Department File Number : | M201576054 |
Claim Number : | 70443 |
Date Submitted : | 10/9/2015 |
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 | Trisha | D | Bowles | ||
Street Address | |||||
245 Riverside Avenue | |||||
City | State | Zip | |||
Jacksonville | FL | 32202 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 482 - 4068 | (888) 974 - 6458 | claims@mymedmal.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Manuel | A | Lopez | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 9049 SW 87 CT | ||||
City | State | Zip Code | County | ||
Miami | FL | 33243 | Dade | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
FL707953 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME81940 | Internal Medicine - 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 | ||||
Other Hospital/Institution | Doctor's Hospital Coral Gables | ||||
Name of Institution | Code | ||||
N/A | 000000 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
9/2/2013 | 1/28/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
neurogenic bladder | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
treatment of urologic condition | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
PATIENT ALLEGED THAT DR. LOPEZ, WHO HAD MINIMAL CONTACTWITH THE PATIENT, FAILED TO ORDER THE PROPER UROLOGICCONSULTATIONS AND FOLLOW THROUGH ON THE ADMITTINGORDERS, ALTHOUGH PATIENT'S LONG TIME UROLOGIST WASFOLLOWING THE PATIENT WHILE IN THE HOSPITAL AND THE PATIENT WAS TRANSFERRED TO ANOTHER HOSPITALIST UPON ADMISSION. | |||||
Severity Of Injury | |||||
Emotional Only - Fright, no physical damage |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 9/15/2015 | ||||
Other Defendants Involved in this Claim | |||||
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 | |||||
7/28/2015 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $10,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $9,830 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Insurance company staff consulted with insured to discuss preventative measures. Risk management referral is made if appropriate. |
Updates | |
No updates found. |
*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Does Dr. MANUEL A LOPEZ, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. MANUEL A LOPEZ, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).