Department File Number : | M201990258 |
Claim Number : | 70653 |
Date Submitted : | 10/14/2019 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MAG MUTUAL INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
58-1449198 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Mercedes | Pressley | |||
Street Address | |||||
3535 Piedmont Road, NE | |||||
City | State | Zip | |||
Atlanta | GA | 30305 | |||
Phone | Ext | Fax | E-Mail Address | ||
(404) 842 - 4882 | MPressley@magmutual.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | David | T | Zamos | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 502 W Highland Blvd. | ||||
City | State | Zip Code | County | ||
Inverness | FL | 34452 | Martin | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
PSL 1603689 00 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME98287 | Radiology - Diagnostic - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Martin | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Physician's Office | |||||
Name of Institution | Code | ||||
MARTIN MEMORIAL MEDICAL CENTER | 100044 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Radiology, Emergency Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
3/15/2017 | 10/2/2018 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
not available | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
not available | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged failure to diagnose hip fracture requiring surgery. | |||||
Principal Injury Giving Rise To The Claim | |||||
not available | |||||
Severity Of Injury | |||||
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
1/23/2019 | 2019CA00090 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Martin | 9/13/2019 | ||||
Other Defendants Involved in this Claim | |||||
Diagnostic Imaging Services, PA Martin Memorial Medical Center, Inc. | |||||
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 | |||||
9/13/2019 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $99,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $22,549 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $3,972 | ||||||||||||||||||||
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 has counseled insured. |
Updates | |
No updates found. |
Does Dr. DAVID T ZAMOS, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. DAVID T ZAMOS, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).