Department File Number :	M200221544
Claim Number :	98M14520
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	GAYLE			KESSELMAN
Insurer Type		Street Address of Practice
Licensed		15275 CRICKET LANE
City		State	Zip Code	County
FORT MYERS		FL	33919	Lee
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
CM0503778		$1,000,000		$3,000,000
Profession or Business			Other Profession or Business
Medical Doctor
License Number		Specialty Code & Classification		Certification Number
46979		Internal Medicine - No Surgery		84257

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
Patient's Home
Name of Institution		Code
Location of Institutional Injury		Other Location of Institutional Injury
Date of Occurrence		Date Reported to Insurer
7/29/1996		11/2/1998

Diagnostic Information
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Suicide
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
19 year old patient committed suicide 10 days after insured discharged patient from hospital.
Diagnostic Code :	798.1
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
Suicide
Severity Of Injury
Permanent: Death.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

Legal Information
Date of Suit	Circuit Court Case Number
3/30/1999	991707
County Suit Filed in	Date of Final Disposition
Pinellas	11/28/2000
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

$20,000

Loss Adjust Expense Paid to Defense Counsel

$16,395

All Other Loss Adjustment Expense Paid

$2,861

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 council, medical experts and claims personel regarding this matter.

Updates

No updates found.