Item G4
BOARD OF GOVERNORS
AGENDA ITEM SUMMARY
Meeting Date: October 21, 2009
Division:
Emergency Services
Bulk Item: Y es ~
No
Department: Fire Rescue
Staff Contact Person/Phone#: Camille Dubroff X60 1 0
AGENDA ITEM WORDING: Approval of settlement and mitigation of Trauma Star bill between
Monroe County Fire Rescue and Thomas Talbert, account #190009-01, from $11,964.00 to $3,000.00.
ITEM BACKGROUND: The patient, Thomas Talbert, a Key West resident, was severely injured in
an auto VS. scooter accident. His medical bills, including a bill for transporting Mr. Talbert by Trauma
Star to Baptist Health South, currently total $121,000, which exceeds the maximum amount of the
defendant's insurance coverage ($100,000). Mr. Talbert's attorneys have conducted an investigation
and are satisfied that the defendant has no other assets with which to pay the remainder. The portion of
the Trauma Star bill remaining after partial reimbursement of $1 ,616 from Mr. Talbert's insurer (Blue
Cross) is $11,964.00. Attorneys representing Mr. Talbert have asked all of the medical providers to
accept a reduced amount on their liens, so that (a) the liens will be paid in full, and (b) Mr. Talbert will
have a small recovery from the insurance proceeds. His attorneys have indicated that they would
accept an additional $3,000 in full and final settlement ofthe Trauma Star bill. IfMr. Talbert were to
file a motion for equitable reduction of all liens in his personal injury action, it is likely that Monroe
County's lien would be reduced to approximately that amount. Mr. Talbert does not qualify for the
Trauma Star resident Waiver as the accident occurred before the effective date of Resolution 152-2009.
The County Attorney's office agrees that a settlement for $3000.00 of what is owed is appropriate
under the circumstances.
PREVIOUS RELEVANT BOG ACTION: None.
CONTRACT/AGREEMENT CHANGES: N/A
STAFF RECOMMENDATIONS: After a detailed review of the factors listed herein, it is the
recommendation of staff that this agenda item is approved as written.
TOTAL COST:
INDIRECT COST: N/A BUDGETED: Yes-X-No
DIFFERENTIAL OF LOCAL PREFERENCE:
COST TO COUNTY:
N/A
SOURCE OF FUNDS:
N/A
REVENUE PRODUCING: Yes X No AMOUNT PER MONTH Year
~~/~
APPROVED BY: County Atty ~ O~~rch~ing _ Risk Management ~
DOCUMENTATION: Included ...lL......- Not Required
DISPOSITION:
AGENDA ITEM #
Revised 07/09
1'0/02/200'3 16:32
3058548266
LEESFIELD PARTNERS
PAGE 01/07
TRIAl. LAWYBJI!l
October 2, 2009
By U.S. Mail and Facsimile
(305) 292-fJS16
Cynthia L. Hall, Esq.
Assistant County Attorney
Monl'oo County Attorney's Office
P.O. Box 1026
~J~~~Lg~~~;~E,')<'" Key West, Florida 33041-1026
PATRICIA M. KE.NNEDY
MM)( .A. SYl..vssT8R
THOMAS SC01..ARO
ALEXANDER). PERKINS
II~ MO\iucJ", Dl<rrltr c( O>I"",bI~
Reply <<I Miami OfjV;r, only:
2)50 $ot,cl1I)1x\e Hlghw.lY
Miami, Aorid. 33133
3OS/8S.<!-4900
800/836-6400
F;vc: 305/854.8266
E-mail: Inro~Leesfie[d.(;on\
Inremec: www.Le6~1d.com
Key West:
615'1, Whlceh~d Street
KeV We!\c. Flilrfd.'\ 33040
So1lIh Bt.<!dl:
tIll Lincoln Road
Mimi Beach, Fl"ti<la 33 [39
WInter ParkJOtl<\l1do:
Of Cournd
&n,.(Id. G<m~1et
:U2 W. Comlt<:J<:lc AVCflue
Suite 215
Wincer P~rk. F1llrld~ .32789
Re:
Thomas "Greg" Talbert
Monroe County Trauma Star Bill
Dear Cynthia:
It was a pleasure speaking with you yesterday. Based on our conversation, I
am hopeful that a resolution of Mr. Talbert's bill with Monroe County Trauma
Star can be reached during the County Commissioners meeting on October 21,
2009. As we discussed, we have our client's authority to resolve Trauma Star's
outstanding balance for $3,000.
