PLCR

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M202298251
Claim Number : 150096
Date Submitted : 2/18/2022
 
Insurer Information
 
Insurer Name Coverage Type
PROSELECT INSURANCE COMPANY Primary
Insurer FEIN Professional License Number
04-1012400  
Insurer Contact Information
Type First Name MI Last Name
Individual Christine M Lopez
Street Address
One Financial Center, 13th Floor
City State Zip
Boston MA 02111
Phone Ext Fax E-Mail Address
(425) 310 - 7140   (425) 310 - 7210 clopez@coverys.com
 
Insured Information
 
Type First Name MI Last Name
Individual Anna   Abel
Insurer Type Street Address of Practice
Licensed 7540 SW 61st Avenue
City State Zip Code County
Miami FL 33143 Dade
Policy Number Per Claim Policy Limits Aggregate Policy Limits
002FL000031296 $250,000 $750,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME116707 Internal Medicine - No Surgery  

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First Name MI Last Name Date of Birth
       
Street Address Gender County where Injury Occurred
  M Palm Beach
City State Zip Code
     
Location where injury occured Other location where injury occured
Emergency Room  
Name of Institution Code
PALM BEACH GARDENS MEDICAL CENTER 100176
Location of Institutional Injury Other Location of Institutional Injury
Other Emergency Room
Date of Occurrence Date Reported to Insurer
2/18/2020 12/1/2020
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
The patient presented via ambulance with complaints of chest pain, heaviness, near syncope diaphoresis, nausea and hypertension
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Failure to diagnose and treat aortic dissection resulting in death
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Failure to diagnose and treat aortic dissection resulting in death
Principal Injury Giving Rise To The Claim
Failure to diagnose and treat aortic dissection resulting in death
Severity Of Injury
Permanent: Death.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Legal Information
 
Date of Suit Circuit Court Case Number
5/13/2021 50-2021-CA-005982
County Suit Filed in Date of Final Disposition
Palm Beach 2/14/2022
Other Defendants Involved in this Claim
 
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 $9,767
All Other Loss Adjustment Expense Paid $4,900
Injured Person's Total Non-Economic Loss $0
Deductible $0
Injured Person's Total Economic Loss
  Incurred to Date Anticipated
Medical Expense $0 $0
Wage Loss $0 $0
Other Expenses $0 $0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Review Procedures
 
Updates
 
No updates found.

 

 

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