Attachment_D_-_Loss_History.pdf
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- Property and Casualty Insurance
- Solicitation number
- RFP-2018-0369
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- Florida
About this file
The document is a Florida Municipal Insurance Trust (FMIT) Claims Activity Report for the City of Casselberry, spanning from January 1, 2007 to December 31, 2017, covering liability and property claims across multiple fund years. The comprehensive report details individual claims for each fiscal year, including claim numbers, loss dates, claimant information, claim codes, and financial breakdowns such as outstanding reserves, paid amounts, and total incurred costs.
The report reveals a pattern of claims across various departments including police, fire, streets, parks and recreation, and waterworks operations, with claim types ranging from vehicle accidents and property damage to workers' compensation injuries and employment-related disputes. The total incurred costs vary by year, with the 2012-2013 fund year showing the highest total at $325,270.58 and the 2017 partial year showing $8,500.00. The claims involve both property damage and personal injury, with many claims related to vehicle accidents, workplace injuries, and municipal infrastructure issues. The document suggests this is part of the city's risk management and insurance documentation, tracking financial exposures and insurance claims across different operational areas.
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Other files
| File | Type | Posted |
|---|---|---|
| RFP-2018-0369_PUR-F-216_Notice_of_Intent_to_Award.pdf | ||
| Work_Comp_Loss_Runs.xls | XLS spreadsheet | |
| Auto_Schedule_as_of_07-05-2018.xls | XLS spreadsheet | |
| Inland_Marine_Schedule_as_of_07-05-2018.xls | XLS spreadsheet | |
| Property_Schedule_as_of_07-05-2018.xls | XLS spreadsheet | |
| Liability_Loss_Runs.xlsx | XLSX spreadsheet | |
| Addendum_1_-_RFP_2018-0369.pdf | ||
| RFP-2018-0369_-_Property_and_Casualty_Insurance.pdf | ||
| Attachment_B_-_Statement_of_Values.pdf | ||
| Attachment_C_-_Projected_Payroll.pdf | ||
| Attachment_E_-_Drug_Free_Workplace.pdf | ||
| Attachment_A_-_Coverage_Document.pdf |
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Text version
FMIT NUMBER: 0079 CLAIMS ACTIVITY FOR JANUARY 01, 2007 - DECEMBER 31, 2017
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
Claims For Fund Year: 2008
GC2008061673 2008-11-05 2008-12-17 CLOSED 2008-12-23
CLAIM CODE: GL CITIZEN ILLNESS
PRIMARY CLAIMANT: NATALIE SIEGEL
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $0.00 $0.00 $0.00
GC2009063166 2009-06-20 2009-06-26 CLOSED 2009-06-26
CLAIM CODE: POL DOOR DAMAGED BY POLICE
PRIMARY CLAIMANT: JUDY MONROE
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $0.00 $0.00 $0.00
GC2009063810 2009-08-27 2009-09-10 CLOSED 2010-03-12
CLAIM CODE: RPP EQUIPMENT THEFT.
PRIMARY CLAIMANT: * CITY OF CASSELBERRY
REAL AND PERSONAL PROPERTY $0.00 $2,099.00 $2,099.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $2,099.00 $2,099.00 $0.00
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
VA2008061173 2008-10-02 2008-10-03 CLOSED 2008-12-03
CLAIM CODE: APD O/V BACKED INTO FIRE TRUCK
PRIMARY CLAIMANT: THOMAS SCHAEFER
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $1,035.08 $1,035.08 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $1,035.08 $1,035.08 $0.00
VA2008061284 2008-10-10 2008-10-21 CLOSED 2009-01-20
CLAIM CODE: APD PEDESTRIAN HIT I/V FAILING TO USE CROSSWALK
PRIMARY CLAIMANT: WILLIE LUMPKIN II
