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HomeMy WebLinkAboutR-85-11904% J-85-1204 12/3/85 RESOLUTION NO. S`J -119 A RESOLUTION AUTHORIZING THE DIRECTOR OF FINANCE TO PAY TO WALTER CANTALOW AND OTHERS ON HIS BEHALF, THE SUM OF TWELVE THOUSAND ONE. HUNDRED EIGHTY ONE DOLLARS AND EIGHTY SEVEN CENTS ($12,181.87), WITHOUT THE ADMISSION OF LIABILTTY, IN FULL AND COMPLETE, SETTLEMENT OF ALL BODILY INJURY, PERSONAL IN,TURY PROTECTION LIENS, WORKERS' COMPENSATION LIENS, CLAIMS AND DEMANDS AGAINST THE CITY OF MIAMI AND UPON EXECUTION OF A RELEASE, RELEASING THE CITY OF MIAMI FROM ALL CLAIMS AND DEMANDS. WHEREAS, Walter Cantalow, through his attorneys, Kurzban, Kurzban & Weinger, originally filed a claim against the Equitable Life Assurance Society of the U.S., which serves as the City's group health insurance administrator. The Equitable's involvement is that in accordance with its in -house -guidelines, it reviewed the claim and denied payment of benefits to Walter Cantalow, a City employee as a result of an "accident". The claim was later amended to name the City of Miami as the Defendant. Mr. Cantalow was injured by way of a gunshot wound that occurred when he was the aggressor in a neighborhood argument (date of incident l/l/82). The E.quitable's guidelines as referred to above, do not permit them to make payments where an individual is the aggressor; however, the City's group insurance policy and the booklet describing same, which is distributed to the employees does not provide for such a coverage exception. Although charged with aggravated battery, the charges against Mr. Cantalow were later nolle prossed by the State Attorney's office; and WHEREAS, the above claim has been investigated by the Torts Committee of the City Attorney's office and in accordance with Ordinance No.84-17, which created the City of Miami's self- insurance program, the City Attorney's office recommends that this claim be settled without any admission of liability for the CITY COMMISSION MEETING OF DEC 19 1985 ii sum of Twelve Thousand One Hundred Eiqhty One Dollars and Eighty Seven Cents ($12,181.e7), the issue of attorney s fees remains open and will be resolved by the Court at a hearing to be held in the near future. NOW, THEREFORE, BE IT RESOLVED BY THE COMMISSION OF THE CITY OF MIAMI, FLORIDA: Section 1. That the Director of Finance is hereby authorized to pay to Walter Cantalow and others on his behalf, the sum of Twelve Thousand One Hundred Eighty One Dollars and Eighty Seven Cents ($12,181.87), without any admission of liability in full and complete settlement of all bodily injury, personal injury protection liens, workers' compensation liens, claims and demands against the City of Miami, excepting attorney's fees, upon execution of a release, releasing the City of Miami from all bodily injury, personal injury protection liens, workers' compensation liens, and claims and demands. PASSED AND ADOPTED this 19th day of December►1985. ATTEST: XAV ER SUAREZ , MAYOR MATTY HIRAI CITY CLERK APPROVE RM AND CORRECTNESS: LUCIA A. DOUGfIERTY CITY ATTORNEY LMF/cm/129 85 -1190 CITY OF MIAMI. FLORIDA INTER -OFFICE MEMORANDUM Honora4l,e Mayor and Members of t>f City Commission tUrb'ia A. ougherty City Att rney R,, December 3, 1985 L-83-151 DATE �'LE Cantalow v. City of Miami 51_,B:L :'Case No. 83-11740 CC 05 R ELF RF N,, LS F N'- LOSURFS Plaintiff, Walter Cantalow, filed his claim against the Equitable Life Assurance Society of the U.S., which serves as the City's group health insurance administrator. The Equitable's involvement is that in accordance with its in -house -guidelines, it originally denied payment of benefits to Walter Cantalow, a City employee as a result of an "accident". The facts of the case are that Mr. Cantalow, a City employee was injured by way of a gunshot wound that occurred after he was the aggressor in a neighborhood argument (date of incident l/1/82). The Equitable's guidelines as referred to above, do not permit them to make payments where an individual is the aggressor; however, the City's group insurance policy and the booklet describing same which is distributed to the employees does not provide for such a coverage exception. Additionally, although charged with aggravated assault, the charges against Mr. Cantalow were nolle prossed by the State Attorney's Office. Medical bills attributable to the incident are Fifteen Thousand Thirty Nine Dollars and Fifty Nine Cents ($15,039.59) and Plaintiff is also seeking attorney's fees and costs totalling Two thousand Nine Hunred Dollars ($2,900.00). All of the medical bills and other damages have been verified as to correctness. After extensive discussions and negotiations, the matter can now be settled for Twelve Thousand One Hundred Eighty One Dollars and Eighty Seven Cents ( $12,181.87), representing approximately 80% of the medical bills incurred plus One Hundred and Fifty Dollars ($150.00) for costs expended by Plaintiff's attorneys. The issue of attorney's fees remains open, and will be resolved by the Court at a hearing to be held in the near future. This claim has been investigated by the City Attorney's office in accordance with Ordinance No. 8417, which created the City of Miami's self -insured program. The City Attorney's office recommends that the City of Miami pay Twelve Thousand One Hundred Eighty One Dollars and Eighty Seven Cents ($12,181.87) to settle this claim. LAD/r /128 Enc. (Resolution) 85-1190