Department File Number : | M201885227 |
Claim Number : | NEWSPC000170069 |
Date Submitted : | 5/2/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
LIBERTY INSURANCE UNDERWRITERS INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
22-2227331 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Julie | Hamilton | |||
Street Address | |||||
615 Crescent Executive Court, Suite 212 | |||||
City | State | Zip | |||
Lake Mary | FL | 32746 | |||
Phone | Ext | Fax | E-Mail Address | ||
(321) 972 - 0121 | juliehamilton@hamlinandburton.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Belinda | Godfrey | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 6200 SW 186th Way | ||||
City | State | Zip Code | County | ||
Everglades | FL | 33332 | Broward | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
AHY593079005 | $500,000 | $1,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Other | Nurse Practitioner | ||||
License Number | Specialty Code & Classification | Certification Number | |||
ARNP2112222 |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Dade | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Physician's Office | |||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Date of Occurrence | Date Reported to Insurer | ||||
10/12/2016 | 8/10/2017 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
The patient was seen for a reccurent fever and cough. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
The patient was examined and diagnosed with viral syndrome, fever and cough. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
It is alleged the Insured misdiagnosed the patient with a viral syndrome. | |||||
Principal Injury Giving Rise To The Claim | |||||
The patient had acute B cell lymphoblastic leukemia. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 12/7/2017 | ||||
Other Defendants Involved in this Claim | |||||
MARTINEZ, LINDA M Nicklaus Children's Hospital DE DIEGO, JORGE A Pediatric Medicine Associates PRovider Group 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 | |||||
1/22/2018 |
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 | $16,597 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $69 | ||||||||||||||||||||
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 | |||||||||||||||||||||
None |
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. BELINDA GODFREY, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. BELINDA GODFREY, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).