As we also discussed, and in the event that the issue is not resolved during the
County Commissioners meeting, I have filed a Motion for Equitable
Distribution and set the matter for hearing on November 11, 2009. Please find
enclosed a courtesy copy of said pleadings for your file.
If there is any additional information that you need, please let m.e know.
Thank you for your attention to this roa~ter.
Very truly ye.urs,
.,1}. ~.
Mark A. Sylvester
~
September 21. 2009
i I adpi
intermedix
500 NW 165th Street
Suite 102
Miami, FL 33169
Monroe County Trauma Star
490 63rd Street, RM 170
Marathon, Florida 33050
RECEIVED \.
~ SEP ;" Z009 . i
By:j)lCf\V-- tA I
Subject: Reduction/Write off Request
Thomas Talbert DOS 8/19/08
190009-01
Dear Camille,
Enclosed you will find a letter from Leesfeild & Partners requerting a
H:d\J({lon/write off for the patient listed above. The patient Date of Service makes him
not eligible for the Waiver program. I am forwarding the request to you for your re-
view/handling. I have attached the bill for convenience.
fhdnk you in advance
~~~
Client Services Representative
Intermedix
500 N.W. 165th street, suite 104
Miami, Fl33169
Office: (305) 945.2280 ext 2111
Fax: (305) 521.0773
Phone 305.945.2280 Fax 305.945.6692 'iNhy,!ntenlil;[i:)T.C!:f\r
IRA 1-1. L1W:>FJliLD
IltutIJ l'..&:fuJi.:J nll,.il Trill! Ul141(T
~'ATRlCIA M. KENNEDY
WO:)'ll6'MMM/rdJ.N :J.!S!^ 'UO!leWJoJU! aJOW JO~ 'JaAlas xeJ Ja)jewX'v'.:/I.:lD Aq paM:~~aJ seM xeJ S!lJl
,
September 17, 2009
BY FACSIMILE ONL Y
305-521 ~0781
Monroe County Trauma Star
ATIN:THEA
Miami Office
Re:
RTffiiit'?
OOB:
001:
~~l~Ji~?'
.;yitiorrr_G.~]ilJ.q~~
02116/1968
08/19/2008
'1&QO:O'9IOll?c
Dear Thea:
MARK A. SYI.Yf:::,i"fJ< Please be advised that this law firm represents Thomas "Gregg" Talbert In relation
to the very serIous injuries he sustained in a motor vehicle accident on August 19,
2008. We have been informed that Monroe County Trauma Star (MCTS) has an
THOMASSCXlLARO outstanding balance of $11,964.00 on Mr. Talbert's account.
Over the past 4 months, we have made numerous atte:npts to resolve the bala nee
AlEXAN!)!;1l J. f'URKINS on Mr. Talbert's account (Se~ attached letters of May 21, 2009 and September 3,
AI..AJII",14JlIll""""'''fG'''''"L~ 2009). To date we have not receIved a response from MCTS.
I<<i'/) <0 Miami OfJ,~, 11111"
:!350 South Dixit. KlghwdY
Miaull.l"lorid.J 3313.1
.305ftjS4-49(10
1lOO/({:i<.i-6ojOO
r,u.::lO'i/ll~H;Z66
1::''''''11: [Ull~IL~"1ilidJ.cnm
Inr~rn~l' w\Vw.I.\.,."iidJ,co.Inl
K.-y \'7 ~Sl:
615'( Whit~hl.':1d (it""',
K~y Wdr, ]llllTi\h. 33,140
~uf<lh IkUj.i"
J III Li"~llln R<Jud
M~"'IL lX.ch, flmid.} l J l}li
At this time, Mr- Talbert's 10tal medical expenses from this incident exceed
$217,000.00. The subrogation claims, liens, and balances on Mr. r albert's medical
expenses exceed $132,000.00.
