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HomeMy WebLinkAboutR-03-0364J-03-227 3/13/03 RESOLUTION NO. 0 3! 364 A RESOLUTION OF THE MIAMI CITY COMMISSION APPROVING THE FINDINGS OF THE EVALUATION COMMITTEE PURSUANT TO REQUEST FOR PROPOSAL NO. 02-03-010, FOR WORKERS COMPENSATION CLAIMS ADMINISTRATION (PART I SERVICES); GENERAL, AUTOMOBILE AND PROFESSIONAL LIABILITY HANDLING CLAIMS ADMINISTRATION (PART II SERVICES), AND/OR MANAGED CARE SERVICES (PART III SERVICES); AUTHORIZING THE CITY MANAGER TO NEGOTIATE A PROFESSIONAL SERVICES AGREEMENT ("AGREEMENT"), WITH GALLAGHER BASSETT SERVICES, INC., THE TOP-RANKED FIRM, FOR THE PROVISION OF PART I AND PART II SERVICES, AND SHOULD NEGOTIATIONS FAIL WITH THE TOP-RANKED FIRM, TO NEGOTIATE WITH CRAWFORD AND COMPANY, THE SECOND -RANKED FIRM, UNTIL A CONTRACT IS NEGOTIATED; FURTHER AUTHORIZING THE CITY MANAGER TO NEGOTIATE AN AGREEMENT WITH PREFERRED GOVERNMENTAL CLAIMS SOLUTIONS (PGCS), THE TOP-RANKED FIRM, FOR THE PROVISION OF PART III SERVICES, FOR A THREE-YEAR PERIOD, WITH THE OPTION TO EXTEND FOR FIVE ADDITIONAL ONE-YEAR PERIODS, AND SHOULD NEGOTIATIONS FAIL, THE EVALUATION COMMITTEE SHALL RECONVENE TO RECONSIDER ITS RECOMMENDATION FOR AWARD; DIRECTING THE CITY MANAGER TO PRESENT THE NEGOTIATED AGREEMENT(S) TO THE CITY COMMISSION FOR CONSIDERATION. WHEREAS, the City of Miami ("City") issued Request for Proposal No. 02-03-010 seeking qualified and experienced firms for the provision of the following services for the Department of Risk Management: CITY COMMTON MEETING :OF APR 1 0, 2003 Resolution No. 03- 36. Part I Services: Workers Compensation Claims Administration Part II Services: General, Automobile and Professional Liability Claims Administration (Police Tort and Public officials Liability) Part III Services: Managed Care Services; and WHEREAS, Risk Management requires the services of a qualified and experienced third -party claims administrator and workers compensation managed care provider to provide alternatives to its Risk Management Division to more efficiently and effectively utilize its resources to reduce the overall number and/or severity of workers compensation and liability claims as well as develop, implement, and monitor certain service quality indicators in an effort to improve the overall quality and efficiency of services provided to the citizens, vendors and employees of the City; and WHEREAS, Parts I and II Services require a Third -party Claims Administrator ("TPA") to assume the daily activities, currently performed by staff in the Risk Management Division, to process and handle the City's claims for Workers' Compensation, and Liability - general, auto, and professional liability (police tort and public officials liability), including all specified adjusting services and other required services such as Page 2 of 6 03_ 364 administration, computerized claim/loss statistical information, and loss fund reconciliation; and WHEREAS, the TPA will also provide 24-hour call center service, recommend risk control measures to protect the City's interests, implement an enhanced comprehensive Safety program, and implement an enhanced comprehensive Light Duty Program for the entire City and all labor groups; and WHEREAS, Part III Services provide that the Managed Care vendor provide all of the services related to the City's Workers Compensation Managed Care Claims, which is essentially a change of vendors, as the City is currently utilizing Occupational Health Systems, Inc. for the provision of these services; and WHEREAS, the Evaluation Committee recommended Gallagher Bassett Services, Inc., as the top-ranked firm, for the provision of both Parts I and II Services; and WHEREAS, the Evaluation Committee further recommended that should negotiations fail with Gallagher Bassett Services, Inc., that the City negotiate with Crawford and Company, the second -ranked firm, until a contract is negotiated to present to the City Commission for final approval; and Page 3 of 6 03- 364 WHEREAS, the Evaluation Committee recommended Preferred Governmental Claim Solutions ("PGCS"), as the top-ranked firm, for the provision of Part III Services; and WHEREAS, the Evaluation Committee further recommended that should negotiations fail with PGCS, the Evaluation Committee shall reconvene to reconsider its recommendation for award; and WHEREAS, the City Manager concurred with the recommendations of the Evaluation Committee; NOW, THEREFORE, BE IT RESOLVED BY THE COMMISSION OF THE CITY OF MIAMI, FLORIDA: Section 1. The recitals and findings contained in the Preamble to this Resolution are adopted by reference and incorporated as if fully set forth in this Section. Section 2. The recommendation of the City Manager to approve the findings of the Evaluation Committee pursuant to Request for Proposal No. 02-03-010, that the firms most qualified to provide Worker's Compensation Claims Administration (Part I Services) and General Automobile and Professional Liability Handling Claims Administration (Part II Services), in rank order are: (1) Gallagher Bassett Services, Inc., the top-ranked firm and (2) Crawford and Company, the second -ranked firm, and the Page 4 of 6 03-- 364 firm most qualified to provide Managed Care Services (Part III Services) is Preferred Governmental Claims Solutions ("PGCS"), are approved. Section 3. The City Manager is authorizedll to negotiate a Professional Services Agreement ("Agreement"), with Gallagher Bassett Services, Inc., the top-ranked firm, for Parts I and II Services, for a three-year period, with the option to extend for five additional one-year periods. Section 4. The City Manager is further authorizedll to negotiate an Agreement with Crawford and Company, the second -ranked firm, should negotiations fail with Gallagher Bassett Services, Inc. Section S. The City Manager is authorizedll to negotiate an Agreement, in a form acceptable to the City Attorney, with Preferred Governmental Claims Solutions ("PGCS") the top-ranked firm, for the provision of Part III services, for a three-year period, with the option to extend for five additional one-year periods. 1� The herein authorization is further subject to compliance with all requirements that may be imposed by the City Attorney, including but not limited to those prescribed by applicable provisions of the City Charter and Code. Page 5 of 6 03- 364 Section 6. The Evaluation Committee shall reconvene to reconsider its recommendation for award should negotiations fail with PGCS. Section 7. The City Manager is directed to present the negotiated Agreements to the City Commission for consideration. Section 8. This Resolution shall become effective immediately upon its adoption and signature of the Mayor.�l PASSED AND ADOPTED this 10th ATTEST: P ISCILLA A. T OMPSON CITY CLERK FORD.A D CORRECTNESS: 033:tr:AS:BSS day of April 2003. /k4-1'UEL A. DIAZ, MAYOR zi If the Mayor does not sign this Resolution, it shall become effective at the end of ten calendar days from the date it was passed and adopted. If the Mayor vetoes this Resolution, it shall become effective immediately upon override of the veto by the City Commission. Page 6 of 6 o3, 364 CITY OF MIAMI, FLORIDA INTER -OFFICE MEMORANDUM TO: Honorable Mayor and DATE: March 27, 2003 FILE Members of th Commis 'on 1 SUBJECT: 1 Workers Compensation Claims Administration, et al. FROM: 0, REFERENCEERFP #02-03-010 1 e Arriola ENCLOSURES: C ' f Administrator/City Manager RECOMMENDATION It is respectfully recommended that the City Commission adopt the attached resolution approving the findings of the Evaluation Committee in connection with RFP #02-03-010: Part I Services: Workers Compensation Claims Administration Part II Services: General, Automobile and Professional Liability Claims Administration (Police Tort and Public Officials Liability) Part III Services: Managed Care Services Further authorizing the City Manager to negotiate a Professional Services Agreement, for City Commission approval, with the following vendors: Parts I and II Services: Gallagher Bassett Services, Inc. Part III Services: Preferred Governmental Claim Solutions (PGCS) BACKGROUND The City of Miami issued RFP #02-03-010 in an attempt to provide alternatives to its Risk Management Department to more efficiently and effectively utilize its resources to reduce the overall number and/or severity of workers compensation and liability claims as well as develop, implement, and monitor certain service quality indicators in an effort to improve the overall quality and efficiency of services provided to the citizens, vendors and employees of the City of Miami. 03- 364 Parts I and II Services would require a Third -parry Claims Administrator (TPA) to assume the daily activities, currently being performed by staff in the Risk Management department, necessary to process and handle the City's claims for: Workers' Compensation; and Liability - general, auto, professional liability (police tort and public officials liability) including all specified adjusting services and other required services such as administration, computerized claim/loss statistical information, and loss fund reconciliation. In addition, the TPA would: Provide 24-hour call center service; Recommend risk control measures to protect the City's interests; Implement an enhanced comprehensive Safety program; and Implement an enhanced comprehensive Light Duty program for the entire City and all labor groups The Evaluation Committee recommended Gallagher Bassett Services, Inc., as the top ranked firm, for the provision of both Parts I and II Services. The Evaluation Committee further recommended that should negotiations fail with Gallagher Bassett Services, Inc., that the City negotiate with Crawford and Company, the second ranked firm, until a mutually acceptable contract is negotiated to bring to the City Commission for final approval. Part III Services provides that the Managed Care vendor provide all of the services relating to the City's Workers Compensation managed care claims. This is essentially a change of vendors, as the City is currently utilizing Occupational Health Systems, Inc. (OHS) for the provision of these services. The Evaluation Committee recommended Preferred Governmental Claim Solutions (PGCS), as the top ranked firm, for the provision of Part III Services. The Evaluation Committee further recommended that should negotiations fail with PGCS, the Evaluation Committee would reconvene to reconsider it's recommendation for award. For the provision of all Services, it is the City's intent, following negotiation, to bring to the City Commission, for its approval, all negotiated contracts with the Successful Proposers. LIA _tDL JA/LH/DE 03- 364 ACCEPTANCE OF CHIEF ADMINISTRATOR/ CITY MANAGER AND EVALUATION COMMITTEE'S RECOMMENDATION RFP NO. 02-03-010 ITEM: WORKERS COMPENSATION CLAIMS ADMINISTRATION; GENERAL, AUTOMOBILE, 8t PROFESSIONAL LIABILITY HANDLING az CLAIMS ADMINISTRATION; AND/OR MANAGED CARE SERVICES DEPARTMENT: Risk Management TYPE: Term Contract REASON: It is recommended the findings of the Evaluation Committee be approved pursuant to RFP #02-03- 010, Workers Compensation Claims Administration (Part 1 Services); General, Automobile and Professional Liability Handling Claims Administration (Part II Services); and/or Managed Care Services (Part III Services); further authorizing the City Manager to negotiate professional services agreement, for City Commission approval, with Gallagher Bassett Services, Inc., the top ranked fine, for the provision of Part 1 and Part II Services, and with Preferred Governmental Claim Solutions (PGCS), the top ranked firm, for the provision of Part III Services. �b Acting Director of Purchasing Date AwardRFP02-03-01 OWorkersCompEtAi 03- 364 CITY OF MIAMI, FLORIDA EVALUATION OF RFP NO. 02-03-010 Workers Compensation Claims Administration (Part I Services); General, Automobile & Professional Liability Handling Claims Administration (Part H Services); and/or Managed Care Services (Part III Services) Part I Services Rater 1 Rater 2 Rater 3 Total Average Rankine: Gallagher Bassett Services, Inc. 156.00 142.00 153.00 451.00 150.33 1 Preferred Governmental Claim Solutions, Inc. 122.00 115.00 128.00 365.00 121.67 4 Crawford and Company 131.00 130.00 124.00 385.00 128.33 2 Cambridge Integrated Services Group 131.00 113.00 127.00 371.00 123.67 3 Part II Services Rater 1 Rater 2 Rater 3 Total Average Rankine: Gallagher Bassett Services, Inc. 161.00 142.00 144.00 447.00 149.00 1 * Preferred Governmental Claim Solutions, Inc. 142.00 115.00 126.00 383.00 127.67 3 Crawford and Company 138.00 130.00 120.00 388.00 129.33 2 * Cambridge Integrated Services Group 130.00 113.00 130.00 373.00 124.33 4 Part III Services Rater 1 Rater 2 Rater 3 Total Average Rankine: Occupational Health Systems, Inc. 124.00 105.00 130.00 359.00 119.67 2 Preferred Governmental Claim Solutions, Inc. 135.00 137.00 145.00 417.00 139.00 1 Cambridge Integrated Services Group 113.00 126.00 119.00 358.50-t-1 19.33 3 # 1: Mr. Elliott Fixler, Risk Management Administrator (former) # 2: Mr. John Petillo, Risk Management Consultant # 3: Mr. Stuart Myers, Expert Advisor on Risk Management Approved by: Ir Michael A. Rath, Acting Director Chief Procurement Officer Date: * Recommended Firms 03- 364 CLM DETAIL (Landscape) Page 2 of 33 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE 1 CLAIM NUMBER DESC OF LOSS - KEY 3 LOS.DATE MED/BI-PTD IND/PD-PTD TOTAL -PAID 020/0000000257/ STRAIN/BACK CAR RAN A STOP SIGN & HE WAS HIT 05/25/57 7821.00 69843.40 87708.00 020/0000000157/ SEIZURES AND LUMBOSACRAL SYNDROME (MVA) 09/24/57 71673.37 73768.40 145786.72 ' 016/0000001360/ STRAIN/BACK PICKING UP CONCRETE BENCHES 02/04/60 105930.99 85571.00 207336.34 020/0000000160/ STRAIN/LOW BACK & COCCYGEAL AREA FELL FROM ROOF 11/04/60 1105.80 78083.70 79246.50 Q 016/0000000162/ STRAIN/LOWER BACK PULLING CHAINS & CUTTING LIMBS 04/25/62 1426.00 75403.77 89204.77 009/0000000262/ STRAIN/BACK AUTO ACCIDENT 10/05/62 85481.43 77745.15 166171.35 009/0000000262/1 STRAIN/BACK AUTO ACCIDENT 10/05/62 0.00 21599.10 21599.10 019/0000000663/ STRAIN/BACK HELPING DRUNK GET BACK IN WAGON 04/20/63 2574.89 72757.40 75352.29 014/0000000863/ CONTUSION/RT ANTERIOR THORAX FOOT SLIPPED 04/23/63 34880.17 73390.98 108754.76 020/0000000963/ LOW BACK INJURIES 11/29/63 656268.46 75486.40 733902.13 020/0000000869/ 016/0000000265/ CERVICAL DISC SYNDROME CHEMICAL HEPATITIS 05/12/64 01/23/65 35282.39 116553.40 73079.43 70847.90 108550.51 194276.33 \` 016/0000000165/ I FRACTURE/RT HAND PACKING BLADE CAUGHT HIS HAND 12/13/65 4106.93 82189.00 99170.93 019/0000000366/ STRAIN/NECK CAR STOPPED SUDDENLY SNAPPING NECK 03/16/66 27368.60 65435.40 93271.61 020/0000000366/ STRAIN/BACK JUMPING OUT OF RAIL CAR 05/18/66 210964.01 53193.40 267541.68 _ 020/0000000766/ STOMACH (PRE-EXISTING INJURY) 07/06/66 393.00 76317.40 81477.40 020/0000000266/ HERNIATED LUMBAR DISC 11/10/66 1136.00 56292.80 65309.70 020/0000000467/ 020/0000000967/ 020/0000000668/ AUTO ACCIDENT STRAIN/BACK ASSISTING MOTORIST PULLING FENDER MULTIPLE CONTUSIONS/SUBJECT 02/18/67 04/28/67 8359.00 16729.33 69853.00 5519.00 78212.00 22924.08 , C RESISTING ARREST 01/27/68 31669.58 4324.00 36013.58 016/0000000268/ STRAIN/BACK STEPPING FROM RUNNING BOARD OF TRUCK 05/02/68 26921.66 73818.40 101304.16 014/0000000969/ LT SIDE OF FACE/ATTACKED BY A PRISONER 02/20/69 31050.65 3626.00 34786.80 009/0000000169/ STRAIN/LUMBAR MUSCLE RE-CURRENCE OF OLD INJURY 07/12/69 12984.33 105230.20 118560.13 009/0000000667/ TWISTED/KNEE SLIPPED ON SIDEWALK 07/16/69 86049.60 52735.36 140050.48 009/0000000269/ 009/0000001069/ STRAIN/LUMBAR MUSCLE MOVING TYPEWRITER STRAIN/BACK 08/14/69 7920.77 80042.00 87966.77 Uj WHILE LIFTING A BOX OF PAPER 12/22/69 5755.65 5184.00 11648.45 016/0000020776/ LUMBAR STRAIN/LOADING WET HOSE 02/10/70 49074.35 70313.00 119575.33 O = 016/0000002670/ STRAIN/BACK WHILE PULLING FIRE HOSE 02/23/70 30093.08 61757.25 92415.98 O 014/0000001570/ MULTIPLE PAINS/WHILE LIFTING HOOD OF CAR 08/17/70 11186.21 77725.16 88931.87 O 016/0000000470/ BROKE BACK/HOPPING DOWN FROM FIRE TRUCK 09/22/70 122140.45 71506.16 193859.41 019/0000001070/ STRAIN/LOWER BACK BENT TO TAKE PAPER FROM TRAY 12/22/70 133701.10 74270.72 208268.60 O ` Q 016/0000000171/ STRAIN/BACK HANDLING HOSE TRIPPED IN TALL GRASS 01/25/71 17980.31 7418.00 25445.56 ^/ 016/0000000971/ STRAIN/BACK WHILE DRAGGING HOSE 04/14/71 16320.50 1995.00 18335.75 7r (1� 014/0000001571/ 020/0000000771/ STRAIN/BACK LEANING OVER RADIATOR CONTUSION/HEAD ABRASION/LT 07/15/71 10820.68 5376.00 16219.25 Lz O HIP THROWN D/ACCIDENT 08/09/71 3675.58 100952.26 105096.34 019/0000000871/ 014/0000000172/ CONTUSION/LT SHOULDER FELL TOWARD CABINETS 09/18/71 13805.96 108292.00 142850.41 Q o STRAIN/BACK JUMPING FROM LADDER 01/07/72 13871.40 91878.00 105807.80 014/0000000672/ TWISTED/LOWER BACK,LT HIP SLIPPED ON CURB 03/11/72 29897.03 44553.60 91303.77 014/0000000572/ CONTUSION/RT SIDE DURING ARREST FELL INTO BUSHES 07/10/72 5228.59 80206.12 100827.71 t.�. 016/0000000972/ 016/0000000272/ STRAIN/BACK WHILE FORCING OPEN A DOOR 09/14/72 3775.44 103650.05 109553.85 STRAIN/LT KNEE AT FIRE DRILL LOADING WET HOSE 12/06/72 2298.00 121151.44 125807.64 009/0000000773/ MULTIPLE CONTUSIONS/VEHICLE LOST CONTROL 06/30/73 36318.00 82975.92 122356.22 014/0000000673/ HEART ATTACK 08/24/73 10172.79 138811.42 168511.04 009/0000000273/ HYPERTENSION 10/19/73 23691.37 135088.34 160356.96 �+�f 014/0000000173/ MULTIPLE FRACTURES/DROVE THROUGH FUNERAL 12/24/73 17536.33 121700.00 139656.33 , n j 020/0000000574/ MULTIPLE INJURIES/CAR ACCIDENT 01/03/74 9118.54 121780.00 132418.48 LJ 009/0000001674/ LACERATION/FOREHEAD AUTO ACCIDENT 01/16/74 125769.50 70937.77 205189.63 014/0000000879/ CONTUSION/RT KNEE AUTO ACCIDENT 01/26/74 11041.11 44260.00 56756.86 " 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE 1 https://www.claimsuite.netIClaimsPortlservlet/com.csedge.claimsport.mcm.PendingDetailLookupServlet?runType=1 &function=... 3/20/2003 CLM DETAIL (Landscape) 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE CLAIM NUMBER DESC OF LOSS - KEY 3 LOS.DATE MED/BI-PTD IND/PD-PTD TOTAL -PAID 016/0000000374/ STRAIN/LOWER LUMBAR WHILE HANDLING EQUIPMENT 02/12/74 22465.23 109782.68 132838.66 020/0000000774/ STRAIN/BACK ENTERING CITY VEHICLE SLIPPED 05/01/74 4258.00 119754.29 134834.29 016/0000000174/ HEART ATTACK/WHILE DRIVING CITY VECHICLE 06/12/74 32023.17 129840.00 162356.27 009/0000001274/ ANXIETY/FOUND BROTHER-IN-LAW FATALLY SHOT 06/29/74 13459.03 122964.93 147505.64 016/0000000974/ STRAIN/NECK WHILE ON PARADE DETAIL IN ACCIDENT 12/31/74 96677.49 117680.00 220776.47 016/0000001775/ CHEST PAINS AND NUMBNESS 01/10/75 5369.20 152485.00 158920.75 016/0000000175/ CERVICAL STRAIN/SPINE ELECTRIC SHOCK RT HAND 05/14/75 32675.98 143020.00 175862.98 020/0000001675/ CORONARY ARTERY DISEASE 07/04/75 133947.72 34180.00 168147.72 009/0000000775/ CERVICAL STRAIN/AUTO ACCIDENT 07/11/75 104100.42 177132.20 283699.60 016/0000002675/ MULTIPLE STRAINS & CONTUSIONS 08/07/75 5134.00 179845.00 186615.00 020/0000001575/ CUMULATIVE TRAUMA/NEURAL HEARING LOSS 08/19/75 18086.59 3862.90 22599.49 020/0000003075/ STRAIN/BACK WHILE LIFTING BAG OF SODA ASH 12/05/75 1273.47 145110.00 170277.42 016/0000000876/ CERVICAL STRAIN/CAR ACCIDENT STRUCK IN REAR 02/05/76 47003.00 152704.00 199707.00 014/0000002076/ STRAIN/NECK & SHOULDER LIFTING HEART PATIENT 05/13/76 41857.60 156832.00 198728.85 020/0000002770/ ABRASIONS/RT SIDE OF BODY IN AUTO ACCIDENT 06/01/76 6694.32 156056.25 167758.44 016/0000001976/ TWISTED/LT KNEE REMOVING SUITCASE FROM SHELF 07/15/76 52556.05 44264.49 102943.15 009/261924811 / HEPATITS B/C BLOOD /DR. SCHIFF/DR.JEFFERS JMH 08/12/76 5904.75 56.00 5965.75 016/0000002576/ STRAIN/BACK FELL 7 FEET 08/26/76 92028.00 154873.60 247580.60 009/0000002276/ HEART ATTACK/WHILE ON DUTY 11/02/76 76996.00 152687.68 230259.48 016/0000000776/ MULTIPLE CONTUSIONS/GETTING OUT CHAIR SLIPPED 11/03/76 37695.48 149846.00 189778.98 020/0000001176/ CONVULSIVE DISORDER/NUMBNESS LT ARM,LEG,CHEST 11/12/76 5062.62 155075.00 160472.42 014/0000001876/ STRAIN/BACK PICKING UP PRISONER OFF THE FLOOR 12/02/76 11664.90 152158.00 165660.58 020/0000002976/ LUMBAR SPRAIN/ASSAULTED WITH A PAIR OF SCISSORS 12/03/76 20771.62 153580.00 174722.07 009/0000001476/ MULTIPLE BURNS/EXPLOSION IN BURNING BUILDING 12/14/76 46964.42 19238.00 66222.42 014/0000003077/ CHEST PAINS/WHILE PERFORMING ROUTINE DUTIES 03/10/77 91965.84 159392.00 251549.05 020/0000003077/ CONTUSION/GROIN AREA KICKED BY OFFENDER 03/14/77 106143.52 21115.00 131409.34 014/0000003577/ MULTIPLE CONTUSIONS/INVOLVED IN HIGH SPEED CHASE 03/17/77 58487.17 161245.00 227454.27 009/0000001577/ CEREBRAL CONTUSION/INVOLVED IN AUTO ACCIDENT 03/22/77 48524.53 161194.00 250870.43 014/0000001077/ STRAIN/RT HIP DURING PHYSICAL FITNESS EXERCISE 04/19/77 91870.95 18334.50 111020.32 020/0000003277/ SPRAIN/BACK TRIPPED OVER OBJECT ON FLOOR 07/08/77 44294.34 164748.00 210733.19 016/0000000577/ CONTUSION/FOREHEAD & RT KNEE AUTO ACCIDENT 07/30/77 66025.39 208532.40 285898.33 014/0000005278/ STRAIN/BACK WHILE AT DRILL 04/09/78 55120.36 119259.08 175394.64 014/0000001378/ TWISTED/BACK GETTING DOWN OFF CRANE FOOT SLIPPED 04/27/78 278263.14 150216.30 433902.33 014/0000001278/ IRREGULAR HEARTBEAT/TAKING TREADMILL TEST 07/11/78 59824.07 162882.00 227095.03 009/0000000878/ STRAIN/NECK & BACK WHILE ON ESCALATOR FELL 09/12/78 89765.01 90534.25 187380.05 020/0000004178/ CONTUSION/BACK FELL IN HOLE DURING FOOT CHASE 11/17/78 38124.02 160585.50 200182.42 009/0000000178/ ATRIAL FIBRILLATION 12/04/78 61125.95 183997.80 246841.73 009/0000000178/1 ATRIAL FIBRILLATION 12/04/78 88.74 57451.97 57540.71 009/0000000478/ TWISTED BACK/WRESTLING WITH A PRISONER 12/04/78 5649.76 214807.09 260216.48 009/0000012478/ CHEST PAIN/WHILE WORKING 12/04/78 12263.75 42159.60 54460.35 016/0000012879/ CONTUSION/LT KNEE PUTTING OFFENDER IN WAGON 01/21/79 453924.08 136905.91 599766.99 014/0000002079/ HERNIATED DISC 03/28/79 26724.54 112252.55 172751.73 016/0000011679/ MULTIPLE CONTUSIONS/IN AUTO ACCIDENT 04/26/79 216154.25 142849.57 360176.33 020/0000003979/ SPRAIN/LT HIP WHILE JOGGING 05/23/79 35305.99 138932.00 176361.99 016/0000012379/ STRAIN/NECK LOW BACK HIT TREE BRANCH W/TOTE BOX 05/29/79 226978.07 175988.00 416179.62 016/0000012379/1 STRAIN/NECK LOW BACK HIT TREE BRANCH W/TOTE BOX 05/29/79 0.00 190461.19 190461.19 014/0000005579/ STRAIN/BACK PICKING UP PAPER FROM FLOOR 06/13/79 25117.00 0.00 25777.00 016/0000011379/ STRAIN/LT KNEE STEPPED ON A LOOSE TILE 09/01/79 80742.60 236835.80 319182.64 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS Page 3 of 33 AS OF 03/20/03 PAGE https://www.claimsuite.netIClaimsPortlservleticom.csedge.claimsport.mcm.PendingDetailLookupServlet?runType=1 &function=... 