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $0.00 $0.00 $0.00
VA2009062210 2009-02-10 2009-03-02 CLOSED 2009-03-04
CLAIM CODE: APD I/V STRUCK PARKED O/V
PRIMARY CLAIMANT:
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $0.00 $0.00 $0.00
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
VA2009062693 2009-04-24 2009-04-28 CLOSED 2009-09-10
CLAIM CODE: APD OV REARENDED IV RIGHT OF WAY
PRIMARY CLAIMANT: KAI CHUNG
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $7,875.00 $7,808.25 $66.75
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $85.00 $0.00 $85.00
TOTAL FOR CLAIM $0.00 $7,960.00 $7,808.25 $151.75
VA2009063373 2009-07-02 2009-07-22 CLOSED 2009-10-12
CLAIM CODE: APD IV #1 SIDESWIPED IV #2
PRIMARY CLAIMANT:
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $2,389.32 $0.00 $2,389.32
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $2,389.32 $0.00 $2,389.32
VA2009063436 2009-07-25 2009-07-30 CLOSED 2009-07-30
CLAIM CODE: APD SUSPECT VEHICLE HIT I/V
PRIMARY CLAIMANT:
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
VA2009063437 2009-07-10 2009-07-30 CLOSED 2009-07-30
CLAIM CODE: APD SUSPECT VEHICLE HIT I/V
PRIMARY CLAIMANT: JASON KWIATKOWSKI
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $0.00 $0.00 $0.00
VA2009063562 2009-07-24 2009-08-12 CLOSED 2009-08-17
CLAIM CODE: APD O/V BACKED INTO I/V
PRIMARY CLAIMANT: WILLIAM RUCKER
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $0.00 $0.00 $0.00
VA2009063923 2009-09-21 2009-09-24 CLOSED 2009-09-24
CLAIM CODE: APD OV BACKED INTO IV
PRIMARY CLAIMANT: MARSHA SLAUGHTER
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
GC2008061211 2008-10-01 2008-10-09 CLOSED 2009-01-06
CLAIM CODE: GL TRIP AND FALL OVER HOLE IN GRASS
PRIMARY CLAIMANT: DAWN HEATHCOCK
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $512.10 $0.00 $512.10
TOTAL FOR CLAIM $0.00 $512.10 $0.00 $512.10
GC2008061426 2008-11-09 2008-11-13 CLOSED 2008-11-13
CLAIM CODE: RPP VEHICLE DAMAGE TO SIGN
PRIMARY CLAIMANT: *CITY OF CASSELBERRY
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $0.00 $0.00 $0.00
GC2009062291 2009-03-01 2009-03-11 CLOSED 2009-03-17
CLAIM CODE: GL O/V HIT BARRICADE
PRIMARY CLAIMANT: LORAN GOFF
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
GC2009062326 2009-02-10 2009-03-16 CLOSED 2012-05-25
CLAIM CODE: GL BICYCLE ACCIDENT
PRIMARY CLAIMANT: JHANNY RODRIGUEZ
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $25,000.00 $25,000.00 $0.00
EXPENSE / LEGAL $0.00 $42,345.21 $0.00 $42,345.21
TOTAL FOR CLAIM $0.00 $67,345.21 $25,000.00 $42,345.21
GC2009063154 2009-02-18 2009-06-25 CLOSED 2013-04-01
CLAIM CODE: GL ALLEGED CABLE CUT
PRIMARY CLAIMANT: PROGRESS ENERGY FLORIDA, CLAIMS DEPARTMENT-PEF152
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $785.25 $0.00 $785.25
TOTAL FOR CLAIM $0.00 $785.25 $0.00 $785.25
GC2009063261 2009-07-01 2009-07-09 CLOSED 2009-07-09
CLAIM CODE: GL CLAIMANT WAS SICK.
PRIMARY CLAIMANT: NATALIE SIEGEL
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
GC2009065209 2009-06-19 2010-03-03 CLOSED 2010-03-22
CLAIM CODE: RPP EQUIPMENT VANDALISM
PRIMARY CLAIMANT: *CITY OF CASSELBERRY
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $0.00 $0.00 $0.00
GC2009065450 2009-03-10 2010-03-26 CLOSED 2011-12-12
CLAIM CODE: GL BICYCLIST HIT CONSTRUCTION SIGN
PRIMARY CLAIMANT: JAMES WHITE
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $100.00 $100.00 $0.00
EXPENSE / LEGAL $0.00 $19,506.63 $0.00 $19,506.63
TOTAL FOR CLAIM $0.00 $19,606.63 $100.00 $19,506.63
GC2009065888 2009-06-01 2010-05-11 CLOSED 2010-08-11
CLAIM CODE: GL ALLEGED IMPROPER STORM WATER MAINTENANCE.