Pursuant to the attached letters. MCTS is required by law to reduce its claimed
balance. The attached letters state our offer to resolve MCTS' claimed balance.
Since we have not received a response to our letter and communications, we will
give MCTS until5p.m. eastern time on Friday, September 18, 2009, to respond or
we will deem Trauma Star's balance waived and disburse any proceeds from a
settlement of this matter to the other lien/balance holders whom have agreed to
reductions.
Very truly yours,
'111~
Mark Sylvester, Esquire
LeesfleJd & Partners. P.A.
VlJd 80;U:e~ 600e/H/6 :a+ea 9~1Z :aBed 9ge9PS9SOC :WOJ.:/
WO::l"!l6"MMM/rdlt4 :ljS!^ 'uO!~eWJOlU! eJOW JO:l 'JaNeS xeJ Je}feWXV:lI::l8 };q pa^!8::l8J seM XBJ SILjl
, ,
LEES FIELD
& PARTNERS
September 3, 2009
Monroe CountJT Tl'auma Star
P,O. Box 61039
Fort Myers, FL 33906
Re:
Patient:
DOB:
DOl:
Acct #:
Thomas G. Talbert
02/16/1968
08/19/2008
190009-01
Dear:
As you know. this firm represents Thomas "Gregg" Talbert in relation to the
very serious injuries he sustained in a motor vehicle accident on August 19,
2008. We have been infol'mad that Monroe County Trauma Star (M:CTS) has
an outstanding balance of $11,964.00 on Mr. Talbert's acCOl.lUt. At this time,
Mr. Talbert's total medical expenses from this incident exceed $217,000.00.
The subrogation claims, liens, and balances on Mr. rr~albert's medical expenses
exceed $132,000.00
Unfortunately, the defendant in l\1r. Talbert's case, Brian Sambor, is woefully
underinsured for the damages that he caused in this accident. Defendant
Sambor purchased $100,000 in bodily injury coverage through GElCO. The
defendant tendered the $100,000, however, due to the magnitude of Mr.
Talberes injuries, and the amount of the subrogation claims, liens and
balances, our law firm did not accept the $100,000 and filed a lawsuit on behalf
oflVIr. Talbert. Through litigation we have unfortunately confirmed that Mr.
Sambor does not have any personal assets to compensate Mr. Talbel't for his
injuries. I am attaching hereto an asset and insurance affidavit completed by
Mr. Sambor for your records (See Exhibit '"An).
The reasonable value ofMt.. Talbert's injuries, disability, past and future pain
and suffering, and economic losses is in excess of $2 million (See Exhibit ....BI.-
List of Injuries).
Due to the fact that the defendant has no assets, the only available l'ecovery
to Mr. Talbert is the $100,000 in bodily injury coverage. Mr. Talbert
understandably will not authorize our fIrm. to accept the $100,000 in insurance
coverage because given the medical expenses, and E:ubrogation claims, liens,
and balances, he would wind up with nothing.
Our firm at this time has agreed to waive OU1' attorneys' fees f01' the benefit of
Wd m:2:~:G~ 600C:/U/6 :aleo 9~/~ :a6ed 99Ggvge90~ :WOJ::I
WOJ'lj6'MMMft:djlll 1!S!^ 'UO!lBWJOjU! aJOW JO::l 'JEWElS XBj J<l}fBWX\f::lI::l8 ^q pEl^!aJaJ SBM XBj S!lll
LEESFIELD
& PARTNERS
Mr. Talbert, however, even with om: firm waiving Our fees, Ml'. Talbert .still
recovers nothing unless the providers agree to accept substantial reductions
in thei);' liens and subrogation claims.
As you know, Florida Law provides that whet'e claimants :receive lese than the
full value of their claims, lien-holders, such as MCTS; must accept a reduction
of their subl'ogation claim pursuant to the doctrine of equitable distribution.
