Department File Number :	M1999645
Claim Number :	97M07600
Date Submitted :	2/10/2000

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	CAROL			LOBACZ
Street Address
6360 NW 5TH WAY, SUITE 303
City				State	Zip
FT. LAUDERDALE				FL	33309
Phone	Ext	Fax	E-Mail Address
(954) 491 - 6078	111	(954) 491 - 6610

Insured Information
Type	First Name		MI	Last Name
Individual	BURTON			CAHN
Insurer Type		Street Address of Practice
Licensed		1150 N. 35TH AVE #350
City		State	Zip Code	County
HOLLYWOOD		FL	33021	Broward
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
KM10076-7		$1,000,000		$3,000,000
Profession or Business			Other Profession or Business
Medical Doctor
License Number		Specialty Code & Classification		Certification Number
006471		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
			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
2/6/1994		3/5/1997

Diagnostic Information

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

SEVERE DEPRESSION AND ATTEMPTED SUICIDE

Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury

INSURED TREATED PATIENT FOR SEVERE DEPRESSION AND ATTEMPTED SUICIDE

Diagnostic Code :

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

NA

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
9/19/1997	97-14717-08
County Suit Filed in	Date of Final Disposition
Broward	9/1/1999
Other Defendants Involved in this Claim
MEMORIAL REGIONAL HOSPITAL
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

$325,000

Loss Adjust Expense Paid to Defense Counsel

$41,779

All Other Loss Adjustment Expense Paid

$15,797

Injured Person's Total Non-Economic Loss

$325,000

Deductible

$0

Injured Person's Total Economic Loss

	Incurred to Date	Anticipated
Medical Expense	$0	$0
Wage Loss	$0	$250,000
Other Expenses	$0	$0

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

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

Updates

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