| Department File Number : | M199701653 |
| Claim Number : | 00-001878 |
| Date Submitted : | 7/21/1997 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| TRUCK INSURANCE EXCHANGE | Excess | ||||
| Insurer FEIN | Professional License Number | ||||
| 95-2575892 | |||||
| Insurer Contact Information | |||||
| Type | Entity Name | ||||
| Entity | |||||
| Street Address | |||||
| City | State | Zip | |||
| FL | |||||
| Phone | Ext | Fax | E-Mail Address | ||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | HEALTHCARE OF FLORIDA | CIGNA | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | *NR | ||||
| City | State | Zip Code | County | ||
| *NR | FL | 33612 | Hillsborough | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| *NR | $500,000 | *NR | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| 0055171 | Internal Medicine - No Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | *NR | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Other Location | |||||
| Name of Institution | Code | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Other | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 2/9/1994 | 9/9/1994 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| *NR | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| *NR | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| *NR | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 4/25/1995 | 0000000095-1790 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| 7/1/1997 | |||||
| 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 | |||||
| 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 | $410,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $26,525 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $14,010 | ||||||||||||||||||||
| Injured Person's Total Non-Economic Loss | $410,000 | ||||||||||||||||||||
| Deductible | $0 | ||||||||||||||||||||
| Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
| Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
| *NR | |||||||||||||||||||||
| Updates | |
| No updates found. |
Does Dr. HEALTHCARE OF FLORIDA CIGNA, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. HEALTHCARE OF FLORIDA CIGNA, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).