Department File Number : | M201575736 |
Claim Number : | 202921 |
Date Submitted : | 5/4/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
PROASSURANCE CASUALTY COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
38-2317569 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Tracy | M | Harris | ||
Street Address | |||||
100 Brookwood Place | |||||
City | State | Zip | |||
Birmingham | AL | 35209 | |||
Phone | Ext | Fax | E-Mail Address | ||
(205) 439 - 7932 | tharris@proassurance.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | HANEEN | Y | ABDELLA | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 5955 Ponce De Leon Blvd | ||||
City | State | Zip Code | County | ||
Miami | FL | 33146 | Dade | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
MP37267 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME104441 | Hematology - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Dade | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Emergency Room | |||||
Name of Institution | Code | ||||
MIAMI CHILDREN'S HOSPITAL | 110199 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Radiology, Emergency Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
1/25/2014 | 4/14/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Abdominal pain and constipation due to sickle cell crisis | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Delay in Diagosis | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
No misdiagnosis made | |||||
Principal Injury Giving Rise To The Claim | |||||
loss of both hands and feet | |||||
Severity Of Injury | |||||
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 8/10/2015 | ||||
Other Defendants Involved in this Claim | |||||
Kidz Medical Services, Inc | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Within the pre-suit period as set forth in 766.106 (more than 90 days before suit is filed). | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
8/12/2015 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $250,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $5,256 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $4,274 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $250,000 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Insured discussed case with defense counsel, insurance personnel, and medical experts. |
Updates | |||||||||||||
Date of Change: | 5/4/2016 3:48:23 PM | ||||||||||||
Reason for Change: | Updated non economic loss information | ||||||||||||
|
*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Does Dr. HANEEN Y ABDELLA, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. HANEEN Y ABDELLA, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).