PRIMARY CLAIMANT: SEMINOLE INDUSTRIAL HOLDINGS
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $648.00 $0.00 $648.00
TOTAL FOR CLAIM $0.00 $648.00 $0.00 $648.00
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
VA2008061720 2008-12-10 2008-12-22 CLOSED 2009-01-13
CLAIM CODE: APD I/V BACKED INTO MAILBOX
PRIMARY CLAIMANT: GRIFFIN WOODS
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $0.00 $0.00 $0.00
VA2009062725 2009-04-26 2009-05-01 CLOSED 2010-07-21
CLAIM CODE: APD O/V SIDESWIPED I/V
PRIMARY CLAIMANT: DONNA MITCHELL
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $10,713.26 $10,713.26 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $10,713.26 $10,713.26 $0.00
VA2009066251 2009-09-26 2010-06-22 CLOSED 2010-06-29
CLAIM CODE: APD IV HIT MAILBOX
PRIMARY CLAIMANT: SHARON DEAR
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $155.97 $155.97 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $155.97 $155.97 $0.00
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
GC2008061343 2008-10-25 2008-10-28 CLOSED 2009-03-04
CLAIM CODE: GL TRIP AND FALL
PRIMARY CLAIMANT: ANDIALIZ CORONA
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $808.00 $0.00 $808.00
TOTAL FOR CLAIM $0.00 $808.00 $0.00 $808.00
GC2008061400 2008-11-07 2008-11-10 CLOSED 2008-12-04
CLAIM CODE: GL TRIP AND FALL
PRIMARY CLAIMANT: LIZZETTE ALCARAZ
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $360.00 $0.00 $360.00
TOTAL FOR CLAIM $0.00 $360.00 $0.00 $360.00
GC2009062125 2008-12-10 2009-02-16 CLOSED 2009-02-17
CLAIM CODE: RPP VEHICLE DAMAGE TO SIGN
PRIMARY CLAIMANT: *CITY OF CASSELBERRY
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
GC2009062151 2009-02-06 2009-02-19 CLOSED 2009-02-20
CLAIM CODE: GL PREMISE INJURY
PRIMARY CLAIMANT: MIKE STELLITANO
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $0.00 $0.00 $0.00
GC2009062881 2009-05-19 2009-05-22 CLOSED 2009-12-02
CLAIM CODE: RPP WIND DAMAGE
PRIMARY CLAIMANT: 010003-CITY OF CASSELBERRY
REAL AND PERSONAL PROPERTY $0.00 $2,250.04 $0.00 $2,250.04
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $587.50 $0.00 $587.50
TOTAL FOR CLAIM $0.00 $2,837.54 $0.00 $2,837.54
GC2009063079 2009-06-13 2009-06-16 CLOSED 2009-08-19
CLAIM CODE: GL TREE LIMB FELL ONTO VEHICLE
PRIMARY CLAIMANT: WALTER ANDINO
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $576.95 $0.00 $576.95
TOTAL FOR CLAIM $0.00 $576.95 $0.00 $576.95
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
GC2009063226 2009-07-01 2009-07-07 CLOSED 2009-07-14
CLAIM CODE: GL O/V STRUCK A WASHOUT.
PRIMARY CLAIMANT: ROBERT MOSS
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $0.00 $0.00 $0.00
GC2009063559 2009-08-03 2009-08-12 CLOSED 2009-08-12
CLAIM CODE: GL ALLERGIC REATION BY VISITOR
PRIMARY CLAIMANT: ULA JORDAN
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $0.00 $0.00 $0.00
GC2009063685 2009-06-11 2009-08-26 CLOSED 2009-10-13
CLAIM CODE: RPP VANDALISM TO EQUIPMENT
PRIMARY CLAIMANT: 016005-TRAFFICE SIGNALS
REAL AND PERSONAL PROPERTY $0.00 $2,243.00 $0.00 $2,243.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $2,243.00 $0.00 $2,243.00
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
VA2008061321 2008-10-21 2008-10-24 CLOSED 2008-11-10
CLAIM CODE: APD O/V BACKED INTO POLICE VEHICLE
PRIMARY CLAIMANT: WILLIE COLSON
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $78.00 $0.00 $78.00
TOTAL FOR CLAIM $0.00 $78.00 $0.00 $78.00
VA2009061889 2009-01-13 2009-01-20 CLOSED 2010-03-26
CLAIM CODE: APD O/V BACKED INTO I/V
PRIMARY CLAIMANT: A AND M SI CONSTRUCTION
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $1,303.80 $1,303.80 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $392.00 $0.00 $392.00
TOTAL FOR CLAIM $0.00 $1,695.80 $1,303.80 $392.00
VA2009063649 2009-08-14 2009-08-21 CLOSED 2009-08-21
CLAIM CODE: APD I/V HIT BUILDING COLUMN
PRIMARY CLAIMANT: WINTER PARK HOSPITAL
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
VA2009063670 2009-08-17 2009-08-25 CLOSED 2009-08-26
CLAIM CODE: APD EQUIPMENT BROKE REAR GLASS.
PRIMARY CLAIMANT:
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $0.00 $0.00 $0.00
GC2008061538 2008-11-07 2008-12-01 CLOSED 2008-12-03
CLAIM CODE: RPP ENTRANCE WALL DAMAGE
PRIMARY CLAIMANT: *CITY OF CASSELBERRY
REAL AND PERSONAL PROPERTY $0.00 $6,236.87 $0.00 $6,236.87
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $6,236.87 $0.00 $6,236.87
GC2008061675 2008-11-17 2008-12-17 CLOSED 2008-12-23
CLAIM CODE: GL CITIZEN ILLNESS
PRIMARY CLAIMANT: SOPHIE HOLLER
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
GC2008063352 2008-10-01 2009-07-21 CLOSED 2013-03-22
CLAIM CODE: E&O CITY FAILED TO SECURE PROPER STATUTORY BOND
PRIMARY CLAIMANT: SOUTHERN LANDSCAPING AND IRRIGATION
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $92,750.00 $25,000.00 $67,750.00
EXPENSE / LEGAL $0.00 $53,907.96 $0.00 $53,907.96
TOTAL FOR CLAIM $0.00 $146,657.96 $25,000.00 $121,657.96
GC2009061903 2009-01-12 2009-01-20 CLOSED 2009-01-30
CLAIM CODE: GL ILLNESS ON PREMISES
PRIMARY CLAIMANT: JOYCE SWAGGERMAN
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $0.00 $0.00 $0.00
GC2009062166 2009-02-19 2009-02-24 CLOSED 2009-02-26
CLAIM CODE: GL PREMISE INJURY
PRIMARY CLAIMANT: CLAYTON ELSIE
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
GC2009062459 2009-02-24 2009-03-31 CLOSED 2009-06-30
CLAIM CODE: GL TRIP AND FALL
PRIMARY CLAIMANT: JUDY LUND
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $616.00 $0.00 $616.00
TOTAL FOR CLAIM $0.00 $616.00 $0.00 $616.00
GC2009063926 2009-06-27 2009-09-24 CLOSED 2009-09-25
CLAIM CODE: GL TRIP AND FALL OVER MANHOLE.
