M200117541

Insurer Information

Insurer Name				Coverage Type
PRONATIONAL INSURANCE COMPANY				Primary
Insurer FEIN		Professional License Number
38-2317569
Insurer Contact Information
Type	First Name		MI	Last Name
Individual	BETH			ROMINGER
Street Address
13919 Carrollwood Village Run, Suite A
City				State	Zip
Tampa				FL	33624
Phone	Ext	Fax	E-Mail Address
(813) 969 - 2010		(813) 969 - 2120	BRominger@ProNational.com

Insured Information

Type	First Name		MI	Last Name
Individual	MARIAM		K	OHN, M.D.
Insurer Type		Street Address of Practice
Licensed		5907 4 STREET NORTH
City		State	Zip Code	County
ST. PETERSBURG		FL	33703	Pinellas
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
1008775		$1,000,000		$3,000,000
Profession or Business			Other Profession or Business
Medical Doctor
License Number		Specialty Code & Classification		Certification Number
0025212		Family Physicians or General Practitioners - No Surgery		00000

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
Prison		Physician's Office
Name of Institution		Code

Location of Institutional Injury		Other Location of Institutional Injury

Date of Occurrence		Date Reported to Insurer
6/21/1994		9/8/1997

Diagnostic Information

Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Occipital intracranial mass consistent with meningioma.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Craniotomy/resection of miningioma.
Diagnostic Code :
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Vastibular disease.
Principal Injury Giving Rise To The Claim
Meningioma causing neuro deficits.
Severity Of Injury
Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung.

Legal Information

Date of Suit	Circuit Court Case Number
4/16/1998	98-300CA/G
County Suit Filed in	Date of Final Disposition
Pasco	8/10/2001
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

$145,000

Loss Adjust Expense Paid to Defense Counsel

$34,522

All Other Loss Adjustment Expense Paid

$9,687

Injured Person's Total Non-Economic Loss

$145,000

Deductible

Injured Person's Total Economic Loss

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

Insured has discussed case with insurance company personnel, medical experts and defense counsel.

Updates

No updates found.