3/20/2003 eM M CLM DETAIL (Landscape) 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE CLAIM NUMBER DESC OF LOSS - KEY 3 LOS.DATE MED/BI-PTD IND/PD-PTD TOTAL -PAID 016/0000012979/ MULTIPLE INJURIES/FELL RUNNING AFTER SUSPECT 11/23/79 114368.10 262530.31 384035.74 014/0000005879/ CONTUSION/LOWER BACK FELL OFF CRANE 12/10/79 82699.55 8658.00 93323.30 014/0000020080/ CONTUSION/RT HIP STEPPING OFF A STEP 01/02/80 56490.68 57515.54 118142.87 020/0000040680/ STRAIN/BACK LIFTING PATIENT 03/14/80 17371.99 3756.00 21154.09 020/0000008780/ PAIN/LT LEG AFTER GOING TO FIRE FELT PAIN 03/29/80 21078.13 74376.21 103309.18 016/0000008480/ CONTUSIONS/LT SIDE OF BODY KICKED BY OFFENDER 06/01/80 34980.85 297973.12 338520.43 014/0000044680/ CONTUSION/RT SHOULDER IN FIGHT W/MENTAL PATIENT 06/04/80 10531.38 107740.49 122638.24 009/0000043680/ STRAIN/BACK BECAUSE OF HEAVINESS OF CAST ON ARM 06/20/80 43950.61 51765.40 96016.51 016/0000042480/ STRAIN/BACK WHILE CARRYING AIR TANK 07/13/80 381681.32 249613.00 631761.78 016/0000042480/* STRAIN/BACK WHILE CARRYING AIR TANK 07/13/80 128.00 126279.32 126412.32 009/0000000280/ STRAIN/BACK FIGHTING FIRE 07/15/80 392962.31 185887.96 587799.72 009/0000012080/ SPRAIN/BACK LIFTING EQUIPMENT 08/07/80 73378.04 62016.12 152864.08 009/0000004780/ MULTIPLE CONTUSIONS/RT LEG HIP & HEAD (MVA) 09/13/80 43037.59 38171.53 83556.87 016/0000020380/ BROKEN/LT LEG TRAILER BROKE LOOSE & HIT HIM 09/19/80 35940.91 55556.40 108432.10 016/0000040880/ STRAIN/BACK LT HIP HIT WHEN HE STOPPED AT S/S 10/27/80 19546.12 189624.38 221636.81 014/0000007380/ STRAIN/UPPER BACK LIFTING A PATIENT 10/31/80 2818.02 2321.00 5675.92 016/0000009780/ STRAIN/BACK BEAR HUG FROM FELLOW EMPLOYEE 11/07/80 155006.55 11402.44 167188.84 016/0000040581/ HERNIA/LIFTING CONCRETE 03/17/81 13545.71 210246.22 251681.28 016/0000100081/ CONTUSION/LT KNEE SLIPPED WHEN GOING DOWNSTAIRS 04/28/81 53492.32 85201.60 138932.62 020/0000098881/ CONTUSION/LT KNEE HOLDING CHAIN SAW AND FELL 10/05/81 59081.05 274604.02 341443.20 016/0000030481/ LACERATION/RIGHT CALF JUMPING OVER FENCE 10/10/81 254338.99 200877.11 459250.73 016/0000088181/ INTERNAL INJURIES/HYDRAULIC RAM BROKE & FELL OFF 11/18/81 64275.23 17135.36 81533.19 009/0000016481/ CONTUSION/RIGHT KNEE HIT ON CORNER OF TRUCK 11/23/81 10544.04 3876.00 14455.54 020/0000098481/ HEART ATTACK/ WHILE ON DUTY 11/30/81 41018.59 3661.03 44700.12 014/0000012782/ RT ANKLE RIGHT KNEE SLIPPED FROM TRUCK 03/01/82 29391.04 6562.61 36103.13 009/0000022782/ CONTUSION/LT LEG VEHICLE FELL TO THE LEFT 03/07/82 15030.72 62238.00 81700.24 009/0000068882/ SPRAIN/NECK,BACK,LT SHOULDER TRUCK TURNED OVER 03/12/82 54477.25 31534.74 86066.09 009/0000040382/ MULTIPLE TRAUMA/HIT BY ANOTHER CAR 05/10/82 96763.13 113128.37 210182.81 016/0000084782/ STRAIN/BACK SLIPPED ON WET FLOOR & FELL ON REAR 08/07/82 42188.81 6894.25 49964.39 014/0000001783/ STRAIN/LOW BACK SLIPPED ON GREASE ON FLOOR 01/09/83 16011.13 183252.00 199369.78 016/0000027783/ HEART ATTACK/HAD JUST ARRIVED AT WORK & HAD PAIN 04/17/83 192679.00 4471.50 197442.75 009/0000040183/ CONTUSION/RT LEG CILIVIAN RAN STOP SIGN 05/18/83 66320.83 30352.00 99094.96 014/0000091183/ CONTUSION/LT KNEE SLIPPED IN HOLE & HIT KNEE 10/19/83 68554.14 107895.75 177330.36 020/0000005884/ INTERNAL INJURIES/HIT BY DRUNKEN DRIVER 01/25/84 4092955.39 287352.00 4385932.38 020/0000024884/ FRACTURE/RT ARM & LEG TRYING TO AVOID TRUCK 03/19/84 33811.43 6624.00 40455.43 014/0000027084/ STIFFNESS/NECK HILE PLAYING VOLLEYBALL 04/04/84 16872.29 545.03 17432.32 009/0000032484/ SPRAIN/BACK WHILE LIFTING A SMOKE EJECTOR 04/19/84 13636.56 504.00 15534.01 009/0000034684/ CONTUSION/LT KNEE HIT HIS KNEE ON SIDE OF TRUCK 04/28/84 28547.44 13824.00 42567.94 016/0000065684/ DISLIGNED VERTEBRAE/IN A CAR ACCIDENT 07/31/84 20036.95 0.00 20229.64 020/0000064884/ BULLET/RT TEMPLE MALE TRIED TO ROB HER 08/01/84 30282.44 120729.60 164230.54 009/0000068584/ MULTIPLE CONTUSIONS/IN ALTERCATION WITH SUSPECT 08/18/84 134020.79 238176.00 374966.29 009/0000068584/1 MULTIPLE CONTUSIONS/IN ALTERCATION WITH SUSPECT 08/18/84 0.00 97660.80 97660.80 014/0000012085/ CHEST PAINS/WHILE ON THE JOB 11/09/84 28388.15 296349.48 326852.08 014/0000012085/1 CHEST PAINS/WHILE ON THE JOB 11/09/84 0.00 128930.09 128930.09 014/0000018385/ STRAIN/BACK WHILE LIFTING TABLE W/TYPEWRITER 12/17/84 8288.23 3168.00 11476.23 009/0000036885/ HIGH BLOOD PRESSURE/FELT LIGHT HEADED WON DUTY 01/23/85 377475.84 275851.84 658049.82 009/0000036885/1 HIGH BLOOD PRESSURE/FELT LIGHT HEADED WON DUTY 01/23/85 3023.08 118972.40 121995.48 016/0000046585/ HYPERTENSION/WHILE ON RESCUE FELT PRESSURE 03/08/85 36523.84 307.00 37267.41 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS Page 4 of 33 0 3�fa 0 AS OF 03/20/03 PAGE https://www.claimsuite.netIClaimsPortlservleticom.csedge.claimsport.mcm.PendingDetailLookupServlet?runType=1 &function=... 3/20/2003 CLM DETAIL (Landscape) 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE CLAIM NUMBER DESC OF LOSS - KEY 3 LOS.DATE MED/BI-PTD IND/PD-PTD TOTAL -PAID 020/0000073485/ SPINAL & HEAD/ W/SITTING ON HORSE IT FELL BACK 06/08/85 13735.41 2456.00 16211.91 009/0000095785/ SHOT IN LEFT HAND, RING FINGER 08/03/85 37558.12 121842.62 160571.37 009/0000095785/1 SHOT IN LEFT HAND, RING FINGER 08/03/85 0.00 71005.40 71005.40 020/0000108485/ CHEST PAINS/ WHILE JOGGING EXPERIENCED PAINS 09/13/85 59737.00 25020.50 85178.62 009/0000028086/ HEART PALPITITATIONS/WHILE WATCHING TV 01/04/86 16571.59 0.00 16622.21 009/0000040386/ STRAIN/LT THIGH WHILE LIFTING BARREL 01/21/86 54059.46 229163.03 287856.16 009/0000040386/1 STRAIN/LT THIGH WHILE LIFTING BARREL 01/21/86 0.00 106055.58 106055.58 016/0000034186/ TWISTED/LT KNEE STEPPED ON A ROCK 01/26/86 99531.59 8820.00 109291.13 016/0000034686/ PVC'S/HEART WHILE ON DUTY 01/27/86 11877.47 315.00 12212.97 009/0000047286/ MULTIPLE CONTUSIONS/IN ALTERCATION WITH SUSPECT 03/07/86 76239.66 67308.32 145938.30 014/0000118086/ MUSCLE STRAIN LOWER BACK/LIFTING BOXES. 04/14/86 4739.00 378.00 5137.25 016/0000060886/ DISLOCATED/LT SHOULDER WHILE PICKING UP CAN 04/24/86 71251.16 14416.47 88509.52 009/0000103186/ CONTUSION/RT LEG IT GOT CAUGHT IN HOPPER 08/29/86 81400.40 146935.31 233774.60 009/0000103186/1 CONTUSION/RT LEG IT GOT CAUGHT IN HOPPER 08/29/86 0.00 56909.56 56909.56 014/0000106486/ SPRAIN/BACK WHILE MOVING LADDER 09/11/86 25835.00 20947.50 47443.36 014/0000022387/ PAIN/BACK INVOLVED IN AUTO ACCIDENT 12/24/86 21221.00 1732.50 23672.06 014/0000025387/ FRACTURE/RT LEG WHILE STANDING ON TRUCK 01/22/87 222930.75 121334.15 350935.33 014/0000034187/ TWISTED/LT KNEE DURING A VOLLEYBALL DRILL 02/04/87 37121.26 9174.00 50044.76 009/0000036187/ CRAMPS/STOMACH INVOLVED IN AUTO ACCIDENT 02/09/87 106180.04 9798.00 118429.15 020/0000050587/ SPRAIN/BACK WHILE LIFTING A RADIATOR 02/12/87 110248.87 145600.42 260528.54 020/0000050587/1 SPRAIN/SACK WHILE LIFTING A RADIATOR 02/12/87 0.00 33560.39 33560.39 014/0000042087/ STRAIN/LT SHOULDER/HOLDING AC SLIPPLED AND FELL 04/06/87 40430.79 4818.00 45570.84 009/0000004488/ POSSIBLE FRACTURE/LT ANKLE/SLIPPED AND TWISTED 10/13/87 23162.46 12210.00 36428.57 016/0000010188/ STRAIN/BACK WHILE MOVING BEDS 11/08/87 43878.66 5032.50 49033.16 009/0000009788/ FX, DISLOCATION, BRUISES/VEHICLE ACCIDENT 11/09/87 55424.57 13530.00 69806.27 020/0000020988/ SPRAIN/BACK 01/01/88 134851.91 226008.00 372081.68 020/0000020988/1 SPRAIN/BACK 01/01/88 0.00 67800.80 67800.80 020/0000047188/ MULTIPLE CONTUSIONS/INVOLVED IN AUTO ACCIDENT 03/15/88 15186.60 688.00 15902.70 020/0000060088/ STRAIN LT.KNEE/SLIPPED & FEEL INJURING LT. KNEE. 04/22/88 64294.07 101296.43 173567.98 020/0000060088/1 STRAIN LT.KNEE/SLIPPED & FEEL INJURING LT. KNEE. 04/22/88 0.00 42181.74 42181.74 014/0000060888/ WOUNDS/LT HIP WAS SHOT IN TRAFFIC 04/28/88 52428.53 189475.20 242574.73 016/0000067488/ COLLISION W/ANOTHER VEH.CAUSING CHAIN REACTION. 05/19/88 14584.38 90388.80 106140.86 009/0000071488/ STRAIN BACK/FELL FROM LADDER LANDING ON CONCRETE 06/07/88 89672.31 247129.60 349934.08 009/0000071488/* STRAIN BACK/FELL FROM LADDER LANDING ON CONCRETE 06/07/88 869.73 78441.80 79331.53 016/0000091789/ HYPERTENSION REVEALED DURING ANNUAL PHYSICAL 06/26/88 17331.84 86376.00 103734.09 020/0000119888/ HYPERTENSION 07/15/88 15812.69 190000.00 206013.44 009/0000118688/ HYPERTENSION -HIGH BLOOD PREASURE 07/18/88 30325.25 129318.47 163943.41 020/0000086888/ TWISTED/LT.KNEE W GOING INTO SHOWER HE SLIPPED. 07/18/88 108584.55 96578.00 217918.00 014/0000101088/ HEARING LOSS WHILE PRACTICING SHOOTING. 08/19/88 12162.63 1290.00 14253.43 016/0000105988/ TWISTED/RT KNEE/RUN OVER RT FOOT BY CAR 09/03/88 125759.47 204028.71 334333.93 016/0000115188/ HEART/WHILE MAKING ARREST FELT A PAIN 09/03/88 136951.84 194016.00 335006.68 016/0000115188/1 HEART/WHILE MAKING ARREST FELT A PAIN 09/03/88 0.00 79652.60 79652.60 020/0000108388/ HYPERTENSION, HIGH BLOOD PRESSURE. 09/15/88 22741.03 7568.00 31872.23 014/066593 / SPRAINS/BACK KNEE/CLM. WAS THREATNED BY K9 DOG 10/06/88 1721.60 189947.00 191688.60 014/066593 /1 SPRAINS/BACK KNEE/CLM. WAS THREATNED BY K9 DOG 10/06/88 0.00 75357.89 75357.89 016/0000005589/ HEART ATTACK 10/20/88 63028.50 4386.00 67461.00 016/0000012589/ CHEST PAIN/EXPERIENCE SHORTNESS OF BREATH & PAIN 11/14/88 99131.79 72977.12 174651.81 016/0000012589/1 CHEST PAIN/EXPERIENCE SHORTNESS OF BREATH & PAIN 11/14/88 632.49 37379.37 38011.86 00315 CITY OF MIAMI 1. CLAIM DETAIL ANALYSIS Page 5 of 33 ryl C Cl C: I< Ly CL .a AS OF 03/20/03 PAGE https://www.claimsuite.netIClaimsPortlservleticom.csedge.claimsport.mcm.PendingDetailLookupServlet?runType=1 &function=... 3/20/2003 CLM DETAIL (Landscape) 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE CLAIM NUMBER DESC OF LOSS - KEY 3 LOS.DATE MED/BI-PTD IND/PD-PTD TOTAL -PAID 009/0000018789/ STRAIN/RT HIP/MISSED A STEP COMING DOWN STAIRS 12/08/88 30133.82 243479.72 277053.59 009/0000018789/* STRAIN/RT HIP/MISSED A STEP COMING DOWN STAIRS 12/08/88 0.00 97875.64 97875.64 016/0000029089/ CARDIAC ARRYTHMIA 01/10/89 87522.09 5068.00 93274.19 016/0000043889/ HYPERTENSION/DX DURING A BLOOD DRIVE 01/30/89 14591.38 0.00 14884.73 009/0000043289/ HEART/DURING REGULAR PATROL BEGAN FEELING DIZZY 02/02/89 10100.73 0.00 10120.98 014/0000048889/ HEART PROBLEMS 02/03/89 59687.61 0.00 59811.86 020/0000050289/ SPRAIN/LT.KNEE SLIPPED ON GREASE ON THE GROUND. 02/14/89 84606.36 73124.00 160313.65 014/0000057089/ CONTUSIONS/LOWER BACK TRIPPRD OVER CEMENT & FELL 03/07/89 165123.55 242178.00 415346.30 014/0000057089/1 CONTUSIONS/LOWER BACK TRIPPRD OVER CEMENT & FELL 03/07/89 0.00 74221.29 74221.29 020/0000057889/ STRAIN/BACK SLIPPED AND TWISTED HIS BACK 03/14/89 17463.42 724.00 19739.43 016/0000060189/ CHEST PAINS EXPERIENCED WHILE DRIVING TO WORK 03/19/89 33935.44 9864.50 46115.44 014/0000084789/ CONTUSION/BACK FELL OFF CHAIR AT BACK GATE 05/09/89 37632.62 7674.40 46580.78 016/0000080689/ CONTUSIONS/MULTIPLE INVOLVED IN VEH. ACCIDENT. 05/17/89 25217.80 79107.60 104496.10 014/0000084689/ STARTED FEELING CHEST PAIN W/IN PATROL BOAT. 06/04/89 172355.10 259802.36 436292.26 014/0000084689/1 STARTED FEELING CHEST PAIN W/IN PATROL BOAT. 06/04/89 0.00 38700.00 38700.00 014/0000084689/2 STARTED FEELING CHEST PAIN W/IN PATROL BOAT. 06/04/89 0.00 0.00 0.00 009/0000095889/ STRAIN/ BACK PO TRIED TO PUSH VHCLE BACK 06/08/89 17986.41 0.00 19329.96 014/0000086089/ CUT & CONTUSIONS/MULTIPLE INVOLVED VEH. ACCIDENT 06/09/89 62690.90 12217.50 75498.15 016/0000089489/ FRACTURE/MULTIPLE INVOLVED IN VEH. ACCIDENT 06/13/89 164281.62 260013.45 426712.18 016/0000089489/* FRACTURE/MULTIPLE INVOLVED IN VEH. ACCIDENT 06/13/89 0.00 72514.00 72514.00 014/0000104189/ HYPERTENSION 06/14/89 22921.94 0.00 23432.26 009/05891 / DIAGNOSED AS HAVING HYPERTENSION 06/20/89 5285.52 39458.00 44789.74 014/0000098489/ STRAIN/MULTIPLE STEPPED ON A ROTTEN BOARD & FELL 06/23/89 71216.81 132492.00 206799.68 009/0000094589/ FRACTURE/RT.CLAVICLE INVOLVED IN VEH. ACCIDENT 06/30/89 25080.11 2896.00 27996.61 016/0000105389/ STRAIN/RTKNEE CARRYING GENERATOR SLIPPED 07/05/89 22882.80 182197.40 207679.65 014/0000132389/ HYPERTENSION 07/13/89 34594.63 0.00 35045.48 014/0000132089/ HYPERTENSION/DIAGNOSED DURING ANNUAL PHYSICAL 07/31/89 9113.71 0.00 9153.30 020/0000118289/ HIGH BLOOD PRESSURE/HEART PHYSICAL EXAMINATION 08/02/89 16589.79 0.00 16609.79 020/0000112589/ SPRAIN/LT SHOULDER FELL ON MOTORCYCLE SLIPPERYRD 08/12/89 21549.78 3258.00 25575.13 014/0000126089/ HIGH BLOOD PRESSURE/DIAGNOSED D ANNUAL PHYSICAL 08/15/89 25469.99 0.00 25490.49 020/0000121089/ HYPERTENSION/HEART 09/05/89 64610.27 90.50 65426.57 009/0000130689/ DIZZINESS CAUSED PROBABLY BY CAR ACCIDENT. 09/15/89 7776.07 0.00 7819.29 014/266702694 / HYPERTENSION/HEART, ANNUAL CHECK UP 09/18/89 24842.86 0.00 24873.61 020/0000128289/ HYPERTENSION/HEART 09/27/89 17274.71 90.50 17823.17 014/261645650 / HEARING LOSS/EARS EXPOSED TO DIFFERENT NOISES. 10/04/89 2129.00 0.00 2144.00 009/267514343 / DIAGNOSED AS HAVING HYPERTENSION BY HIS PHYCICIA 10/05/89 32682.69 0.00 32984.54 009/179263198 / HYPERTENSION/DIAGNOSED AT HIS LAST PHYSICAL 10/06/89 27138.47 0.00 27349.29 016/266864458 / STRAIN/BACK, WHILE LIFTING WEIGHTS IN FITNESS 10/06/89 67787.21 148329.50 221558.76 016/266864458 /1 STRAIN/BACK, WHILE LIFTING WEIGHTS IN FITNESS 10/06/89 633.00 57616.00 58254.00 016/264476841 / BRUISES/RT.LEG HIT HIMSELF WITH A BARREL 10/09/89 3646.41 133260.02 141508.03 016/264476841 /1 BRUISES/RT.LEG HIT HIMSELF WITH A BARREL 10/09/89 0.00 91046.23 91046.23 009/026321530 / DURING ANNUAL PHYSICAL HYPERTENSIN WAS DIAGNOSED 10/11/89 22998.90 0.00 23313.65 016/264213609 / STRAIN/BACK A VEH.LOST CONTROL, HIT HIS MOTORCYC 10/26/89 34720.88 170599.59 207161.47 016/583803459 / CONTUSIONS/KNEESSLIPPED ON GRAVEL SURFACE & FELL 10/26/89 78128.35 27240.50 108685.78 016/261403220 /2 STRAIN/BACK W LIFTING BAGS OF ITEM INTO TRUCK 11/02/89 7983.04 110388.18 119147.57 014/265602509 / HYPERTENSION/HEART, DISCOVERED DURING STRESSTEST 11/07/89 24268.97 0.00 24349.16 009/264452223 / SPRAINS & BRUISES/MULTIPLE INVOLVED IN VEH.ACCID 12/21/89 39669.28 9774.00 50138.78 009/580545330 /2 CONTUSIONS/LT. KNEE INVOLVED IN VEH. ACCIDENT 02/01/90 78804.86 268077.20 361141.45 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS Page 6 of 33 �3C AS OF 03/20/03 PAGE https://www.claimsuite.net/ClaimsPortlserviet/com.csedge.claimsport.mcm.PendingDetailLookupServlet?runType=1 &function=... 3/20/2003 CLM DETAIL (Landscape) 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS Page 7 of 33 AS OF 03/20/03 PAGE 6 CLAIM NUMBER DESC OF LOSS - KEY 3 LOS.DATE MED/BI-PTD IND/PD-PTD TOTAL -PAID 016/022692 / HEART/DIAGNOSED WITH HYPERTENSION 02/02/90 6779.90 0.00 6914.46 014/261376085 / STRAIN/BACK ATTEMPTING TO BREAK A DOOR AT A FIRE 03/04/90 7056.00 0.00 7356.50 016/263590350 / CUT/MULTIPLES INVOLVED IN VEHICLE ACCIDENT 03/09/90 78257.86 23493.00 101892.18 016/45290 / HEART/CHEST PAINS, WHILE IN CAR, EATING 03/12/90 93326.49 191477.50 290888.57 016/45290 /1 HEART/CHEST PAINS, WHILE IN CAR, EATING 03/12/90 0.00 53941.00 53941.00 009/262687338 / STRAIN/LT KNEE, INVOLVED IN VEH. ACCIDENT 03/13/90 3689.66 0.00 3709.66 014/079604546 / CONTUSION/RT.SIDE OF BODY, SLIPPED & FELL. 03/16/90 10412.59 5008.79 15463.38 020/46590 / CHEST PAIN/HOSPITALIZED W/ HYPERTENSION 03/23/90 12739.27 382.00 13146.29 016/103390 / STRAIN/LT.KNEE WHILE PLAYING BASKETBALL 04/06/90 98668.09 221721.75 323559.92 016/103790 / RESPIRATORY/HEART PHYSICAL FITNESS 04/16/90 39006.43 248777.50 288624.68 016/103790 /1 RESPIRATORY/HEART PHYSICAL FITNESS 04/16/90 130.23 64982.00 65117.23 009/113290 / ABNORMAL PHYSICAL/POSS. BLOCKAGE OF MAIN ARTERY. 05/21/90 27696.62 916.80 28634.42 009/46990 / HEART/DIAGNOSED AT ANNUAL PHYSICAL EXAM 05/24/90 38855.55 103056.00 141996.45 020/58390 / BRUISES/MULTIPLE W DRIVING TRUCK IT FLIPPED OVER 06/07/90 131856.83 75476.02 213309.12 020/58390 /1 BRUISES/MULTIPLE W DRIVING TRUCK IT FLIPPED OVER 06/07/90 0.00 33248.95 33248.95 020/78190 / HEARING LOSS/DUE TO REPEATED TRAUMA. 08/01/90 10422.00 33525.00 43967.00 016/121690 / ABNORMAL ECHOCARDIOGRAM DURING PHYSICAL 08/14/90 10393.07 0.00 11252.82 016/119890 / HEARING LOSS DUE TO PROLONG EXPOSURE TO NOISES. 09/25/90 23804.70 0.00 23824.70 009/53691 / HIGH BLOOD PRESSURE/DURING ANNUAL PHYSICAL 10/01/90 6475.25 0.00 6511.50 016/15591 / DIAGNOSED AS HAVING HIGH BLOOD PRESSURE. 10/26/90 14082.59 0.00 15125.17 009/11391 / STRAIN/LT.KNEE TWISTED,STEPPED ON UNEVEN SIDEWAL 11/15/90 29119.32 190691.16 222065.14 009/11391 /1 STRAIN/LT.KNEE TWISTED,STEPPED ON UNEVEN SIDEWAL 11/15/90 . 0.00 61957.88 61957.88 009/11991 / STRAIN/MULTIPLE FELL OFF FROM A WHEELECHAIR. 11/21/90 11039.44 13981.20 25247.29 014/28891 / CONTUSION/BACK,WHEEL FELL OFF TRUCK & HIT HIM 11/22/90 71948.85 116557.75 189032.53 014/28891 /1 CONTUSION/BACK,WHEEL FELL OFF TRUCK & HIT HIM 11/22/90 0.00 42920.16 42920.16 014/16591 / CONTUSIONS/MULTIPLE FEEL DURING TRAINING EXERCIS 11/30/90 50306.31 9015.20 60041.01 016/19591 / HIGH BLOOD PRESSURE/NOTED DURING ANNUAL PHYSICAL 12/05/90 94191.20 2005.50 114319.54 016/105991 / HEART/DIAGNOSED WITH HYPERTENSION 12/17/90 17097.85 286.50 17460.68 020/21291 / STRAIN/RT KNEE,RESPONDING TO A KITCHEN FIRE 12/19/90 22345.23 2292.00 25269.59 009/27891 / CONTUSION/INVOLVED IN MVA 01/14/91 18603.85 5488.00 24133.85 009/38291 / CONTUSION/FACE, KNEES,ENTERING ELEVATOR,TRIPPED. 02/26/91 31477.23 7305.60 39398.58 009/41591 / BRUISES&CONTUSIONS/MUTLIPLE, MVA,STRUCK BLDG. 02/27/91 110481.98 12250.00 125386.89 009/103391 / SKIN CANCER/FACE ARMS,SHOULDERS,EXPOSURE TO SUN 03/05/91 9373.38 0.00 10230.63 020/44891 / STRAIN/NECK, BACK,PAYLOADER HIT HIS TRUCK. 03/08/91 70217.80 89042.56 164037.66 020/44891 /1 STRAIN/NECK, BACK,PAYLOADER HIT HIS TRUCK. 03/08/91 0.00 43243.20 43243.20 020/44891 /3 STRAIN/NECK, BACK,PAYLOADER HIT HIS TRUCK. 03/08/91 0.00 43775.95 43775.95 016/43091 / HEART ATTACK/CLMT SUFFERED HEART ATTACK 03/10/91 117932.99 146241.13 266721.27 016/43091 /1 HEART ATTACK/CLMT SUFFERED HEART ATTACK 03/10/91 64.76 52251.00 52320.76 020/47891 / CONTUSION/RT. SHOULD. SWEPER HIT WALL 03/22/91 52766.18 192883.09 250258.01 020/47891 /1 CONTUSION/RT. SHOULD. SWEPER HIT WALL 03/22/91 442.06 65272.56 65729.62 009/48091 / CONTUSION/LT KNEE,KICKED BY SUSPECT. 03/23/91 97039.46 201882.39 303657.46 009/48091 /1 CONTUSION/LT KNEE,KICKED BY SUSPECT. 03/23/91 0.00 41002.40 41002.40 020/47991 / FRATURE/RIBS,MULT.INJURIES,FELL FROM SCAFFOLD 03/25/91 105202.55 144612.86 257493.14 016/59891 / PASSED OUT/WHILE SITTING AT DESK. 05/08/91 73237.43 137491.53 216563.77 020/69491 / CHEST PAIN/HEART 05/09/91 205569.61 240766.40 454479.12 020/69491 /1 CHEST PAIN/HEART 05/09/91 0.00 55961.00 55961.00 020/69491 /2 CHEST PAIN/HEART 05/09/91 0.00 45675.00 45675.00 016/62591 / STRAIN/BACK, LIFTING PATIENT 05/12/91 21522.83 2744.00 24564.18 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE https://www.claimsuite.netIClaimsPortlservleticom.csedge.claimsport.mcm.PendingDetailLookupServlet?runType=1 &function=... 3/20/2003 M 0 CLM DETAIL (Landscape) 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE CLAIM NUMBER DESC OF LOSS - KEY 3 LOS.DATE MED/BI-PTD IND/PD-PTD TOTAL -PAID 009/68791 / FOREIGN DEBRIS/LT EYE,WHILE MOWING GRASS 06/03/91 46745.92 191053.33 239713.55 009/68791 /1 FOREIGN DEBRIS/LT EYE,WHILE MOWING GRASS 06/03/91 0.00 55493.00 55493.00 020/72891 / STRAIN/BACK,AFTER KNEELING DOWN FOR A LONG TIME 06/12/91 32519.61 27200.41 66230.10 014/72291 / HEART/DURING PHYSICAL SHOWED HIGH BLOOD PRESSURE 06/13/91 9186.64 98.00 9526.62 020/77791 / FRATURE/THORACIC VERTEBRAE,FELL FROM 2ND STORY 06/26/91 27324.87 44296.00 75197.87 016/88891 / CHEST PAIN/HEART 07/06/91 130343.25 208936.00 351378.45 009/82191 / HEART/DURING PHYSICAL,HIGH BLOOD P.WAS DIAGNOSED 07/09/91 5461.17 25287.08 30769.00 020/83191 / STRAIN/RT KNEE,TWISTED KNEE AS WAS ARRESTING SUS 07/10/91 48244.01 37512.25 89419.71 020/92891 / HYPERTENSION/DIAGNOSED BY DOCTOR. 08/15/91 3567.75 0.00 3598.75 020/94891 / HEART/ABNORMALITIES DURING ANNUAL PHYSICAL 08/21/91 14302.66 0.00 14411.21 014/99791 / POSSIBLE SKIN CANCER/FACE,HANDS,ARMS,POLICE WORK 09/04/91 1812.76 0.00 1843.01 020/037492 / HYPERTENSION/HEART 09/05/91 8445.20 0.00 8470.20 009/98791 / HEART/DIAGNOSED WITH HIGH BLOOD PRESSURE 09/06/91 83247.94 49980.00 137173.58 016/100391 / STRAIN/RT SHOULDER, MID.BACK,PULLING ROPE 09/09/91 61935.83 20678.00 84917.48 014/99491 / HIGH BLOOD PRESSURE/DIAGNOSED DURING ANNUAL PHYS 09/11/91 32397.64 6664.00 39117.80 018/104391 / HEART/DURING PRIVATE SURGERY,EKG WAS ABNORMAL 09/16/91 3513.65 2156.00 5707.05 009/022792 / HYPERTENSION/DIAGNOSED BY DOCTOR 09/19/91 19768.96 0.00 20253.96 009/105891 / STRAIN/LOW BACK,RETURNING FROM P.L. TRIPPED/FALL 09/30/91 3629.07 13328.00 17043.94 009/024892 / STRAIN/BACK,WORKING IN A SMALL STAHL 12/26/91 43318.82 3136.00 51928.58 014/026392 / PASSED OUT/WORKING AT STATION/DIAG.HIGH BLOOD P. 01/05/92 17368.68 818.00 18517.20 016/029292 / CONTUSION/LT HIP,NECK,BACK,INVOLVED IN MVA 01/15/92 55892.04 54499.25 116874.78 014/034092 / STRAIN/NECK,BENT DOWN TO SEARCH UNDER VEHICLE 02/02/92 59997.74 22495.00 83812.89 016/043692 / HYPERTENSION/DURING PHYSICAL EXAMINATION 02/13/92 21114.34 0.00 21145.14 016/043292 / STRAIN/NECK,BACK,INVOLVED IN MVA 03/13/92 53299.48 6544.00 67407.15 016/042892 / MULTIPLE CONTUSIONS/BACK,HIP,NECK,STRUCK BY MC 03/17/92 110530.99 10020.50 120814.46 020/046092 / TWISTED/RT. ANKLE JUMPING OUT OF TRUCK. 03/23/92 4302.46 2482.00 6804.46 016/047892 / STRAIN/BACK WHILE REMOVING LARGE OBJECTS 03/24/92 8541.56 409.00 8991.36 014/143792 / HEART/DURING ANNUAL PHYSICAL NOTICED ABNORMALITI 04/01/92 2850.90 0.00 2870.90 009/048592 / NECK/LOWER BACK PAIN INVOLVED IN MVA. 04/06/92 42404.85 6953.00 50106.94 016/049392 / STRAIN/BACK VEH.'S FRONT WHEEL FELL OFF. 04/07/92 28029.74 818.00 28979.34 016/092292 / NOSEBLEED (AS A RESULT OF HYPERTENSION) 04/22/92 25928.76 204.50 26161.76 014/090492 / SPRAIN/NECK & LOW BACK INVOLVED IN VEH. ACCIDENT 04/26/92 10164.92 42229.25 52964.87 016/095592 / HYPERTENSION/DIAGNOSED IN ANNUAL PHYSICAL 05/06/92 7558.01 0.00 7586.36 014/095192 / CRUSHED RT. FOOT WHILE CRANE WAS BACKING UP. 05/12/92 9955.42 27157.73 37221.30 016/095792 / STRAIN/BACK LIFTING A BIN, PULLED MUSCLE 05/20/92 10048.48 736.62 11186.80 020/110292 / HIGH BLOOD PRESSURE/DIAGNOSED ANNUAL PHYSICAL 06/15/92 14319.72 0.00 14339.72 020/141892 / HYPERTENSION/DIAGNOSED DURING ANNUAL PHYSICAL. 06/23/92 9795.22 0.00 9815.22 009/114092 / CONTUSION/RT.KNEE OPENING DOOR HIT HER KNEE 07/14/92 39262.81 27046.27 69188.13 020/117892 / CONTUSIONS/RT.ARM,WRIST,BACK SLIPPED ON OIL. 07/22/92 38104.00 33210.80 75195.35 016/124292 / HEART/HYPERTENSION DIAGNOSED ON ANNUAL PHYSICAL 08/11/92 48459.74 205236.20 259094.85 016/124292 /1 HEART/HYPERTENSION DIAGNOSED ON ANNUAL PHYSICAL 08/11/92 0.00 48218.18 48218.18 009/144292 / HYPERTENSION/DIAGNOSED DURING ANNUAL PHYSICAL 08/16/92 17435.09 103276.95 122538.06 009/127592 / SPRAIN/SHOULDERS,BACK FELL W STEPPING UNTO TRUCK 08/21/92 11448.31 6434.47 18426.03 020/131892 / STRAIN/LOW & MID BACK WHILE UNLOADING A TRUCK. 09/03/92 56683.86 60868.29 117624.75 014/136792 / CONTUSION/WHOLE SIDE OF LT. BODY HIT BY FENCE. 09/19/92 53987.06 33374.40 90393.90 016/020993 / CONTUSION/NECK & BACK HIT BY TRUCK'S BED. 10/02/92 69025.21 178107.15 251396.29 020/005993 / CONTUSION/LT. KNEE 10/12/92 38434.58 2045.00 40709.54 014/002093 / STRAIN/BACK AGGRAVETED A PREEXISTING BACK PROBLE 10/15/92 38329.07 12372.25 50884.12 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS 0_7 Page 8 of 33 AS OF 03/20/03 PAGE https://www.claimsuite.netIClaimsPortlservletlcom.csedge.claimsport.mcm.PendingDetailLookupServiet?runType=l &function=... 