| Department File Number : | M201989848 |
| Claim Number : | 65415 |
| Date Submitted : | 8/30/2019 |
| 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 | Dennis | Kurz | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 659 North East Highway 19, u=Unit one | ||||
| City | State | Zip Code | County | ||
| Crystal River | FL | 34429 | Citrus | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| PSL 1616042 10 | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| PA2297 | Physicians - No Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Citrus | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Physician's Office | |||||
| Name of Institution | Code | ||||
| PEDIATRIC SURGERY CENTER - ODESSA | 14960656 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Other | Physician's Office | ||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 12/21/2016 | 5/8/2017 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Tachycardia | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Patient had heart rate of 211 at medical clinic. Patient was sent home and passed away the following day. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| Alleged failure to perform an EKG and recommend patient to ER. | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Death | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 4/2/2019 | 2018-CA-000251 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Citrus | 8/2/2019 | ||||
| Other Defendants Involved in this Claim | |||||
| Quick Care Med, LLC St. Martin, Dacelin | |||||
| 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 | |||||
| 8/2/2019 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $1,000,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $9,783 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $1,490 | ||||||||||||||||||||
| 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. |
| Department File Number : | M201990146 |
| Claim Number : | 62003 |
| Date Submitted : | 10/3/2019 |
| 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 Street, NE | |||||
| City | State | Zip | |||
| Atlanta | GA | 30305 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (404) 842 - 5377 | MPressley@magmutual.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Dennis | Kurz | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 659 North East Highway 19 Unit one | ||||
| City | State | Zip Code | County | ||
| Crystal River | FL | 34429 | Citrus | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| PSL1616042 10 | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| PA2297 | Pulmonary Diseases - No Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Citrus | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Physician's Office | |||||
| Name of Institution | Code | ||||
| A MEDICAL OFFICE FOR WOMEN | 13960104 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Other | Not available | ||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 12/21/2016 | 5/8/2017 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Tachycardia | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Patient had heart rate of 211 @ medical clinic. Wa s sent home and passed away following day. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| Alleged failure to perform an EKG and recommend patient to ER | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Death. | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 4/2/2018 | 2018-CA000251 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Citrus | 8/2/2019 | ||||
| Other Defendants Involved in this Claim | |||||
| Quick Care Med, LLC | |||||
| 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 | |||||
| 8/2/2019 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $1,000,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $9,783 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $1,490 | ||||||||||||||||||||
| 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. DENNIS KURZ, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. DENNIS KURZ, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).