As stated, the full value of Mr. Talbert's claim is conservatively estimated at
$2 million. As there is only $100,000 in msurrowe coverage, Mr. Talbert
stands to recover only 5% of the value of his claim. Pursuant to the doctrine
of equitable distribution, all balance and lien holdel's would be entitled to the
same percentage. MOTS under the equitable distribution formula would be
entitled to 5% of its subrogation claim, a total of $5-98.20.
ApTJlication of the Equitable Distribution Formula
Net :recovery to Thomas Talbert
after costs (40% Attorneys fees will be waived):
$ 100,000.00
$ 2,000,000.00
0.05
(fotal Value of the olaim:
Pro Rata Ratio: (Net recovery J value of claim):
Total benefits paid for injury by MOTS:
$ 11,964.00
MQ'I':;'s recoverable Claim
(Benefiw · Pro rata Ratio):
$ 598.20
In applying the equitable distribution formula, the court will also take into
account the fact that MOTS is not the only lie::l-holder in this matter.
Competing liens in this matter include thirteen (13) other health providers as
well as Mr. Talbert's health insurance:
BlueCross BlueShield of FL
LKMC
Baptist Hospital
Miami IJR/Phy-Med Grp.
AMRINCO
BPT Compo Path. AS60C
Kendall Anesth Assoc
NEB FloridaJPro Bills
Select PT - KW
Infectious DP/IC System
Sheridan ER Physicians
$ 107,372.78
$ 3,385.46
$ 3,000.00
$ 1, 3~O.12
$ 1,259.87
$ 1,060.25
$ 941.90
$ 900.00
$ 683.64
$ 581.18
$ 310,08
lNd ro:l~:U 600l/H/6 :EllBO 9~/v :a6ed 99l9v99908 :WOJ::I
WO:)"ll6'.MNvIllJrc414 l!S!^ 'UO!l8WJOJU! aJOW JO:l "JaNes xepa>jewX\f:l1:l8 ^q pe^!~"J SeM X8j S!41.
LEESFIELD
& PAltTNERS
Radiology in Paradise $
Baton Rouge Ortho Clinic $
KW urgent Care $
244.00
50.00
5.00
TOTAL:
$ 121,124.28
At this time however, we have been authorized by our client to offer MCTS
IRA H. tBI1SrlEW $2,000 on its lien. This is substantially mOl'e than that which would be
Ik,...J("~,"fl,'/r"",IIT,"IIl.......,,., allowed under the equitable distribution formula. In offering $2,000, it is our
intention to try to resolve Mr, Talbert's claim and the liens, balances, and
subrogation claims of his providers, as soon as possible.
l'ATIUCIA M. Kl!NNEUY
MARK A. SYI:VF_';,HR
TllOMAS SlX.llA.J\U
ALI:'XANllliR J I'ERKINl:i
Attl AJmith..J in UiHri., oj (.'b1~'N.bkl
Ek/Jry CO Miami Offic, ollly'
2.350 S.,uch (ljxh: lli~:hw~\,
Miatlli. FIlIrl,b Tlfn
305/854-4900
Hlll.l/li.lt\.Q400
r~x' 30518')4-8266
n'lII,,;I: 1Ilk~L.......,lidJ.C<Jm
lmcmcc www.Lccsfidd.C1110
K<y \!:'o!j(,
(1)'/, Whir~h",,,1 Str~"r
K",y W\;ll, FloriJu 33010
S/luJJ.I!<...-i!;
Illl Lincoln Rosd
Mi,lIl1i ~,,'h, I'llJriua 33139
Please note> that in addition to be presented with the numbers herein, a court
of law hearing an equitable distl'ibution motion will also hear abo\tt the
tragedy that left this otherwise healthy 40-year-old man disabled for life. At
a hearing on this matter we will not be offering $2,500 to satisfy the
subrogation claim, rather we will ask the court to aJ.Dply the fOl'mula and rule
that MCTS is only entitled to $598.20.
Lastly, in addition to l'ecovering $1,500,00 from our client's settlement, MCTS
already recovered $1,616.00 from our client's health insurance. MOTS will
have recovered Over $3,500 which represents 30% ofitlS total bill.
Should MOTS not agree to this offer, they will not be included in any
disbursement of the settlement proceeds based on the agreement of the other
lien holders to these terms.
