Department File Number :	M200432209
Claim Number :	PPC-03-031027
Date Submitted :	7/28/2004

Insurer Information
Insurer Name				Coverage Type
EVEREST INDEMNITY INSURANCE COMPANY				Primary
Insurer FEIN		Professional License Number
22-3520347
Insurer Contact Information
Type	First Name		MI	Last Name
Individual	Nancy			Thomas
Street Address
2000 West Sam Houston Parkway South, 19th Floor; One Briarlake Plaza
City				State	Zip
Houston				TX	77042-361
Phone	Ext	Fax	E-Mail Address
(713) 935 - 8868		(713) 461 - 8130	nancy_thomas@ajg.com

Insured Information
Type	First Name		MI	Last Name
Individual	Stuart			Levy
Insurer Type		Street Address of Practice
Licensed		1265 Viscaya Parkway
City		State	Zip Code	County
Cape Coral		FL	33990	Lee
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
4700000063-031		$250,000		$3,000,000
Profession or Business			Other Profession or Business
Medical Doctor
License Number		Specialty Code & Classification		Certification Number
ME34669		Surgery - Obstetrics - Gynecology

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	Lee
City			State	Zip Code
Location where injury occured		Other location where injury occured
Hospital Inpatient Facility
Name of Institution		Code
CAPE CORAL HOSPITAL		100244
Location of Institutional Injury		Other Location of Institutional Injury
Labor and Delivery Room
Date of Occurrence		Date Reported to Insurer
6/25/2002		10/23/2003

Diagnostic Information

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

Delivery of infant

Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury

Alleged failure to properly examine and communicate patient's clinical status; alleged failure to admit, alleged failure to respond timely to fetal distress; alleged negligent use of Cervidil for induction.

Diagnostic Code :

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

N/A

Principal Injury Giving Rise To The Claim

Death of infant

Severity Of Injury

Permanent: Death.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

Legal Information
Date of Suit	Circuit Court Case Number
	*NR
County Suit Filed in	Date of Final Disposition
*NR	7/12/2004
Other Defendants Involved in this Claim
Yeomans, Susan R Physicians Primary Care of SW Florida
Stage of Legal System at which Settlement was Reached or Award Made
After arbitration is initiated or prior to suit being filed.
Final Method of Claim Disposition
Settled by parties
Court Decision	Other
No Court Proceedings.
Arbitration
Claim subject to arbitration, but settlement reached in lieu of award.
Date of Payment
2/27/2004

Financial Information

Was there a settlement Resulting in payment to the Plaintiff?

Yes

Indemnity Paid by Insurer on behalf of Insured

$125,000

Loss Adjust Expense Paid to Defense Counsel

$4,072

All Other Loss Adjustment Expense Paid

$151

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

Unknown

Updates

No updates found.