| Department File Number : | M201782941 |
| Claim Number : | 21009-01 |
| Date Submitted : | 9/1/2017 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| PODIATRY INSURANCE COMPANY OF AMERICA | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 58-1403235 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Angeline | Schave | |||
| Street Address | |||||
| 3000 Meridian Blvd. Ste. 400 | |||||
| City | State | Zip | |||
| Franklin | TN | 37067 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (615) 371 - 8776 | 2998 | (615) 986 - 1945 | aschave@picagroup.com | ||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Marc | Klein | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 7050 W Palmetto Park Rd., Ste. 18 | ||||
| City | State | Zip Code | County | ||
| Boca Raton | FL | 33433 | Palm Beach | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 1PD0016138 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Podiatric Physician | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| PO1505 | |||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Palm Beach | ||||
| 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 | ||||
| 5/7/2012 | 7/16/2014 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Fibular Fracture, right leg | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Patient placed in pneumatic walker, to remain non-weight bearing for three weeks | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Patient alleges that insured was negligent in failing to properly evaluate and treat an unstable ankle fracture when he first presented to insured's office on 4/16/12, in that he did not obtain a new x-ray to evaluate the patient for any instability in the fracture since the date of his discharge from the ER four days prior. | |||||
| Severity Of Injury | |||||
| Temporary: Major - Burns, surgical material left, drug side effect, brain damage. Recovery delayed. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| *NR | |||||
| County Suit Filed in | Date of Final Disposition | ||||
| *NR | 8/21/2017 | ||||
| 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 | |||||
| 8/24/2017 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $85,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $14,070 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $3,328 | ||||||||||||||||||||
| Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
| Deductible | $0 | ||||||||||||||||||||
| Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
| Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
| Specialty Code #80993 | |||||||||||||||||||||
| 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. MARC KLEIN, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. MARC KLEIN, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).