| Department File Number : | M201782517 |
| Claim Number : | 6030245 |
| Date Submitted : | 7/6/2017 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| OMS NATIONAL INSURANCE COMPANY, RISK RETENTION GROUP | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 36-3571664 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Janet | L | Meyer | ||
| Street Address | |||||
| 6133 North River Road, Suite 650 | |||||
| City | State | Zip | |||
| Rosemont | IL | 60018 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (800) 522 - 6670 | (847) 653 - 8486 | janet.meyer@fortressins.com | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Nishul | P | Patel | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 9526 Lago Drive | ||||
| City | State | Zip Code | County | ||
| Boynton Beach | FL | 33472 | Palm Beach | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 2001063 | $2,000,000 | $6,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Dentistry | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| DN16630 | Dentists - Engaged in oral surgery or operative dentistry on patients rendered unconscious through the administering of any anesthesia or analgesia | ||||
| 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 | ||||
| Physician's Office | |||||
| Name of Institution | Code | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 10/19/2012 | 8/24/2015 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| The patient was referred by his general dentist for evaluation of two infected wisdom teeth, #s 31 and 32. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| The insured saw the patient on one occasion, performed a panorex & planned to perform the treatment plan pending insurance approval. As the insurance company only allowed portions of the recommended treatment plan and the insured's continued attempts to obtain approval failed the patient failed to return in follow up. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Patient alleged the insured was negligent in failing to diagnose cell tumor which was diagnosed two years post treatment. The patient further alleged that this delay in diagnosis resulted in additional surgical treatment. | |||||
| Severity Of Injury | |||||
| Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 7/20/2016 | 16-018577 CA 06 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Dade | 6/30/2017 | ||||
| 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 | |||||
| 6/27/2017 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $370,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $23,544 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $3,937 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Unknown | |||||||||||||||||||||
| 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. NISHUL P PATEL, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. NISHUL P PATEL, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).