Department File Number : | M201679383 |
Claim Number : | C159651 |
Date Submitted : | 8/9/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
ADMIRAL INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
22-2235730 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Angela | Rando | |||
Street Address | |||||
1000 Howard Boulevard Suite 300 | |||||
City | State | Zip | |||
Mount Laurel | NJ | 08054 | |||
Phone | Ext | Fax | E-Mail Address | ||
(856) 857 - 3367 | arando@admiralins.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Nina | Lazovic | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 6901 SW 75th Terrace | ||||
City | State | Zip Code | County | ||
Miami | FL | 33143 | Dade | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
EO000019016-03 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME98974 | Physicians or Surgeons |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Dade | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Outpatient Facility | |||||
Name of Institution | Code | ||||
SOUTH MIAMI HOSPITAL | 100154 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
10/25/2013 | 9/17/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Patient had a fish hook stuck in his right buttock. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Doctor attempted to remove the hook by making an incision but was unable to. The wound was stitched and the patient was referred to the emergency room where the hook was removed. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Doctor was unable to remove the hook. | |||||
Severity Of Injury | |||||
Temporary: Slight - Lacerations, contusions, minor scars, rash. No delay. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
10/1/2015 | CACE 15-018810(21) | ||||
County Suit Filed in | Date of Final Disposition | ||||
Broward | 1/22/2016 | ||||
Other Defendants Involved in this Claim | |||||
Baptist Outpatient Services Inc Criticare Clinics South Miami Hospital 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 | |||||
7/27/2016 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $4,250 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $17,348 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $2,181 | ||||||||||||||||||||
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. |
*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Department File Number : | M201576419 |
Claim Number : | 170377 |
Date Submitted : | 4/5/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
PROASSURANCE CASUALTY COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
38-2317569 | |||||
Insurer Contact Information | |||||
Type | Entity Name | ||||
Entity | ProAssurance Companies | ||||
Street Address | |||||
100 Brookwood Place | |||||
City | State | Zip | |||
Birmingham | AL | 35209 | |||
Phone | Ext | Fax | E-Mail Address | ||
(205) 439 - 7969 | jgrasse@proassurance.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Nina | Lazovic | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 6131 LaGorce Drive | ||||
City | State | Zip Code | County | ||
Miami Beach | FL | 33140 | Dade | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
MP35465 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME98974 | 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 | Broward | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Physician's Office | |||||
Name of Institution | Code | ||||
N/A | 000000 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
4/16/2008 | 2/25/2011 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Ringworm on breasts and fungal toe lesions | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Patient did not timely undergo mammogram ordered by her gynecologist. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
No Misdiagnosis Made | |||||
Principal Injury Giving Rise To The Claim | |||||
Patient became septic from an infection of the port used for administration of chemotherapy. | |||||
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 | ||||
8/4/2011 | 11-18083 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Broward | 11/19/2015 | ||||
Other Defendants Involved in this Claim | |||||
Weiss, Simon Rivera-Hidalgo, Zoraida Memorial Regional Hospital | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Claim or suit abandoned. | |||||
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 | $66,555 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $53,088 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Insured discussed case with defense counsel, insurance personnel, and medical experts. |
Updates | ||||||||||
Date of Change: | 4/5/2016 12:02:06 PM | |||||||||
Reason for Change: | updated ALAE | |||||||||
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Does Dr. NINA LAZOVIC, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. NINA LAZOVIC, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).