PRIMARY CLAIMANT: SHERLEY PACHECO
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $0.00 $0.00 $0.00
GC2009065341 2009-06-18 2010-03-18 CLOSED 2012-02-21
CLAIM CODE: GL BICYCLIST HIT POTHOLE
PRIMARY CLAIMANT: RONALD CAMP
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
GC2009065443 2009-07-10 2010-03-26 CLOSED 2017-05-18
CLAIM CODE: E&O VIOLATION OF CIVIL RIGHTS
PRIMARY CLAIMANT: MARIE JOHNSON
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $131,175.71 $0.00 $131,175.71
TOTAL FOR CLAIM $0.00 $131,175.71 $0.00 $131,175.71
VA2008061393 2008-10-31 2008-11-10 CLOSED 2009-01-28
CLAIM CODE: APD I/V BACKED INTO O/V
PRIMARY CLAIMANT: WILLIAM KITCHEN
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $733.44 $733.44 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $733.44 $733.44 $0.00
VA2009061967 2009-01-26 2009-01-27 CLOSED 2009-03-26
CLAIM CODE: APD WINDSHIELD DAMAGE
PRIMARY CLAIMANT:
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $184.86 $0.00 $184.86
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $184.86 $0.00 $184.86
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
VA2009062408 2009-03-23 2009-03-26 CLOSED 2009-08-13
CLAIM CODE: APD I/V HIT BUILDING
PRIMARY CLAIMANT: MICHAEL ELLIOTT
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $400.00 $400.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $464.00 $0.00 $464.00
TOTAL FOR CLAIM $0.00 $864.00 $400.00 $464.00
VA2009063086 2009-06-15 2009-06-16 CLOSED 2009-06-16
CLAIM CODE: APD OV STUCK IV
PRIMARY CLAIMANT: LINDA GENTRY
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $0.00 $0.00 $0.00
Claim Activity For 10/01/2008 - 9/30/2009
Number of Claims: 50 Total Incurred: $333,969.15
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
Claims For Fund Year: 2009
GC2009067418 2009-10-01 2010-11-08 CLOSED 2010-11-08
CLAIM CODE: E&O ALLEGED WRONGFUL REFUSAL TO PROVIDE WATER SERVICE
PRIMARY CLAIMANT:
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $0.00 $0.00 $0.00
GC2010065497 2010-03-25 2010-03-31 CLOSED 2010-03-31
CLAIM CODE: RPP FIRE DAMAGE.
PRIMARY CLAIMANT: *CITY OF CASSELBERRY
REAL AND PERSONAL PROPERTY $0.00 $2,375.00 $0.00 $2,375.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $2,375.00 $0.00 $2,375.00
GC2010065735 2010-04-21 2010-04-27 CLOSED 2010-05-24
CLAIM CODE: GL TRIP AND FALL
PRIMARY CLAIMANT: CATHY RYAN
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
GC2010079657 2010-01-01 2014-12-16 CLOSED 2015-06-23
CLAIM CODE: GL EEOC...PKG
PRIMARY CLAIMANT: MARK STEIN
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $8,594.00 $0.00 $8,594.00
TOTAL FOR CLAIM $0.00 $8,594.00 $0.00 $8,594.00
VA2009064122 2009-10-17 2009-10-19 CLOSED 2009-11-23
CLAIM CODE: APD I/V SIDESWIPED O/V
PRIMARY CLAIMANT: SARAH RECHER
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $0.00 $0.00 $0.00
VA2009064788 2009-11-01 2010-01-20 CLOSED 2010-01-21
CLAIM CODE: APD I/V HIT HYDRANT
PRIMARY CLAIMANT:
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $508.00 $0.00 $508.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $508.00 $0.00 $508.00
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
GC2010065044 2010-02-09 2010-02-15 CLOSED 2010-04-02
CLAIM CODE: GL MEALS ON WHEELS PARTICIPANT UNRESPONSIVE
PRIMARY CLAIMANT: LENA LANIER
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $0.00 $0.00 $0.00
GC2010065284 2010-02-04 2010-03-11 CLOSED 2010-06-11
CLAIM CODE: GL VEHICLE HIT DRAIN
PRIMARY CLAIMANT: DOMINICK TODARO
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $0.00 $0.00 $0.00
GC2010065348 2010-01-22 2010-03-18 CLOSED 2010-03-22
CLAIM CODE: RPP EQUIPMENT VANDALISM
PRIMARY CLAIMANT: *CITY OF CASSELBERRY
REAL AND PERSONAL PROPERTY $0.00 $3,580.81 $0.00 $3,580.81
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $3,580.81 $0.00 $3,580.81
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
GC2010065799 2010-03-22 2010-05-04 CLOSED 2011-08-26
CLAIM CODE: POL ALLEGED EXCESSIVE FORCE.