3/20/2003 CLM DETAIL (Landscape) 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 CLAIM NUMBER DESC OF LOSS - KEY 3 LOS.DATE MED/BI-PTD IND/PD-PTD TOTAL -PAID 020/002793 / STRAIN/LOWEOR BACK -TWISTED BACK W GETTING IN CAR 10/15/92 2427.39 1308.80 3756.19 020/006193 / CONTUSION/RT. SIDE & RT. FOOT FELL DOWN STAIRS 10/20/92 80336.57 126217.40 213867.97 014/011293 / SPRAIN/BACK WHILE CHASING SUSPECT ON FOOT. 11/22/92 31449.72 7466.50 40313.78 016/143192 / FRACTURED NOSE/TRIPPED & HIT HER NOSE ON A CHAIR 12/14/92 39235.16 145195.00 188189.42 016/143192 /1 FRACTURED NOSE/TRIPPED & HIT HER NOSE ON A CHAIR 12/14/92 0.00 42682.00 42682.00 016/016193 / STRAIN/LOWER BACK & LT. FOOT INVOLVED IN M.V.A. 12/24/92 41150.31 66295.15 112940.20 009/031293 / CONTUSION/BUTTER AND ARM SELIPPED AND FELL 02/08/93 16076.87 0.00 16114.07 009/025093 / STRAIN/RT. SHOULDER MOVING A 55 LBS. DRUM. 02/18/93 11640.44 340.00 12886.20 016/030493 / SPRAIN/RT.KNEE HIT KNEE AGAINST TRUCK 02/23/93 13643.33 4870.32 18758.19 014/041393 / STRAIN/BACK SLIPPED WHILE WALKING ON RAMP: 03/04/93 39264.76 211225.00 254100.64 014/041393 /1 STRAIN/BACK SLIPPED WHILE WALKING ON RAMP. 03/04/93 0.00 40519.91 40519.91 009/033293 / FOREIGN BODY/LT. EYE/ DUST FELL INTO HIS EYE 03/08/93 21722.14 2200.59 24599.83 014/036693 / STRAIN/LOWER BACK INJURED WHILE MOVING A PATIENT 03/09/93 13359.55 9243.75 22772.45 020/036293 / STRAIN/RT. KNEE STEPPED INTO A WATER HOLE 03/20/93 47047.45 24437.50 81279.65 014/038593 / SPRAIN/BACK PLACING A BOX IN CAR'S TRUCK CI 03/26/93 39098.35 7007.92 50203.60 014/038693 / STRAIN/NECK, & BACK INVOLVED IN VEH. ACCIDENT. 03/27/93 8916.65 3740.00 12692.38 014/048893 / HEART/ABNORMAL EKG DIAGNOSED DURING ANNUAL PHYSI 04/21/93 51030.66 69949.73 123054.50 009/051693 / CONTUSIONS/RT.KNEE,LT.ELBOW, ETC, MAKING ARREST 04/30/93 36802.56 8925.00 46223.76 014/019094 / STRAIN/NECK INVOLVED IN A VEHICLE ACCIDENT 05/18/93 588.60 204425.00 211303.58 014/019094 /1 STRAIN/NECK INVOLVED IN A VEHICLE ACCIDENT 05/18/93 0.00 35474.00 35474.00 016/059193 / STRAIN/LT. LEG A TRAFFIC VIOLATOR STRUCK HER. 05/30/93 15574.97 1785.00 17379.97 016/064093 / SPRAIN/LT.KNEE & LEG WHILE MAKING AN ARREST 06/19/93 5785.43 3400.00 9205.43 009/066093 / SPRAIN /MULTIPLE /SLIPPED ON A WATER SPOT 06/22/93 25927.26 244073.46 273015.78 009/066093 /1 SPRAIN /MULTIPLE /SLIPPED ON A WATER SPOT 06/22/93 0.00 42220.05 42225.05 009/066093 /2 SPRAIN /MULTIPLE /SLIPPED ON A WATER SPOT 06/22/93 0.00 121.41 121.41 016/004594 / HEART/CHEST PA./CONDUCTING ROLLCALL IN THE OFFC. 07/01/93 13201.28 850.00 14081.28 014/099693 / HYPERTENSION 07/08/93 17800.77 0.00 17825.77 016/072593 / CONTUSION/RT. KNEE W REMOVING A BOARD FROM VEH. 07/13/93 80407.76 203282.30 290016.08 016/072593 /2 CONTUSION/RT. KNEE W REMOVING A BOARD FROM VEH. 07/13/93 0.00 35682.00 35682.00 016/072593 /3 CONTUSION/RT. KNEE W REMOVING A BOARD FROM VEH. 07/13/93 0.00 99800.00 99800.00 009/076093 / STRAIN/RT. SHOULDER LIFTING GARBAGE CAN. 07/26/93 10355.71 3413.26 13788.97 009/078093 / STRAIN/PHYSICAL TRAINING AGGRAVATED OLD INJURY 07/26/93 15915.21 0.00 16023.21 014/077493 / HEART/COMPLAINED OF CHEST PAIN WHILE ON DUTY. 08/01/93 86845.69 145817.50 234513.82 014/077493 /1 HEART/COMPLAINED OF CHEST PAIN WHILE ON DUTY. 08/01/93 0.00 32241.60 32241.60 016/077893 / HEART/NERVE CONDUCTION DISORDER 08/02/93 51281.14 86125.00 137426.14 014/081393 / RT ANK-WRIST-IND FING-ARM-WHILE RESC DRWN VICTIM 08/03/93 1031.35 425.00 1476.35 016/092093 / HYPERTENSION 08/03/93 8108.24 0.00 8485.54 009/070894 / INJURED WHILE ON DUTY 08/04/93 25208.20 8175.00 34123.20 020/078893 / CHEST,LT ARM/POSSIBLE HEART,DRIVE AND FEEL PAIN 08/04/93 74196.77 175950.00 254935.62 009/032994 / RESPIRATO/HEART STARTED HAVING IRREGULAR BEATS 08/13/93 4909.81 0.00 5893.71 009/080093 / HIGH BLOOD PRESSURE/ANNUAL PHYSICAL 08/17/93 6227.48 0.00 6423.48 020/080393 / STRAIN/LOWER BACK FELT PAIN W WALKING UPSTAIRS. 08/25/93 10140.91 2762.50 12923.41 020/087193 / STRAIN/RT. KNEE TRIPPED OVER A WIRE. 08/25/93 7577.16 14726.00 22323.16 020/087293 / HEART/CORONARY HEART DISEASE ANNUAL PHYSICAL. 08/27/93 65836.65 196753.02 263102.03 014/095193 / MULTI INJURED BOTH KNEES/RT. ARM/LOWER BACK 09/27/93 74543.58 850.00 75848.69 014/000194 / HEART/ABNORMAL STRESS TEST 10/05/93 137654.48 182155.00 328814.28 014/000194 /1 HEART/ABNORMAL STRESS TEST 10/05/93 841.60 35978.60 36825.20 016/035694 / HYPERTENSION/HEADACHE, TENSION 10/09/93 5624.46 765.00 6409.46 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS Page 9 of 33 AS OF 03/20/03 PAGE https://www.claimsuite.netIClaimsPortlservleticom.csedge.claimsport.mcm.PendingDetailLookupServiet?runType=1 &function=... 3/20/2003 GO M M 0 CLM DETAIL (Landscape) 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 CLAIM NUMBER DESC OF LOSS - KEY 3 LOS.DATE MED/BI-PTD IND/PD-PTD TOTAL -PAID" 009/004994 / STRAIN/LOWER BACK/CHASING A SUBJECT PULL MUSCLE 10/19/93 15622.66 425.00 16116.62'„ 016/013294 / HYPERTENSION 10/28/93 19270.28 0.00 20109.28 016/014994 / HYPERTENSION 10/29/93 5786.85 0.00 5816.62 " 016/011694 / INJURED RT KNEE/SLIPPED ON OIL 10/30/93 17411.06 4250.00 21686.06-1 020/008894 / HYPERTENSION/DIAGNOSED DURING ANNUAL PHYSICAL 11/09/93 5571.83 0.00 5591.83 014/006794 / STRAIN/MULTIPLE/FLEW INTO THE BACK OF A CAR 11/13/93 41352.02 10412.50 . 53269.19 016/011594 / SPRAIN/RT. KNEE, ELBOW TRIPPED OVER A TREE 11/23/93 30050.48 25925.00 58752.43 020/011794 / TWISTED LOWER BACK/CHECKING FIRE TRUCK 11/24/93 17275.42 5100.00 22438.02 •< 016/042694 / DIAGNOSED WITH HEPATITIS "C". 11/30/93 33909.44 1381.25 35317.29 014/017194 / HYPERTNESION 12/08/93 4071.86 0.00 4101.86 y; 016/016594 / SPRAIN/RT. LEG SLIPED ON AIRHOSE. 12/14/93 70045.26 192950.00 263032.26 016/016594 /1 SPRAIN/RT. LEG SLIPED ON AIRHOSE. 12/14/93 0.00 38822.00 38822.00 i 014/023594 / INJURED RT KNEE/RESCUEING SOMEONE FROM A VEHICLE 12/23/93 22081.49 4887.50 26990.09 016/025994 / CONTUSION/LT.KNEE, FOOT,WRIST SLIPPED & FELL. 01/14/94 39446.42 9392.19 52727.84 016/029394 / STRAIN/BACK/LIFTING CARTON OF PAPER 01/18/94 23192.03 9057.60 32328.20 016/028194 / RESPIRATORY/LUNGS/INHALLED GAS FUMA 01/25/94 6418.44 0.00 6438.44 020/028594 / HYPERTENSION/BLOOD PRESSURE 01/25/94 6852.99 0.00 6872.99 016/037194 / STRAIN/LOWER BACK/RUNNING AFTER BURGLAR 02/09/94 45718.76 7992.00 54397.16 014/042094 / CONTUSION /MULTIPLES CAR ACCIDENT M.V.A 03/18/94 15694.47 4440.00 21029.46 014/104694 / HYPERTENSION DISEASE 03/26/94 39004.17 222162.14 261684.61 014/104694 /1 HYPERTENSION DISEASE 03/26/94 0.00 27504.53 27504.53 016/054994 / HEART DISEASE/HEART DETECTED DURING ANNUAL PHYSI 03/31/94 43910.97 15984.00 59914.97 009/091194 / HIGH BLOOD PRESSURE/HYPERTENSION 04/06/94 6405.25 0.00 6425.25 016/049494 / SCRATC./RT.KNEE ASSIST.TO FIGHT CAUGHT WIT.METAL 04/07/94 34938.15 33300.00 81427.06 016/093994 / CERVICAL DISCOGNETIC SYNDROME 04/18/94 50821.29 10434.00 66865.62 009/058894 / EXPOSURE/BOTH EARS SHOOTING AT GUN RANGE FEW 04/28/94 3826.00 0.00 3852.10 020/061094 / BRUISED/HEART,RT. ANKLE,SHOULDERS,(MERCY,CORCES) 05/04/94 15494.73 6216.00 21790.45 016/058494 / HEART/ HEART ATTACK 05/10/94 29972.45 107498.00 141514.13 014/065294 / CONTUSION/HEAD (DR. RAMIREZ 856-3592) 05/23/94 15398.09 5481.15 21031.24 009/066194 / HIGH BLOOD PRESSURE (DR GUERRA) 05/24/94 12328.38 0.00 12524.38 014/064894 / CONTUSION/HEAD,ARM,NECK,KNEE RT.BREAST 05/25/94 5138.58 6869.90 12259.53 014/072094 / HYPERTENSION 05/25/94 51548.55 149872.98 206769.77 014/072094 /2 HYPERTENSION 05/25/94 0.00 25531.77 25531.77 018/04922000 / HYPERTENSION/HEART 06/01/94 4179.21 9324.00 15056.88 009/070994 / STRAIN/LOWER BACK (DR MILLHEISER) 06/13/94 47739.28 119926.86 176892.32 009/070994 /2 STRAIN/LOWER BACK (DR MILLHEISER) 06/13/94 0.00 27394.00 27394.00 009/071494 / SPRAIN/RT KNEE (CEDARS ER) 06/15/94 25095.29 53119.80 80336.75 009/071994 / HYPERTENSION (DR. MARRACCINI 666-8858) 06/15/94 102417.24 101676.00 204223.39 014/72494 / STRAIN/NECK AND BACK 06/18/94 53139.13 28774.00 81978.63 016/105094 / PHY WHIGH BLOOD PRESSURE 06/29/94 9242.21 0.00 9263.31 014/080194 / CONTUSION RIGHT SIDE 07/12/94 311.35 0.00 331.35 014/078194 / SPRAIN/RT HAND,FINGER 07/13/94 28892.72 3996.00 32970.52 020/076794 / HYPERTENSION 07/13/94 7899.63 444.00 8363.63 016/081194 / HIGH BLOOD PRESSURE 07/14/94 3474.35 0.00 3494.35 016/083594 / SPRAIN MIDDLE SECTION OF BACK 07/18/94 15605.75 3996.00 19729.90 009/077394 / HIGH BLOOD PRESSURE 07/20/94 38215.59 177958.13 221065.70 009/077394 /1 HIGH BLOOD PRESSURE 07/20/94 0.00 29664.00 29664.00 014/077794 / SWOLLEN LEFT ANKLE/ 07/26/94 6879.46 2220.00 9147.18 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS Page 10 of 33 AS OF 03/20/03 PAGE https://www.claimsuite.netIClaimsPordservietlcom.csedge.claimsport.mcm.PendingDetailLookupServlet?runType=1 &function=... 3/20/2003 CLM DETAIL (Landscape) 00315 CITY OF MIAMI CLAIM NUMBER 014/088394 / 020/087894 / 009/014195 / 016/093494 / 014/097794 / 016/103894 / 020/001195 / 009/004295 / 014/007495 / 014/007495 /1 009/057095 / 016/021195 / 014/027495 / 016/020095 / 016/021595 / 009/024695 / 009/028695 / 020/107395 / 016/032595 / 020/036395 / 016/031995 / 020/036495 / 009/045495 / 014/037695 / 020/044195 / 009/107595 / 009/072495 / 009/052895 / 016/053295 / 009/057295 / 009/063595 / 009/071695 / 009/107495 / 016/065895 / 016/073195 / 020/076795 / 016/078195 / 020/079395 / 021/069199 / 020/003096 / 014/079695 / 020/086295 / 014/086595 / 016/008596 / 009/004196 / 016/005196 / 014/002896 / 021/003696 / CLAIM DETAIL ANALYSIS DESC OF LOSS - KEY 3 SPRAIN LOWER BACK/NECK SMOKE INHALATION HYPERTENSION FRACTURED VERT.(T-1), HIGH PULSE, DEHYDRATED CONTUSIONS RIGHT ELBOW/HEAD/RIGHT KNEE HYPERTENSION HYPERTENSION CONTUSIONS/HANDS/KNEES/RT ANKLE HYPERTENSION HYPERTENSION SPRAIN/STRAIN/RIGHT FOOT/MT.SINAI/DR. LEEDS DIAGNOSIS HIGH BLOOD PRESSURE/HYPERTENSION HIGH BLOOD PRESS. YEARLY PHY'L B.P. HIGH ALSO HYPERTENSION/HGH BLOOD PRES 170/104/DR.SPIVACK CERVICAL AND LUMBAR STRAIN LEFT EAR RINGING/LACK OF HEARING HYPER/H.BLOOD 150/100/DR.VANDENBOSCH/261-0445 HYPERTENSION/HEART/MT.SINAI/DR.BOROS/DR.WILBUR HYPERTENSION HYPERTENSION PAIN LOW BACK CHEST PAINS/DIZZINESS/HIGH BLOOD PRESSURE SPRAIN RIGHT HAND & FOREARM/PAIN/FINGERS & SHLDR SPRAIN LOWER BACK/DR. FRED SMITH 407-687-1878 SPRAIN LOWER BACK/MT. SINAI CARDIAC PROBLEM/HEART/DR.ROSENBERG/UNIV OF MIAMI STRAINED TENDON/RT. ELBOW/ARM SPRAIN LOWER BACK CHEST PAINS/HEART SPRAIN LOWER BACK/CEDARS E.R. PAIN/LOWER BACK HIGH BLOOD PRESSURE EARS/HEARING LOSS/MIAMI HEARING CENTER & MERCY TWISTED/SPRAIN/RIGHT KNEE/DR.SELESNICK/662-2426 BODY WEAKNESS/PVC/HEART SHARP PAIN IN LOWER BACK/DR. ENNIS STRAIN TO LEFT LEG LUMP TO LEFT UPPER FOREHEAD/MT. SINAI/METRO D. HIGH BLOOD PRESSURE DIAGNOSIS ANNUAL PHYSICAL/ABNORMALMITIES OF HEART STRAIN/LEFT SHLDR/ARM/TORSO/NECK/BACK HEART ATTACK/90% ARTERY BLOCKAGE STRAIN LEFTSIDE NECK AREA SUSTAINED INJURIES TO STRAIN/SPRAIN/RIGHT HIP SPRAIN/STRAIN LOWER BACK SPRAIN RIGHT THUMB/DR. ORBAY 661-3000 SPRAIN LEFT KNEE 11 00315 CITY OF MIAMI LOS.DATE 08/15/94 08/28/94 09/01/94 09/05/94 09/14/94 09/22/94 09/29/94 10/13/94 10/15/94 10/15/94 11/21/94 12/14/94 12/19/94 12/24/94 01/04/95 01/10/95 01/10/95 01/19/95 01/22/95 02/15/95 02/19/95 02/21/95 03/01/95 03/08/95 03/27/95 03/29/95 04/18/95 05/04/95 05/05/95 05/10/95 06/07/95 06/12/95 06/19/95 06/20/95 07/13/95 07/25/95 07/31/95 08/12/95 08/15/95 08/16/95 08/19/95 08/25/95 09/15/95 09/26/95 10/03/95 10/03/95 10/07/95 10/12/95 MED/BI-PTD 10602.29 10911.88 13203.29 57526.49 2983.21 13621.57 4610.35 26220.09 93259.42 0.00 6021.68 10670.31 4156.65 3246.89 25744.60 3819.71 25201.30 2436.43 10360.43 28751.88 14743.16 19514.92 8632.27 15015.04 13560.08 9680.66 8798.00 4478.24 30549.70 31013.01 30566.01 6018.28 1600.00 12299.40 8085.28 12125.35 14920.97 12790.83 5307.57 11666.13 10975.14 102778.17 5159.71 8354.10 26716.04 88556.84 602.94 79161.99 CLAIM DETAIL ANALYSIS IND/PD-PTD 13081.14 1776.00 666.00 50279.68 0.00 111.00 555.00 6660.00 107448.00 10964.00 222.00 12166.77 0.00 111.00 8358.00 3397.50 0.00 0.00 2378.25 4643.25 8885.13 453.00 2042.90 4437.25 20951.25 0.00 226.50 9060.00 5889.00 76670.25 3003.20 0.00 0.00 6002.25 10192.50 6708.88 3575.88 5209.50 4934.77 4985.08 8334.50 6568.50 792.75 6228.75 11551.50 15175.50 1602.28 34368.91 AS OF 03/20/03 PAG TOTAL -PAID 24231.19 12707.88 13889.29 108720.47 3683.21 13770.64 5361.35 34280.19 214757.88 10964.00 6371.28 22857.08 4176.65 3387.19 34182.60 7237.21 26051.30 2459.13 12760.88 33415.13 23681.50 19989.02 10840.43 20113.39 34532.43 9876.66 9085.30 13560.44 39317.04 113686.95 33596.03 6214.28 1600.00 19177.25 18358.45 18854.23 18516.85 18263.28 10277.25 16777.11 20479.60 109874.75 5999.94 14602.85 42161.78 103945.84 2225.22 113725.52 Page 11 of 33 AS OF 03/20/03 PAGE 10 https://www.claimsuite.netIClaimsPortlservleticom.csedge.claimsport.mcm.PendingDetailLookupServlet?runType=1 &function=... 3/20/2003 d+ M M C> CLM DETAIL (Landscape) Page 12 of 33 1 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE 11 M CLAIM NUMBER DESC OF LOSS - KEY 3 LOS.DATE MED/BI-PTD IND/PD-PTD TOTAL -PAID 016/010596 / CHEST PAINS 10/14/95 108768.28 173272.50 287296.55 016/010596 /1 CHEST PAINS 10/14/95 0.00 27233.00 27233.00�.M, 020/010896 / CONTUSION LEFT HAND/PINKY FINGER 11/08/95 48718.38 24116.40 82162.55 'R' �'`" ' Q 020/010996 / CONTUSION TO RIGHT FOOT 11/11/95 2524.57 5322.75 8043.32 C? 014/018696 / SPRAINED BACK/NECK/HEAD 12/06/95 26141.41 18803.50 45863.77 009/016996 / STRAIN/SPRAIN/ABRASION LEFT ELBOW & BACK 12/11/95 12471.96 8821.49 22612.40 014/022496 / TWISTED RIGHT KNEE 01/04/96 4316.89 3487.50 7837.29 g� 014/024896 / PAIN IN BUTTOCKS/RT. HIP/BACK 01/18/96 20203.29 16275.00 48393.31 rf== k 009/044496 / HEARING LOSS IN BOTH EARS/MIAMI HEARING CON INC 01/19/96 4822.00 0.00 4907.10 �" J 016/027396 / HEART ATTACK/DIFFICULTY SLEEPING 01/28/96 21558.70 9300.004 35206.70 4 j 0 016/034896 / SPRAIN/LOWER BACK & ELBOW 01/30/96 12681.69 0.00 12738.28 020/029496 / NECK/LOW BACK/RT SHLDR/ABDOMEN/RT KNEE/LEFT LEG 01/31/96 13695.99 1395.00 15110.99m s, da 020/039096 / CHEST PAINS 02/01/96 43547.53 48243.75 97399.67 Cl 014/031996 / PAIN IN LOWER BACK02/05/96 19400.40 0.00 19602.53 014/021797 / HYPERTENSION/HEART/HIGH BLOOD/DR CENTURION 02/12/96 7907.66 0.00 7946.92 L 020/038396 / SHARP PAIN RIGHT SIDE OF BACK 03/01/96 27753.24 31813.91 60030.74 014/037296 / SPRAIN RT. KNEE/DR ANTUNE2/THROMBOSIS 03/11/96 65362.23 46848.75 113222.98 020/038996 / SPRAIN/PULLED MUSCLE/RT. SHOULDER/DR. S. RAMIRE 03/11/96 98353.31 51615.00 152882.24 016/043096 / CONTUSION TO RIGHT HIP 03/21/96 127169.90 10881.00 138873.70 009/040296 / STRAIN/SPRAIN RIGHT SIDE/SHOULDER/BUTTOC 03/22/96 19898.32 12903.75 32822.07 020/015197 / CORONARY ARTERY DISEASE/HEART 04/01/96 22965.09 930.00 24114.22 016/044796 / LOWER BACK 04/03/96 15979.86 1370.94 21366.50 009/046696 / HIGH BLOOD PRESSURE/CHEST PAINS/CIRCULATORY SYS. 04/04/96 46238.40 33945.00 82493.73 016/057396 / HERNIA/GROIN AREA 04/05/96 49717.46 10427.46 60837.82 014/079196 / CHEST PAINS 04/09/96 6215.45 930.00 7165.45 020/050296 / TWISTED BACK 05/02/96 81858.63 146405.25 230035.04 009/056596 / ANNUAL PHY'L DETECTED HIGH BLOOD PRESSURE 05/08/96 71591.36 5580.00 78424.72 020/057996 / HIGH BLOOD PRESSURE/HEART 05/08/96 1340.64 1860.00 3223.14 016/053596 / ELEVATED HIGH BLOOD PRESSURE 05/10/96 3556.74 465.00 4041.74 020/073296 / HYPERTENSION 05/29/96 97091.46 135901.13 237348.35 020/073296 /1 HYPERTENSION 05/29/96 0.00 18258.84 18258.84 020/073296 /2 HYPERTENSION 05/29/96 0.00 0.00 0.00 009/059496 / DIAGNOSED WITH HYPERTENSION/HEART 06/03/96 1394.36 0.00 1399.36 016/058696 / CONTUSION/RIGHT SHOULDER 06/03/96 3860.37 0.00 6971.85 009/060396 / HYPERTENSION/HIGH BLOOD PRESSURE 06/20/96 2975.53 0.00 3171.53 016/080796 / PAIN IN BACK/PAN AMERICAN HOSPITAL 06/29/96 20436.50 0.00 20456.50 016/068796 / HYPERTENSION 07/09/96 6885.91 0.00 6905.91 016/068396 / SPRAIN/STRAINED RIGHT SHOULDER 07/10/96 37135.84 44182.50 81338.34 020/067096 / CONTUSION/BACK/DR. FRANK HEMFLING 746-8789 07/10/96 24468.97 3371.25 28149.62 016/068596 / INJURED RIGHT HAND 07/12/96 78686.02 19413.75 100499.97 016/069496 / EXTREME PAIN IN LOWER BACK AREA/DR.C. VIRGIN 07/16/96 18749.81 52101.21 76987.56 009/071096 / SPRAIN LOWER BACK/NUMBNESS IN FEET 07/17/96 21003.75 7486.50 29384.31 009/075596 / STRAIN/SPRAIN LOWER BACK/DR.JOEL KALLAN,M.D. 07/19/96 38777.31 45267.88 91362.11 016/070796 / TWISTED RIGHT KNEE/PAIN & STIFFNESS 07/21/96 24993.35 10113.75 35127.10 016/074196 / HEART 07/25/96 79255.28 11160.00 90435.28 016/073396 / SHARP PAIN UPPER/LOWER BACK/RT ANKLE 07/31/96 23053.65 1395.00 24468.65 009/075296 / DISLOCATED/SPRAIN RIGHT SHOULDER/CERVICLE 08/07/96 6720.65 1395.00 8135.65 021/075796 / PAIN IN LOW BACK & NECK 08/13/96 16871.09 465.00 22077.80 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE 11 https://www.claimsuite.netIClaimsPortlservleticom.csedge.claimsport.mcm.PendingDetailLookupServlet?runType=1 &function=... 3/20/2003 CLM DETAIL (Landscape) Page 13 of 33 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/034 PGE `4 Q) CLAIM NUMBER DESC OF LOSS - KEY 3 LOS.DATE MED/BI-PTD IND/PD-PTD TOTAL -PAID L ." 016/014997 / HIGH BLOOD PRESSURE/CARDIO SYSTEM 08/23/96 2246.88 0.00 2270.56 c' `� >,, 009/110896 / HYPERTENSION 08/28/96 3620.52 0.00 3690.52 Y � 'q 016/079696 / CHEST PAINS/HEART 08/29/96 44407.00 10346.25 55464.63 009/081296 / SPRAIN/STRAIN NECK/DR. ELLIOTT GRUSKY 09/05/96 10763.85 0.00 10833.85+' 009/081196 / SPRAIN/BRUISES TO NECK/UPP'R BACK/BOTH KNEES 09/06/96 22246.93 16391.25 43928.57 009/084096 / ALLERGIC REACTION/COUGHING/TIGHT CHEST/LUNGS 09/14/96 15500.56 6510.00 22912.62 r 009/110096 / BACK PAIN 09/19/96 16960.05 0.00 17938.08 019/085396 / HEART/HYPERTENSION 09/19/96 7517.20 0.00 7539.59 t5 009/086296 / FRACTURED RIGHT RING FINGER 09/26/96 529.12 2515.54 3064.66 020/181366122 / PAIN AND NUMBNESS/RT. HAND/ROGER KHORI MD 10/01/96 7585.19 3487.50 11964.69 `ice 020/109096 / SEVERELY INFECTED/AMPUTATED LEFT PINKY TOE 10/03/96 3074.27 13672.12 16942.39 009/003897 / LOWER BACK/RIGHT FOOT/BODY CHILLS/NAUSEA 10/15/96 2669.08 809.47 3498.55 �� D 016/06552001 / STRAIN/MULTIPLE CONTUSIONS 10/23/96 0.00 0.00 207.00 020/007997 /1 CARDIAC ARREST/HEART ATTACK/WESTSIDE HOSPITAL 10/25/96 0.00 11111.00 11111.00 020/007997 /3 CARDIAC ARREST/HEART ATTACK/WESTSIDE HOSPITAL 10/25/96 0.00 11111.00 11111.00 016/005497 / SPRAIN/CONTUSION LOW BACK/BUTTOCKS/LEGS/THIGHS 10/26/96 37670.21 11625.00 49649.18 020/008097 / INJURED RIGHT WRIST 11/15/96 18139.07 3974.50 23490.92 014/009197 / BRUISES/CONTUSIONS TO LEFT LEG/LEFT ARM/BACK 11/29/96 13374.99 5347.50 18757.49 009/009297 / BRUISES/PAIN/BACK/CHEST/RT KNEE/ARMS/THIGHS 12/02/96 153177.01 208537.48 364810.67 020/025197 / HYPERTENSION/HEART 12/02/96 6969.25 697.50 7686.75 020/010697 / HYPERTENSION/HEART 12/05/96 8424.04 13950.00 22576.00 016/014597 / BROKEN RIGHT SHOULDER 12/10/96 14518.63 10074.85 28535.66 016/014597 /1 BROKEN RIGHT SHOULDER 12/10/96 0.00 17323.42 17323.42 020/011997 / NECK/BACK PAIN/DR. JAY STEIN 12/11/96 19905.55 7323.75 27779.30 014/011697 / RIGHT SHOULDER 12/13/96 4712.64 1395.00 6127.64 014/013097 / MULTIPLE CONTUSUIONS/FOREARM,BACK AND NECK 12/20/96 16174.09 4068.75 20422.96 016/013597 / PAIN IN LOWER BACK 12/23/96 39870.56 8951.25 49101.17 020/014297 / GUNSHOT WOUND TO BACK OF HEAD 01/01/97 95290.09 154597.25 249907.34 020/014297 /2 GUNSHOT WOUND TO BACK OF HEAD 01/01/97 0.00 17994.00 17994.00 020/016397 / INJURED LEFT LEG/CEDARS E.R. 01/13/97 51653.75 20650.88 72860.63 009/025897 / STRAIN LOW BACK/TORN LIGAMENT UPPER LEFT BUTTOCK 01/20/97 14998.98 25866.01 42251.99 020/016697 / MUSCLE PAIN/LEFT LEG/ HERNIATED DISC/CEDARS E.R. 01/20/97 70486.96 25387.00 95893.96 016/017497 / LACERATIONS/BRUISES RT. FOREARM/ELBOW & RT KNEE 01/23/97 366.01 0.00 1106.01 009/027397 / HEART/TARYACARDIAL/BROWARD GENERAL HOSPITAL 01/31/97 13616.89 79600.00 98236.89 009/027397 /1 HEART/TARYACARDIAL/BROWARD GENERAL HOSPITAL 01/31/97 0.00 8354.00 8354.00 009/027397 /2 HEART/TARYACARDIAL/BROWARD GENERAL HOSPITAL 01/31/97 0.00 8695.00 8695.00 009/027397 /3 HEART/TARYACARDIAL/BROWARD GENERAL HOSPITAL 01/31/97 0.00 8695.00 8695.00 009/027397 /4 HEART/TARYACARDIAL/BROWARD GENERAL HOSPITAL 01/31/97 0.00 8695.00 8695.00 016/022997 / LEFT SHOULDER/DR.ZVAJIC 02/23/97 42286.34 20836.50 64605.34 016/075697 / HYPERTENSION/ ENTIRE BODY/DEWEY KNIGHT MEDICAL 03/04/97 6910.34 0.00 6930.34 016/078897 / PALPITATIONS/HEART DR. A. FERNANDEZ 03/05/97 13534.80 958.00 14512.80 020/028097 / CONTUSION TO BOTH KNEES/BACK & NECK 03/16/97 51388.61 37122.50 89902.57 016/038897 / RT SIDE/WAIST/LEG/FEET-SEVERE PAIN/DR.S.RAMIREZ 03/17/97 2352.00 0.00 2432.00 016/033397 / NUMBNESS/SWELLING/PAIN IN RT WRIST & HAND 03/22/97 24881.79 9717.37 36685.66 016/047197 / CIRCULATORY SYSTEM 03/26/97 1272.00 3592.50 4884.50 014/032997 / MVA -MULTIPLE INJURIES/NECK/BACK/KNEES/LEFT SIDE 03/31/97 139191.04 118809.44 267416.85 014/032997 /2 MVA -MULTIPLE INJURIES/NECK/BACK/KNEES/LEFT SIDE 03/31/97 0.00 16482.00 16482.00 016/033497 / MVA-NECK/BACK/RT WRIST/RT KNEE -CEDARS HOSPITAL 04/09/97 0.00 0.00 98.98 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE 12 https://www.claimsuite.netIClaimsPordservleticom.csedge.claimsport.mcm.PendingDetailLookupServlet?runType=1 &function=... 3/20/2003 CLM DETAIL (Landscape) 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS Page 14 of 33 AS OF 03/20/03 PAGE _13 r LL t°J CLAIM NUMBER DESC OF LOSS - KEY 3 LOS.DATE MED/BI-PTD IND/PD-PTD TOTAL -PAID 014/266258312 / HYPERTENSION/DR. CENTURION 04/11/97 14891.35 1916.00 16833.25 020/047997 / HIGH BLOOD/ABNORMAL EKG (HEART) CIRCULATORY 04/23/97 15832.01 0.00 16028.01 009/039897 / RIGHT EAR PAIN 05/01/97 2401.44 0.00 2421.44 014/055097 / HIGH BLOOD PRESSURE/HYPERTENSION/DR.CENTURION 05/02/97 8410.46 0.00 8600.40 009/040097 / PAIN IN CHEST/LEFT ARM/HEADACHE & LEFT JAW 05/05/97 13305.99 479.00 13828.24 014/051897 / HIGH BLOOD PRESSURE/HEART 05/05/97 4005.37 0.00 4025.37 014/077697 / HYPERTENSION/HEART DR. GILMORE 05/07/97 2644.01 0.00 2664.01 016/040697 / HEART & HIGH BLOOD PRESSURE (150/100) 05/07/97 6857.68 479.00 8236.68 020/053397 / TWISTED SPRAIN/LEFT ANKLE & KNEE 05/10/97 23904.47 8592.45 32692.92 014/057897 / HYPERTENSION/HEART/HIGH BLOOD PRESSURE 05/20/97 17426.00 0.00 17446.00 014/066697 / HEARING LOSS/BOTH EARS/DR. TARKAN 05/28/97 2315.89 0.00 2335.89 014/048397 / SPRAIN RIGHT SHOULDER 06/09/97 20669.24 19960.38 40649.62 009/047597 / STRAIN/SPRAIN RIGHT GROIN/CEDARS E.R. 06/11/97 21477.25 54058.64 76737.49 014/261902326 / HEARING LOSS/DURING ANNUAL PHYSICAL 06/18/97 4288.00 0.00 4298.00 016/050897 / CONTUSIONS HEAD & LEFT KNEE & BACK PAIN 06/26/97 14555.85 16864.75 33205.31 014/056097 / SPRAIN LEFT KNEE/DR. RAMIREZ 07/09/97 1702.00 359.25 2081.25 014/054997 / HEARING LOSS/BOTH EARS 07/11/97 3751.00 0.00 3756.00 020/053297 / BODY/HEAD (HEART) 07/11/97 25745.34 9101.00 34866.34 009/055697 / STRAIN/SPRAIN LOWER BACK/DR. JAY STEIN 07/21/97 1773.88 0.00 1793.68 020/265621757 / HIGH BLOOD PRESSURE/GILMORE MD 07/29/97 20056.41 11975.00 32218.25 020/053799 / HYPERTENSION/HEART 08/11/97 4376.55 0.00 4401.20 014/060597 / SPRAIN LOWER BACK & NECK/DR. MENDELSSOHN 08/13/97 50558.93 42152.00 103208.11 009/062297 / HYPERTENSION/HIGH BLOOD PRESSURE (190/110)/MERCY 08/20/97 5600.67 479.00 6275.67 009/064697 / FRACTURED RIGHT ARM 08/22/97 23117.53 12933.00 36070.53 020/067097 / HYPERTENSION 08/26/97 22250.41 10921.20 33358.89 020/067497 / LOSS OF HEARING/DR. HORACIO GROISMAN 325-0090 09/05/97 9663.44 0.00 9683.44 014/067797 / HIGH BLOOD PRESSURE 170/100 HEART 09/11/97 2098.92 956.00 3556.92 014/071497 / HYPERTENSION/HEART DR. CENTURION 09/25/97 17968.92 5269.00 23299.26 014/073197 / PAIN IN CHEST/ SAW HIS DOCTOR 09/26/97 20653.56 0.00 20673.56 020/002598 / HEPATHIS C VIRUS/ LIVER/ DR. ANDRES COWLEY 10/06/97 36984.62 0.00 39019.22 020/016498 / HIGH BLOOD PRESSURE/DR. JIM HIRSCHMAN 10/17/97 3040.01 359.25 3419.26 014/004896 / PAIN/RT.ANKLE JACKSON 10/20/97 22913.33 7815.35 30757.20 020/020298 / PAIN/LT.KNEE/DR. BARRY 10/28/97 4002.16 7299.07 12471.23 009/005598 / CONT./RT. HAND RT. KNEE /MERCY E.R. 10/30/97 2708.00 0.00 3728.00 009/008596 / PAIN/ NECK/MICHAEL ROSS M.D. 11/01/97 28850.91 58953.53 106267.47 016/014598 / PAIN/RT. ARM,HIP AND LEG/ANGEL VIDAL 11/10/97 6266.90 5604.17 13501.04 020/039198 / HIGH BLOOD/W/TOLD BY PRIVATE DR.ABOYUT HIGH BLOO 11/13/97 1618.19 0.00 1779.49 020/027298 / HBP/HEART/DR.HUGH GILMORE 11/17/97 2953.62 0.00 3149.62 009/020698 / PAIN/CHEST MERCY HOSPITAL 11/19/97 3393.25 479.00 3914.09 009/009398 / PAIN/NECK AND BACK 11/25/97 20957.14 9699.75 30692.96 009/009998 / SHARP PAIN/UPPER BACK/ CEDAR HOSPITAL 11/25/97 2293.55 1215.81 3529.36 020/025498 / LOST OF HEARING/MERCY 11/25/97 3760.00 0.00 3775.00 016/011398 / BRUISES AND ABRASION/RT.KNEE& BUTTOCKS/MERCY 12/06/97 7356.28 0.00 7376.26 009/013598 / DAMAGE TO RT LOWER REAR TOOTH/P.ALVAREZ DDS 12/14/97 3438.63 2155.50 5609.13 014/029598 / PAIN/LT.ARM,HAND&CHEST/HYPERTENSION 12/24/97 7018.56 0.00 7038.56 009/022698 / DIZZY/HEART/MERCY HOSPITAL 01/06/98 2927.94 0.00 2947.94 009/018098 / PAIN/BOTH HANDS,SMALL FINGER & LT. ANKLE/MT.SINA 01/12/98 36575.70 16382.26 57961.77 020/018398 / PAIN/CHEST N.SHORE HOSP.ER DR.GILMORE 01/12/98 4678.95 1976.00 7327.73 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE 13 https://www.claimsuite.netIClaimsPortlservleticom.csedge.claimsport.mcm.PendingDetailLookupServlet?runType=1 &function=... 