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Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Department File Number :	M2022101448
Claim Number :	406361
Date Submitted :	12/30/2022

 

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	ANNA		V	ABEL
Insurer Type		Street Address of Practice
Licensed		3345 Burns Road
City		State	Zip Code	County
Palm Beach Gardens		FL	33410	Palm Beach
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
0843952		$250,000		$750,000
Profession or Business			Other Profession or Business
Medical Doctor
License Number		Specialty Code & Classification		Certification Number
ME116707		Hospitalists

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
Hospital Inpatient Facility
Name of Institution			Code
PALM BEACH GARDENS MEDICAL CENTER			100176
Location of Institutional Injury			Other Location of Institutional Injury
Radiology, Emergency Room
Date of Occurrence			Date Reported to Insurer
2/18/2020			12/7/2020

 

Diagnostic Information
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
The patient was taken to the ER via fire rescue following a fall at home. The patient is deceased.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
The patient was admitted to the hospital by our insured for further evaluation.
Diagnostic Code :
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
The patient was ultimately diagnosed with an aortic dissection. The patient passed while in surgery.
Severity Of Injury
Permanent: Death.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
Date of Suit			Circuit Court Case Number
5/20/2021			50-2021-CA-005982
County Suit Filed in			Date of Final Disposition
Palm Beach			12/13/2022
Other Defendants Involved in this Claim
ClareMEdica Health Partners, LLC Accountable Care Hospitalist Group Advanced Cardiovascular Consultants, LLC Rosen, Carlo L Rathjen , Erin R FEF Partners, LLC Junior, George S Inphynet Contracting Services Mohanty, Jyoti B Yaffe, Michael E Palm Beach Hospitalist Group, LLC Paragon Contracting Services, LLC Rohit Dandiya MD, PA dba Gardens Medical Group Dandiya, Rohit R Southwest Florida Emergency Management, LLC Tenet Florida Physician Services, LLC
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
12/13/2022

 

Financial Information
Was there a settlement Resulting in payment to the Plaintiff?					Yes
Indemnity Paid by Insurer on behalf of Insured					$250,000
Loss Adjust Expense Paid to Defense Counsel					$12,086
All Other Loss Adjustment Expense Paid					$11,625
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
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate.

 

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*NR: Prior to 04/28/1999 this field was not required in submitted claims.

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