Department File Number : | M201988421 |
Claim Number : | 161840-1 |
Date Submitted : | 2/20/2020 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
HEALTH CARE INDEMNITY, INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
61-0904881 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Christina | J | Stoker | ||
Street Address | |||||
2515 PARK PLAZA, BLDG 2-3E | |||||
City | State | Zip | |||
Nashville | TN | 37203 | |||
Phone | Ext | Fax | E-Mail Address | ||
(615) 344 - 1779 | (866) 715 - 7235 | christina.stoker@hcahealthcare.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | MARA | P | COHEN | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 8201 WEST BROWARD BLVD | ||||
City | State | Zip Code | County | ||
PLANTATION | FL | 33324 | Broward | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
HCI-10115 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Other | PHYSICIAN ASSISTANT | ||||
License Number | Specialty Code & Classification | Certification Number | |||
PA9108429 |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Broward | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Emergency Room | |||||
Name of Institution | Code | ||||
WESTSIDE REG. MED. CTR (PLANTATION) | 100228 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | EMERGENCY ROOM | ||||
Date of Occurrence | Date Reported to Insurer | ||||
12/6/2015 | 5/19/2017 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
COMPLAINTS OF COUGH, GENERALIZED WEAKNESS AND YELLOW SPUTUM FOR ONE WEEK. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
DIAGNOSED AND TREATED FOR PNEUMONIA. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
FAILURE TO DIAGNOSE AND TREAT ACUTE RESPIRATORY ISSUES. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
10/3/2017 | CACE-17018224 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Broward | 3/13/2019 | ||||
Other Defendants Involved in this Claim | |||||
KHAN, D.O., KHALIL | |||||
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 | |||||
12/10/2018 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $50,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $29,010 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $13,162 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $50,000 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
REFERRED TO RISK MANAGEMENT. |
Updates | |
No updates found. |
Does Dr. MARA P COHEN, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. MARA P COHEN, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).