3/20/2003 CLM DETAIL (Landscape) Page 15 of 33 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE 14 M CLAIM NUMBER DESC OF LOSS - KEY 3 LOS.DATE MED/BI-PTD IND/PD-PTD TOTAL -PAID 009/038498 018/06502002 / SPRAIN/STRAIN/RT.KNEE/W/ENTERING THE BUILDING 01/20/98 7173.98 1001.57 18320.33 0 �) ^ / MITRAL VALVE PROLAPSE/HEART 01/22/98 0.00 0.00 132.00 w 009/020198 / SPRAIN/BACK,WRIST, SHOULDER/CEDARS 01/23/98 16089.30 4569.50 20678.80 019/020398 / PAIN/LOWER BACK/DR FERNANDEZ 1-26-98 01/26/98 14060.50 454.19 19771.01 016/072198 / HEARTHIGH BLOOD PRESSURE 02/03/98 3057.40 0.00 3136.07 009/023098 / PAIN AND NUMBNESS/CHEST MERCY HOSPITAL 02/09/98 10801.029199.00 15020.02 vim 016/028098 / PAIN LT.SHOULDER BLADE/CEDARS MEDICAL CTR. 02/09/98 12271.89 988.00 13279.89 �• V 020/014099 / HEAD/HEART/CHEST 02/11/98 12240.04 0.00 12255.04 009/027398 / STRAINED/LUMBER SPINE LT.SIDE/JMH 02/22/98 10881.42 22100.62 33500.48 '" Q 009/023099 / HEART/CARDIO VASCULAR 02/24/98 1249.18 0.00 1269.18 M 014/028298 / HEAD/HYPERTENSSON/CEDARS HOSPITAL 02/25/98 22011.18 4946.00 27187.91 009/034398 / PAIN/LOWER BACK/SALVADOR RAMIERZ MD 03/05/98 68781.39 44809.17 115960.98` m.� 009/039098 / HEART/HEART ANNUAL PYH.TEST 03/17/98 13095.47 494.00 13609.47 Cn ) 009/032598 / PAIN/LT.KNEE,LT.SHOULDER,LT.ELBOW/CEDARS HEALTH 03/20/98 4467.10 0.00 4898.05 _ iL 020/038298 / STRAIN/LOWER RT. SIDE (BACK) WHILE LIFTING BOXES 04/13/98 6394.26 123.50 6678.56 r� ?j g 009/093998 / CHEST PAIN/SITTING DOWN DOING PAPER WORK FELT 04/20/98 22117.91 2717.00 24916.94') 021/078899 / STRAIN/RT.KNEE 04/21/98 2031.00 0.00 2051.00 - 009/050098 / SPRAINED/RT.SHOULDER/DURING AN ARREST 05/03/98 8266.63 0.00 8286.63 020/063998 / HIGH BLOOD PRESSURE/WHILE LOCATING A CABLE TURN 05/11/98 3233.88 0.00 3248.88 016/046798 / HIGH BLOOD PRESSURE/DURNING CHECK UP 05/13/98 5906.67 0.00 5932.54 016/046598 / HYPERTENSION/ 05/18/98 18768.97 988.00 19852.77 020/049298 / HEAD INJURY 05/23/98 46617.12 16302.00 64599.05 009/047998 / HYPERTENISON/ANNUAL PHYSCIAL 05/26/98 8264.23 988.00 9912.23 016/048898 / BRUISE/RT.KNEE/HIT KNEE ON CORNER OF CAR 05/27/98 4334.93 6000.00 10354.93 016/049798 / PAIN/LOW BACK/WHILE ON THE ESCALATOR 05/27/98 3361.54 1235.00 4694.54 014/050298 / PAIN/CHEST/WENT FOR A PHYSCIAL 05/28/98 3128.04 3705.00 6877.04 016/053498 / MYOCARDIAL INFRACTION/FELT HEART RATE INCREASING 06/11/98 9648.39 17043.00 28750.59 020/053898 / HYPERTENSION/ANNUAL PYHSCIAL 06/11/98 2210.25 0.00 2362.25 014/054298 / HYPERTENSION 06/12/98 2100.95 617.50 2728.45 009/057398 / PAIN/LT.SHOULDER,NECK AND MIDDLE OF BACK 06/15/98 10465.60 5681.00 16513.60 020/054998 / HEART/POST-PHYSICAL 06/19/98 3008.80 0.00 3008.80 020/063598 / STRAINED/MULITIPLE BODY PARTS/MOVING A FREIGHT 06/27/98 7782.09 0.00 8064.89 016/055898 / SEVERE/HEAD,NECK INJURIES/ROAD RASH ALL OVER BOD 07/03/98 1036216.84 120783.00 1166388.79 016/055898 /1 SEVERE/HEAD,NECK INJURIES/ROAD RASH ALL OVER BOD 07/03/98 0.00 11352.80 11352.80 009/061398 / SPRAIN/LT.KNEE/GETTING OUT OF CRUISER 07/06/98 10898.38 2223.00 13126.38 016/059998 / MULTIPLE BODY PARTS 07/20/98 3962.86 508.32 6940.58 014/062098 / DID NOT PASS HIS YEARLY PHYSICAL -CARDIAC 07/27/98 24940.52 2470.00 28886.52 009/072398 / UPPER BACK AREA(THORACIC AREA) 08/03/98 0.00 0.00 20.00 014/064798 / SPRAIN/RT.ANKLE&KNEE/ELEV.STUCK BETWEEN FLOORS 08/04/98 18503.59 3581.50 22740.09 009/067198 / HYPERTENISON/ANNUAL PHYSICAL 08/12/98 1475.21 494.00 2145.21 020/067998 / KNEE/HE WAS ATTEMPTING TO APPREHEND A SUSPECT. 08/20/98 38657.61 13338.00 51995.61 014/06782000 / HYPERTENSION/HEART 08/21/98 14144.14 0.00 14496.14 009/073598 / STRAIN/VERTEBRAS 09/03/98 22261.95 11485.50 36958.00 014/075898 / CHEST PAIN 09/05/98 15302.43 988.00 16310.43 020/077998 / HEART/ACCORDING TO THE PHYSICAL TEST/OFF DUTY 09/08/98 37873.06 8521.50 46414.56 021/080999 / EXPOSURE/INTERNAL ORGANS 09/09/98 9849.24 123.50 10289.54 014/032199 / HYPERTESION/MOUNT SINAI MEDICAL CENTER 09/14/98 13460.82 988.00 14468.82 009/080698 / LOW BACK/STRAIN 09/22/98 3034.21 0.00 3054.21 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE 14 https://www.claimsuite.netIClaimsPordservleticom.csedge.claimsport.mcm.PendingDetailLookupServlet?runType=1 &function=... 3/20/2003 CLM DETAIL (Landscape) Page 16 of 33 �L 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE 15 CLAIM NUMBER DESC OF LOSS - KEY 3(1 LOS.DATE MED/BI-PTD IND/PD-PTD TOTAL -PAID 17 O`° dDi 009/081398 / HEART/MILD STROKE 09/22/98 21736.65 29929.92 53358.07 016/082998 / SPRAIN/LEFT ANKLE 09/25/98 34186.65 25441.00 60437.65 F g~~ 009/044399 / HYPERTENSION/HEART 10/12/98 6078.22 0.00 6728.22 d -:! 016/013899 / CONTUSION/RT. KNEE 10/22/98 42393.17 7155.15 50037.32 f 020/005399 / ARRYTHMIAS/ANEMIC 10/27/98 2294.74 123.50 2918.24 009/006199 / INTERNAL ORGANS 10/29/98 2630.61 0.00 2692.01 ,a 009/006299 / LOW BACK AREA 10/29/98 3966.46 5303.04 9351.42 €" 016/010099 / POSSIBLE STROKE 10/29/98 2828.59 84101.23 92453.61 014/008099 / EE HAS HIGH BLOOD PRESSURE 11/05/98 7246.79 0.00 7348.18 014/017899 / HIGH BLOOD PRESSURE 12/01/98 698.00 0.00 786.00 C41 016/010799 / INTERNAL ORGANS/BLOOD PRESSURE 12/02/98 16768.92 2964.00 21007.92 014/015299 / MULTIPLE CONTUSIONS/LT. KNEE AND RT. SHOULDER 12/04/98 6159.32 12473.50 22417.25 016/046099 / HYPERTENSION/HEART 12/07/98 11700.45 0.00 11720.45 �- 020/020299 / RT HAND AND BACK 12/10/98 9966.66 494.00 11876.61 014/025099 / CONTUSION/LOWER RT. ARM 12/12/98 4694.30 1265.94 6106.20 009/015699 / CONTUSION LEFT KNEE 12/18/98 25735.76 9402.40 38919.87 020/016599 / FRACTURE/MULTIPLE LOWER EXTREMITIES 12/20/98 195411.22 24082.50 259865.72 014/014699 / STRAIN/BOTH WRISTS/LT.SHOUDER 12/21/98 4446.53 0.00 4622.53 014/017299 / STRAIN/RT. KNEE /DR JOE FERNANDEZ 12/29/98 25344.50 8921.99 34286.49 009/023699 / STRAIN LOW BACK AREA/BOTH EYES 01/13/99 7033.02 1174.50 8212.52 021/073699 / STRAIN/RT. ANKLE 01/15/99 17781.95 7102.29 25074.65 016/042699 / CHEST PAINS/HEART/COLUMBIA CEDARS MEDICAL CTR 01/20/99 21579.92 0.00 21607.47 009/025899 / HYPERTENSION/HEART 02/09/99 11876.87 3132.00 15905.14 016/027799 / CHEST PAIN 02/22/99 14792.46 1305.00 16239.46 016/035199 / INTERNAL ORGANS/LUNGS 02/23/99 609.20 1044.00 1658.20 014/028199 / HYPERTENSION/HEART 02/25/99 8671.41 1435.50 10286.91 014/031799 / HYPERTENSION/HEART 03/02/99 18033.05 0.00 18058.55 016/034199 / CHEST PAINS/HEART/MERCY HOSPITAL 03/03/99 729.00 0.00 729.00 009/033399 / HYPERTENSION/HEART 03/08/99 13326.41 7308.00 20654.41 018/048399 / HYPERTENSION/COLUMBIA CEDARS MEDICAL CENTER 03/13/99 3407.34 0.00 3412.34 014/0012000 / HYPERTENSION/HEART 03/18/99 3951.12 0.00 4127.12 014/034099 / CHEST PAINS/HEART/JACKSON MEMORIAL HOSPITAL 03/19/99 2323.45 7607.20 10004.15 014/047699 / HYPERTENSION/HEART 03/19/99 6868.65 0.00 6878.65 016/035899 / CONTUSION RT. KNEE 03/23/99 9665.44 10365.85 21594.29 020/042999 / STRAIN LEFT ANKLE/877-472-2726 03/23/99 10008.50 5481.00 15872.80 009/02892000 / STRAIN/LT.KNEE 04/01/99 680.00 0.00 2759.40 016/042399 / STRAIN/MULTIPLE INJURY/JACKSON MEMORIAL HOSPITAL 04/09/99 16257.96 12471.48 28925.44 009/038699 / HYPERTENSION/HEART 04/12/99 24656.55 1174.50 26012.38 020/038199 / CHEST PAIN/HEART/PARKWAY REGIONAL MEDICAL 04/12/99 6765.82 11484.00 19970.31 016/046299 / STRAIN LOW BACK AREA/JACKSON MEMORIAL HOSPITAL 04/15/99 21068.07 3726.94 31950.20 016/064499 / HYPERTENSION/HEART 04/15/99 2897.40 0.00 2897.40 014/043599 / CONTUSION/LT. ANKLE/COLUMBIA CEDARS MEDICAL CTR 04/17/99 7252.03 10732.51 18340.18 014/057299 / HYPERTENSION/HEART 04/21/99 11360.20 18139.50 30378.60 020/059999 / CONTUSION MULTIPLE BODY PARTS 04/21/99 22622.26 10521.42 34005.04 020/043899 / STRAIN MULTIPLE BODY PARTS/JACKSON MEMORIAL HOSP 04/24/99 1063.67 1305.00 2378.67 009/00442000 / HYPERTENSION/HEART 04/28/99 72091.90 7960.50 80365.80 014/046199 / CHEST PAINS 04/28/99 10458.97 3654.00 14117.97 009/045099 / HYPERTENSION/HEART 04/29/99 3791.75 0.00 3811.75 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE 15 https://www.claimsuite.netIClaimsPortlservleticom.csedge.claimsport.mcm.PendingDetailLookupServlet?runType=1 &function=... 3/20/2003 CLM DETAIL (Landscape) 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS Page 17 of 33 AS OF 03/20/03 PAGE 16 CLAIM NUMBER DESC OF LOSS - KEY 3 LOS.DATE MED/BI-PTD IND/PD-PTD TOTAL -PAID 016/047399 / STRAIN/MULTIPLE UPPER EXTREMITIES 05/06/99 6628.41 3254.97 10069.38 016/047299 / HEART/MERCY HOSPITAL 305-285-2610 05/07/99 14517.07 1957.50 16538.24 020/074999 / CHEST PAINS/DIZZINESS 05/09/99 3482.55 0.00 3487.55 016/070899 / HYPERTENSION/HEART 05/18/99 2604.66 7830.00 10454.66 009/051199 / STRAIN RT. KNEE/COLUMBIA CEDARS MEDICAL CTR 05/21/99 6660.25 9138.00 15862.99 014/062499 / HEART CONDITION 05/25/99 7153.77 2088.00 9417.77 014/063899 / HYPERTENSION/HEART 05/27/99 2168.95 0.00 2173.95 009/052599 / MULTIPLE BODY PARTS 05/29/99 22282.87 14746.50 37039.37 016/052799 / CHEST PAIN/HEART 05/31/99 5746.25 3393.00 9139.25 016/053699 / STRAIN/INTERNAL ORGANS 06/03/99 3214.49 0.00 3214.49 009/054799 / HYPERTENSION/HEART 06/08/99 2150.18 0.00 2150.18 009/055499 / HYPERTENSION/HEART 06/08/99 5985.95 3915.00 9920.95 009/055999 / HYPERTENSION/HEART 06/08/99 2081.90 12136.50 14218.40 020/060199 / STRAIN/MULTIPLE BODY PARTS 06/11/99 13311.19 1566.00 15068.19 016/059399 / CONTUSION/MULTIPLE LOWER EXTREMITIES 06/17/99 4064.34 459.51 4716.18 009/060899 / SPRAIN/RT. KNEE 06/24/99 13991.80 2166.12 16162.92 020/061799 / CARPAL TUNNEL/MULTIPLE UPPER EXTREMITIES 06/25/99 583.91 4698.00 5291.91 009/02882000 / CONTUSION/RT.THIGT AND HIP 07/06/99 11391.64 49645.78 66702.78 016/064099 / SPRAIN/MULTIPLE BODY PARTS 07/19/99 7523.44 15057.93 25721.37 020/066299 / HYPERTENSION/ HEART 07/28/99 1311.36 0.00 1331.36 009/03912000 / HYPERTENSION/HEART 07/29/99 2693.63 10962.00 13675.63 016/079999 / HYPERTENSION/HEART 07/30/99 7513.60 0.00 7518.60 014/04802000 / HYPERTENSION/HEART 08/01/99 4400.64 0.00 4415.64 009/074899 / HYPERTENSION/HEART 08/02/99 87685.99 3523.50 91918.49 016/068199 / HYPERTENSION/HEART 08/05/99 16568.21 2610.00 19183.21 014/068299 / SPRAIN RT. KNEE 08/07/99 25581.25 7308.00 33503.69 020/068099 / PALPITATION/HEART 08/08/99 73778.57 32103.00 106067.57 016/070399 / HYPERTENSION/HEART 08/09/99 2437.70 0.00 2447.70 009/00372000 / HYPERTENSION/HEART 08/13/99 5063.41 0.00 5072.76 021/074699 / CONTUSION/MULTIPLE BODY PARTS 08/15/99 10228.91 3915.00 14510.91 009/083199 / HEARING LOSS (TRAUMATIC ONLY)/ EAR(S) 08/16/99 5730.50 0.00 5730.50 009/075799 / HYPERTENSION/HEART 08/17/99 32022.76 1566.00 33608.76 021/071099 / HYPERTENSION/HEART 08/18/99 6247.25 1566.00 7823.25 014/071799 / CHEST PAINS/HEART 08/19/99 13282.10 3132.00 16419.10 009/01152000 / HEART DISEASE/HEART 08/26/99 15502.58 35897.78 56163.88 016/074099 / HYPERTENSION/HEART 08/26/99 1643.63 2479.50 4128.13 016/073499 / STRAIN RT. THUMB/CARPAL TUNNEL SYNDROME 08/27/99 3741.41 2610.00 6532.41 009/076699 / CHEST PAINS/HEART 09/07/99 8385.38 1174.50 9579.88 016/077999 / CONTUSION MULTIPLE BODY PARTS 09/07/99 6005.90 11484.00 18489.90 014/077699 / CONTUSION/RT.SHOULDER,LOWER BACK/BOTH KNEES 09/08/99 19287.57 20044.43 42830.19 016/082699 / CONTUSION/ HEAD/BUTTOCKS/LT.ANKLE 09/16/99 4625.02 1960.30 7132.32 014/081599 / CONTUSION MULTIPLE BODY PARTS 09/22/99 11749.09 5220.00 17057.09 016/00142000 / STRAIN/RT.ELBOW/LOWER BACK 10/01/99 3710.61 3345.86 7247.47 016/00142000 /1 STRAIN/RT.ELBOW/LOWER BACK 10/01/99 0.00 5018.79 5018.79 009/00982000 / FELL ILL & WEAK/INTERNAL ORGANS 10/05/99 12797.95 26361.00 39440.55 021/00492000 / CARPAL TUNNEL SYNDROME/LT.HAND 10/05/99 5858.49 5490.67 11349.16 009/00632000 / HEART & SPRAINED LEFT HAND 10/07/99 45033.47 26752.50 73827.97 016/00872000 / HEART DISEASE/HEART 10/14/99 42438.86 92655.00 136068.86 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS C.)a o� "� U Q 0 b 0 ca C: •a- L0 O d ri) AS OF 03/20/03 PAGE 16 https://www.claimsuite.net/ClaimsPortlservletlcom.csedge.claimsport.mem.PendingDetailLookupServlet?runType=1 &function=... 3/20/2003 d� M M 0 CLM DETAIL (Landscape) 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS Page 18 of 33 AS OF 03/20/03 PAGE 17 CLAIM NUMBER DESC OF LOSS - KEY 3 LOS.DATE MED/BI-PTD IND/PD-PTD TOTAL -PAID 016/00872000 /1 HEART DISEASE/HEART 10/14/99 0.00 7950.00 7950.00 009/00382000 / CONTUSION/LT.LOWER LEG 10/15/99 12271.02 9513.24 24125.54 021/01002000 / STRAIN/LT.UPPER ARM(INCLUDING CLAVICLE/SCA) 10/17/99 8039.50 6119.05 14158.55 020/00562000 / STRAIN LOW BACK AREA (INCLUDING LUMBAR) 10/27/99 6745.75 3913.77 10835.52 020/00812000 / HYPERTENSION/HEART 10/27/99 3650.45 0.00 3650.45 016/00862000 / STRAIN/LT.KNEE 11/06/99 19707.96 13572.00 33299.96 016/01352000 / STRAIN/LOW BACK AREA(INCLUDING LUMBAR) 11/11/99 26282.35 19836.00 46314.35 016/01142000 / FOREIGN BODY/LT. EYE 11/16/99 4189.28 0.00 4199.28 018/01522000 / CARPAL TUNNEL SYNDROME/LT.HAND 12/01/99 903.91 0.00 903.91 016/01312000 / CHEST PAIN/MERCY HOSPITAL 12/02/99 2834.85 391.50 3231.35 018/01582000 / STRAIN/GROIN AND LOW BACK 12/13/99 3239.18 15790.50 19343.63 020/06062000 / CHEST PAIN/HEART 12/17/99 1954.89 0.00 2130.89 014/02302000 / SPRAIN/RT.KNEE/LT. GLUTEAL AREA 12/31/99 23818.61 9112.79 33077.20 009/02272000 / CONTUSION/LT.ELBOW 01/07/00 20631.05 41026.02 67568.52 009/02272000 /1 CONTUSION/LT.ELBOW 01/07/00 0.00 0.00 0.00 009/02232000 / STRAIN/LOW BACK AREA 01/11/00 8625.70 5054.97 14657.73 016/02182000 / CONTUSION/BOTH KNESS 6 ABDOMEN AREA 01/11/00 2426.86 1238.94 3665.80 014/02372000 / HYPERTENSION/HEART 01/17/00 2477.10 1252.39 3838.49 016/02722000 / ALL OTHER/BECAME FAINT AND NAUSEOUS 01/25/00 24034.96 10143.75 34178.71 014/02602000 / CONTUSION/LOW BACK TO RT.HIP ARCA 01/28/00 106183.67 56970.07 165842.20 014/02602000 /1 CONTUSION/LOW BACK TO RT.HIP ARCA 01/28/00 0.00 432.60 432.60 014/02742000 / CONTUSION/MULTIPLE BODY PARTS 02/01/00 16170.15 3787.00 20152.05 018/02812000 / CHEST PAIN/HEART 02/04/00 6900.86 405.75 7482.61 020/03252000 / CONTUSION/LT.FOOT 02/14/00 5978.00 3853.07 10717.78 009/03122000 / STRAIN/PAIN FROM WAIST DOWN 02/22/00 7296.36 1352.50 9168.68 014/03472000 / STRAIN/RT SHOULDER 03/03/00 17162.97 3530.01 22985.73 016/03612000 / CONTUSION/UPPER ARM 03/11/00 15203.27 8543.81 25172.08 014/03702000 / HYPERTENSION/HEART 03/13/00 4029.34 0.00 4205.34 009/03562000 / STRAIN/LOWER AND UPPER BACK 03/14/00 10245.34 2839.01 15300.85 020/08022000 / HYPERTENSION/HEART 03/14/00 4275.82 0.00 4275.82 009/01302001 / HEART/MURMUR 03/21/00 815.07 0.00 815.07 014/04142000 / CHEST PAINS/CHEST/ATRIAL FIBILATION 04/07/00 8666.29 5680.50 14346.79 009/04382000 / HYPERTENSION/HEART 04/11/00 4242.09 0.00 4242.09 009/04312000 / LACERATION/TOES 04/13/00 28642.36 1827.21 31098.21 009/04342000 / STRAIN/PAIN CHEST AREA/LIGHT HEADED 04/14/00 7422.58 270.50 7698.08 016/04792000 / CHEST PAINS, FAINTING 05/06/00 26978.02 8250.25 35514.27 020/05012000 / CONTUSION/RT.SHOULDER AND LOWER BACK 05/11/00 585.06 501.52 1110.58 018/05082000 / STRAIN/LEFT KNEE 05/19/00 36147.55 12254.72 48402.27 016/05112000 / HYPERTENSION/HEART 05/23/00 1576.15 135.25 1857.20 020/05142000 / HYPERTENSION/HEART 05/23/00 4172.66 0.00 4192.66 009/05252000 / STRAIN/LOW BACK AREA 05/31/00 4727.40 1217.25 7257.99 018/05282000 / HYPERTENSION/HEART 06/01/00 2926.25 1082.00 4159.05 018/05522000 / CONTUSION/HEAD 06/05/00 70485.09 24489.36 97831.45 014/05602000 / DIZZY/UPPER EXTREMITIES 06/06/00 39766.87 2705.00 42680.90 016/05632000 / STRAIN/RT.GROIN-TESTICLE 06/13/00 2532.70 1938.71 7231.41 020/00462002 / HYPERTENSION/HEART 06/13/00 1139.17 0.00 1139.17 020/05672000 / STRAIN/RIGHT SHOULDER 06/13/00 2185.53 1352.50 3538.03 020/05962000 / MULTIPLE HEAD INJURY 07/01/00 60796.74 44362.54 105423.28 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE 17 https://www.claimsuite.netIClaimsPortlservleticom.csedge.claimsport.mcm.PendingDetailLookupServlet?runType=1 &function=... 3/20/2003 d'+ M CLM DETAIL (Landscape) Page 19 of 33 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE 18 CLAIM NUMBER DESC OF LOSS - KEY 3 LOS.DATE MED/BI-PTD IND/PD-PTD TOTAL-PAID(3 '7 z 020/05962000 /1 MULTIPLE HEAD INJURY 07/01/00 0.00 2464.95 2464.95.x," ' Ci 020/05962000 /2 MULTIPLE HEAD INJURY 07/01/00 0.00 2464.95 2464.95,'-; 020/05962000 /3 MULTIPLE HEAD INJURY 07/01/00 0.00 2464.95 2464.95[t 018/06122000 / STRAIN/LT.KNEE 07/06/00 27170.50 13525.00 40959.501111 018/06212000 / FRACTURE, LACERATIONS/LT FEMUR, MULTIPLE BOD PAR 07/10/00 49608.26 14219.87 58828.13S::; f „'.... 014/07202000 / STRAIN/BOTH ARMS, NECK,BACK 07/14/00 446.84 0.00 446.84- 018/06572000 / FOREIGN BODY/BOTH EYES 07/17/00 903.96 927.99 1831.95;3 ;. t 014/06702000 / GROIN AREA STRAIN/DEEP VEIN THOMBOSIS 07/21/00 12758.89 8295.00 21370.69,`;° 014/06752000 / STRAIN/NECK 07/25/00 2737.09 1623.00 4537.59•-•; 020/06292001 / STRAIN/RT.SHOULDER 07/26/00 1115.90 0.00 1153.90; z.. 016/06882000 / STRAIN/LOW BACK AREA 07/31/00 24990.76 9467.50 34691.75..•' 009/07532000 / HYPERTENSION/HEART 08/01/00 5504.09 0.00 5729.09 019/06902000 / HEART/CONDITION 08/01/00 8358.33 2434.50 10802.83 s 016/07062000 / STRAIN/LOW BACK AREA 08/09/00 489.21 541.00 1030.21 016/07242000 / CHEST PAIN/HEART 08/13/00 25786.23 9116.29 34936.00(' 018/01242001 / HYPERTENSION/HEART 08/15/00 2836.91 0.00 2836.91 018/07332000 / HYPERTENSION/HEART 08/17/00 2765.08 0.00 2775.08 016/01022001 / HYPERTENSION/HEART 08/21/00 1960.50 0.00 1960.50 018/07292000 / STRAIN/LOW BACK AREA 08/21/00 2698.26 270.50 3109.56 009/07602000 / HYPERTENSION/HEART 08/23/00 3034.99 1623.00 4662.99 018/07412000 / HYPERTENSION/HEART 08/24/00 14623.23 541.00 15164.23 018/07442000 / CHEST PAINS/HEART 08/24/00 4768.96 0.00 4900.96 020/07522000 / STRAIN/LT.KNEE 08/28/00 386.29 0.00 386.29 020/07612000 / HYPERTENSION/HEART 08/30/00 2472.64 0.00 2648.64 020/08162000 / HEART DISEASE/HEART 09/01/00 3048.99 10144.00 13397.99 016/08002000 / STRAIN/LOW BACK AREA/RAMIREZ (ORTHO) 09/02/00 9144.39 9061.75 18592.14 020/07902000 / HYPERTENSION/HEART 09/12/00 1989.27 0.00 1989.27 018/01772001 / HYPERTENSION/HEART 09/15/00 1151.99 0.00 1151.99 009/01792001 / HYPERTENSION/HEART 09/18/00 1061.09 0.00 1257.09 019/04262003 / HEART PALPITATIONS/HEART 09/18/00 0.00 0.00 0.00 009/08132000 / CHEST PAIN/CHEST 09/19/00 12246.26 1623.00 13969.26 009/08172000 / ABNORMAL STRESS TEST/HEART 09/19/00 31384.73 6492.00 38228.73 018/00302001 / IRREGULAR HEARTBEAT/HEART 09/19/00 2389.50 0.00 2394.50 019/08202000 / CONTUSION TO RT. KNEE/STRAIN BOTH WRISTS 09/20/00 1550.00 1907.85 3457.85 009/00022001 / CHEST PAINS/HEART 09/23/00 6452.81 0.00 6457.81 014/00862001 / HYPERTENSION/HEART 09/27/00 6537.80 2705.00 9418.80 009/06082001 / HEART DISEASE/HEART 09/30/00 125.00 0.00 125.00 014/00222001 / STRAIN/MULTIPLE BODY PARTS 10/01/00 6878.54 13930.75 21444.70 014/00122001 / STRAIN/LT.KNEE 10/03/00 36286.96 20666.20 58606.83 014/00312001 / RESPIRATORY DISORDERS/HEART/LUNG 10/10/00 8537.65 0.00 8537.65 018/02532001 / PAINS IN CHEST & DOWN LT.ARM 10/13/00 1781.00 0.00 1781.00 016/00472001 / SPRAIN/RT.ANKLE 10/14/00 12185.69 6289.47 18651.16 010/01502001 / PAINS/LOWER BACK & BOTH HANDS 10/23/00 5021.20 4760.80 10095.00 019/00782001 / STRAIN/LT.KNEE 10/27/00 34098.27 26836.03 63058.64 009/02902001 / NUMBNESS TO RT.SHOULDER/NECK & RT.HAND 11/01/00 1433.00 0.00 2435.00 020/00902001 / STRAIN/SORENESS/RT.SHOULDER/RT.ARM/UPPER BACK 11/01/00 4764.80 0.00 4764.80 018/01162001 / CONTUSION/LT.KNEE 11/02/00 3270.13 4197.51 11163.84 014/01112001 / DISLOCATION/RT.KNEE 11/03/00 43180.80 27240.67 72161.74 00315 CITY OF MIAMI ii CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE 18 https://www.claimsuite.net/ClaimsPortlservlet/com.csedge.claimsport.mcm.PendingDetailLookupServlet?runType=1 &function=... 