A.M. Best Co. has placed the financial strength rating of A- (Excellent) of Health Care Indemnity, Inc. (HCI) (Nashville, TN) under review with negative implications.

This rating action follows the recent announcement that HCI's ultimate parent company, HCA Inc. (HCA) (Nashville, TN) (NYSE: HCA), has executed a definitive merger agreement with a private equity consortium. A.M. Best's concern arises from the additional debt to be taken on by HCA immediately following the close of the transaction, which will increase its already high debt levels. The transaction is subject to stockholder and regulatory approvals. The transaction is expected to close in fourth quarter 2006.

HCI insures the primary layer of professional and general liability risks for all domestic healthcare facilities owned or indirectly owned by HCA. It also insures professional and general liability risks associated with Triad Hospitals, Inc. which was once part of HCA and Capella Healthcare, which acquired hospitals from HCA.

The rating will remain under review pending the close of the transaction. Upon completion of the transaction, any deterioration in the financial condition at HCA will likely result in a rating downgrade of HCI.

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A.M. Best Co., established in 1899, is the world's oldest and most authoritative insurance rating and information source. For more information, visit A.M. Best's Web site at www.ambest.com.