Department File Number : | M201782486 |
Claim Number : | FL0482 |
Date Submitted : | 7/5/2017 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
HEALTHCARE UNDERWRITERS GROUP, INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
74-3129288 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Yvette | de la Morena | |||
Street Address | |||||
1250 S. Pine Island Road Suite 300 | |||||
City | State | Zip | |||
Plantation | FL | 33324 | |||
Phone | Ext | Fax | E-Mail Address | ||
(954) 923 - 1900 | ymorena@hugroups.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | VERNON | P | MONTOYA | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 289 SW Stonegate Terrace, Suite 103 | ||||
City | State | Zip Code | County | ||
Lake City | FL | 32024 | Columbia | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
196-000 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME61981 | Hematology - Minor Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Suwannee | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Prison | |||||
Name of Institution | Code | ||||
N/A | 000000 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Prison | ||||
Date of Occurrence | Date Reported to Insurer | ||||
6/1/2015 | 10/11/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Treatment was sought for Hep C. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Alleged no treatment was given | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
No misdiagnosis | |||||
Principal Injury Giving Rise To The Claim | |||||
Alleged no treatment for Hep C. given during incarceration. | |||||
Severity Of Injury | |||||
Emotional Only - Fright, no physical damage |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
4/26/2016 | 3:15-CV-00649-MMH-JR | ||||
County Suit Filed in | Date of Final Disposition | ||||
Suwannee | 6/28/2017 | ||||
Other Defendants Involved in this Claim | |||||
Corizon Health Corp Marceus, Dr. Jones, Sec, FL Dept of Corr, Julie Le, Chuong Cabrero Muniz, Dr. | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Claim or suit abandoned. | |||||
Final Method of Claim Disposition | |||||
No Payment Made | |||||
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? | No | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $0 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $8,375 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Discussed with insured. |
Updates | |
No updates found. |
This page is not displaying certain sensitive information.
Department File Number : | M201783433 |
Claim Number : | FL0429 |
Date Submitted : | 10/19/2017 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
HEALTHCARE UNDERWRITERS GROUP, INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
74-3129288 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Yvette | de la Morena | |||
Street Address | |||||
1250 S. Pine Island Road Suite 300 | |||||
City | State | Zip | |||
Plantation | FL | 33324 | |||
Phone | Ext | Fax | E-Mail Address | ||
(954) 923 - 1900 | ymorena@hugroups.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Vernon | P | Montoya | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 289 SW Stonegate Terrace, Suite 103 | ||||
City | State | Zip Code | County | ||
Lake City | FL | 32024 | Columbia | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
196-000 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME61981 | Hematology - Minor Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Lake | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Prison | |||||
Name of Institution | Code | ||||
N/A | 000000 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Prison | ||||
Date of Occurrence | Date Reported to Insurer | ||||
10/8/2014 | 9/23/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Patient sought treatment for chronic lymphatic leukemia | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Patient alleges that the insured discontinued Rituxan wrongfully. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
No misdiagnosis | |||||
Principal Injury Giving Rise To The Claim | |||||
Patient alleges discontinued medication resulted in enlarged lymph nodes in his neck and emotional duress. | |||||
Severity Of Injury | |||||
Emotional Only - Fright, no physical damage |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
7/28/2015 | 4:15cv127MW-CAS | ||||
County Suit Filed in | Date of Final Disposition | ||||
Lake | 9/29/2017 | ||||
Other Defendants Involved in this Claim | |||||
Bucarelli, A Martinez, Alfonso Marceus, P | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Claim or suit abandoned. | |||||
Final Method of Claim Disposition | |||||
Disposed of by Court | |||||
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? | No | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $0 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $45,870 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Discussed with insured. |
Updates | |
No updates found. |
This page is not displaying certain sensitive information.
Department File Number : | M201885107 |
Claim Number : | FL0511 |
Date Submitted : | 4/19/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
HEALTHCARE UNDERWRITERS GROUP, INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
74-3129288 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Yvette | de la Morena | |||
Street Address | |||||
1250 S. Pine Island Road Suite 300 | |||||
City | State | Zip | |||
Plantation | FL | 33324 | |||
Phone | Ext | Fax | E-Mail Address | ||
(954) 923 - 1900 | ymorena@hugroups.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Vernon | P | Montoya | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 289 SW Stonegate Terrace, Suite 103 | ||||
City | State | Zip Code | County | ||
Lake City | FL | 32024 | Columbia | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
196-000 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME61981 | Hematology - Minor Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Duval | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Prison | |||||
Name of Institution | Code | ||||
N/A | 000000 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Prison | ||||
Date of Occurrence | Date Reported to Insurer | ||||
7/14/2015 | 11/10/2017 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Treatment was sought for pharynx cancer | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Alleged failure to treat and diagnose squamous cell carcinoma | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
No misdiagnosis | |||||
Principal Injury Giving Rise To The Claim | |||||
Alleged failure to treat and diagnose squamous cell carcinoma resulting in death. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
11/10/2017 | 3:170-cv-00778-MMH-J | ||||
County Suit Filed in | Date of Final Disposition | ||||
Duval | 4/11/2018 | ||||
Other Defendants Involved in this Claim | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Claim or suit abandoned. | |||||
Final Method of Claim Disposition | |||||
Disposed of by Court | |||||
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? | No | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $0 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $15,145 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Discussed with insured |
Updates | |
No updates found. |
This page is not displaying certain sensitive information.
Does Dr. VERNON P MONTOYA, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. VERNON P MONTOYA, MD has at least 3 medical malpractice case(s), lawsuit(s), or complaint(s).