3/20/2003 CLM DETAIL (Landscape) Page 20 of 33 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE 9 CLAIM NUMBER DESC OF LOSS - KEY 3 LOS.DATE MED/BI-PTD IND/PD-PTD FCS TOTAL -PAID 018/01692003 / CONTUSION/LT.FOREARM,LT.SHOULDER,LT.SIDE & BACK 11/06/00 0.00 0.00 ..3 0.00 018/01032001 / HYPERTENSION/HEART 11/08/00 3030.82 0.00 3030.82 tee.. ZI-1 016/01232001 / FRACTURE/LT.HAND 11/13/00 879.68 1634.04 4073.72 0 010/01732001 / STRAIN/UPPER RT.ARM 11/23/00 24490.50 7033.00 32066.50 u 010/01382001 / HYPERTENSION/BRAIN 11/29/00 3373.18 405.75 3778.93 018/08842002 / EXPOSED/ONTERNAL ORGANS 12/01/00 0.00 0.00 2971.82 016/01682001 / HYPERTENSION/HEART 12/07/00 10935.40 405.75 11473.15 009/02832001 / STRAIN/NECK & HEAD 12/13/00 1884.42 5830.80 7891.22 e 010/05142001 / CONTUSION/CHEST(INCLUDING RIBS/STERNUM/SOFT) 12/13/00 213.40 0.00 213.400 010/02112001 / HIGH BEATING HEART RATE/HEART 12/28/00 4583.75 2705.00 7314.67 iq 016/02162001 / FAINT/INTERNAL ORGANS 12/30/00 9308.91 1217.25 10702.16 r 019/02252001 / CHEST PAIN/HEART 01/04/01 1561.25 428.25 1989.50 019/02462001 / LACERATION/LT.KNEE 01/12/01 2877.09 874.62 4024.51 ui 014/02582001 / CHEST PAINS/FAINTED & STRUCK HIS HEAD 01/18/01 5967.23 0.00 5967.23 019/02722001 / HYPERTENSION/HEART 01/18/01 816.84 0.00 816.84 014/04402001 / HYPERTENSION/HEART 01/19/01 475.00 0.00 475.00 014/07282001 / CONTUSION/RT.ARM/BOTH KNEES/RT.HAND & BACK 01/19/01 1996.24 5388.30 7384.54 016/02752001 / FRACTURE/RT.FEMUR & KNEECAP 01/20/01 48074.41 12276.50 60438.91 009/05392001 / PAIN/DISCOMFORT/HEART 01/22/01 1537.00 0.00 1537.00 019/02762001 / HYPERTENSION/HEART 01/22/01 6569.35 0.00 6701.35 016/03372001 / STRAIN/LOW BACK AREA 01/29/01 120.20 0.00 360.20 018/02952001 / CONTUSION/RT.KNEE & LT.SHOULDER 01/29/01 42312.96 14988.75 57699.05 018/02962001 / HEART/ECHO CARDIOGRAM 01/30/01 4537.25 428.25 4965.50 018/02972001 / STRAIN/RT.SHOULDER 01/30/01 21089.63 19436.40 41426.03 018/03192001 / CONTUSION/LEFT KNEE 02/05/01 4491.57 0.00 4491.57 014/03152001 / HYPERTENSION/HEART 02/07/01 3458.35 571.00 4381.35 018/03212001 / SPRAIN/MULTIPLE BODY PARTS 02/08/01 1316.45 4484.08 5800.53 009/03412001 / HYPERTENSION/HEART 02/09/01 2136.91 0.00 2136.91 016/03242001 / STRAIN/LT.SHOULDER 02/12/01 17648.38 4826.58 22650.96 016/03432001 / STRAIN/LT.KNEE 02/15/01 17444.62 15988.00 33625.62 014/03422001 / HYPERTENSION/HEART 02/16/01 866.20 0.00 1042.20 010/04372001 / PAIN/DISCOMFORT/TWIST HIS BACK/RT.LEG 02/20/01 180.01 0.00 185.01 016/03932001 / STRAIN/UPPER ARMS AND HIS CHEST AREA 02/25/01 27773.69 5281.75 33055.44 010/03952001 / STRAIN/RT.UPPER ARM 02/26/01 26874.59 30543.43 58688.52 010/06772001 / HEART 02/28/01 97.00 0.00 97.00 018/03842001 / STRAIN/LT.KNEE 02/28/01 17447.15 4211.79 21723.98 019/06922001 / HEART ATTACK/HEART 03/01/01 2859.95 0.00 2859.95 014/04222001 / STRAIN/HEAD, NECK, AND HANDS 03/02/01 10824.68 18793.51 29970.19 018/05052001 / HEART DISEASE/HEART 03/06/01 29.00 0.00 29.00 018/05922001 / HYPERTENSION/HEART 03/07/01 1510.03 0.00 1510.03 010/04462001 / HYPERTENSION/HEART 03/14/01 25510.38 571.00 26081.38 010/04482001 / STRAIN/NECK & HIPS 03/15/01 9827.79 20841.50 30997.06 010/07202001 / HYPERTENSION/HEART 03/15/01 11165.00 7994.00 19290.28 016/04832001 / HYPERTENSION/HEART 03/19/01 5028.10 4419.14 11216.81 010/00432002 / HYPERTENSION/HEART 03/20/01 2779.06 0.00 2779.06 016/04732001 / INTERNAL ORGANS 03/20/01 2678.25 0.00 2678.25 018/04822001 / HYPERTENSION/HEART 03/20/01 154.00 0.00 154.00 010/04842001 / STRAIN/RT.KNEE AND UPPER BACK 03/22/01 8252.73 1222.08 11599.68 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE 19 https://www.claimsuite.netIClaimsPortlservleticom.csedge.claimsport.mcm.PendingDetailLookupServlet?runType=l &function=... 3/20/2003 4" CLM DETAIL (Landscape) Page 21 of 33 Cp 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE 20 'M CLAIM NUMBER 005/09032002 / DESC OF LOSS - KEY 3 STRAIN/LOW BACK LOS.DATE MED/BI-PTD IND/PD-PTD TOTAL -PAID 019/06412001 / AREA HEART/DISEASE/HEART 03/23/01 0.00 0.00 748.09 . 0 � �_ 0 018/05222001 / HEARING LOSS/BOTH EARS 03/27/01 04/03/01 139.00 483.00 0.00 139.00 016/05562001 / CHEST PAIN/HEART 04/08/01 3479.05 0.00 285.50 483.00 3764.55 :3 0- � ' 018/05412001 / HYPERTENSION/HEART 09/09/01 1907.00 0.00 1907.00 �? �'''L"' 005/00352002 / HYPERTENSION/HEART 04/17/01 2427.49 0.00 2427.99 -.- Q 018/06122001 / PAIN/DISCOMFORT/RT.HAND 04/18/01 7079.02 9599.25 16956.27 , -% _ ] 019/05772001 / FOREIGN BODY/RT.EYE 04/23/01 910.78 766.76 1853.59 `b 018/06732001 / STRAIN/LOW BACK AREA 05/01/01 1816.94 0.00' 1922.54 Vie` a rj 019/06052001 / EXPOSED/INTERNAL ORGANS 05/02/01 0.00 0.00 0.00 0 016/06952001 / HYPERTENSION/HEART 05/08/01 2544.80 571.00 3293.80 _0 Q 4" 016/06352001 / CONTUSION/UNK WHAT INJURIES ARE 05/19/01 36861.97 20966.21 64960.81 a` --� 005/07822001 009/08542001 / / HEART DISEASE/HEART 05/16/01 402.00 0.00 402.00 c� .'% "'- 009/06692001 / CHEST PAIN/HEART CHEST PAIN/HEART 05/27/01 6015.23 0.00 6028.73 P`:>' t 018/06942001 / STRAIN/LOW BACK AREA 05/29/01 05/31/01 1565.00 351.95 0.00 1565.00 �' �� { 010/06122002 / CHEST PAIN/HEART 06/07/01 201.00 277.18 0.00 629.13 w 009/02952003 / CANCER/PULMORARY/RESPIRATIRY SYSTEM 06/11/01 0.00 0.00 201.00 019/07092001 / SPRAIN & TWISTED LT.KNEE & RT.ANKLE 06/13/01 19612.36 5139.00 180.00 24751.36 014/08602001 / HYPERTENSION/HEART 06/18/01 1162.00 0.00 1294.00 005/07222001 / STRAIN/NECK, UPPER & LOWER BACK 06/19/01 10202.22 0.00 13466.45 019/07252001 / HYPERTENSION/HEART 06/19/01 1851.79 0.00 1851.79 018/07402001 / STRAIN/LOW BACK AREA 06/25/01 568.03 1448.40 2016.43 016/07592001 / HYPERTENSION/HEART 06/27/01 515.24 0.00 647.24 005/07532001 / CHEST PAIN/HEART 06/29/01 3016.16 ?2,&4.00 5652.16 018/07612001 009/07762001 / / STRAIN/LT.KNEE 07/02/01 19000.21 4915.67 25578.38 010/07792001 / CONTUSION/NECK AND HEAD STRAIN/LT.ARM & UPPER BACK AREA 07/03/01 25564.70 3423.99 30548.14 005/07662001 / HYPERTENSION/HEART 07/04/01 07/05/01 91.00 586.71 1595.38 016/07832001 / STRAIN/LOW BACK AREA 07/07/01 1111.83 1790.64 999.25 0.00 2111.08 009/07782001 / STRAIN/NECK 07/10/01 5163.50 6192.13 3659.64 18641.38 020/07842001 / CONTUSION/RT.SHOULDER 07/12/01 822.68 0.00 822.68 019/07902001 / SPRAIN/RT.WRIST 07/15/01 2764.95 0.00 2940.95 016/07952001 / HYPERTENSION/HEART 07/16/01 671.87 1570.25 2242.12 005/07982001 / HYPERTENTION/HEART 07/19/01 2757.44 2284.00 5173.44 014/02402002 / VISION/EYES 07/19/01 52.00 0.00 221.18 016/08342001 / CONTUSION/RT.KNEE AND LT.HIP 07/19/01 4098.90 2664.78 8077.68 016/02752003 / HEART/MURMUR 07/23/01 0.00 0.00 0.00 018/08222001 / STRAIN/RT.SHOULDER 07/25/01 15042.69 6281.00 21641.39 020/03032002 / STRAIN/LT.SHOULDER 07/25/01 265.00 0.00 353.04 009/08552001 / HYPERTENSION/HEART 07/26/01 10312.79 285.50 10703.89 009/08482001 / HYPERTENSION/HEART 07/30/01 2881.39 1142.00 4023.39 019/08582001 / ABNORMAL EKG/INTERNAL ORGANS 07/30/01 1679.86 856.50 2536.36 018/08672001 / CHEST PAINS, NUMBNESS/LT.THUMB/GROIN AREA 08/01/01 1646.00 0.00 1646.00 005/08752001 / CONTUSION/LT.KNEE 08/03/01 13422.47 6677.05 20451.52 020/08642001 / STRAIN/LOW BACK AREA 08/04/01 17241.86 15131.50 32549.36 005/08652001 / HYPERTENSION/HEART 08/06/01 151.00 0.00 151.00 018/08682001 / CHEST PAIN/HEART 08/06/01 4147.03 1855.75 6134.78• 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE 20 https://www.claimsuite.netIClaimsPortlservleticom.csedge.claimsport.mcm.PendingDetailLocrkupServlet?runType=1 &function=... 3/20/2003 C;LM DE -FAIL (Landscapc) Page 22 of 33 https://www.claimsuite.netIClaimsPortlservleticom.csedge.claimsport.mcm.PendingDetailLoc7kupServlet?runType=l &function=... 3/20/2003 e7t 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE 21 M CLAIM NUMBER 019/08722001 / DESC OF LOSS - KEY 3 STRAIN/CHEST PAIN/LT.KNEE08/06/01 LOS.DATE MED/BI-PTD IND/PD-PTD TOTAL -PAID -14' 010/08762001 / STRAIN/LOW BACK AREA 2743.61 3800.46 6817.07,U P� 014/08802001 / HEART 08/07/01 08/10/01 34308.77 18317.78 56818.99 U 005/09072001 / HYPERTENSION/HEART 08/14/01 1074.00 171.00 0.00 1206.00 -3 n 019/08872001 / SPRAIN/LT.KNEE AND ANKLE 08/19/01 9910.69 0.00 2426.75 347.00 7658.32 �) 016/01002002 / HYPERTENSION/HEART 08/17/01 1050.66 0.00 1050.66 _0 020/09042001 / STRAIN/LOW BACK AREA 08/17/01 171.95 0.00 434.15 020/08372002 020/09082001 / EXPOSURE/INTERNAL ORGANS 08/19/01 0.00 0.00 0.00; 005/09242001 / FELT DIZZI & WEAK/INTERNAL ORGANS 08/20/01 4138.15 0.00' 4314.15° 010/09702001 / / STRAIN/BOTH SHOULDERS HYPERTENSION/HEART 08/28/01 1801.66 0.00 1942.46 08/29/01 114.00 0.00 114.00 'f,) 016/09272001 020/07352002 / STRAIN/LOW BACK INCLUDING LUMBAR 08/29/01 3432.61 6852.00 10960.61 / HYPERTENSION/HEART 08/30/01 1608.91 0.00 1608.41 010/01062002 / HYPERTENSION/HEART 09/13/01 1468.86 0.00 1468.86 " 016/09652001 / CONTUSION/LOWER BACK & HIPS 09/15/01 318.00 0.00 318.00 018/09692001 / LOOSENED TOOTH, SWOLLEN LIP/FACE 09/18/01 5393.39 0.00 5393.39 -- 014/09682001 / STRAIN/LOW BACK (INCLUDING LUMBAR) 09/19/01 11797.54 17701.01 30756.35 019/09812001 / LACERATION/RIGHT UPPER ARM (INCLUDING CLAVICLE) 09/25/01 1424.61 2185.70 3610.31 020/00022002 / CONTUSION/RT.KNEE,BACK, NECK, RT.SHOULDER 09/30/01 4379.20 1284.75 5693.95 016/00142002 / STRAIN/LOW BACK AREA 10/01/01 3171.24 1335.12 6181.36 020/00202002 / CHEST PAIN/HEART 10/05/01 8120.17 0.00 8120.17 020/00442002 / INTERCRANIAL HYPERTENSION/HEAD 10/14/01 648.79 6281.00 6945.89 016/00412002 / STRAIN/LOW BACK AREA 10/15/01 1678.76 0.00 1678.76 005/00752002 / CHEST PAIN/HEART 10/16/01 857.89 0.00 1979.06 020/00502002 / STRAIN/LOW BACK AREA 10/17/01 1612.15 -0.00 1627.15 020/01332002 / STRAIN/RT. AND LT. WRISTS 10/24/01 1405.34 0.00 1405.34 005/00922002 / PREMATURE ATRIAL CONTRACTION/HEART 11/02/01 1648.00 0.00 1648.00 019/01262002 / CONTUSION/RT.LOWER ARM 11/05/01 6502.24 0.00 6502.24 020/01122002 / STRAIN/LOW BACK AREA 11/08/01 31309.37 24407.55 56048.87 010/01372002 / CONTUSION/BOTH SHOULDERS & LT.KNEE 11/19/01 42230.66 10281.72. 54795.04 016/01362002 / CONTUSION/LT.ELBOW 11/20/01 25884.71 7994.00 34054.71 020/01452002 / STRAIN/LOW BACK AREA 11/21/01 1180.30 3031.88 4212.18 018/01412002 / CONTUSION/RT.SHOULDER AND ARM 11/22/01 2700.18 2602.05 5478.23 018/01592002 / CHEST PAIN/HEART 11/27/01 2152.31 0.00 2152.31 005/04942002 / HYPERTENSION/HEART 11/29/01 1983.84 0.00 1998.84 009/0177202 / STRAIN/RT.KNEE 12/03/01 5856.88 3997.00 9853.88 019/02142002 / SPRAIN/LEFT SHOULDER 12/04/01 3403.50 4871.10 8450.60 010/01802002 / STRAIN/RIGHT SIDE 12/10/01 43140.54 23982.00 68204.54 018/01792002 / STRAIN/LOW BACK (INCLUDING LUMBAR) 12/10/01 4154.26 1713.00 6043.26 016/01992002 / CONTUSION/LT.SHOULDER 12/11/01 1804.02 142.75 1946.77 009/01892002 / CONTUSION/RT.KNEE 12/13/01 2127.19 2851.09 5409.87 005/02532002 / HYPERTENSION & MITRO-VALVE PROLAPSE/HEART 12/19/01 2258.99 0.00 2346.99 019/02092002 / STRAIN/RT. INDEX & MIDDLE FINGER 12/19/01 3562.51 1713.00 5451.51 018/02242002 / STRAIN/LEFT LOWER LEG 12/27/01 5639.14 3997.00 9636.14 020/02332002 / INFLAMMATION/LT.KNEE 12/27/01 16432.62 7280.25 23712.87 016/03052002 / CONTUSION/LT.WRIST AND SHOULDER 12/31/01 18785.99 3854.25 22816.24 020/02352002 / STRAIN/TWISTED RT.KNEE AND RT.ANKLE 12/31/01 11434.95 3711.50 15503.45 009/03252002 / HYPERTENSION/HEART 01/01/02 804.65 0.00 804.65. 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE 21 https://www.claimsuite.netIClaimsPortlservleticom.csedge.claimsport.mcm.PendingDetailLoc7kupServlet?runType=l &function=... 3/20/2003 CLM DETAIL (Landscape) 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS Page 23 of 33 AS OF 03/20/03 PAGE 22 C) a,_5ff. 7 � CLAIM NUMBER DESC OF LOSS - KEY 3 LOS.DATE MED/BI-PTD IND/PD-PTD TOTAL -PAID 002/02592002 / STRAIN/LOW BACK, INCLUDING LUMBAR 01/03/02 4516.64 0.00 5560.39 018/02612002 / CONTUSION/RT.SHOULDER 01/03/02 7072.21 2376.00 9800.21 020/02882003 / ALL OTHER/HEART 01/09/02 0.00 0.00 0.00 005/02902002 / CHEST PAIN/HEART 01/20/02 2846.06 1782.00 4804.06 014/02922002 / STRAIN/LOWER BACK/LT.KNEE 01/20/02 14619.88 12325.50 27126.38 014/03232002 / IRREGULAR HEARTBEAT/HEART 01/21/02 1661.00 0.00 1837.00 009/02952002 / STRAIN/MULTIPLE UPPER EXTREMITIES 01/22/02 1241.00 0.00 1241.00 018/04262002 / CHEST PAIN/HEART 01/26/02 5890.70 0.00 5890.70 016/03122002 / CONTUSION/NECK, BACK, RT,KNEE AND HIP 01/30/02 2518.78 1336.50' 3855.28 005/03282002 / STRAIN/CHEST (INCLUDING RIBS/STERNUM/SOF) 01/31/02 9421.21 891.00 10488.21 005/03242002 / HYPERTENSION/HEART 02/04/02 13845.36 2376.00 16529.36 005/04032002 / HYPERTENSION AND HEART COMPLICATIONS 02/05/02 12623.98 445.50 13069.48 018/03272002 / STRAIN/LT.KNEE 02/05/02 4573.65 3415.50 7989.15 014/03332002 / CHEST PAIN/HEART 02/08/02 6177.23 0.00 6177.23 020/03512002 / STRAIN/LOW BACK AREA 02/13/02 1168.34 0.00 1168.34 018/03532002 / STRAIN/LOW BACK AREA 02/18/02 3078.76 110.88 6258.79 002/03612002 / STRAIN/LT.WRIST AND HAND 02/20/02 1776.57 0.00 1776.57 009/03602002 / CHEST PAIN/HEART 02/20/02 24729.71 8989.42 36393.10 020/03752002 / CARDIAC PALPITATIONS/HEART 02/23/02 222989.42 14404.50 238557.79 018/03682002 / FRACTURE/NOSE 02/25/02 9323.09 1188.00 10511.09 031/03732002 / FOREIGN BODY/RT.EYE 02/27/02 0.00 0.00 0.00 005/04812002 / STRAIN/LT.ANKLE 02/28/02 659.84 0.00 659.84 009/03782002 / DIZZINESS & WEAKNEE/INTERNAL ORGANS 02/28/02 5393.60 2376.00 7769.60 009/04372002 / STRAIN/RT.SHOULDER 02/28/02 3762.65 0.00 3762.65 010/03872002 / STRAIN/RIGHT HAND, LEFT SHOULDER 03/04/02 190.00 -0.00 190.00 016/04042002 / HYPERTENSION/HEART 03/05/02 2849.45 594.00 3455.45 010/04162002 / CONTUSION/RT.HIP 03/13/02 402.28 0.00 402.28 005/05802002 / ALL OTHER/HEART 03/14/02 2293.00 0.00 2293.00 018/04112002 / CHEST PAIN/HEART 03/14/02 4932.44 2079.00 7011.44 016/04122002 / GAS FUMES/INTERNAL ORGANS 03/15/02 399.00 0.00 399.00 010/05922002 / CHEST PAIN/HEART 03/16/02 749.50 0.00 749.50 005/04182002 / STRAIN/LOWER BACK AND RT. HIP 03/18/02 1929.95 0.00 1929.95 016/04392002 / CONTUSION/RT.ARM/ STRAIN/RT.HIP,LEG AND FOOT 03/20/02 6284.00 0.00 10670.16 009/04442002 / CARPAL TUNNEL SYNDROME/BOTH HANDS 03/21/02 880.61 0.00 880.61 020/04352002 / STRAIN/LOW BACK AREA (INCLUDING LUMBAR) 03/21/02 1624.80 594.00 2394.80 010/04432002 / ALL OTHER/HEAD 03/22/02 0.00 0.00 0.00 005/04502002 / HEART DISEASE/HEART 03/25/02 1557.65 0.00 1583.65 005/04552002 / STRAIN/LOW BACK AREA 03/27/02 4611.32 0.00 4616.32 005/04572002 / HYPERTENSION/HEART 03/27/02 11939.41 594.00 12564.41 010/04682002 / HEARING LOSS/EAR(S) 04/01/02 0.00 0.00 0.00 009/04732002 / STRAIN/RT.SHOULDER 04/03/02 23287.11 8613.00 31900.11 020/04882002 / STRAIN/RT.ARM/FROM SHOULDER TO WRIST 04/03/02 15730.72 10023.80 28213.53 031/04722002 / EXPOSED/MOUTH 04/03/02 0.00 0.00 0.00 018/04782002 / FRACTURE/RIGHT HAND 04/06/02 8245.03 5885.60 14130.63 005/05262002 / CONTUSION/RT.ELBOW 04/09/02 3482.05 .7224.32 10706.37 009/07152002 / HEART 04/09/02 957.00 0.00 957.00 005/05912002 / HYPERTENSION/HEART 04/10/02 2208.43 0.00 2208.43 018/05022002 / IRRITATION/BOTH FEET AND HANDS 04/10/02 1529.28 773.68 2346.96. 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE 22 https://www.claimsuite.netIClaimsPortlservlet/com.csedge.claimsport.mcm.PendingDetailLookupServlet?runType=1 &function=... 3/20/2003 et+ M 0 CLM DM AIL (Landscape) 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS CLAIM NUMBER 018/04932002 / DESC OF LOSS - KEY 3 SPRAIN/RIGHT WRIST LOS.DATE MED/BI-PTD IND/PD-PTD 016/05312002 / STRAIN/LOW BACK AREA 04/11/02 04/12/02 2705.32 0.00 016/05002002 / STRAIN/RT.KNEE 04/13/02 1030.73 605.65 1588.92 005/05192002 / EXPOSED/HEPATITIS 04/16/02 1375.00 0.00 0.00 009/05092002 / HEART DISEASE/HEART 04/17/02 145.98 0.00 016/05112002 / ALL OTHER/RT.ANKLE,RT.ARM, AND RT.LOWER LEG 04/21/02 820.71 405.73 018/05162002 / STRAIN/RT.KNEE 04/22/02 4554.28 4009.50 016/07192002 / STRAIN/LT.ARM,LOWER & UPPER ARM, LT.ELBOW 04/23/02 1361.85 0.00 020/05462002 / HIGH LEVEL OF LIVER ENZYMES 04/24/02 102.00 0.00 005/02892003 / ALL OTHER/HEART 04/24/02 0.00 0.00 014/07932002 / ALL OTHER/HEART 04/25/02 2445.20 0.00 016/05202002 / HYPERTENSION/HEART 04/25/02 5781.75 148.50 016/05272002 / CONTUSION/RT.UPPER BACK AREA 04/26/02 837.80 0.00 020/05662002 / HYPERTENSION/HEART 04/29/02 2759.29 0.00 005/05502002 / STRAIN/UPPER BACK AREA 05/03/02 5266.14 1374.52 010/05562002 / HYPERTENSION/HEART 05/03/02 566.64 0.00 016/05782002 / STRAIN/LOW BACK AREA 05/03/02 6352.56 5516.64 018/05592002 / CHEST PAIN/HEART 05/06/02 3465.51 1188.00 005/01582003 / HEARING LOSS/EARS 05/08/02 738.00 0.00 009/05612002 / STRAIN/LOW BACK AREA 05/09/02 3581.13 106.92 010/05692002 / STRAIN/LOW BACK AREA 05/09/02 3099.95 2120.09 016/06302002 / HYPERTENSION/HEART 05/09/02 4464.20 0.00 016/05742002 / CONTUSION/NECK,ENTIRE BACK,LOWER WAIST,WRISTS 05/11/02 1941.06 0.00 031/05842002 / LACERATION/RT.THUMB 05/12/02 0.00 0.00 031/05832002 / LACERATION/RT.LOWER ARM 05/13/02 452.20 016/06182002 / TACHYCARDIA/HEART 05/15/02 1556.00 ..0.00 0.00 014/06672002 / HYPERTENSION/HEART 05/17/02 250.00 0.00 010/06082002 / STRAIN/LOWER ARM 05/20/02 2218.87 0.00 010/05962002 / STRAIN/RT.KNEE 05/21/02 24044.59 8226.90 016/06072002 / IRREGULAR EKG/HEART 05/21/02 380.85 0.00 016/05992002 / STRAIN/LOW BACK AREA (INCLUDING LUMBAR) 05/22/02 522.75 0.00 010/06392002 / HYPERTENSION/HEART 05/27/02 3034.25 0.00 010/06472002 / CONTUSION/LT.SIDE/BACK 05/30/02 917.00 1679.29 014/06262002 / STRAIN/RT.LOWER AMR 06/02/02 2282.95 594.00 010/06242002 / CHEST PAIN/HEART 06/03/02 1417.40 0.00 031/09102002 / CONTUSION/LT.RIBS 06/03/02 643.25 0.00 020/06402002 / HYPERTENSION/HEART 06/05/02 3310.79 0.00 005/06872002 / STRAIN/LOW BACK AREA 06/06/02 5416.54 2427.42 010/06372002 / STRAIN/RT.SHOULDER 06/07/02 3631.51 8367.07 010/06372002 /1 STRAIN/RT.SHOULDER 06/07/02 0.00 0.00 014/06612002 / CONTUSION/STIFFNESS NECK/LOWER BACK & TR. WRIST 06/08/02 1610.48 0.00 016/06452002 / STRAIN/LOW BACK AREA 06/08/02 6448.23 14148.89 010/06462002 / STRAIN/RT.ANKLE 06/09/02 14379.73 5791.50 016/06482002 / STRAIN/LT.KNEE 06/10/02 21719.33 5049.00 009/06982002 / STRAIN/GROIN 06/11/02 740.89 0.00 020/06552002 / STRAIN/RT.FOOT 06/12/02 2569.56 445.50 020/06542002 / IRREGULAR EKG/HEART 06/14/02 60678.78 14404.50 009/06632002 / DIFFICULTY BREATHING/HEADACHE/INTERNAL ORGANDS 06/17/02 1948.30 0.00 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS Page 24 of 33 AS OF 03/20/03 PAGE 23 TOTAL -PAID 2705.32 C ' U 2630.65 605.65 _ i j- 1380.00 1380.00 145.98 �3 1226.44 8563.78 1361.85 102.00] 0.00 2445.20 �- v 5930.25 837.80 2759.29 6816.66 566.64 14472.10 4653.51 738.00 3688.05 5220.04 4514.20 2941.06 0.00 452.20 1556.00 250.00 2394.87 32271.49 380.85 522.75 3034.25 2596.29 2876.95 1417.40 658.25 3310.79 7843.96 11998.58 0.00 1610.48 20631.12 20203.75 26768.33 745.89 4252.56 75083.28 1948.30• AS OF 03/20/03 PAGE 23 https://www.claimsuite.netIClaimsPortlservleticom.csedge.claimsport.mcm.PendingDetailLookupServlet?runType=1 &function=... 3/20/2003 d CC Clio. C;LM DETAIL (Landscape) Page 25 of 33 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE 24 well M CLAIM NUMBER 018/06702002 / DESC OF LOSS - KEY 3 STRAIN/RT.KNEE LOS.DATE MED/BI-PTD IND/PD-PTD TOTAL -PAID 018/06912002 / CONTUSION/LT.KNEE 06/23/02 23138.32 8167.50 31424.82 014/06992002 / HYPERTENSION/HEART 06/30/02 07/03/02 954.75 2223.61 0.00 954.75 7Z pl 010/07952002 / STRAIN/RT.LOWER ARM 07/05/02 198.97 0.00 2223.61 -Q � v C) 010/08902002 010/07112002 / INFLAMMATION/RT.KNEE 07/06/02 11099.53 0.00 3564.00 198.97 14663.531 rm �+ / STRAIN/LOW BACK AREA 07/08/02 987.95 0.00 987.45 031/07102002 / CONTUSION/LT.ELBOW,LT.ANKLE AND BACK INJURY 07/08/02 2392.95 0.00 2392.95 005/00472003 / HYPERTENSION/HEART 07/09/02 120.00 0.00 120.00 005/07312002 014/07282002 / / CONTUSION/LT.KNEE/AND BACK HYPERTENSION/HEART 07/10/02 4162.07 6767.77'_ 11996.70 , 014/07252002 / HYPERTENSION/HEART 07/10/02 1852.00 0.00 1852.00 �` '' co 031/07172002 / LACERATION/LT.THUMB 07/11/02 07/11/02 547.20 665.25 0.00 547.20 Cf 005/08022002 / ABNORMAL EKG/HEART 07/12/02 19709.75 0.00 1782.00 665.25 21491.75 N �-�UO 005/07212002 005/07242002 / / CHEST PAIN/HEART 07/13/02 11923.81 1336.50 13260.31 s' FRACTURE/COLLAR BONE/CUT RT.SIDE/FACE & EAR 07/14/02 1202.30 4158.00 5375. w 031/02012003 / INFLAMMATION/LT.TOE 07/15/02 0.00 0.00 0.00 014/07462002 / HYPERTENSION/HEART 07/16/02 160.13 0.00 160.13 (7592 T}) 005/07372002 005/03582003 / / STRAIN/RT.SHOULDER HEART 07/18/02 24181.68 5061.76 29243.99 DISEASE/HEART 07/19/02 0.00 0.00 0.00 031/07342002 / CONTUSION/RT.INDEX,MIDDLE AND RING FINGER 07/21/02 9832.82 5613.30 15466.12 010/07412002 / CONTUSION/MULTIPLE BODY PARTS/UNK. 07/22/02 21486.95 7246.80 28733.75 018/07992002 / HYPERTENSION/HEART 07/22/02 7758.71 4009.50 11768.21 005/07732002 / STRAIN/LOW BACK AREA 07/23/02 2222.19 0.00 2222.19 020/07532002 / HYPERTENSION/HEART 07/24/02 4078.95 0.00 4078.95 018/07582002 005/07642002 / / CONTUSION/LT.KNEE WEAK 07/25/02 1557.10 ,.A.00 1557.10 009/07692002 / AND DIZZY/INTERNAL ORGANS 07/26/02 4032.78 0.00 4032.78 020/07572002 / HYPERTENSION/HEART STRAIN/RT.SHOULDER 07/26/02 2640.41 4603.50 7243.91 016/07702002 / STRAIN/LT. HAND 07/27/02 2761.78 0.00 2761.78 031/07592002 / CONTUSION/RT.LOWER ARM 07/29/02 07/29/02 918.38 0.00 918.38 018/07792002 / HYPERTENSION/HEART 07/30/02 1417.77 2084.77 0.00. 1917.77 018/08132002 / BLURRY VISION AND DIZZINESS/M.BODY PARTS 07/30/02 47.60 0.00 0.00 2084.77 020/07652002 / HYPERTENSION/HEART 07/30/02 914.24 0.00 233.24 914.24 005/08052002 / STRAIN/LT.SHOULDER,NECK AND UPPER BACK 08/01/02 2958.95 0.00 2958.95 009/07752002 / CHEST PAIN/HEART 08/01/02 1253.75 0.00 1253.75 018/07852002 / HEART DISEASE/HEART 08/02/02 8501.98 5494.50 14011.48 031/07832002 / LACERATION/FINGER 08/03/02 1995.15 135.93 2131.08 010/07842002 / CONTUSION/BACK AND SHOULDER AREAS 08/04/02 3662.00 0.00 3667.00 010/07892002 / CONTUSION/RT.KNEE 08/05/02 0.00 0.00 020/08092002 / STRAIN/LOW BACK AREA, INCLUDING LUMBAR 08/05/02 1134.20 0.00 0.00 1134.20 020/09262002 / CHEST PAIN/HEART 08/06/02 7221.61 0.00 7221.61 005/08062002 / STRAIN/LT.KNEE 08/07/02 1524.40 0.00 1524.40 014/07962002 / HYPERTENSION/HEART 08/07/02 513.00 0.00 513.00 014/08152002 / HYPERTENSION/HEART 08/13/02 589.00 0.00 589.00 018/08102002 / HYPERTENSION/HEART 08/13/02 453.00 0.00 453.00 018/09072002 / CONTUSION/RT.HAND,RT. HIP AND LOWER BACK AREA 08/13/02 3219.95 0.00 3219.95 005/01062003 / ALL OTHER/HEART 08/14/02 120.00 0.00 120.00 009/00532003 / ALL OTHER/HEART 08/20/02 1991.13 0.00 1991.13. 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE 24 https://www.claimsuite.netIClaimsPortlservleticom.csedge.claimsport.mcm.PendingDetailLookupServlet?runType=1 &function=... 3/20/2003 U AVI 111 ; I Al L (Landscapc) Page 26 of 33 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE 25 CLAIM NUMBER 031/03862003 / DESC OF LOSS - KEY 3 EXPOSURE LOS.DATE MED/BI-PTD IND/PD-PTD TOTAL -PAID 031/03872003 / EXPOSURE 08/20/02 195.00 0.00 . R5 195 00 p� x- 010/08292002 / INFLAMMATION/LT.KNEE 08/20/02 195.00 0.00 195.00 �! 016/08262002 / HYPERTENSION/HEART 08/21/02 2888.27 0.00 2886.27 brf$ v \d C) 016/08392002 /CONTUSION/RT.HAND 08/21/02 9860.43 3861.00 13721.43 1 �+ 031/08232002 / LACERATION/HANDS AND WRISTS 08/21/02 08/21/02 792.29 0.00 792.29 005/08252002 / STRAIN/LT.KNEE 0.00 0.00 0.00 a 014/08302002 / STRAIN/RT.KNEE 08/22/02 2225.97 1336.50 3562.47 020/08272002 /HYPERTENSION/HEART 08/22/02 4063.01 0.00 4063.01 031/08312002 / EXPOSED/INTERNAL ORGANS 08/22/02 2082.56 148.50'_ 2231.06 031/08322002 / EXPOSED/INTERNAL ORGANS 08/23/02 180.20 0.00 180.20 031/08332002 / EXPOSED/INTERNAL ORGANS 08/23/02 180.20 0.00 180.20 031/08342002 / CONTUSION/NOSE 08/23/02 180.20 0.00 180.20 010/08432002 /STRAIN/RTKNEE 08/25/02 1146.35 0.00 1146.35 p.. 009/08472002 / . CHEST PAIN/HEART 08/27/02 23870.83 3415.50 27286.33 010/08442002 / +TUBERCULOSIS AND ELEVETED BLOOD PRESSURE 08/28/02 08/28/02 2271.00 0.00 2271.00 005/08462002 / CHEST PAIN/HEART 727.00 0.00 727.00 009/08482002 / STRAIN/RT.SIDE/NECK AND SHOULDER 08/29/02 1861.65 1188.00 3049.65 020/08602002 / STRAIN/RT.SHOULDER 08/29/02 2780.63 5494.50 9781.13 010/08552002 / HYPERTENSION/HEART 08/30/02 813.00 1264.01 2077.01 010/08572002 / STRAIN/RT.KNEE 09/03/02 10525.61 1485.00 12010.61 018/08592002 / HYPERTENSION/HEART 09/03/02 200.60 0.00 200.60 010/08582002 / STRAIN/LT.FOOT 09/03/02 1976.52 2376.00 4352.52 010/08692002 / CONTUSION/LT.THUMB AND RT. KNE 09/09/02 09/04/02 181.71 0.00 181.71 005/00112003 / INTERNAL ORGANS 669.07 995.50 1114.57 010/00132003 / HYPERTENSION/HEART 09/05/02 0.00 +.Q•00 0.00 010/02672003 / HEART DISEASE/HEART 09/05/02 0.00 0.00 0.00 020/08662002 / CONTUSION/RT.ANKLE 09/05/02 0.00 0.00 020/08662002 /1 CONTUSION/RT.ANKLE 09/06/02 3377.41 3288.74 6.00 6666 .15 031/08682002 / DISLOCATION/LEFT SMALL FINGER 09/06/02 0.00 603.76 603.6 018/08752002 / STRAIN/UPPER RIGHT CHEST 09/08/02 262.16 0.00 262.116 018/08762002 / STRAIN/LOW BACK AREA 09/10/02 493.26 0.00 493.26 018/06802002 / CONTUSION/BACK, NECK, AND RT.HAND 09/10/02 1005.83 0.00 1005.83 009/09182002 / INFLAMMATION/RT.FOOT 09/10/02 4816.73 0.00 6009.23 018/09142002 / CONTUSION/HEAD 09/11/02 623 .27 0.00 623.27 020/08822002 / STRAIN/LOW BACK AREA 09/12/02 6690.00 0.00 6690.00 010/08862002 / FOREIGN BODY/LT.EYE 09/12/02 2828.42 5933.95 8761.87 031/08882002 / LACERATION/HEAD 09/13/02 198.57 0.00 198.57 031/08912002 /LACERATION/LT.WRIST 09/15/02 1156.77 148.50 1305.27 020/00482003 / HYPERTENSION/HEART 09/16/02 371.39 0.00 371.39 031/08922002 / STRAIN/RT.HAND 09/17/02 929.11 0.00 929.11 016/08982002 / CHEST PAIN/HEART 09/17/02 1085.90 599.00 1679.90 019/09002002 /09/18/02 CONTUSION/BOTH SHOULDERS,NECH AND UPPER BACK 09/19/02 6096 71 594.00 6690.71 031/09012002 / DERMATITIS/ARMS,RT.SHOULDER,BACK AND CHEST 09/20/02 1424.56 0.00 1424.56 009/00102003 / MULTIPLE CONTUSIONS 1499.38 0.00 1999.38 019/00092003 / INFLAMMATION/LT.KNEE 09/21/02 0.00 0.00 0.00 020/09092002 / STRAIN/NECK 09/21/02 6120.75 2673.00 8793.75 031/09052002 / LACERATION/LT.LOWER ARM 09/22/02 581.31 0.00 581.31 09/22/02 123.50 0.00 123.50 . 