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w � <br /> The 'f\/ Of North ("l8y)K'n8 Liability Insurance Trust K700,X <br /> Legal Department <br /> Telephone:(9|9)96h-3V4l <br /> UNIVERSITY Opwnxn|CxxouNaHOSPITALS Facsimile:(9/v)*66-6Zx5 <br /> |o\ Mannino Drive,2nd Floor,Wing e <br /> | cxopr|niU`mc275w <br /> CONFIRMATION OF INSURANCE COVERAGE FOR PROFESSIONAL LIABILITY <br /> This Confirmation of Insurance Coverage in being issued specifically to verify professional liability <br /> coverage for the referenced insureds while practicing within the scope of their employment <br /> responsibilities during the dates of coverage noted. This information should be treated confidentially. <br /> INSURED.- Martha C. Cndough. MD <br /> DATES OF COVERAGE: O8/15/O2—OS/3O/15 <br /> NAME OFCARRIER: UNC Liability Insurance Trust Fund <br /> AMOUNT OF COVERAGE, 07/U104—O6/3015 <br /> Covered individuals are subject k)o limit of$3 million for all <br /> � <br /> damages against covered individual arising out ofa single <br /> � <br /> claim. The total limit of liability for all loss arising out ofa <br /> single claim ia$7 million regardless cf the number cfinsureds <br /> involved, <br /> O50103—O0/ 0/04 <br /> $7 million cf professional liability self-insurance coverage <br /> for each individual. <br /> U8/15/O2-05/U1/O3 <br /> $7 million of professional liability self-insurance retention per <br /> claim. <br /> Additional self-insurance and commercial excess insurance <br /> over and above the primary retention, <br /> CURRENT POLICY TYPE: Occurrence basis <br /> POLICY NUMBER: Not applicable <br /> CLAIMS HISTORY: None <br /> Completed by: Date <br /> Associate V.P. of Risk Management, <br /> Accreditation & Regulatory Affairs <br /> University ofNortb Carolina Hospitals and the School of Medicine of the UniversityvfNorth Carolina ut Chapel Hill <br />