Department File Number :

Insurer Information

Insurer Name				Coverage Type
MEDICAL ASSURANCE COMPANY, INC. (THE)				Primary
Insurer FEIN		Professional License Number
63-0720042
Insurer Contact Information
Type	First Name		MI	Last Name
Individual	Suzanne		E	Shelton
Street Address
2801 SW 149 Avenue, Suite 200
City				State	Zip
Miramar				FL	33027
Phone	Ext	Fax	E-Mail Address
(954) 602 - 5857			bshelton@proassurance.com

Insured Information

Type	First Name		MI	Last Name
Individual	Jonathan		B	Warach
Insurer Type		Street Address of Practice
Licensed		500 VONDERBURG DR STE 215
City		State	Zip Code	County
BRANDON		FL	33511-5977	Hillsborough
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
MP30093		$1,000,000		$3,000,000
Profession or Business			Other Profession or Business
Medical Doctor
License Number		Specialty Code & Classification		Certification Number
ME48688		Neurology - Including Child - No Surgery

Injured Person Information

First Name	MI	Last Name		Date of Birth

Street Address			Gender	County where Injury Occurred
			F	Hillsborough
City			State	Zip Code

Location where injury occured		Other location where injury occured
Other Hospital/Institution		South Bay Internal Medicine
Name of Institution		Code

Location of Institutional Injury		Other Location of Institutional Injury
Patients' Room
Date of Occurrence		Date Reported to Insurer
6/10/1999		10/18/2000

Diagnostic Information

Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Transdient ischemic attack.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Alleged failure to timely treat ulcerated plaque in left internal carotic artery.
Diagnostic Code :
Misdiagnosis Made, If Any, Of Patient's Actual Condition
N/A
Principal Injury Giving Rise To The Claim
Hemiparalysis
Severity Of Injury
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage.

Legal Information

Date of Suit	Circuit Court Case Number
11/6/2001	01-001002
County Suit Filed in	Date of Final Disposition
Hillsborough	2/14/2003
Other Defendants Involved in this Claim
KREBS, JOSEPH Zzala, Pravinchandra Jonathan B. Warach, M.D./P.A. Behnke & Krebs, M.D./P.A. d/b/a South Bay Internal Medicine
Stage of Legal System at which Settlement was Reached or Award Made
During appeal.
Final Method of Claim Disposition
Settled by parties
Court Decision	Other
Other	Plaintiff dropped appeal/for cost & fee
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

$102,593

All Other Loss Adjustment Expense Paid

$38,066

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 discussed claim with insurance personnel and medical experts.

Updates

No updates found.