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE 25 https://www.claimsuite.net/ClaimsPort/servlet/com.csedge.claimsport.mcm.PendingDetailLookupServiet?runType=1 &function=... 3/20/2003 CLM DETAIL (Landscape) Page 27 of 33 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE 26 m CLAIM NUMBER 031/09092002 / DESC OF LOSS - KEY 3 LACERATION/BOTH LOS.DATE MED/BI-PTD IND/PD-PTD TOTAL -PAID V J-- C1� 0 i 005/00242003 / HANDS ABNORMAL STRESS TEST/HEART 09/22/02 0.00 0.00 0.00 :© ' v w, 019/00202003 / STRAIN/NECK AND RT.SHOULDER AREA 09/23/02 1849.00 0.00 1849.00 =p ;c' 010/02662003 / CHEST PAIN/HEART 09/23/02 2887.10 0.00 2887.10 �- 018/09132002 / CONTUSION/RT.KNEE 09/24/02 09/25/02 0.00 0.00 0.00 0 ' :,L- 0 014/09162002 / STRAIN/LT.LOWER LEG 1336.25 0.00 1336.25 : ` �' s ,s,. 016/09122002 / HYPERTENSION/HEART 09/26/02 1385.31 1039.50 2424,91 0�� 018/09112002 / SPRAIN/LT.KNEE 09/26/02 2908.71 0.00 2908.71 ;01, "', m 020/00992003 / MITRAL VALVE PROLAPSE/HEART 09/26/02 09/26/02 843.47 0.00' 893.47 009/09222002 / CONTUSION/LT.WRIST 09/27/02 506.00 0.00' 506.00 a U . 018/09232002 / HYPERTENSION/HEART 2982.25 1782.00 4764.25i t ;i ?7_ 031/09192002 / DISLOCATION/LT.PINKY FINGER 09/28/02612.90 09/28/02 0.00 612.90 �- `'7 `! 0 031/09242002 / LACERATION/LT.FINGERCL 1096.77 0.00 1096.77 C 031/00692003 / CONTUSION/RT.FOREARM/HAND/RT.HIP AREA 09/28/02 09/30/02 0.00 1843.30 0.00 0.00 e 031/09202002 / STRAIN/RT.HAND 09/30/02 148.50 1991.80 019/00142003 / STRAIN/UPPER BACK AREA 10/03/02 277.76 0.00 277.76; 019/00182003 / INFLAMMATION/RT.KNEE 10/03/02 604.60 1647.63 0.00 604.60 016/00162003 / CONTUSION & INFLAMMATION LT.KNEE 10/04/02 575.26 2970.00 0.00 4617.63 005/00222003 / SPRAIN/LT.KNEE 10/07/02 0.00 575.26 005/01142003 / ALL OTHER/HEART 10/07/02 467.00 0.00 0.00 018/00192003 / STRAIN/RT.SHOULDER 10/07/02 276.20 0.00 467.00 018/00232003 / SPRAIN/RT.ANKLE 10/08/02 362.54 0.00 276.20 018/00722003 / ABNORMALITIES/HEART AND LUNGS 10/09/02 508.00 166.71 529.25 005/01532003 / ALL OTHER/HEART 10/09/02 0.00 508.00 018/01752003 / VALVE PROLAPSE/HEART 10/10/02 0.00 387.00 0.00 0.00 019/00392003 / SPRAIN/RT.ANKLE 10/11/02 1191.33 X.00 387.00 031/00342003 / SPRAIN/RT.WRIST 10/13/02 226.05 0.00 1191.33 010/00372003 / CONTUSION/MULTIPLE BODY PARTS/EXPOSURE 10/14/02 280.09 0.00 0.00 226.05 016/00932003 / CONTUSION/KNEES AND HANDS,SPRAIN LT.ELBOW 10/14/02 6181.54 1188.00 280.09 7369.54 031/00382003 / LACERATION/RT.FINGER 10/15/02 941.22 0.00 941.22 005/01302003 / ALL OTHER/HEART 10/16/02 446.00 0.00 446.00 016/00812003 / INFLAMMATION/RT.HAND 10/18/02 1615.40 3028.35 4643.75 019/00502003 / STRAIN/RIGHT SHOULDER 10/18/02 2738.68 0.00 2916.88 016/02482003 / CONTUSION/FACE 10/18/02 0.00 0.00 019/00552003 / CONTUSION/LT.ANKLE, AND HIP 10/22/02 685.69 0.00 0.00 685.69 019/00602003 / STRAIN/UPPER BACK AREA 10/22/02 1541.72 0.00 1541.72 031/00592003 / LACERATION/LT.FINGER 10/22/02 249.09 0.00 249.09 005/00672003 / CONTUSION/SHOULDER & RT. ARM 10/24/02 170286.46 3322.74 173609.20 018/00762003 / ALL OTHER/INTERNAL ORGANS 10/24/02 147.00 0.00 147.00 031/00622003 / STRAIN/RT.ELBOW 10/24/02 185.76 0.00 185.76 031/00782003 / FOREIGN BODY/RT.EYE 10/26/02 417.15 0.00 417.15 020/00862003 / STRAIN/LOW BACK AREA 10/30/02 790.87 0.00 790.87 031/00802003 / INFLAMMATION/LT.INDEX FINGER 10/30/02 602.83 0.00 602.83 014/00832003 / HYPERTENSION/HEART 10/31/02 199.00 0.00 199.00 031/00872003 / CONTUSION/RT.HAND FINGER 10/31/02 425.00 0.00 425.00 005/01092003 / STRAIN/LOW BACK AREA 11/01/02 0.00 0.00 0.00 014/00942003 / INFLAMMATION/LT.KNEE 11/01/02 825.49 0.00 825.49 031/01002003 / SPRAIN/RT.THUMB AND RT.FOREARMS 11/03/02 1183.19 0.00 1183.19 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE 26 https://www.claimsuite.netIClaimsPortlservlet/com.csedge.claimsport.mcm.PendingDetailLookupServlet?runType=1 &function=... 3/20/2003 CLM DETAIL (Landscape) Page 28 of 33 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE 27 M CLAIM NUMBER 020/01342003 / DESC OF LOSS - KEY 3 ALL OTHER/ASTHMA,ALLERGIES,SINUSITIS LOS.DATE MED/BI-PTD IND/PD-PTL TOTAL -PAID U 0 031/01082003 / ALLERGIC FOREIGN BODY/BOTH EYES 11/04/02 56.00 148.18 204.18 « M 031/01872003 / LACERATION/RT.LOWER LEG 11/04/02 337.46 0.00 337.46 :3 0 031/02392003 / LACERATION/RT.ELBOW 11/04/02 1505.76 0.00 1505.76 01 c � 018/01112003 / EKG ABNORMAL/HEART 11/04/02 11/05/02 0.00 0.00 0.00 0?<<`-_- 019/01042003 / INFLAMMATION/LT.HAND 11/05/02 14596.52 148.50 14745.02 • ' ? A 020/01132003 / STRAIN/UPPER ARM:,' 11/05/02 368.05 0.00 368.05 C� 031/01172003 / CONTUSION/HEAD 2516.73 445.50 2962.23 020/01122003 / ALL OTHER/HEART 11/05/02 29.75 0.00 29.75 •'3 (t3 019/01232003 / STRAIN/LOW BACK AREA 11/06/02 1825.09 0.00' 1825.09 019/01192003 / CONTUSION/NECK,SHOULDER AND BACK 11/09/02 11/11/02 4004.95 0.00 4071.95 i) 27_ 0 010/01282003 / SPRAIN/RT.ANKLE 7154.18 1782.00 8936.18 `vO fxe 018/01322003 / STRAIN/LOW BACK AREA 11/12/02 273.80 0.00 273.80 019/01262003 / SPRAIN/RT.FOOT 11/12/02 483.97 103.99 587.96 _3 '' 031/01292003 / LACERATION/LT.EYE 11/13/02 11/14/02 1169.81 1633.50 2803.31 ra, 019/01442003 / ALL OTHER/NOSE/THROAT 720.21 0.00 720.21 '.__l 014/01462003 / STRAIN/LOW BACK AND NECK 11/14/02 11/14/02 496.34 0.00 496.34 020/01702003 / STRAIN/RT.KNEE 11/14/02 1769.20 148.50 1917.70 031/01372003 / CONTUSION/HEAD 11/15/02 1155.27 0.00 1155.27 031/01392003 / SPRAIN/RT.PINKY FINGER 11/15/02 183.00 71.40 0.00 183.00 010/01472003 / LACERATION/RT.SHOULDER, RT.SIDE OF HIS HIP 11/16/02 0.00 0.00 71.40 018/01492003 / STRAIN/LT.WRIST 11/18/02 483.50 0.00 0.00 016/01502003 / STRAIN/LOW BACK AREA 11/18/02 1187.95 0.00 0.00 483.50 010/01482003 / SPRAIN/RT.ANKLE / CONTUSION/ LT.SHOULDER 11/19/02 0.00 0.00 1191.95 018/01562003 031/01612003 / / CONTUSION/LT.WRIST 11/19/02 332.45 3,x6.35 0.00 638.80 005/01512003 / SPRAIN/RT.HAND STRAIN/LOW BACK AREA 11/19/02 424.46 0.00 424.46 010/01542003 / STRAIN/RT.ANKLE AND RT.SIDE OF BODY 11/20/02 11/20/02 744.59 0.00 762.09 031/01552003 / LACERATION/LT.HAND 11/20/02 430.29 0.00 430.29 016/02072003 / CONTUSION/CHEST 11/22/02 710.50 0.00 710.50 019/01602003 / SPRAIN/LT.ANKLE 11/25/02 37.00 293.15 0.00, 37.00 019/01672003 / STRAIN/LT.ANKLE 11/27/02 1523.79 1188.00 594.00 1481.15 005/01682003 / CONTUSION/HEAD 11/27/02 11739.88 6715.74 2117.79 18472.90 014/01642003 / HYPERTENSION/HEART 11/29/02 0.00 0.00 019/01662003 / STRAIN/RT.KNEE 11/29/02 1631.44 148.50 0.00 1779.94 , 009/01632003 / STRAIN/LOW BACK AREA (INCLUDING LUMBAR) 12/02/02 1419.37 0.00 1419.37 019/01652003 / STRAIN/EE'S RT.SIDE 12/02/02 1391.08 2737.51 4128.59 031/01852003 / SPRAIN/RT.THUMB 12/02/02 211.19 0.00 211.19 019/01712003 / STRAIN/LT. KNEE 12/03/02 809.95 594.00 1403.95 031/01782003 / FOREIGN BODY/RT.EYE 12/03/02 165.75 0.00 165.75 005/02082003 / HYPERTENSION/HEART 12/05/02 3342.89 1039.50 4382.39 019/01762003 / EXPOSED/HEPATITIS B & TUBERCULOSIS 12/06/02 0.00 0.00 0.00 020/01772003 / ALL OTHER/HEART 12/06/02 0.00 0.00 0.00 019/01792003 / STRAIN/RT.ANKLE,BOTH HANDS AND LOWER ARMS 12/07/02 2522.59 1258.54 3856.01 019/01832003 / STRAIN/LOW BACK AREA 12/10/02 626.95 0.00 626.95 019/01902003 / STRAIN/RT.WRIST 12/10/02 112.60 0.00 112.60 019/01842003 / CONTUSION/RT.HIP 12/11/02 973.13 0.00 973.13 019/01862003 / FRACTURE/LT.HAND 12/11/02 648.54 0.00 648.54. 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE 27 https://www.claimsuite.netIClaimsPortlservlet/com.csedge.claimsport.mcm.PendingDetailLookupServiet?runType=1 &function=... 3/20/2003 CIA Ul;'I'nll. (Landscape) Page 29 of 33 https://www.claimsuite.netIClaimsPortlservlet/com.esedge.claimsport.mcm.PendingDetailLookupServlet?runType=1 &function=... 3/20/2003 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE 28 CLAIM NUMBER 031/01912003 / DESC OF LOSS - KEY 3 LOS.DATE MED/BI-PTD IND/PD-PTD TOTAL -PAID U v 0 CONTUSION/LT.FINGER 12/11/02 144.00 0.00 144.00 s U) i 031/01892003 005/01932003 / IRRITATION/RT.EYE 12/12/02 367.67 0.00 367.67-(� Z! / ALL OTHER/HEART 12/12/02 8711.46 2376.00 11087.46 €)- `- E 031/01942003 / SPRAIN/RT.HAND 12/13/02 138.40 0.00 138.90 009/03312003 / CARPAL TUNNEL SYNDRONE/BOTH HANDS 12/13/02 0.00 0.00 0.00 031/01962003 018/03142003 / LACERATION/RT.FINGER 12/14/02 124.60 0.00 124.60 / CONTUSION/RT.KNEE 12/14/02 0.00 O.QO 0.00 Q 019/01982003 / STRAIN/LT.LOWER ARM 12/15/02 2466.26 1188.00 3654.26 031/02022003 / CONTSION/RT.THUMB 12/15/02 331.50 0.00' 331.50 .. ; 005/02032003 / HEART DISEASE/HEART 12/16/02 1880.00 0.00 1880.00 c;, 0 009/02042003 / STRAIN/LT.KNEE AND LOWER BACK 12/16/02 1117.52 0.00 1117.52 to 031/02572003 / CONTUSION/RT.LEG/MOUTH/PUNCTURE SHIN 12/18/02 0.00 0.00 0.00 019/02182003 / FOREIGN BODY/BOTH EYES 12/20/02 309.95 0.00 309.95 031/02192003 / LACERATION/LEFT RING FINGER 12/20/02 341.24 0.00 341.29 j 016/02202003 / STRAIN/MULTIPLE BODY PARTS 12/20/02 893.40 0.00 893.40 019/02122003 / STRAIN/FINGER 12/22/02 325.53 0.00 325.53 010/02212003 / CONTUSION/MULTIPLE BODY PARTS 12/22/02 0.00 0.00 9.00 019/02222003 / PUNCTURE/LEFT LOWER LEG 12/23/02 59.00 0.00 59.00 019/02272003 / STRAIN/RIGHT UPPER ARM (INCLUDING CLAVICLE) 12/26/02 998.60 0.00 998.60 031/02242003 / SMOKE INHALATION/LUNGS 12/28/02 0.00 286.76 286.76 019/02252003 / CONTAGIOUS DISEASE/RT.HAND 12/30/02 0.00 0.00 0.00 019/02292003 / CHEMICAL POISONING/MOLT. BODY PARTS 12/31/02 119.19 0.00 119.19 031/02602003 / CONTUSION/MOUTH 12/31/02 1118.00 0.00 1118.00 019/02322003 / STRAIN/RT.ANKLE 01/02/03 333.58 0.00 333.58 031/02332003 / LACERATION/LT.HAND 01/02/03 0.00 -0.00 0.00 019/02402003 / INFLAMMATION/RT.WRIST 01/02/03 292.49 0.00 292.49 020/02592003 / RESPIRATORY DISORDERS/INTERNAL ORGANS 01/03/03 209.58 0.00 209.58 019/02342003 / STRAIN/RT.ELBOW 01/04/03 1611.19 0.00 1611.19 019/02632003 / CONTUSION/RT.ELBOW 01/04/03 531.17 0.00 531.17 019/02362003 / STRAIN/LT.UPPER ARM 01/05/03 539.25 0.00. 539.25 016/02372003 / INFLAMMATION/RT.EYE 01/05/03 42.00 0.00 42.00 031/02412003 / CONTUSION/RT.TOE 01/07/03 310.57 0.00 310.57 019/02432003 / STRAIN/LT.SHOULDER 01/07/03 280.04 0.00 280.04 019/02442003 / BURN/LT.EYE 01/08/03 177.50 0.00 177.50 019/02472003 / CONTUSION/NECK AND BACK 01/08/03 270.56 0.00 270.56 014/02552003 / STRAIN/RT.THIGH 01/08/03 155.16 0.00 155.16 019/02562003 / CONTUSION/RT.RIBS 01/08/03 48.00 0.00 48.00 019/03512003 / CONTUSION/RT.KNEE 01/08/03 0.00 0.00 0.00 019/02492003 / STRAIN/UPPER BACK AREA 01/09/03 935.97 0.00 935.97 005/02512003 / STRAIN/LT.KNEE 01/09/03 220.67 0.00 220.67 019/02522003 / FRACTURE/RT.FRONT TOOTH 01/10/03 1009.10 0.00 1009.10 019/02532003 / CHEST PAIN/CHEST 01/10/03 126.00 0.00 126.00 031/02622003 / PUNCTURE/RT.HAND 01/11/03 401.10 0.00 401.10 031/02542003 / LACERATION/LT.PINKY FINGER 01/13/03 18.00 0.00 18.00 018/02612003 / IRRITATION/EYE 01/13/03 228.65 0.00 228.65 018/02642003 / CHEST PAIN/HEART 01/13/03 612.30 1216.00 1828.30 009/02652003 / STRAIN/UPPER BACK 01/14/03 6231.00 848.27 7079.27 019/02842003 / CONTUSION/RT.EYE 01/15/03 51.00 0.00 51.00. 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE 28 https://www.claimsuite.netIClaimsPortlservlet/com.esedge.claimsport.mcm.PendingDetailLookupServlet?runType=1 &function=... 3/20/2003 CLM DE'T'AIL (Landscape) Page 30 of 33 https://www.claimsuite.netIClaimsPortlservleticom.csedge.claimsport.mcm.PendingDetailLookupServlet?runType=1 &function=... 3/20/2003 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE 29 CLAIM NUMBER 031/02762003 / DESC OF LOSS - KEY 3 LACERATION/HAND LOS.DATE MED/BI-PTD IND/PD-PTD TOTAL -PAID 009/02852003 / STRAIN/LOW BACK AREA 01/17/03 1106.73 0.00 1106.73 .U_ 0 1 031/03962003 / CONTAGIOUS DISEASE/INTERNAL ORGANS 01/17/03 01/17/03 59.00 0.00 59.00 -0 � 031/03472003 / CONTAGIOUS DISEASE/INTERNAL ORGANS 01/17/03 0.00 0.00 0.00 0.00 0.00 ' 031/03482003 / CONTAGIOUS DISEASE/INTERNAL ORGANSao 01/17/03 0.00 0.00 0.00 0.00 0 a �' 031/03492003 / CONTAGIOUS DISEASE/INTERNAL ORGANS 01/17/03 0.00 0.00 031/03502003 / CONTAGIOUS DISEASE/INTERNAL ORGANS 01/17/03 0.00 0.00 0.00 0.00;>� 020/02692003 / CONTUSION/LT.SHOULDER 01/19/03 0.00 0.00 0.00 019/02702003 / STRAIN/RT.KNEE 01/19/03 454.75 0.00' 454.75 `' (7) o 018/02792003 / SPRAIN/RT.ANKLE 01/20/03 903.60 912.00 1815.60 031/02802003 / FOREIGN BODY/LT.EYE 01/21/03 0.00 0.00 0.00 019/02922003 / ALL OTHER/HEAD 01/21/03 77.35 0.00 77.35 `se 031/02822003 / PUNCTURE/HEAD 01/22/03 302.98 0.00 302.98= ;, 019/02832003 / FOREIGN BODY/RT. EYE 01/22/03 234.40 0.00 234.40 _"' _ 031/02812003 / LACERATION/LT.THUMB 01/23/03 636.68 33.08 669.76) 014/03122003 / EXPOSED/INTERNAL ORGANS/POISONING CHEMICAL 01/23/03 0.00 0.00 0.00 019/03292003 / POISONING CHEMICAL/INTERNAL ORGANS 01/23/03 0.00 0.00 0.00 016/02872003 / AL OTHER/LOWER LEG 01/24/03 47.60 0.00 71.60 031/02932003 / CONTUSION/LT.RING AND MIDDLE FINGERS 01/25/03 0.00 0.00 0.00 009/02862003 / STRAIN/LOW BACK AREA 01/27/03 198.38 0.00 198.38 031/03032003 / FOREIGN BODY/LT.EYE 01/27/03 138.84 0.00 138.84 019/02942003 / CONTUSION/RT.KNEE 01/28/03 0.00 0.00 0.00 016/02982003 / STRAIN/RT.SHOULDER 01/28/03 0.00 458.29 458.29 019/02992003 / CONTUSION/LEFT RIB 01/30/03 53.55 0.00 53.55 019/03022003 / STRAIN/LOW BACK AREA 01/30/03 193.30 -0.00 193.30 016/03202003 / HEART DISEASE/HEART 01/30/03 0.00 0.00 0.00 005/03322003 / HEART DISEASE/HEART 01/30/03 0.00 0.00 0.00 005/03152003 / HYPERTENSION/HEART 01/31/03 0.00 0.00 0.00 019/03052003 / POSSIBLE FRACTURE/LEFT WRIST 02/02/03 0.00 279.86 279.86 018/03062003 / CONTUSION/HEAD 02/03/03 0.00 0.00, 0.00 031/03072003 / STRAIN/LOW BACK/INCLUDING LUMBAR. 02/03/03 59.00 0.00 59.00 031/03102003 / PUNCTURE/RIGHT LOWER ARM 02/03/03 0.00 0.00 0.00 019/03332003 / STRAIN/RT.LOWER ARM 02/03/03 0.00 0.00 0.00 031/03112003 / PUNCTURE/RT.HAND 02/04/03 0.00 0.00 0.00 009/03162003 / HYPERTENSION/HEART 02/04/03 0.00 0.00 0.00 019/03352003 / STRAIN/LOW BACK AREA 02/04/03 0.00 0.00 0.00 019/03172003 / STRAIN/RT.NKEE 02/05/03 0.00 0.00 0.00 019/03192003 / STRAIN/RT.ANKLE 02/06/03 19957.33 2736.00 22693.33 018/03592003 / STRAIN/RT.SHOULDER 02/06/03 0.00 0.00 0.00 019/03342003 / SPRAIN/RT.ANKLE 02/07/03 0.00 0.00 0.00 031/03382003 / CONTUSION/RT.HAND 02/08/03 0.00 0.00 0.00 019/03362003 / STRAIN/LOW BACK AREA 02/09/03 0.00 0.00 67.00 010/03372003 / CHEST PAIN/HEART 02/10/03 0.00 0.00 0.00 031/03392003 / CONTUSION/HEAD 02/10/03 134.23 0.00 134.23 031/04112003 / DERMATITIS/UPPER RT.ARM 02/10/03 0.00 0.00 0.00 019/03402003 / CONTUSION/LT.ARM AND NECK 02/11/03 0.00 0.00 0.00 019/03442003 / CONTUSION/NECK, & ALTERED MENTAL STATUS 02/11/03 0.00 0.00 0.00 019/03452003 / SPRAIN/LT.KNEE 02/11/03 0.00 760.00 760.00. 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE 29 https://www.claimsuite.netIClaimsPortlservleticom.csedge.claimsport.mcm.PendingDetailLookupServlet?runType=1 &function=... 3/20/2003 C;LM DL'I'All, (Landscape) Page 31 of 33 t7+ 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE 30 U 0 CLAIM NUMBER 019/03562003 / DESC OF LOSS - KEY 3 STRAIN/M.BODY PARTS/NECK AND UPPER BACK LOS.DATE MED/BI-PTD IND/PD-PTD TOTAL -PAID -0-' CL 031/03912003 / CONTUSION/RT.HAND 02/11/03 0.00 0.00 0.00 , M 031/03422003 / CONTUSION/FACE 02/12/03 0.00 0.00 0.00 Cl a-+ C) 031/03432003 / FOREIGN BODY/LT.EYE 02/12/03 0.00 0.00 0.00 +-'?'moi 019/03522003 / SPRAIN/RT.ANKLE 02/12/03 0.00 0.00 0.0002/13/03 018/03532003 / STRAIN/LOWER BACK 6 CONTUSION,LT.KNEE 02/14/03 0.00 0.00 0.00 0.00 (:3 031/03542003 / PUNCTURE/HAND 456.00 456.00 019/03572003 / SPRAIN/LT.ANKLE 02/14/03 0.00 1758.91 1758.91 010/03632003 / HEART DISEASE/HEART 02/17/03 0.00 0.00 0.00 �. 010/03602003 / CONTUSION/MULTIPLE BODY PARTS 02/17/03 02/18/03 0.00 0.00'_ 0 .00 j n 016/03612003 / STRAIN/LOW BACK AREA 02/18/03 0.00 0.00 0.00 sr 031/03672003 / INFLAMMATION/RT.FOOT 02/18/03 0.00 0.00 0.00 . 005/04002003 / HYPERTENSION/HEART 02/18/03 0.00 0.00 0.00 _ 019/03622003 / STRAIN/LOW BACK AREA 02/19/03 0.00 0.00 0.00 :dJ 031/03652003 / CONTUSION/BOTH KNEES, LT.SHIN 02/19/03 0.00 0.00 0.00 0.00 009/03662003 / CONTUSION/LT.SHOULDER,LOWER ABDOMEN AND NECK 02/19/03 0.00 0.00 0.00 0.00 018/03722003 / PUNCTURE/RT.ARM 02/19/03 0.00 0.00 019/03642003 / STRAIN/LOW BACK AREA 02/20/03 0.00 0.00 0.00 019/03682003 / LACERATION/LT.TIP OF INDEX FINGER 02/20/03 0.00 0.00 0.00 014/03692003 / HYPERTENSION/HEART 02/21/03 393.75 393.75 019/03702003 / STRAIN/RT.SHOULDER 02/22/03 0.00 0.00 0.00 010/03732003 / STRAIN/RT.KNEE 0.00 0.00 0.00 009/03742003 / SPRAIN/LT.ANKLE 02/24/03 0.00 0.00 0.00 019/03752003 / CONTUSION/BOTH AHNDS,RT.KNEE,WAIST 02/24/03 02/24/03 0.00 760.00 760.00 019/03762003 / CONTUSION/TWISTED ANKLE/STRUCK HIS MOUTH 02/24/03 0.00 0.00 0.00 0.00 019/03802003 / SPRAIN/LT.ANKLE 02/24/03 -4.00 0.00 019/04032003 / IRRITATION/LT.AMPIT AND CHEST 02/24/03 0.00 0.00 0.00 0.00 018/03782003 / CHEST PAIN/HEART 02/25/03 0.00 0.00 0.00 019/03792003 / INFLAMMATION/BOTH LEGS AND HANDS 02/25/03 0.00 0.00 0.00 0.00 010/03842003 / SPRAIN/LT.ANKLE AND LT.KNEE 02/25/03 0.00 0.00 0.00 005/03922003 / CHEST PAIN/HEART 02/25/03 450.00 _ 0.00 0.00 031/03812003 / PUNCTURE/LT.FOOT 02/26/03 0.00 450.00 019/03852003 / STRAIN/LT.SHOULDER 02/26/03 0.00 0.00 0.00 019/03832003 / STRAIN/LOW BACK AREA 02/27/03 0.00 0.00 0.00 009/03992003 / HYPERTENSION/HEART 02/27/03 0.00 0.00 0.00 + 019/03882003 / LACERATION/LT.EYE 02/28/03 0.00 0.00 0.00 018/03902003 / CONTUSION/LOWER RT.LEG AND RT.KNEE 02/28/03 0.00 0.00 0.00 0.00 019/03912003 / FRACTURE/RT.2ND AND 3RD FINGERS 02/28/03 0.00 0.00 0.00 019/03892003 / LACERATION/FACE 03/01/03 0.00 304.00 0.00 304.00 020/03982003 / HEART ATTACK/HEART 03/02/03 0.00 0.00 019/03952003 / SPRAIN/RT.FOOT 03/03/03 0.00 0.00 0.00 010/04012003 / HYPERTENSION/HEART 03/03/03 0.00 0.00 0.00 019/04052003 / STRAIN/RT.SHOULDER 03/03/03 0.00 0.00 0.00 019/03932003 / CONTUSION/RT.KNEE 03/04/03 0.00 0.00 0.00 019/03942003 / STRAIN/GROIN 03/04/03 0.00 0.00 0.00 019/03962003 / FOREIGN BODY/LT.EYE 03/04/03 0.00 0.00 0.00 019/04072003 / CONTUSION/UPPER BACK (THORACIC AREA) 03/04/03 0.00 0.00 0.00 019/04092003 / INFLAMMATION/BACK AND NECK 03/04/03 0.00 0.00 0.00 0.00 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE 30 https://www.claimsuite.netIClaimsPortlservleticom.csedge.claimsport.mcm.PendingDetailLoo,kupServlet?runType=1 &function=... 3/20/2003 C;LM DEA'AIL (Landscape) 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS Page 32 of 33 AS OF 03/20/03 PAGE 31 CLAIM NUMBER 019/04042003 / DESC OF LOSS - KEY 3 CONTUSION/LT.LOWER LEG LOS.DATE MED/BI-PTD IND/PD-PTD TOTAL -PAID 019/04062003 / STRAIN/LT.LEG,LT.ARM & LT.ANKLE 03/05/03 03/06/03 0.00 0.00 0.00 016/04082003 / HYPERTENSION/HEART 0.00 0.00 0.00 019/04102003 / CONTUSION/RT.WRIST,LT.SHOULDER,LT.FOREARM,LT.KNE 03/06/03 03/06/03 0.00 0.00 0.00 0.00 010/04152003 / HYPERTENSION/HEART 0.00 0.00 019/04202003 / CONTUSION/LT.KNEE 03/06/03 0.00 0.00 0.00 019/04142003 / CONTUSION/RT.ARM 03/06/03 0.00 0.00 0.00 019/04162003 / STRAIN/LOW BACK AREA 03/07/03 0.00 0.00 0.00 019/04122003 / SPRAIN/RT.ANKLE 03/07/03 0.00 0.00 0.00 019/04132003 / STRAIN/RT.WRIST 03/08/03 0.00 0.00' 0.00 019/04282003 / SPRAIN/RT.ANKLE 03/09/03 0.00 0.00 0.00 010/04172003 / INFECTION/LOW BACK AREA (INCLUDING LUMBAR) 03/09/03 03/10/03 0.00 0.00 0.00 031/04182003 / CONTAGIOUS DISEASE/MULTIPLE BODY PARTS 03/11/03 0.00 0.00 0.00 019/04192003 / CONTUSION/LT.WRIST,LT.HAND,LT.KNEE,LOWER LEG ETC 03/11/03 0.00 0.00 0.00 019/04232003 / STRAIN/LOW BACK AREA 03/11/03 0.00 0.00 019/04242003 / CONTUSION.RT.ANKLE 0.00 0.00 0.00 009/04212003 / HYPERTENSION/HEART 03/12/03 0.00 0.00 0.00 018/04222003 / FRACTURE/LT.WRIST/SCRAPE LOWER LT.LEG 03/13/03 03/13/03 0.00 0.00 0.00 019/04252003 / STRAIN/RT.UPPER LEG 0.00 0.00 0.00 019/04292003 / CONTUSION/LT.KNEE 03/13/03 0.00 0.00 0.00 016/04302003 / CANCER/SKIN/BOTH FOREARMS 03/13/03 0.00 0.00 0.00 031/04272003 / PUNCTURE/LT.LOWER ARM 03/13/03 0.00 0.00 0.00 019/04312003 / CONTUSION/LT.HAND 03/19/03 0.00 0.00 0.00 019/04322003 / LACERATION/LT.LOER LEG 03/14/03 0.00 0.00 0.00 009/04342003 / STRAIN/LOW BACK AREA 03/15/03 0.00 0.00 0.00 019/04332003 / STRAIN/LOW B ACK AREA 03/15/03 0.00 ' ,,.00 0.00 014/04372003 / ALL OTHER/LT.ELBOW 03/16/03 0.00 0 0.00 0.00 019/04352003 / CONTUSION/RT.LOWER HIP AND RT.THIGH 03/16/03 03/17/03 0.00 0.00 0.00 019/04362003 / STRAIN/UPPER BACK AREA 03/18/03 0.00 0.00 0.00 0.00 0.00 0.00 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS AS OF 03/20/03 PAGE 31 https://www.claimsuite.netIClaimsPortlservleticom.csedge.claimsport.mcm.PendingDetailLookupServlet?runType=1 &function=... 3/20/2003 CO M U 0 N O � ;:) AS OF 03/20/03 PAGE 31 https://www.claimsuite.netIClaimsPortlservleticom.csedge.claimsport.mcm.PendingDetailLookupServlet?runType=1 &function=... 3/20/2003 CO M CLM DETAIL (Landscape) 00315 CITY OF MIAMI CLAIM DETAIL ANALYSIS FREQUENCY 1 -MEDICAL 3 -INDEMNITY 2 -EXPENSE TOTAL -CLAIM DEDUCTIBLE OPEN INCURRED 146941434321.64 42802238.26 2542587.64 86779147.54 .00 OPEN PAID/DATE 132632770924.31 34390840.96 1570791.92 68732557.19 .00 OPEN OUTSTANDI 1456 8663397.33 8411397.30 971795.72 18046590.35 .00 AVERAGE OP 28205.80 29136.99 1730.83 59073.62 .00 CLOSED PAID 0 .00 .00 .00 .00 .00 CLOSED NO PAY 0 .00 AVERAGE CLOS .00 .00 .00 .00 .00 TOTAL INCURRED 469 1434321.64 42802238.26 2542587.64 86779147.54 .00 TOTAL PAID/DAT 132632770924.31 34390840.96 1570791.92 68732557.19 .00 RECOVERY 3RD PARTY 1636702.47- .00 NET INCURRED CLAIM 85142445.07 .00 TOTAL LOSS - CLAIM + DEDUCT 86779147.54 Page 33 of 33 AS OF 03/20/03 PAGE 32 ? a CL it n https://www.claimsuite.netIClaimsPortlservleticom.csedge.claimsport.mcm.PendingDetailLookupServlet?runType=1 &function=... 