PRIMARY CLAIMANT: JAMES FRALEIGH
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $7,207.80 $0.00 $7,207.80
TOTAL FOR CLAIM $0.00 $7,207.80 $0.00 $7,207.80
GC2010066012 2010-05-08 2010-05-25 CLOSED 2010-06-18
CLAIM CODE: RPP VEHICLE DAMAGE TO STREET LIGHT
PRIMARY CLAIMANT: *CITY OF CASSELBERRY
REAL AND PERSONAL PROPERTY $0.00 $3,734.35 $3,734.35 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $365.06 $0.00 $365.06
TOTAL FOR CLAIM $0.00 $4,099.41 $3,734.35 $365.06
GC2010066156 2010-05-26 2010-06-10 CLOSED 2010-07-01
CLAIM CODE: GL WATER DAMAGE TO BUILDING
PRIMARY CLAIMANT: MITCHELL MELLS
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $1,870.00 $1,870.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $1,870.00 $1,870.00 $0.00
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
GC2010066740 2010-08-08 2010-08-12 CLOSED 2010-09-24
CLAIM CODE: RPP LIGHTNING DAMAGES
PRIMARY CLAIMANT: *CITY OF CASSELBERRY
REAL AND PERSONAL PROPERTY $0.00 $2,560.33 $0.00 $2,560.33
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $2,560.33 $0.00 $2,560.33
GC2010067733 2010-05-25 2010-12-20 CLOSED 2011-02-14
CLAIM CODE: GL ALLEGED INJURY FROM EMT HANDLING
PRIMARY CLAIMANT: MIGUEL ZULUAGA
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $1,816.00 $0.00 $1,816.00
TOTAL FOR CLAIM $0.00 $1,816.00 $0.00 $1,816.00
GC2010079656 2010-01-01 2014-12-16 CLOSED 2015-08-10
CLAIM CODE: GL EEOC...PKG
PRIMARY CLAIMANT: WALTER POOLEY
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $6,842.00 $0.00 $6,842.00
TOTAL FOR CLAIM $0.00 $6,842.00 $0.00 $6,842.00
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
VA2010064978 2010-02-07 2010-02-09 CLOSED 2010-02-09
CLAIM CODE: APD SUSPECT VEHICLE HIT IV
PRIMARY CLAIMANT: GERALD WILLIAMS, JR.
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $0.00 $0.00 $0.00
VA2010066249 2010-05-30 2010-06-22 CLOSED 2012-01-24
CLAIM CODE: APD ALLEGED FIRE TRUCK DAMAGE TO DRIVEWAY
PRIMARY CLAIMANT: CHRISTINA NOVOTNY
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $325.35 $0.00 $325.35
TOTAL FOR CLAIM $0.00 $325.35 $0.00 $325.35
VA2010066840 2010-08-11 2010-08-24 CLOSED 2010-10-21
CLAIM CODE: APD OV CHANGED LANES INTO IV
PRIMARY CLAIMANT: DIANA STERLING
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $1,827.50 $1,827.50 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $1,827.50 $1,827.50 $0.00
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
VA2010067204 2010-09-28 2010-10-05 CLOSED 2011-12-19
CLAIM CODE: APD OVI REARENDED OV2 HITTING IV
PRIMARY CLAIMANT: CLARENCE SICHLER
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $730.50 $0.00 $730.50
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $730.50 $0.00 $730.50
GC2010066567 2010-06-14 2010-07-27 CLOSED 2010-07-27
CLAIM CODE: GL VEHICLE HIT SEWER CAP
PRIMARY CLAIMANT: ROBERT AYDT
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $0.00 $0.00 $0.00
GC2010066579 2010-07-26 2010-07-28 CLOSED 2010-11-23
CLAIM CODE: GL WATER MAIN BREAK
PRIMARY CLAIMANT:
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $540.45 $0.00 $540.45
TOTAL FOR CLAIM $0.00 $540.45 $0.00 $540.45
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
GC2010067047 2010-05-21 2010-09-16 CLOSED 2012-11-28
CLAIM CODE: E&O ALLEGED WRONGFUL TERMINATION
PRIMARY CLAIMANT: GORDON PLEASANTS
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $0.00 $0.00 $0.00
GC2010079654 2010-01-01 2014-12-16 CLOSED 2015-06-23
CLAIM CODE: GL EEOC...PKG
PRIMARY CLAIMANT: KAREN GILBERT
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $9,350.00 $0.00 $9,350.00
TOTAL FOR CLAIM $0.00 $9,350.00 $0.00 $9,350.00
GC2010079655 2010-01-01 2014-12-16 CLOSED 2015-08-10
