Department File Number : | M202091103 |
Claim Number : | 364316 |
Date Submitted : | 1/15/2020 |
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 | Mili | K | Varghese | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 461 S. Nova Road | ||||
City | State | Zip Code | County | ||
Ormond Beach | FL | 32174 | Volusia | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
0195338 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME114974 | Family Physicians or General Practitioners - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Volusia | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Physician's Office | |||||
Name of Institution | Code | ||||
FLORIDA HEALTH CARE PLAN, INC. | 20960297 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
7/21/2017 | 12/18/2017 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
29 year old came for her preventative health management annual visit with complaints of back pain, buttock pain, lower extremity pain, back stiffness, numbness, and paresthesia. She was later diagnosed with disc desiccation at L4-5 and L5-S1. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
no procedure rendered causing injury | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Numbness to her toes and bladder and bowel incontinence. | |||||
Severity Of Injury | |||||
Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
4/23/2019 | 2019-CA-000979 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Seminole | 11/25/2019 | ||||
Other Defendants Involved in this Claim | |||||
Florida Health Care Plans, Inc. | |||||
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 | |||||
11/25/2019 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $1,000,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $45,839 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $10,641 | ||||||||||||||||||||
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. |
Does Dr. MILI K VARGHESE, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. MILI K VARGHESE, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).