PLCR

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M2023101469
Claim Number : 4120210204002
Date Submitted : 1/4/2023
 
Insurer Information
 
Insurer Name Coverage Type
ASPEN AMERICAN INSURANCE COMPANY Primary
Insurer FEIN Professional License Number
75-2344200  
Insurer Contact Information
Type First Name MI Last Name
Individual Kimberly   Kenon
Street Address
655 N. Franklin Street
City State Zip
Tampa FL 33602
Phone Ext Fax E-Mail Address
(813) 226 - 1340     Kkenon@bbprograms.com
 
Insured Information
 
Type First Name MI Last Name
Individual Nidia H De Jesus
Insurer Type Street Address of Practice
Licensed 51 SW 42nd Ave.
City State Zip Code County
Miami FL 33134 Dade
Policy Number Per Claim Policy Limits Aggregate Policy Limits
PPPAAIC01309020 $250,000 $750,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME119093 Surgery - Plastic  

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
  F Dade
City State Zip Code
     
Location where injury occured Other location where injury occured
Other Outpatient Facility iBody Aesthetics
Name of Institution Code
N/A 000000
Location of Institutional Injury Other Location of Institutional Injury
Other Recovery House-Dolls Getaway Miami
Date of Occurrence Date Reported to Insurer
1/26/2021 2/1/2021
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
The patient sought the insured's care for elective cosmetic surgery.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
The insured performed a Brazillian Butt Lift on 01/26/2021, via liposuction and autologous fat transfer to the buttocks and hips.
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None. The patient was thoroughly examined after the procedure and found to be stable and met the criteria to be discharged from the recovery room.
Principal Injury Giving Rise To The Claim
The allegation is wrongful death following the cosmetic procedure.
Severity Of Injury
Permanent: Death.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Legal Information
 
Date of Suit Circuit Court Case Number
  *NR
County Suit Filed in Date of Final Disposition
*NR 12/19/2022
Other Defendants Involved in this Claim
 
Stage of Legal System at which Settlement was Reached or Award Made
Within the pre-suit period as set forth in 766.106 (more than 90 days before suit is filed).
Final Method of Claim Disposition
Settled by parties
Court Decision Other
No Court Proceedings.  
Arbitration
Claim not subject to Arbitration.
Date of Payment
12/14/2022
 
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 $35,217
All Other Loss Adjustment Expense Paid $424
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
N/A
 
Updates
 
No updates found.

 

 

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

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