3/20/2003 ow EXPERT CONSULTANT AGREENIENT BETS EP., CITY OF MIAMI. F? 01UDA E: LIOT FIXLER THIS AGREEMENT is made and entered into this /A da• of 2002. b-,• and Cite of Miarn:. Florida. a political subdivision of the State of Florida, hereinafter referred to as the "C:t�." and Elliot Fix'.er. an individual. hereinafter referred to as "Expert Consultant.' - WITNESSETH: WHEREAS. City from time to time retains persons on a contract basis to perform certain specialized defined tasks for the City that r,qutrl- knowledge. skills and, training not otherwise available to the City by temporary or permanent members of the classified or unclassified service and which tasks. by their nature. require independent and autonomous judgment WHEREAS. City desires to retain Expen Consultant and Expert Consultant had been deemed qualified by the City and agrees to perform the services (-Services") described 'herein. NOW. THEREFORE, pursuant to Sec. 18.116 of the Cih Code. the parties. in consideration of the mutual obligations expressed herein. agree as fc,ilows: Section 1, Services. The City shalt retain Expert Consultant and assign him to the Risk Management Department where he shzll perform the following services: Expert Consultant will provide interim management services of the operations of the Rist: 'Management Department including, but not limited to, supervision of the operating functions of Risk managernert, malting recommendations to management on modifications to the SUBMITTED INTO THE PUBLIC RECORD FOR 03- 364 ITEMON y-�o-ate Risk Management Program. evaluating employee performance and recommending further actions to Management. acvisine on the disposition of workers' compensatior and liabiliry cases. and providing such other managerial tasks as required by the Cite. Section 21, Remuneration. The Expert Consultant shall receive i en -Fwusand and 00/100 ($10,000.00) Dollars. per month and commencing on Nlonday. September 9. 2002. and hereafter. The maximum compensation parable hereunder sl:al: not exceed One Hundred and Twenty Thousand and 001100 (Si20.000.00) Dollars. Expert Consultant shall not be entitled to any employment emoluments, but. from time to time. the City may vrovide Expert Consultant with access to and use of City properiN at the sole discretion of the Cite Manager. .Expert Consultant acknowledges that such access or use does not alter his status as an Independent Contractor. Expert Consultant shall be required to complete Form W-9 (attached). Further, Expert Consultant expressly acknowledges that he shall not acquire status as a Cit% classified employee temporary or p-,rmanent, or unclassified. by virtue of this Agreement. Section J. TerM Expert Consultant sha'.1 commence performance of the Services an NdaAday. September 9. 200" and terminate these Services on Frida., Septeif*er 5, 2003. Expert Consultant shall not commence performance of the St ;rvices until such time as this Agreement has been fully executed by all parties and the cornpleted Form W-9 has been received by the City. Section 4. Telminatioa_ This Agreement may be terminated at the sole discretion of the Cite Manager with or without cause 2 In the event of termination of this -a3 City Clerk 03- 364 Agreement for an} reason. with or without cause, Expert Consuitaat shall not nave recourse to any City of Miami C:ievance or Discipl,nan Procedures. Section 5. Relationshir Betnxeen Parties. Expert Consul.ar,t, under the terms and conditions of this Agreement, is an independent contractor and not a Cit% employee. All work product developed by the Expert Consultant in performing the Services provided for in this Agreerrert are, and shall remain the property of the Cite. Section 6. Indemnification. Expert Consultant shall indemnify, defend and hold harmless the City and its officials. ernpioyees and agents (c:oilectively referred to as "Indemnitees'*) and each of theta from and against all loss. costs, penalties. fines darnages. claims. expenses (including, attorney's fees) or liabilities (collectively referred to as "Liabilities"; by reason of any injury to or death o:' an-, person or damage to or desuvction or loss of any property arising out of resulting from. or in connection with (i) the performance or non-performance of the sen --ices contemplated by this Agreement Nvhich is or is alleged to be directly or indirectly caused. in whole or in pari, by any act. omission. default or negligence (whether active or passive) of' Expert Consultant, regardless of w=hether it is. or is alleged to be. caused in whole or part (whether joint. concurrent or contributing) by any act, omission, default or negligence (.whether actiltIc or passive) of the Indemnitees, or any of them or (ill the failure of the provider to comply wiI, any of the paragraphs herein or the failure of the >rxpen Consultant to conform to statutes, ordinances, or other regulations or requirement of any governmental authoiity. federal or state. in connection with the performance of this Agreement. Expert Consultant expressly agrees to indemnify and hold harmless the Indemnitees, or an of them. from Subm tis � ;=Ito the rt.lblic itot a) __ _ on z/ PriscA!a A. T Ompson City Clerk 03- 364 and against all liabilities which may be asserted b} Expert Consultant. as provided aboN . for which the Expert Consultant's liability would otherwise be lifni,ed to payment under State Workers' Compensation or similar laws. Expert Consultant furt:7er understar:d: tra, Florida Workers' Compensation benefits available to employees of the Cit% are not available to Expert Consultant under this Agreement. Section'. Insurance. The Expert Consultant fully understands that it shall; be the responsibility of the Expert Consultant to secure his/her own insurance coNerage(s). as applicable insurance(s) will not be paid by the Cite on behalf of the Expert Consultant while perfoming the Services. Section 8. Nondisc iminaILpn. Expert Consultant represents and warrants to the Citv that he does not and will not engage in discriminatory practices and that there shall be no discrimination in connection with Expert Consultant's performance under this Agreement on account of race. calor, sex, religion. age. handicap. marital status or national origin. Expert Consultant further covenants that no otherwise qualified individual shall, solely by reason of hisfher race. color. sex. religion. age. handicap. marital status or national origin, be excluded from participation in, be denied services, cr Subm-Wed !nto the public c� { �^ �ey1 6A. i �:� x,0 .37 1 Jre.'.m,Y.s io A iJ� it yTLe,YT! _ _ -(0 03 risdiEa A. Thompson a City Clerk 03- 364 be subject to discriminativu under any provision of this Agreement. IN, WITNESS WHEREOF. the Parties hereto,+ have executed this P,greement on the day and year first above written. ATTEST: r , Priscilla Thompson �. Cin• Clerk APPROVED AS TO FORM CORRECTNESS:.. ' V,'00I /ROD1kdw EL,LIOT FIXL.ER CITY OF MIAN—ii. FLORIDA s 03- 364 Alii -./0-03y9 City Clerk 03- 364 JOHN J. PETILL O, JR., CPA, ARM,CIC ,y January 14, 2003 Ms. Rosalie Mark City of Miami Department of Employee Relations 444 S. W. Second Avenue, 7th Floor Miami, FL 33130 Re: Employee Benefit Consulting Services Dear Rosalie: SUBMITTED INTO THE PUBLIC RECORD FOR ITEM v ON John J. Petillo, Jr., CPA, ARM, CIC can provide valuable Employee Benefit Consulting Services to the City of Miami. I am taking this opportunity to describe these services. Our primary objective is to assist the City of Miami in designing an Employee Benefits Program that best fits your philosophy for providing comprehensive benefits which are cost effective. In addition, we will help formulate criteria - to objectively review your current insurance providers, and, as indicated, select insurance vendors such as insurance companies, brokers and third -party administrators, which best meet the needs of the City of Miami. Our role would be as a supplement to the City of Miami's current Employee Benefits Program. We would serve as a satellite office of your risk management and human resources departments, lending our expertise in the fields of the finance and transfer of risk, as well as employee policies and procedures. We will accomplish this objective by providing services as follows: A B C D E F. G H Analyze current plan design and relate benefits to Employee need and Employer cost. Prepare specifications. Conduct negotiations with insurance companies, brokers and agents during purchase or renewal of insurance. Assist in purchasing specific and aggregate stop loss insurance. Review and comment with reference to third party agreements and assist in selection of third party administrators including interviewing and negotiations. Assist in finding a managed care network to take advantage of competitive rates and pre- arranged discounted fees. - } q e public vith Obtain and analyze quotations and submit recommendations to managent. Review scope of claims utilization to develop a cost containment program. iV'i'1 ,3ciiha A. 1 hompsonClty Clerk Q3, 364 k Ms_ Rosalie Mark City of Miami January 14, 2003 Page 2 l Obtain proposals from audit firms specializing in medical claims to help audit the ongoing program as well as protect the validity of claims accumulated towards the aggregate stop loss. J. Evaluate the effect of incentive programs in conjunction with Wellness programs in order to further reduce claims costs. K. Identify risk exposures stemming from Group Insurance and other employee benefit plans. L. Audit insurance policies, endorsements, and invoices to verify rates and premiums for existing policies; analyze policies for errors, omissions, overcharges and other deficiencies., M. Analyze the potential for bringing claims administration in-house. N. Review Employee Benefits Liability and Fiduciary Liability exposure arising from in-house claims administration. Enclosed please find descriptive information which includes the following: 1. My Biography 2. Current Client Reference List I look forward to meeting with you so that we may discuss specific methods for enhancing your Employee Benefits Program. I will be attending meetings at the City of Miami on Friday, January 24, 2003. 1 will contact you so that we may arrange to meet at a mutually convenient time on Friday, January 24, 2003. Sincerely, John J. Petillo, Jr., CPA, ARM, CIC JJP/mm Enclosure P feai dks .t A. ej "4Or pso Y City Clerk 03- 364 JOHN J. PETILLO, JR., CPA, ARM, CIC - ASSOCIATE John J. Petillo, Jr., joined Insurance Consulting Associates (ICA) in February 1987. John is now at the Avenel, NJ branch of iCA, which he established with fellow Associates in July 1999. His responsibilities include identifying risks from all properties and operations, auditing insurance policies, preparing insurance specifications, and tailoring coverages to the specific risk and exposure needs of iCA's clients. He conducts negotiations with insurance companies and agents, prepares risk management manuals, and assists in developing an in-house "Insurance Manager" to direct insurance operations. He also monitors all insurance services provided to clients including insurance companies, agents and others, and reviews with management cost-saving alternatives. Before joining ICA, John worked for Natcontainer Corporation from 1975 to 1987 and became vice president and general manager. During this period of John's professional career, he was a member of the Board of Directors, serving on the Executive and Underwriting Committees of a captive insurance company, domiciled in Grand Cayman. From 1971 to 1975, John held a senior accounting position with the public accounting firm of J.H. Cohn and Company. At ICA, John has developed strong expertise in risk management, property & casualty and health insurance coverage, safety and loss prevention and claims handling. His diversified client portfolio includes clients in manufacturing and distribution including wholesalers, retail including supermarkets, real estate, construction, printing, fuel oil, advertising, jewelry, steel, entertainment, and the service industry sector including law firms and environmental consultants. John graduated Villanova University in 1971, earning a Bachelor of Science degree. His professional designations include: Certified Public Accountant (CPA) in 1977, Associate in Risk Management (ARM) in 1989, Certified Insurance Counselor in 1997. His professional affiliations include: Society of Risk Management Consultants, New Jersey Society of Certified Public Accountants, American Institute of Certified Public Accountants, U. S. Chamber of Commerce and The New Jersey Business and industry Association (NJB1A). John is also a former member of the insurance Committee of the New Jersey Society of Certified Public Accountants and Executives' Association of New Jersey and the Association of Independent Corrugated Converters. public r €ith ..,� 1/_A* --p-3 pr�sciffl a x'34 'iY 4 a� City Clerk 03- 364 RISK MANAGEMENT PRIVATIZATION "A SAFETYISSUE " PRESENTATION BY: CHARLIE COX AFSCME LOCAL 1907 SUBMITTED INTO THE PUBLIC R"ECORD FOR LL.ON 03- 364 REMARKS OF AFSCMIE LOCAL 1907 CONCERNING PRIVITIZATION OF RISK MANAGEMENT Delivered by Charlie Cox, President, at the Miami City Corarission, March 27, 2003. We have major problems in Risk Management, These problems need to be fixed. The problems you are facing are not with the workers. The issue is SAFETY, SAFETY AND MORE SAFETY. As long as the workers of the City are injured you will have workers compensation claims and as long as the users of the City facilities get injured, you will have general liability claims. The problem with the approach that you are being asked to take is that it ignores the key issue of SAFETY. You have before you a recommendation that you should enter into a contract that -A-ill take public services and outsource them to a company with its corporate headquarters in Illinois. It should come as no surprise to any of you that I rise in opposition to the proposal that public services should be outsourced and that the taxpayers' money sent to Illinois. Make no mistake, in the long run outsourcing will cost you more money. It has to. Gallagher Bassett is in this to make money and you can't have huge corporate salaries and perks without charging more ,money than it costs to provide those services. Gallagher Bassett will charge you 1,370.000. 00 for 900 workers comp cases and you now pay 639,271.00 for ail 1382 cases. Gallagher Bassett will charge you 0120,000 for 710 general liability cases. ZYou now pay 209,411 for 962 general liability casesp You haven't spent the money or made the of%rt it takes to make Risk Management work. No wonder it doesn't work property. If you give the workers the tools and the chance, they will, come through for you, every time. Right now, you pay 130,000 per year for a computer system in risk management that is useless. You pay this 130,000 each year, over and over. Instead of going on the radio talking about how bad the civil service is, why don't you do what managers do and manage? Install the proper computer system —give the people the tools to do their job. And what will happen at the end of the contract period? You will have no in - 1 cure expertise in administering claims. How much will Gallagher Bassett charge you? Are they low -balling you now, so they can make money later? You will not save money by outsourcing public services. We are aware of Gallagher Bassett and it generally has a good reputation. The proposal states that certain costs will be extra. These costs awhere the real money is spent. The costs that are extra iare nclude: Legal fees Professional Photographs Medical Records Experts rehabilitation costs Fees for service of Process y �o 03 n City 03- 364 Architects, contractors Engineers Property damage appraisal Sub rosy investigation Official documents and transcripts Managed care Medical examinations Travel Court reports Accident reconstruction y Outside investigation Once again, management's failings are blamed on the workers. Your ordinance creates a self-insurance program. There is a Board of trustees, which is made up of the City Manager, the Director of finance and the insurance manager. If the program isn't working, it's their fault. The ordinance also provides that the city Manager appoint a city sell insurance and insurance committee. The ordinance says, and has said since 1975, that the City be self-insured but that it purchase umbrella coverage. It wasn't untii 2001 that you had an umbrella policy. This isn't the workers fault. It was the fault of management. We can dance around the issue of workers compensation and general liability claims and how much it is costing the City and talk about how it is administered and how we can change its administration and what kind of reports we should get and the like— but it is an avoidance of the real issue—safety. Not just worker safety but safety of the residents and visitors to the City Of Miami. Why don't you do something to promote worker safety and to make the City a safer place so you don't have as many general liability and workers compensation claims. I have looked thru this proposal --read it over and over again-- and not a word is mentioned about safety. The City Manager was a businessman --and obviously a successful one at that— so he should be aware of Alcoa Aluminum and how its worker safety program increased its bottom line. haul O'Neill, the former Secretary of Treasury, became chief executive of Alcoa Aluminum in 1987. The company's profits were 4.8 million. When he left, the company's profits were 1.5 billion. This is a pretty good lesson in sound business management. How did he do it? By increasing worker safety. On his first day on the job, O'NeiU told the company's executives --and the company was in terrible financial shape—that the company couldn't talk people into buying more aluminum and couldn't raise the prices, so for the company to get better, it had to cut costs. In order to cut costs, he told the executives, we had to work with the workers and the way to do that was to show the workers that you care about them AND THE WAY TO DO THAT WAS TO ACTUALLY CARE ABOUT THEM AND THE WAY TO DO THAT WAS TO ELIMINATE JOB RELATED INJURIES. And the executives were judged by how well they did with eliminating job related injuries. Alcoa did that and the company's profits Submitted Into the public Priscilla A. hr,,rnp,1. o11 City Clerk 03- 364 were huge. On August 29, 2001 Liberty Mutual Insurance Company released a report showing that for every 1 dollar invested in workplace safety, 3 dollars or more is saved. The workers in this city are engaged in difficult, specialized jobs, where injuries can happen --yet the city has one safety officer. Nonc of you have ever sat with the family of a city worker who died in an on the job injury, but I have. Why don't you do something about worker safety? Okay, let's say that the Manager doesn't care about the workers and worker safety—surely you must care about the safety of the users of city's property and facilities. There is nothing in any of the proposals that discuss cutting down on the number and extent of the injuries. The Manager's Memorandum to you states that Gallagher Bassett would "implement an enhanced comprehensive safety program" Where? I challenge you to show me where in this proposal there is any discussion about safety and implementing an enhanced safety program? In fact, we called the Miramar office of Gallagher Bassett on Tuesday. We spoke to Mr. Carta, the branch manager, and asked to speak to the safety officer and were told that there were none in the Miramar office. Didn't the evaluation committee realize that there is no safety program? Tell the workers and the taxpayers the truth: you have done and will continue to do nothing for workplace safety or the safety of the users of the City. APM1-95 establishes a Safety Management Program. its purpose is to - and I quote - to identify and mitigate and for eliminate unsafe acts, practices and conditions that have the potential to result in financial liability for the City of Miami. It is supposed to be City wide and include all departments. The program is not being followed. It is not being followed because Safety has not and is not a priority of this City and there will be no improvement in workers comp or general liability until this city tells its workers and its residents that we care about you and we will work to make it safer for you. Your Safety Coordinator works exceptionally hard and does the best she can do, but I person is not enough. Safety needs to become the central organizing principle of the City if you want to save money. You can save money by cutting down on claims and you can cut down on claims by making the City safer. You have workers who care about the system and want to make it work. Keep the money here, in south Florid, don't send it to Illinois. Care about the workers and care abnut the residents. Give the workers the tools to do their jobs. J-xumenu\2003\030241.Siwcc hri skmast3.dx r , C'EC 03- 364 CURRENT CITY SALARIES WORKER'S COMPENSATION SUPERVISOR 1 71,441.34 CLAIM ADJUSTORS 10 449,322.22 MEDICAL CLERK 0 -- TECH ASSISTANT 4 118,508.29 TOTALS 15 639,271.85 LIABILITY SUPERVISOR 0 ------- CLAIM -CLAIM ADJUSTORS 4 209,411.49 TECH ASSISTANT 0 -- TOTALS 4 209,411.49 INCLUDES: I TEMPORARY AND I ADJUSTORWHICH HANDLES BOTH WORKER'S COMP AND LIABILITY INCLUDES: I TEMPORARY THE ABOVE HANDLE: 1,382 WORKER'S COMPENSATION AND 962 GENERAL LIABILITY CASES IJ City Clerk 03- 364 FEBRUARY 2.7, 2003 CITY OF MIAMI PAGE 196 REPORT 180-300 PAYROLL / PERSONNEL SYSTEM DEPT/DIV 006200 YEARS OF SERVICE AS OF 02/26/03 EMPLE GROUP JOB CODE YRS SERVICE MTHS SERVICE ANNUAL SALRY ----------EMPLOYEE NAME ---------- DIANE J ERICSON 21 008052 0 0 115,000.08 MARY A HUNTER 08 009254 0 3 47,840.00 ENERGILIA A LOPEZ O1 001810 0 4 34,356.61 p ELENA GONZALEZ O1 001812 1 1 43,918.99 ANTOINE P LAURENT O1 001011 1 2 19,019.31 NORMA BENBERRY O1 001812 1 9 46,064.51 SADIE S BROWN O1 001010 2 1 24,316.86 COURTLAND BULLARD O1 001820 2 3 41,852.93 NILDA J PRENDES O1 001154 2 4 32,740.66 PATRICE E NOVAL 04 001330 2 4 68,077.15 BOOt - :, JOANN T DOUGLAS O1 001812 2 7 46,064.51 CHRISTOPHE M BLALOCK O1 001812 2 7 41,852.93 JEFFREY L COLLIER O1 001812 2 7 43,918.99 PAULA C CHANDLER O1 001021 2 10 20,952.67 ANGELLA A BREADWOOD 06 008051 3 2 71,441.34 MIRIAM BALASINO O1 001060 3 7 31,204.37 MARIA L HERNANDEZ O1 001812 9 2 46,064.51 JORGE R PEREZ 06 008083 11 1 64,792.42 ANA M CRUZ O1 001808 13 7 43,918.99 DENISE R MORALES ..