Department File Number : | M201783824 |
Claim Number : | 1043399 |
Date Submitted : | 8/28/2018 |
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 | Sony | Sanon | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 5328 SW 195th Ter | ||||
City | State | Zip Code | County | ||
Miramar | FL | 33029 | Broward | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
F41427 | $100,000 | $300,000 | |||
Profession or Business | Other Profession or Business | ||||
Physician Assistant | |||||
License Number | Specialty Code & Classification | Certification Number | |||
PA3363 | Physicians or Surgeons Assistants |
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 | ||||
N/A | 000000 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
11/20/2015 | 4/18/2017 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
pulmonary fibroids | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
follow up appointment regarding comorbidities, documentation | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged negligent treatment | |||||
Principal Injury Giving Rise To The Claim | |||||
Death | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
9/25/2017 | CACE-17-015731 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Broward | 11/14/2017 | ||||
Other Defendants Involved in this Claim | |||||
Bazzi, Ali A | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Within 90 days of suit being filed. | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
11/16/2017 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $100,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $12,389 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $3,708 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $93,500 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
N/a |
Updates | ||||||||||
Date of Change: | 2/13/2018 1:37:02 PM | |||||||||
Reason for Change: | ALE UPDATE 2/13/2018 | |||||||||
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Date of Change: | 8/28/2018 10:59:32 AM | |||||||||
Reason for Change: | ALE UPDATE | |||||||||
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Does Dr. SONY SANON, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. SONY SANON, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).