CLAIM CODE: GL EEOC...PKG
PRIMARY CLAIMANT: JERRY JORDAN
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $6,130.00 $0.00 $6,130.00
TOTAL FOR CLAIM $0.00 $6,130.00 $0.00 $6,130.00
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
VA2009064505 2009-12-01 2009-12-08 CLOSED 2010-01-13
CLAIM CODE: APD I/V HIT O/V AT FIRE SCENE
PRIMARY CLAIMANT: CITY OF LONGWOOD
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $2,050.19 $2,050.19 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $2,050.19 $2,050.19 $0.00
VA2009064536 2009-11-19 2009-12-09 CLOSED 2009-12-09
CLAIM CODE: APD IV DOOR HIT OV
PRIMARY CLAIMANT: PATRICIA FFURD
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $0.00 $0.00 $0.00
VA2010065122 2010-01-27 2010-02-24 CLOSED 2010-03-16
CLAIM CODE: APD O/V SIDESWIPED I/V
PRIMARY CLAIMANT: SEMINOLE COUNTY
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
VA2010066154 2010-06-02 2010-06-10 CLOSED 2010-07-14
CLAIM CODE: APD I/V BACKED INTO FENCE.
PRIMARY CLAIMANT: SUBURBAN EXTENDED STAY
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $935.00 $935.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $935.00 $935.00 $0.00
VA2010066961 2010-08-25 2010-09-07 CLOSED 2010-10-07
CLAIM CODE: APD OV BACKED INTO IV
PRIMARY CLAIMANT: KAREN RANSOM
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $1,914.00 $1,914.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $1,914.00 $1,914.00 $0.00
GC2009064245 2009-10-29 2009-11-04 CLOSED 2009-11-04
CLAIM CODE: GL TRIP AND FALL
PRIMARY CLAIMANT: MARY BILOW
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
GC2009064674 2009-12-28 2009-12-30 CLOSED 2009-12-30
CLAIM CODE: GL TRIP AND FALL
PRIMARY CLAIMANT: DANIEL FOULKER
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $0.00 $0.00 $0.00
GC2010065557 2010-03-24 2010-04-06 CLOSED 2010-04-08
CLAIM CODE: GL VEHICLE HIT CONTRACTOR EQUIPMENT.
PRIMARY CLAIMANT: CHARLES HOWLETT
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $0.00 $0.00 $0.00
GC2010065792 2010-04-23 2010-05-03 CLOSED 2010-06-29
CLAIM CODE: RPP MECHANICAL BREAKDOWN POWER SURGE
PRIMARY CLAIMANT: *CITY OF CASSELBERRY
REAL AND PERSONAL PROPERTY $0.00 $12,376.98 $0.00 $12,376.98
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $407.55 $0.00 $407.55
TOTAL FOR CLAIM $0.00 $12,784.53 $0.00 $12,784.53
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
GC2010065830 2010-04-10 2010-05-05 CLOSED 2011-07-10
CLAIM CODE: GL ACCIDENT LEAVING GOLF CART RETURN
PRIMARY CLAIMANT: ROCKY MORELAND
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $448.00 $0.00 $448.00
TOTAL FOR CLAIM $0.00 $448.00 $0.00 $448.00
GC2010066153 2010-05-28 2010-06-10 CLOSED 2010-06-10
CLAIM CODE: RPP VANDALISM
PRIMARY CLAIMANT: *CITY OF CASSELBERRY
REAL AND PERSONAL PROPERTY $0.00 $1,250.94 $0.00 $1,250.94
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $1,250.94 $0.00 $1,250.94
VA2010065526 2010-02-25 2010-04-02 CLOSED 2010-04-05
CLAIM CODE: APD I/V BACKED INTO POLE
PRIMARY CLAIMANT:
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
VA2010067743 2010-09-11 2010-12-21 CLOSED 2011-04-27
CLAIM CODE: APD ARCING DAMAGE TO FIRE TRUCK ELECTRICAL
PRIMARY CLAIMANT:
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $0.00 $0.00 $0.00
Claim Activity For 10/01/2009 - 9/30/2010
Number of Claims: 37 Total Incurred: $65,408.77
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
Claims For Fund Year: 2010
GC2011068381 2011-03-01 2011-03-10 CLOSED 2011-03-22
CLAIM CODE: GL FIRE RESCUE DAMAGE TO RESIDENCE
PRIMARY CLAIMANT: ADRIAN O'TOOLE
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $1,144.67 $1,144.67 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $659.40 $0.00 $659.40