-•-04, () 001156 15 3 48,316.11 i gl Q fel" .; c., ;:Y 0 FEBRUARY 2-7, 2003 CITY OF MIAMI PAGE 197 REPORT 180-300 PAYROLL / PERSONNEL SYSTEM DEPT/DIV 006200 YEARS OF SERVICE AS OF 02/26/03 EMPLE GROUP JOB CODE YRS SERVICE MTHS SERVICE ANNUAL SALRY ----------EMPLOYEE NAME---------- AME---------- w BONNIE BONNIE L WILLEY 06 008083 17 7 58,779.55 ANTIONETTE R DAVIS 01 001812 20 8 57,388.24 DORIS I RAMIREZ 01 001022 23 0 43,968.29 SYLVIA L OGUNTOYINBO 01 001345 23 11 55,965.52 DULCE M BORGES 06 008083 27 11 71,441.34 TOTAL COUNT: 29 DEPT TOTALS: x- c-, cr The City of Miami 7/1/2003 - 7/1/2004 DEDICATED UNIT (1) COST AND TERMS as of January 22, 2003 10 risxfacs.com users Data Transfer - 1 Source included $21,000 Total 3 $2,311,800 'Workers' Coni ensation (2) Dedicated Unit Estimated Workers' Compensation Claim Volume: 900 Workers' Compensation Staff 1 Working Supervisor 7 Claim Adjusters 1 Medical Only Clerk 3 Tech. Assistant Liability Program Fee: $920,800 Workers' Compensation Program Fee: $1,370,000 10 risxfacs.com users Data Transfer - 1 Source included $21,000 Total 3 $2,311,800 Liability (2) Dedicated Unit Estimated Liability Claim Volume: 710 Liability Staff 1 Working Supervisor 5 Claim Representatives 1 Tech. Assistannt Liability Program Fee: $920,800 10 risxfacs.com users Data Transfer - 1 Source included $21,000 Total 3 $2,311,800 This material is the proprietary, confidential property of Gallagher Bassett Services, Inc. It has been provided to you for the sole purpose of considering a quote for claims administration services. It is not to be duplicated or shared in any form with anyone other than the individuals of such prospective client that have a business need to know the information. It must be destroyed or retumed to Gallagher Bassett Services, Inc. after its intended use. 03- 364 �d AP":"." city Clerk This material is the proprietary, confidential property of Gallagher Bassett Services, Inc. It has been provided to you for the sole purpose of considering a quote for claims administration services. It is not to be duplicated or shared in any form with anyone other than the individuals of such prospective client that have a business need to know the information. It must be destroyed or retumed to Gallagher Bassett Services, Inc. after its intended use. 03- 364 The City of Miami COSTS AND TERMS (1) Claims will be handled for the life of the contract with no additional per claim fees or Time and Expense. (2) Included in the Dedicated Unit Fees are the following. RISX-FACS Account Administration - Account Coordinator -Topical Captioned Reports @ $50,000 -Index Bureau Reporting -Settlement Authority: - General Liability: $10,000 - Workers' Compensation: $10,000 - Quarterly Meetings - Acknowledgments on all claims other than Medical Only. (3) Billing and Payment Terms: Fees will be billed on an agreed upon interval (monthly or quartley) during the calendar year. Fees are payable upon receipt of the invoice. Gallagher Bassett reserves the right to charge 1 % per month, or maximum legal rate, on balences unpaid after 30 days. r y..'!0.-03 City berk City of Miami dedicated Unit C&T 1/21/2003 03- 364 aG WI LL -252 The City of Miami LIFE OF PARTNERSHIP COSTS AND TERMS Effective Date: 7/1/03 Service Workers Compensation of Claimants Per Claimant Fee Deposit# of Partnership Medical Only 720 $129 $92,880 Indemnity 180 $850 $153,000 Total Workers Compensation 900 $245,880 Liability General BI 120 $695 $83,400 General PD 80 $335 $26,800 Auto BI 210 $695 $145,950 Auto PD 140 $335 $46,900 Professional Liability 160 $825 .$132,000 0 $0 $0 Total Liability,710 $435,050 Ancillary Services Administration Included Data Management Included Account Management $15,000 Index Bureau Reporting Included Claim Reporting (telephonic, web or a -Fax) Included risxfacs.com -10 Users Included Electronic Incident 0 $45 $0 Total: 0 1 $15,000 Additional Services risxfacs.com-Additional Users -Full 0 $2,195 $0 dsxfacs.com -Additional Users -inquiry 0 $1,095 $0 Total: 0 $0 Grand Total: 1,610 $695,930 Date: 1/17/03 Ubey� �,t-� 1 i _ U $IC 44 rely€'i."i rI"e ice: A, . 'ierk This material is the proprietary, confidential property of Gallagher Bassett Services, Inc. It has been provided to you for the sole purpose of considering a quote for claims administration services. It is not to be duplicated or shared in any form with anyone other than the individuals of such prospective client that have a business need to know the information. M must be destroyed or returned to Gallagher Bassett Services. Inc. after its intended use. 03- 364 .kms LL -i.12 City of Miami RUN IN CLAIMS COSTS AND TERMS #W-_ Per Claimant, Service Claimants-- Fee Tbtal-, Run -In Claims Medical Only - one time fee 265 $55 $14,575 Indemnity - per claim / per year 1,065 $395 $420,675 Auto Liability - per claim / per year 318 $395 $125,610 General Liability - per claim / per year 329 $395 $129,955 Professional Liability 350 $395 $138,250 Run-in Claims: Total 2,327 1 $829,065 Data�Tapes-, Sburce- 1 Rate $15,000 Total! $15,000 Transactions / Detail Payments 1 $6,000 $6,000 Notes 0 $6,000 $0 Data Tapes: Total 2 $21,000 Storage- Closed Files 0 $1 $01 Storage: Total 0 $0 Grand Total: 2,329 $850,065 k C A. 44x,k This matenal is the proprietary, confidential property of Gallagher Bassett Services. Inc. It has been provided to you for the sole purpose of considering a quote for claims administration services. It is not to be duplicated or shared in any form with anyone other than the individuals of such prospective client that have a business need to know the information. It must be destroyed or returned to Gallagher Bassett Services. Inc. after its intended use. 03- 364 LIFE OF PARTNERSHIP COSTS AND TERMS (1) Claim Deposits will be reviewed semi-annually and audited at the 18th, 24th, 36th and 48th month. (2) Claims will be handled for the life of the partnership with no additional per claim fees. If you should decide to non -renew, the existing open files can be handled in one of three ways. ■ Gallagher Bassett would continue to handle the open files at our prevailing rates fee per year per open file. ■ Gallagher Bassett would continue to handle the open files on a Time and Expense Basis. ■ Gallagher Bassett would return the files to the client. (Contingent upon Carrier approval.) Note: There will be additional charges for ongoing Data Management (R/SX-FACS®), dsxfacs.com users, Administration and Banking fees for as long as GB handles claims. (3) Data Management includes the following: • New Claim Setup • Historical Claims • Monthly Report by Email or the Website • Carrier Report Package by Email or Website (4) Account Administration includes the following: • Designated Account Manager • Topical Captioned Reports @$50,000 • Index Bureau Reporting • Settlement Authority @$25,000 • Banking Administration (SIMMS) - Provided Loss Fund is Properly Funded • One Audit Per Year • Four Meetings per Year • Reserve Alerts @ $10,000 and subsequent $5,000 changes (5) Claim Reporting • ClaimLine - Telephonic 800# reporting • Web Reporting - First reports via the web • e -Fax - Fax reporting (wc only) (6) risxfacs.com: Standard internet browser access to Gallagher Bassett claim database (7) Billing and Payment Terms: Fees will be billed on an agreed upon interval (monthly, quarterly) during the calendar year. Fees are payable upon receipt of the invoice. Gallagher Bassett reserves the right to charge I% per month, or the maximum legal ra on ba) nces un aid after 30 days. I ' d ti�Af� t , , publi" rc This material is the proprietary, confidential property of Gallagher Bassett Services, Inc. It has been provided to you for the sole purpose of considering a quote for claims administration services. It is not to be duplicated or shared in any form with anyone other than the individuals of such prospective client that have a business need to know the information. It must be destroyed or returned to Gallagher Bassett Services. Inc. after its intended use. 03- 364 STANDARD CLAIMS MANAGEMENT SERVICES Claim Charges: The claim charge is applicable per claimant per line of coverage. Example: A client during working hours is involved in an automobile accident with another vehicle with two occupants. Both occupants were injured, both cars were damaged and our client was injured. The claims handling charges (example only) will be: Claimant #1 - Auto Liability Bodily Injury $738 Claimant #2 - Auto Liability Bodily Injury 738 Claimant Owner - Auto Liability Property Damage 376 Client — Workers' Compensation 761 Client — Auto Physical Damage 300 $2,913 The total GB fee for this one occurrence is $2,913 to adjust the accident. Specific claim charges by claimant by line of coverage is normal practice in our industry. Allocated Expenses: Shall be your responsibility and shall include, but not be limited to: Legal Fees • Professional Photographs • Extraordinary costs for witness statements • Medical records • Experts' rehabilitation costs • Fees for service of process • Architects, contractors • Engineer • Police, fire, coroner, weather, or other such • Property damage appraisals • Sub rosa investigation • Official documents and transcripts • Pre- and post judgment interest paid • Subrogation at 15% of gross recovery • Managed Care • Medical Examinations • Extraordinary Travel made at client's request • Court reports • Accident reconstruction • Chemist • Collection cost payable to third parties on subrogation • Any other similar cost, fee or expense negotiation, settlement or defense of a claim or loss which must have the explicit prior approval of the client • Outside Investigation Managed Care: Managed Care services may include, but are not limited to: • Preferred provider organization networks • Automated state fee scheduling • Medical case management and vocational rehabilitation network • Utilization review services • Light duty/return-to-work programs • Prospective injury manlgep>fsties-; • Hospital bill audit servicp@C;C? it a'i '43 City Clerk This material is the proprietary, confidential property of Gallagher Bassett Services, Inc. It has been provided to you for the sot& purpose of considering a quote for claims administration services. It is not to be duplicated or shared in any farm with anyone other than the individuals of such prospective client that have a business need to know the information. It must be destroyed or retumed to Gallagher Bassett Services. Inc. after its intended use. 03-- 364 STANDARD CLAIMS MANAGEMENT SERVICES Workers Compensation - Medical Only Claims Evaluate and adjudicate work-related claims involving medical treatment only. Claims will be adjudicated according to statutory state requirements and corporate guidelines. The guidelines anticipate: • Investigation sufficient to determine claim type and compensability • No subrogation is required. • Lost days do not exceed statutory waiting period. • No payments for indemnity and vocational rehab. • No loss notices, captioned reports, client meetings or settlement authority is required. • Payments on claims do not exceed $2,500 Services provided beyond the guidelines stated above will be considered indemnity cases and will be on a contract basis only. Workers Compensation - Indemnity Claims Investigate, evaluate and adjudicate work-related claims involving disability and/or payment of medical and other expenses. Claims will be adjudicated according to statutory state requirements and corporate guidelines. Incident - Electronic and Manual Review first report and mark as "Incident". If an adjuster is required to perform any additional work other than reviewing the first report, the incident will be converted to a claim. Liability Claims Investigate, evaluate and adjudicate all third -party claims for which you may be legally obligated. Third -party claims will be managed and administered in accordance with our product guidelines. Property Claims Investigate, evaluate and adjudicate all first -parry claims which you report involving damage or loss of real or personal property. First -party claims will be managed and administered in accordance with our product guidelines. R_ ._, 'Clerk chis material is the proprietary, confidential property of Gallagher Bassett Services, Inc. It has been provided to you for the sole purpose of considering a quote for claims administration services. It is not to be duplicated or shared in any form with anyone other than the individuals of such prospective client that have a business need to know the information. It must be destroyed or retumed to Gallagher Bassett Services, Inc. after its intended use. 03- 364 MANAGED CARE SERVICES Qj ChargesCOSTSANDTERMS State Fee Scheduling $1.30 per line (2 -line header) -OR- iter 20% of savings -OR— $8.50 per bill . AND _ $79 per hour for nurse time Usual, Customary and Reasonable Bill Review $1.35 per line (2 -line header) —AND— $79 per hour for nurse time PPO Hospital and Outpatient Care Networks (OCN) 30% of savings Out of Network Bill Review 35% of savings Telephonic Case Management $60 Medical Triage $185 per Indemnity claim (1st 30 days) $145 per claim (2nd 30 days) After 60 days or Catastrophic - $79 per hour $100 per medical only claim Hospital Certification Program $180 combined inpatient hospital pre-certification/continued stay review _OR_ $95 for hospital inpatient precertification $85 for hospital inpatient continued stay review Utilization Review Program $85 for outpatient precertifcation $65 for outpatient continued review Medical Case Management and Vocational Rehabilitation - $79 per hour plus expense Hourly AK, CA, HI, NY Hospital Bill Audit Program $79 per hour Florida Managed Care Bill Review and PPO at prevailing rate TCM @ $250 per Indemnity for first 30 days; $185 for second 30 days and $79 per hour thereafter. UR at prevailing rates FCM at prevailing rates MCO . All other states Price varies by state PPO Retail Pharmaceutical Network Discounted prescription costs Wholesale Prescriptions and Medical Equipment Program Cost of prescriptions and medical equipment OSHA Reporting $3,000 per year (includes set-up, OSHA access & unlimited OSHA logs and summaries Qj iter _5 9 This matenal is the propnetary. confidential property of Gallagher Bassett Services. Inc. It has been provided to you for the sola purpose of considering a quote for claims administration services. It is not to be duplicated or shared in any form with anyone other than the individuals of such prospective client that have a business need to know the informabon. It must be destroyed or returned to Gallagher Bassett Services, Inc. after its intended use. 03- 364 GGallagher Bassett Service Commitment We at Gallagher Bassett vow to deliver results that are the product of our primary objective — a `zero defects' commitment to quality. When you partner with Gallagher Bassett, you can assure yourselves that the following values will always be instilled in the services we provide to you: • Integrity is the heart of our business ethic. • Mutual respect is the cornerstone of all of our relationships. • Teamwork is how we get the job done best. • We will not be bound by the status quo, but will innovate to assure the best solutions. As leaders we will exhibit responsibility by setting standards for reliability, capability and trust. On behalf of Gallagher Bassett's senior claims management team, we promise to: • Handle your claims in an efficient and professional manner. • Adhere to responsible claims handling product standards. • Guarantee total savings, resulting from our bill review and PPO service offerings. • Abide to mutually agreed upon service instructions. • Remain attentive to our partners gage and measurement for success' Rather than working for you, we promise to work with you in establishing a partnership that will enable our two companies to achieve optimal results and a maximum return on your investment. By establishing a mutually respected relationship with us, you can expect to receive from us the benefits of a true leader and all that it implies: synergistic relationships, dedicated services, and a wealth of experience to better serve you. Sincerely, The Gallagher Bassett Senior Claims Management Team Rich McKenna Emil J. Bravo President Executive Vice President John LaMacchia Sr. Vice President Northeast Zone John Zitko Sr. Vice President Central Zone John Walsh Sr. Vice President Southeast Zone George Prause Sr. Vice President West Zone Norm Darling Executive Vice President David Kocourek Sr. Vice resident Sales a?1ils�ilgexr{eIs�: ev ss5'� 4,d:�pj item +- 364 POLICY NUMBEF , CITY OF MIA"II APM-1-95 DATE: May 14, 2001 ISSUED BY: Carlos A. Gimenez City Manager 00 i * INCIR/ *RATE ADMINISTRATIVE POLICY SUBJECT: SAFETY MANAGEMENT PROGRAM REVISIONS REVISED DATE OF SECTION REV S1SI0_N Created 09/21/95 All 03/21/01 LMP changed to APM 03/21/01 Page 1 of 4 PURPOSE: The City of Miami is self-insured for Workers' Compensation and General Liability and, pursuant to Florida Statute (FS) 381.10.008, is required to have a comprehensive Safety and Health Program, hereinafter referred to as the Safety Management Program. Effective this date, this Administrative Policy supersedes all previous directives relating to this subject. The purpose of the safety program is two -fold. First, to effectively reduce the frequency and severity of duty -related injuries to our employees thus increasing their productivity and lowering workers' compensation exposure. Second, to identify, mitigate and/or eliminate those unsafe related acts and conditions which occur within the City resulting in financial liability on the part of the City. The Objectives of the Safety Management Program are: To promote a safe and healthy work environment for. all City of Miami employees; To ideritify and mitigate and/or eliminate unsafe acts, practices and conditions that have the potential to result in financial liability for the City of Miami. Safety must be the first consideration in the operation of all City business. Safety is the responsibility of all employees, from management to support staff. This policy outlines the scope of att Program and supercedes all previous policies. The policy will be as follows: Ker I. SCOPE Q R, The Safety Management Program is City-wide and includes all personnel and departments. The program serves to review loss prevention in a proactive manner, establishing appropriate incentives as well as accountability for safety-related issues on a City-wide and departmental basis. The program resides in the Risk Management Department with a full-time individual designated as the Safety Coordinator. The Safety Coordinator serves as a liaison to all city departments and services for safety issues. 03- 364 APM-1-95 Pae 2 of 4 II. CONCEPT OF OPERATIONS A. Safety Coordinator The Safety Coordinator is the liaison to all City departments and personnel concerning safety issues and shall carry out the following duties: 1. Identification, evaluation and reporting of unsafe acts, conditions and practices which can result in financial loss to the City; Planning, implementing and reporting on the activities of the safety management program 2. Planning and carrying out regular periodic safety inspections of facilities, vehicles and equipment 3. Analyzing and reporting on workers' compensation and liability trends 4. Presenting timely and concise reports to management 5. Developing and implementing safety educational and training programs based on departmental and employee needs 6. Coordinating City-wide safety committee meetings 7. Planning and implementing safety awards/incentive programs B. City-wide Safety Committee 1. The City-wide Safety Committee is the main conduit of the Safety Management Program. The Committee will review and analyze departmental and City-wide safety and loss prevention data; review policies pertaining to loss prevention; coordinate implementation of safety policies; review safety performance and initiate appropriate actions; establish safety and loss prevention goals and objectives consistent wi City-wide policies. Recommendations will be made based on ongoing analysis of trends and data. 2. The Safety Coordinator is the Chairperson of the City-wide Safety Committee and shall not have voting rights. The Safety Coordinator will direct the agenda and functions of the Committee. 3. Committee Representation a) The below listed departments will provide (through the labor/management process) a full-time member of the Committee selected through the labor/management process. (1) Police (2) Fire -Rescue (3) Public Works (4) Parks and Recreation (5) GSA 03-- 364 APM-1-95 3 of 4 (6) Solid Waste (7) One Member at Large selected by the President of AFSCME Local 1907 4. Authoritv The City -Wide Safety Committee shall have the authority to recommend policy and/or operational changes regarding safety issues, through the appropriate labor/management process. Committee members are of equal status within the Committee. 5. Chain of Command Recommendations from the City -Wide Safety Committee will be handled through the labor/management process. The Safety Coordinator shall present committee recommendations to the Risk Management Administrator. Actions and follow-up will be reported back to the Committee through the Safety Coordinator. Individual departmental safety representatives will have primary responsibility for addressing safety issues within their departments. 6. Function The City-wide Safety Committee functions in two distinct yet overlapping areas: 1. As a Whole —The Committee looks at issues via a City-wide global perspective to develop solutions that transcend departmental lines. For instance, a program that could reduce back injuries in the Parks Department might easily find its way into all other City departments. 2. As Individuals — Each Committee member has a primary responsibility for the safety related issues within the department they represent. It is recognized that safety issues unique to particular departments also exist and require attention focused on the merits of the issue. Here, the individual representative will be able to address the issue while possessing the sensitivity of their department's day-to-day operations. JU-tle public 7. Meeting Schedule n `41b /e 63 The City -Wide Safety Committee shall meet as often�� WX111, 1Q less than quarterly during a calendar year. ' C. Departmental Safety Committees 1. Departmental Safety Committees shall be established within the departments from which a representative has been selected for the City- wide Safety Committee and a "departmental" level committee shall be established serving the balance of departments and general employees as represented by the individual so selected from the City-wide Committee. 03— 364 APM-1-95 Nee 4 of 4 2. Departmental Safety Committees shall be made up of equal number of labor and management representatives as selected through the labor/management process. Departmental committees shall be no larger than eight members and no smaller than four members total. 3. The department representatives to the City-wide Safety Committee shall serve as ad hoc members of the Departmental Committee for liaison and coordination purposes and shall have no voting rights. 4. The Departmental Safety Committee shall be involved with the safety issues peculiar to that department and develop policies in conjunction with their representative on the City-wide Committee. It is not the intent that permission will be required from the City-wide Committee for policy decisions within the Departmental Committee, but it is recognized that a level of coordination must take place to prevent implementation of policies or programs that are in conflict with one another from department to department. 5. Departmental Safety Committees shall meet at a minimum bi-monthly and produce minutes of their activities to be distributed to all department members and the Safety Coordinator. 6. Departmental Safety Committees are recommending bodies only and do not have the authority to make or approve policy. They shall forward their recommendations to their department director for action. 7. The City-wide Safety Coordinator shall act as a technical advisor to the Departmental Safety Committees and have no voting rights D. Individual Employees Individual employee participation and motivation cannot be understated and indeed are critical to the objectives and success of the Safety Management Program. As goals are met and real cost savings materialize over time, individual employees and departments should share in these savings through employee/departmental recognition programs and safety incentives. At the same time, continued unsafe acts and practices will be carefully scrutinized and appropriate remedial actions taken. 03- 364