Department File Number : | M201472195 |
Claim Number : | 107-020412 |
Date Submitted : | 9/29/2014 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
LEXINGTON INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
25-1149494 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | LORRAINE | S | PRENDERGAST | ||
Street Address | |||||
3650 BROOKSIDE PARKWAY | |||||
City | State | Zip | |||
ALPHARETTA | GA | 30022 | |||
Phone | Ext | Fax | E-Mail Address | ||
(678) 240 - 1238 | (855) 674 - 8541 | lorraine.prendergast@aig.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | JORGE | MARTINEZ-LLORENS | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 4016 SUN CITY CENTER BLVD. | ||||
City | State | Zip Code | County | ||
SUN CITY CENTER | FL | 33573 | Hillsborough | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
6796927 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME73859 | Radiology - Diagnostic - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Hillsborough | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Other Hospital/Institution | SUN CITY HOSPTITAL dba SOUTH BAY HOSPITA | ||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Radiology, Emergency Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
2/13/2012 | 11/5/2012 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Failure to diagnose a traumatic penetrating injury to the neck resulted in stroke in 5 yr old female. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Failure to diagnose a traumatic penetrating injury to the neck resulted in stroke in 5 yr old female. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Failure to diagnose a traumatic penetrating injury to the neck resulted in stroke in 5 yr old female. | |||||
Severity Of Injury | |||||
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
4/21/2014 | 12746427 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Hillsborough | 9/26/2014 | ||||
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 | ||||
Other | SETTLED AT MEDIATION | ||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
8/21/2014 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $999,165 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $835 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
BETTER ASSESS PATIENTS |
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.
Does Dr. JORGE MARTINEZ-LLORENS, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. JORGE MARTINEZ-LLORENS, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).