Department File Number : | M201576637 |
Claim Number : | 70073 |
Date Submitted : | 2/13/2017 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MEDMAL DIRECT INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
27-2813188 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | James | P | Lacey | ||
Street Address | |||||
245 Riverside Ave, Suite 550 | |||||
City | State | Zip | |||
Jacksonville | FL | 32202 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 482 - 4068 | (888) 974 - 6458 | claims@medmaldirect.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | John | M | Crump | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 11945 San Jose Blvd Suite 300 | ||||
City | State | Zip Code | County | ||
Jacksonville | FL | 32223 | Duval | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
FL707369 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME46878 | Surgery - General |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Duval | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Outpatient Facility | |||||
Name of Institution | Code | ||||
BAPTIST MEDICAL CENTER AND WOLFSON | 100088 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
5/21/2012 | 5/22/2012 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Tumor Removal | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Patient underwent surgery to remove a tumor from her leg | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Patient sustained an injury to the femoral nerve in the process of removing the tumor | |||||
Severity Of Injury | |||||
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 2/8/2017 | ||||
Other Defendants Involved in this Claim | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Settlement Reached Prior to Pre-Suit Period | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $6,250 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $5,901 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Risk Management consulted insured. |
Updates | |||||||||||||
Date of Change: | 2/13/2017 10:05:43 AM | ||||||||||||
Reason for Change: | This is a supplemental payment made of 1250 was made to the patient in exchange for a full release. The file is now closed. | ||||||||||||
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*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
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Does Dr. JOHN M CRUMP, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. JOHN M CRUMP, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).