TOTAL FOR CLAIM $0.00 $1,804.07 $1,144.67 $659.40
GC2011069155 2011-04-30 2011-06-01 CLOSED 2012-01-23
CLAIM CODE: POL DOOR DAMAGED BY POLICE ENTRY
PRIMARY CLAIMANT: DARRELL BURKHOLDER
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $0.00 $0.00 $0.00
GC2011069467 2011-04-27 2011-07-12 CLOSED 2012-03-01
CLAIM CODE: GL EXTRA CONTRACTUAL
PRIMARY CLAIMANT: CARLOS SANSON
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $7,608.00 $0.00 $7,608.00
TOTAL FOR CLAIM $0.00 $7,608.00 $0.00 $7,608.00
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
GC2011069487 2011-06-13 2011-07-14 CLOSED 2011-07-25
CLAIM CODE: GL ALLEGED IMPROPER ROAD MAINTENANCE
PRIMARY CLAIMANT: GREG PETERSON
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $0.00 $0.00 $0.00
GC2011071496 2011-06-08 2012-03-01 CLOSED 2012-11-07
CLAIM CODE: POL ALLEGED IMPROPER POLICE CONDUCT
PRIMARY CLAIMANT: JAMES ROBERTS
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $0.00 $0.00 $0.00
GC2011072233 2011-04-27 2012-06-04 CLOSED 2014-02-18
CLAIM CODE: E&O ALLEGED WRONGUL TERMINATION/DISCRIMINATION
PRIMARY CLAIMANT: CARLOS SANSO
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $50,000.00 $25,000.00 $25,000.00
EXPENSE / LEGAL $0.00 $133,294.95 $0.00 $133,294.95
TOTAL FOR CLAIM $0.00 $183,294.95 $25,000.00 $158,294.95
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
VA2011068367 2011-03-02 2011-03-09 CLOSED 2011-04-05
CLAIM CODE: APD TRANSPORT VEHICLE ENGINE FIRE
PRIMARY CLAIMANT:
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $130.00 $0.00 $130.00
TOTAL FOR CLAIM $0.00 $130.00 $0.00 $130.00
VA2011069586 2011-07-17 2011-07-27 CLOSED 2011-08-01
CLAIM CODE: APD IV DAMAGED WHILE PARKED
PRIMARY CLAIMANT:
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $0.00 $0.00 $0.00
VA2011070041 2011-08-24 2011-09-13 CLOSED 2011-10-31
CLAIM CODE: APD IV HIT OV
PRIMARY CLAIMANT: PAMELA CROWLEY
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
GC2010067381 2010-10-15 2010-10-28 CLOSED 2010-11-03
CLAIM CODE: RPP TRUCK DAMAGE TO HYDRANT
PRIMARY CLAIMANT: *CITY OF CASSELBERRY
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $0.00 $0.00 $0.00
GC2011068560 2011-03-02 2011-04-06 CLOSED 2011-06-27
CLAIM CODE: GL ALLEGED SOFA DAMAGE FROM PARAMEDICS
PRIMARY CLAIMANT: ROBERT VOLOSIN
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $688.00 $0.00 $688.00
TOTAL FOR CLAIM $0.00 $688.00 $0.00 $688.00
GC2011070097 2011-08-30 2011-09-16 CLOSED 2011-10-18
CLAIM CODE: RPP VEHICLE DAMAGE TO SIGN
PRIMARY CLAIMANT: *CITY OF CASSELBERRY
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $44.69 $0.00 $44.69
TOTAL FOR CLAIM $0.00 $44.69 $0.00 $44.69
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
GC2011070345 2011-08-20 2011-10-13 CLOSED 2013-01-14
CLAIM CODE: RPP VEHICLE DAMAGE TO TRAFFIC SIGNAL POLE
PRIMARY CLAIMANT: 016005-TRAFFICE SIGNALS
REAL AND PERSONAL PROPERTY $0.00 $4,197.74 $0.00 $4,197.74
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $44.69 $0.00 $44.69
TOTAL FOR CLAIM $0.00 $4,242.43 $0.00 $4,242.43
GC2011070969 2011-02-15 2011-12-29 CLOSED 2012-06-05
CLAIM CODE: GL CABLE CUT
PRIMARY CLAIMANT: PROGRESS ENERGY
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $0.00 $0.00 $0.00
VA2010067563 2010-11-04 2010-11-30 CLOSED 2012-01-25
CLAIM CODE: APD MEMBER DRIVER CROSSED CENTER LINE HITTING OV
PRIMARY CLAIMANT: ELIZABETH KARNES
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
VA2010067885 2010-11-04 2011-01-13 CLOSED 2011-02-11
CLAIM CODE: APD IV BACKED INTO POST
PRIMARY CLAIMANT:
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $518.40 $0.00 $518.40
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $518.40 $0.00 $518.40
