| Department File Number : | M201886375 |
| Claim Number : | 274/CIG/PHY/16 |
| Date Submitted : | 9/11/2018 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| Community Insurance Group SPC, LTD | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 00-0000000 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Chirag | Patel | |||
| Street Address | |||||
| 877 111th ave north | |||||
| City | State | Zip | |||
| Naples | FL | 34108 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (239) 594 - 8002 | (239) 597 - 3447 | cpatel@nasamri.com | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Chirag | Patel | |||
| Insurer Type | Street Address of Practice | ||||
| Self-Insurer | 6101 Pine Ridge Rd | ||||
| City | State | Zip Code | County | ||
| Naples | FL | 34119 | Collier | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 274/CIG/PHY/16 | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME113138 | Surgery - Orthopedic | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Collier | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| PHYSICIANS REGIONAL MEDICAL CENTER - COLLIER BOULEVARD | 23960057 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Operating Suite | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 6/25/2014 | 12/15/2016 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Right foot and ankle pain. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Right flatfoot reconstruction | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| medical intervention of subsequent healthcare provider...left with a varus deformity in her right foot... | |||||
| Severity Of Injury | |||||
| Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 12/15/2016 | 16-CA-004383 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Lee | 4/4/2018 | ||||
| Other Defendants Involved in this Claim | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference. | |||||
| Final Method of Claim Disposition | |||||
| Disposed of by Arbitration | |||||
| Court Decision | Other | ||||
| No Court Proceedings. | |||||
| Arbitration | |||||
| Claim subject to arbitration, but settlement reached in lieu of award. | |||||
| Date of Payment | |||||
| 4/9/2018 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $440,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $0 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| n/a | |||||||||||||||||||||
| 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.
| Department File Number : | M201886376 |
| Claim Number : | SW-FL-1415 |
| Date Submitted : | 9/11/2018 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| Community Insurance Group SPC, LTD | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 00-0000000 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Chirag | Patel | |||
| Street Address | |||||
| 877 111th ave north | |||||
| City | State | Zip | |||
| naples | FL | 34108 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (239) 594 - 8002 | (239) 597 - 3447 | cpatel@nasamri.com | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Chirag | Patel | |||
| Insurer Type | Street Address of Practice | ||||
| Self-Insurer | 6101 Pine Ridge Rd | ||||
| City | State | Zip Code | County | ||
| Naples | FL | 34119 | Collier | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| SW-FL-1415 | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME113138 | Surgery - Orthopedic | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Collier | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| PHYSICIANS REGIONAL MEDICAL CENTER - COLLIER BOULEVARD | 23960057 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Operating Suite | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 2/16/2014 | 6/23/2015 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Displaced femur fracture of the right leg. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Right distal femur ORIF, right lateral compartment fasciotomy and percutaneous skeletal fixation and removal. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| failure to use appropriate internal fixation procedure | |||||
| Severity Of Injury | |||||
| Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 6/23/2015 | 11-2015-CA-001143-00 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Collier | 3/27/2018 | ||||
| Other Defendants Involved in this Claim | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| After court verdict and prior to filing of notice of appeal. | |||||
| Final Method of Claim Disposition | |||||
| Settled by parties | |||||
| Court Decision | Other | ||||
| Judgment for the plaintiff. | |||||
| 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 | $175,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $0 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
| Injured Person's Total Non-Economic Loss | $175,000 | ||||||||||||||||||||
| Deductible | $0 | ||||||||||||||||||||
| Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
| Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
| n/a | |||||||||||||||||||||
| 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.
| Department File Number : | M202092900 |
| Claim Number : | 377984 |
| Date Submitted : | 6/30/2020 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE) | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 95-3014772 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Kelly | Andrews | |||
| Street Address | |||||
| 12724 Gran Bay Parkway, W., Suite 400 | |||||
| City | State | Zip | |||
| Jacksonville | FL | 32258 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (904) 360 - 3038 | kandrews@thedoctors.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Chirag | S | Patel | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 877 111th Avenue N., Suite 1 | ||||
| City | State | Zip Code | County | ||
| Naples | FL | 34108 | Collier | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 967620 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME113138 | Surgery - Orthopedic | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Collier | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Patient's Home | |||||
| Name of Institution | Code | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Other | Physician's Office | ||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 2/21/2017 | 12/3/2018 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| The patient presented for hammer toe surgery. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| The patient alleges alleged failure to timely prescribe antibiotics post hammer toe surgery. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| The patient had amputation of her left 5th toe and 2/3 if the 5th metatarsal. | |||||
| Severity Of Injury | |||||
| Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 5/15/2019 | 11-2019-CA-001961-00 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Collier | 6/29/2020 | ||||
| Other Defendants Involved in this Claim | |||||
| Neuroscience and Spine Associates, PL | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference. | |||||
| Final Method of Claim Disposition | |||||
| Settled by parties | |||||
| Court Decision | Other | ||||
| No Court Proceedings. | |||||
| Arbitration | |||||
| Claim not subject to Arbitration. | |||||
| Date of Payment | |||||
| 6/29/2020 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $75,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $21,153 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $6,379 | ||||||||||||||||||||
| Injured Person's Total Non-Economic Loss | $75,000 | ||||||||||||||||||||
| 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. Patient Safety referral is made if appropriate. | |||||||||||||||||||||
| Updates | |
| No updates found. |
Does Dr. CHIRAG PATEL, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. CHIRAG PATEL, MD has at least 3 medical malpractice case(s), lawsuit(s), or complaint(s).