Department File Number : | M201680663 |
Claim Number : | 5144546-03 |
Date Submitted : | 2/13/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MEDICAL PROTECTIVE COMPANY (THE) | Primary | ||||
Insurer FEIN | Professional License Number | ||||
35-0506406 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Lynn | Louthan | |||
Street Address | |||||
5814 Reed Road | |||||
City | State | Zip | |||
Ft Wayne | IN | 46835 | |||
Phone | Ext | Fax | E-Mail Address | ||
(260) 486 - 0778 | reportaclaim@medpro.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Lance | A | Maki | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 700 W Oak St | ||||
City | State | Zip Code | County | ||
Kissimmee | FL | 34741 | Osceola | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
732940 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME92412 | Surgery - Obstetrics - Gynecology |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Osceola | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
OSCEOLA REGIONAL HOSPITAL | 100110 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Labor and Delivery Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
11/4/2009 | 11/9/2010 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Pregnancy | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Delivery | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Failure to perform timely C-section | |||||
Principal Injury Giving Rise To The Claim | |||||
brain damage | |||||
Severity Of Injury | |||||
Permanent: Grave - Quadraplegia, severe brain damage, lifelong care or fatal prognosis. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
1/21/2011 | 11-CA-197-MP | ||||
County Suit Filed in | Date of Final Disposition | ||||
Osceola | 12/9/2016 | ||||
Other Defendants Involved in this Claim | |||||
OB Hospitalist Group Inc Ojeda MD, Ezer | |||||
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 | |||||
12/9/2016 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $250,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $50,115 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $5,549 | ||||||||||||||||||||
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 | |||||||||||||||||||||
N/A |
Updates | ||||||||||
Date of Change: | 8/29/2017 10:38:48 AM | |||||||||
Reason for Change: | ALE UPDATE 8/29/2017 | |||||||||
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Date of Change: | 2/13/2018 1:49:45 PM | |||||||||
Reason for Change: | ALE UPDATE 2/13/2018 | |||||||||
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Department File Number : | M201781356 |
Claim Number : | 347007 |
Date Submitted : | 3/7/2017 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE) | Primary | ||||
Insurer FEIN | Professional License Number | ||||
95-3014772 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Kelly | Andrews | |||
Street Address | |||||
12724 Gran Bay Parkway, W., Suite 400 | |||||
City | State | Zip | |||
Jacksonville | FL | 32258 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 360 - 3038 | kandrews@thedoctors.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Lance | Maki | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 200 Avenue F NE | ||||
City | State | Zip Code | County | ||
Winter Haven | FL | 33881 | Polk | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
0684883 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME92412 | Surgery - Obstetrics - Gynecology |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Brevard | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
HOLMES REGIONAL MEDICAL CENTER | 100019 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Labor and Delivery Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
7/6/2015 | 9/7/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Delivery of pregnancy by another physician via c-section. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Alleged delay in delivery. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
None. | |||||
Principal Injury Giving Rise To The Claim | |||||
Alleged neurological impairment of newborn. | |||||
Severity Of Injury | |||||
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 2/28/2017 | ||||
Other Defendants Involved in this Claim | |||||
Trupiano, MD, Christine Holmes Regional Medical Center | |||||
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 | |||||
No Payment Made | |||||
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? | No | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $0 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $8,177 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $741 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate. |
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. LANCE A MAKI, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. LANCE A MAKI, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).