostic Information

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

COMPLAINTS OF ANXIETY AND DEPRESSION

Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury

ALLEGED FAILURE TO SUPERVISE PATIENT, FAILURE TO REMOVE BELT FROM PATIENTS POSESSION AND TO PROTECT PATIENT FROM HERSELF.

Diagnostic Code :

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

*NR

Principal Injury Giving Rise To The Claim

ATTEMPTED SUICIDE

Severity Of Injury

Emotional Only - Fright, no physical damage

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

Legal Information
Date of Suit	Circuit Court Case Number
2/18/1997	97-002437(11)
County Suit Filed in	Date of Final Disposition
Broward	8/8/2002
Other Defendants Involved in this Claim
Stage of Legal System at which Settlement was Reached or Award Made
Claim or suit abandoned.
Final Method of Claim Disposition
Settled by parties
Court Decision	Other
Other
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

$67,000

All Other Loss Adjustment Expense Paid

$0

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

INSURED HAS CONSULTED WITH DEFENSE COUNSEL, MEDICAL EXPERTS AND CLAIMS PERSONNEL REGARDING THIS MATTER

Updates

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