| Department File Number : | M201886283 |
| Claim Number : | GC100108475A20153217 |
| Date Submitted : | 8/28/2018 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| CARE RISK RETENTION GROUP, INC. | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 52-2395338 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Sarah | McIntosh | |||
| Street Address | |||||
| PO Box 22989 | |||||
| City | State | Zip | |||
| Louisville | KY | 40252 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (502) 708 - 3103 | smcintosh@rmsc.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Elsa | Cortorreal | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 6969 SW 24th St. | ||||
| City | State | Zip Code | County | ||
| Miami | FL | 33155 | Dade | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| PPL0900257 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Dentistry | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| DN11432 | Dental General Practice - NOC | ||||
| 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 | ||||
| 3/7/2015 | 8/15/2016 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Teeth 5, 6, 11, and 12 required the placement of maxillary implants | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Insured dentist surgically implanted maxillary implants for teeth 5, 6, 11, and 12. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Further bone loss and the 4 implants needed to be replaced. | |||||
| Severity Of Injury | |||||
| Permanent: Minor - Loss of fingers, loss or damage to organs. Includes non-disabling injuries. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 8/11/2017 | 17-019589-CA | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Dade | 1/22/2018 | ||||
| Other Defendants Involved in this Claim | |||||
| 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 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $150,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $38,983 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
| Injured Person's Total Non-Economic Loss | $100,000 | ||||||||||||||||||||
| Deductible | $0 | ||||||||||||||||||||
| Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
| Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
| Policy in place. | |||||||||||||||||||||
| 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.
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
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Does Dr. ELSA CORTORREAL, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. ELSA CORTORREAL, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).