GC2010067978 2010-11-06 2011-01-28 CLOSED 2011-05-17
CLAIM CODE: GL TRIP AND FALL
PRIMARY CLAIMANT: ANA KALLERGIS
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $490.95 $0.00 $490.95
TOTAL FOR CLAIM $0.00 $490.95 $0.00 $490.95
GC2011068289 2011-02-08 2011-03-02 CLOSED 2012-08-06
CLAIM CODE: GL ALLEGED IMPROPER EMT HANDLING
PRIMARY CLAIMANT: ESTATE OF MARIE RUEBUSCH
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $12,870.12 $0.00 $12,870.12
TOTAL FOR CLAIM $0.00 $12,870.12 $0.00 $12,870.12
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
GC2011068551 2011-02-14 2011-04-06 CLOSED 2011-12-01
CLAIM CODE: GL EMT FATALITY
PRIMARY CLAIMANT: ESTATE OF DARRYL TWOMEY
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $0.00 $0.00 $0.00
GC2011068759 2011-03-31 2011-04-22 CLOSED 2011-07-28
CLAIM CODE: RPP STORM DAMAGE
PRIMARY CLAIMANT: *CITY OF CASSELBERRY
REAL AND PERSONAL PROPERTY $0.00 $14,668.00 $0.00 $14,668.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $736.00 $0.00 $736.00
TOTAL FOR CLAIM $0.00 $15,404.00 $0.00 $15,404.00
GC2011069423 2011-05-16 2011-06-30 CLOSED 2011-07-28
CLAIM CODE: RPP VEHICLE DAMAGE TO TREE
PRIMARY CLAIMANT: *CITY OF CASSELBERRY
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
GC2011069433 2011-06-29 2011-07-05 CLOSED 2011-07-28
CLAIM CODE: GL SEWER MAIN LINE COLLAPSE
PRIMARY CLAIMANT: AQUA MARINES WATERFRONT
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $1,057.60 $0.00 $1,057.60
TOTAL FOR CLAIM $0.00 $1,057.60 $0.00 $1,057.60
VA2010067860 2010-12-24 2011-01-11 CLOSED 2011-01-28
CLAIM CODE: APD SUSPECT VEHICLE RAMMED IV
PRIMARY CLAIMANT:
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $3,204.56 $0.00 $3,204.56
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $0.00 $0.00 $0.00
TOTAL FOR CLAIM $0.00 $3,204.56 $0.00 $3,204.56
VA2011068493 2011-03-08 2011-03-24 CLOSED 2011-05-24
CLAIM CODE: APD PUSH BUMPER DAMAGED VEHICLE
PRIMARY CLAIMANT: MARIA BELTRAN
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $430.94 $430.94 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $80.00 $0.00 $80.00
TOTAL FOR CLAIM $0.00 $510.94 $430.94 $80.00
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
GC2011069156 2011-05-21 2011-06-01 CLOSED 2011-08-12
CLAIM CODE: GL VEHICLE HIT MANHOLE
PRIMARY CLAIMANT: CHRIS THOMAS
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $815.30 $0.00 $815.30
TOTAL FOR CLAIM $0.00 $815.30 $0.00 $815.30
GC2011073846 2011-02-05 2012-12-13 CLOSED 2013-08-12
CLAIM CODE: POL ALLEGED WRONGFUL DEATH
PRIMARY CLAIMANT: PRITTI THE STATE OF SHEPHERD
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $0.00 $0.00 $0.00
PROPERTY DAMAGE $0.00 $0.00 $0.00 $0.00
INJURY $0.00 $0.00 $0.00 $0.00
EXPENSE / LEGAL $0.00 $24,918.17 $0.00 $24,918.17
TOTAL FOR CLAIM $0.00 $24,918.17 $0.00 $24,918.17
VA2011069666 2011-07-25 2011-08-03 CLOSED 2012-09-24
CLAIM CODE: APD ALLEGED IV REARENDED OV
PRIMARY CLAIMANT: MILTON FELIZ
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $707.90 $0.00 $707.90
PROPERTY DAMAGE $0.00 $660.83 $660.83 $0.00
INJURY $0.00 $18,000.00 $18,000.00 $0.00
EXPENSE / LEGAL $0.00 $170.00 $0.00 $170.00
TOTAL FOR CLAIM $0.00 $19,538.73 $18,660.83 $877.90
CITY OF CASSELBERRY AS OF DECEMBER 31, 2017
FILE NUMBER LOSS DATE RECEIVED OPEN/CLOSED O/S RESERVES PAID TO DATE RECOVERIES TOTAL INCURRED
FLORIDA MUNICIPAL INSURANCE TRUST
MEMBERS QUARTERLY REPORT - LIABILITY/PROPERTY
VA2011070040 2011-08-17 2011-09-13 CLOSED 2011-10-20
CLAIM CODE: APD IV HIT SHRUBBERY
PRIMARY CLAIMANT:
REAL AND PERSONAL PROPERTY $0.00 $0.00 $0.00 $0.00
AUTO PHYSICAL DAMAGE $0.00 $1,126.00 $0.00 $1,126.00
PROPERTY…
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