Should MOTS agree to this offer, we will be able to f()l-ward your check within
weeks of yoU!' response. If you are agreeable to this offer, please sign below
and retUl'D. this letter by fax to my attention at (305) 854-8266 to include in
our file. Thank you for your attention and for your anticipated help in
promptly resolving this matter.
Vr~yours, Mi Uff!llJie ~
e~U1BE '7 . d" r "" ~ >q-.
LEES FIELD & PARTNERS, P.A.
Signatul'e:
Print Name:
On behalf of Monroe County Trauma Star
VIld t;O:U:(;~ 600(;IL~/6 :aleo
9 ~/S :aB8d
99(;9PS9S0€ :WOJ:l
wO:)'!J6'iWM'Ilrc414 :l!S!^ 'UO!+EWJOlU! aJOW JO;:/ 'JaNaS XBl Ja)jEwXV::II::I8 };q pa^!a::laJ SEM XEl S!41
AFFIDAVIT OF BRlAN SAMBOR
.STATE OF FLORIDA )
)
COUNTY OF MONROE )
BEFORE MEl the Ulldersign~d authority, person~ly appeared BRIAN
SAMBOR, who after being first duly sworn, under penalty of peljury, hereby affirms
and states:
1. My name is BRIAN BAMBOR, I have knowledge of the .facts stated
herein. I currently reside at 1901 S. Roosevelt Boulevard, Apt. 205N, Key West,
FL 33040.
2. I am. a.ware that Thom.as G. Talbert is making el'8im.s aga.inBt me for the
personal injuries h;e sustained, on August 19, 20,08. as a result of a collision between
an au.tomobile that I own and was operating at the time, and a moped driven and
occupied by ~maa G. T~bert, said collision OCCUl'l'~g at or near the intersecti?n of
Whitehead Street and Angela Street. in Key West, Monroe C(!)uuty. Florida.
3. On August 19, 2008, the only insurance poijey that would prove. benefits
to a person(s) injured by the operation of my motor vehicle~ which was registered and
owned by the a..:ffiant, and bears vehicle identification n:umber JT3GN86RXTOO15232.
and license plate IOIQEI (hereinafter "the subjectvehicle"), is an automobile insurance
.policy with Geico lneirance Company (hereinafter "Geico/), policy number 0461654204,
with bodily iIJjury coverage of $100,000.00 per person, $3oo,@00.00 per occurrence.
4. On August 19, 2008., I was not afforded any additOOnal insurance coverage
. for bodily injury resulting from.my ownership of the subject. vehicle from any other
SO~, whether it be ~urance policies with a. motor vehicle insuraneEt company,
lAId SO:U:~~ 600G/H/6 :alea 9~n~ :a6Ed 99G9VWSOS :WOJ:l
wO::J'!j6'lvI.^M'I/rdll4 :1!S!^ 'UO!IBWJOJU! aJOW JO::J ,'JaNaS xej Ja>jewXV:lI::J8 ^q pe^!a::JaJ seM xeJ S!41
insurance policies with other insurers, ihsurance coverage through employers, excess
or um.brella insurance, or any othe:r insurance coverage or other source .of monetary
. .
CO'9'€U"age for bodily injury resulting from my oper.ation. qf the subject vehicle.
I swear that the information contained in this affi.davitiS' true and correct to the best
. of my knowledge.
FURTHER AFFIANT SAYETB NAUGHT.
DATED lIilil :3 day of CJfJ1' '/ , 2009.
~ 1Vt~ s.J.-
BRIAN AMBOR
BEFORE.h1E, the undersigned authority, personally appeared BRIAN SAMBOlt. who
is (perSonally known to me) (or has produced identification/- r A, L.
), and who, being first by me duly sworn, acknowledges that he/she is the
person duly antho~zed to execute the foregoing Authorization. for Settlement; and that
he(lShe has read the Authorization for Settlement, underS~ds its terms, approves of
the authorization, and he/she executed the same in my presence, this ~ day of
~,2009. .. .... .
SWORN io and S~CRIBEO before /"f- day of 'Nf.O
. 2009.
