Department File Number : | M201886008 |
Claim Number : | 1036038-01 |
Date Submitted : | 7/26/2018 |
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 | Marcus | Frey | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 13767 N US Hwy 441 | ||||
City | State | Zip Code | County | ||
Lady Lake | FL | 32159 | Sumter | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
805375 | $500,000 | $1,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Other | Podiatric Physician | ||||
License Number | Specialty Code & Classification | Certification Number | |||
PO3605 |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Marion | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Other Outpatient Facility | Ocala Surgical Center | ||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Date of Occurrence | Date Reported to Insurer | ||||
8/13/2014 | 9/2/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Chronic open wound, left foot | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Surgery to resect ulceration | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
negligent care | |||||
Principal Injury Giving Rise To The Claim | |||||
Amputation of big toe | |||||
Severity Of Injury | |||||
Permanent: Minor - Loss of fingers, loss or damage to organs. Includes non-disabling injuries. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
12/1/2016 | 16-CA-1756 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Marion | 7/9/2018 | ||||
Other Defendants Involved in this Claim | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
After appeal. | |||||
Final Method of Claim Disposition | |||||
Disposed of by Court | |||||
Court Decision | Other | ||||
Other | Dissmiaal after Appeal | ||||
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 | $10,888 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $6 | ||||||||||||||||||||
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 | |||||||||||||||||||||
n/a |
Updates | |
No updates found. |
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Does Dr. MARCUS FREY, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. MARCUS FREY, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).