I
,
My commission expires:
:v~
. ,-::""~ ~c:~tEOE'ttolurM.
. '"'lld:. Dlana u:Snt'
~:. :CDmmisol- olT.l4 ...,
. '.~ ~ ,.;:' Jl' . """IlIDD6316f"
" "n"- . ,'1qlJ.l'll8: l.t A h 10 U\I
. ..~t, ..'~l.....,.....:.....~ ,2011
. ...........,)cao.IJJlDlGcc,DIC. .
- 2 -
INd fX):t;~;U 600C:IL~/6alea 9~/U :a6ed 99C:9vC;9S0S :WOJ:J
wo:yu6'^"^,,^,,,rd1l4 :1!SI^ 'uO!lBWJOIUI "JOW JO:J 'JaNas;>re1 Ja)jewXI:f:J 1:J8 JIG pa^!a:laJ seM xel S!41
LEESFIELD
&. PARTN'ERS
LIST OF INJURIES
SUSTAINED BY
THOMAS "GREGG" TALBERT
· LEFT HIP FRACTURE
· LEFT HIP SURGERY REQUlRlNG BIPOLAR LEFT HIP
REPLACEMENT
· RIGHT OPEN FEMORAL FRACTURE
· RIGHT OPEN FEMORAL SURGERY (OPEN REDUCTION
lNTERNAL FIXATION)
· ATTRIBUTED A DISABILITY RA TlNG A rAGE 40
· Ll1.:.F'T HIP DEFORMITY
· RlGHT THIGH DEFORMITY
· SEVERE ANEMIA SECONDARY TO ACCTE BLOOD LOSS
· MUL TIPLE BLOOD TRANSFUSIONS
· HYPONATREMIA
· THROMBOCYTOPENIA
· COMORBID OF ALLERGIC RHINITIS AND DERMATITIS
· SEVEN-DAY ADMISSION AT BAPTIST HOSPITAL'S
INTENSIVE CARE UNIT
· SIX MONTHS OF PHYSICAL THERAPY (INCLUDING ONE
MONTH AT BAPTIST REHABlLIr A TI0N DEPARTMENT)
Wd €O:G~:G~ 600GIL~/6 :atBa 9~lB~ :a6ed 992;9vS9S0B :WOJ:J
STATEMENT
DATE
9/21/09
11gooo~-.01.'...'.
190009-01
TRAUMA STAR
PO BOX 61039
FORT MYERS, FL
BX301A
ACCOUNT
NUMBER
33906
AMOUNT PAID $
OUR TOLL FREE PHONE NUMBER IS
PLEASE DIAL NUMBER AS SHOWN
1-866-432-2813
MAKE CHECKS PAYABLE IN U.S. DOllARS TO:
THOMAS TALBERT
904 TERRY LN APT 1
KEY WEST, FL 33040
TRAUMA STAR
PO BOX 61039
FORT MYERS, FL
33906
PATIENT NAME: THOMAS TALBERT
PHONE NUMBER:
TRANSPORTED TO: BAPTIST HOSPITAL
'~~~~~~9~1s~1~~~~!g~{~
(I~!t~!~ "
8/19/08 AIR TRANSPORT
MILEAGE CHARGE
INSURANC PAYMENT
101.0 @ $ 80.00
5500.00
8080.00
1616.00
* * * IMPORTANCE NOTICE * * *
IN ORDER FOR YOUR INSURANCE TO BE BILLED PLEASE PROVIDE THE REQUIRED INFORMATION
REQUESTED ON THE REVERSE SIDE OF THE FORM AND SIGN THE TOP PORTION.
IF THERE IS ANY PROBLEM REGARDING THE PAYMENT OF THIS Bill, CONTACT OUR TOLL FREE ACCOUNT IJ.9000~-oi:
OFFICE AT ( 1, _ a b,b, Lt...?_ .:).ft 1 ::t ) WITHIN 5 DAYS TO MAKE ARRANGEMENTSpHONE NUMBER NUMBER, " (, ,';" , " "
PLEASE SHOW1'.C!:;CllJNi fIlOMl:ltl,O'f<IffiL CHECKS.
ZZ