Department File Number : |
M200012820 |
Claim Number : |
95-22340-042 |
Date Submitted : |
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Insurer Information |
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Insurer Name |
Coverage Type |
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PRONATIONAL INSURANCE COMPANY |
Primary |
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Insurer FEIN |
Professional License Number |
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38-2317569 |
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Insurer Contact Information |
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Type |
First Name |
MI |
Last Name |
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Individual |
JAMES |
M |
RACHAL |
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Street Address |
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City |
State |
Zip |
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FL |
33134 |
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Phone |
Ext |
Fax |
E-Mail Address |
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(305) 442 - 4001 |
7220 |
(305) 444 - 5427 |
JRachal@ProNational.com |
Insured Information |
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Type |
First Name |
MI |
Last Name |
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Individual |
THOMAS |
J |
GOLDSCHMIDT, M.D. |
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Insurer Type |
Street Address of Practice |
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Licensed |
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City |
State |
Zip Code |
County |
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CORAL SPRINGS |
FL |
33071-6078 |
Broward |
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Policy Number |
Per Claim Policy Limits |
Aggregate Policy Limits |
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M-1003678 |
$250,000 |
$750,000 |
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Profession or Business |
Other Profession or Business |
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Medical Doctor |
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License Number |
Specialty Code & Classification |
Certification Number |
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ME 0048497 |
Neurology - Including Child - No
Surgery |
0 |
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Injured Person Information |
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First Name |
MI |
Last Name |
Date of Birth |
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Street Address |
Gender |
County where Injury Occurred |
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M |
*NR |
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City |
State |
Zip Code |
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Location where injury occured |
Other location where injury occured |
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Patient's Home |
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Name of Institution |
Code |
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Location of Institutional Injury |
Other Location of Institutional
Injury |
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Date of Occurrence |
Date Reported to Insurer |
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Diagnostic Information |
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Final Diagnosis For Which Treatment
Was Sought Including Patient's Actual Condition |
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Major Depression |
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Operation, Diagnostic, Or Treatment
Procedure Rendered Causing The Injury |
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Failure to properly evaluate and
recognize this patient's suicidal risk. |
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Diagnostic Code : |
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Misdiagnosis Made, If Any, Of
Patient's Actual Condition |
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None. |
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Principal Injury Giving Rise To The
Claim |
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Death by suicide. |
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Severity Of Injury |
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Permanent: Death. |
Legal Information |
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Date of Suit |
Circuit Court Case Number |
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95-8987 (25) |
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Date of Final Disposition |
Broward |
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Other Defendants Involved in this
Claim |
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CARE UNIT OF FLORIDA, INC. |
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Stage of Legal System at which
Settlement was Reached or Award Made |
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During trial, but before court
verdict. |
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Final Method of Claim Disposition |
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Settled by parties |
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Court Decision |
Other |
Other |
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Arbitration |
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Claim not subject to Arbitration. |
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Date of Payment |
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Financial Information |
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Was there a settlement Resulting in
payment to the Plaintiff? |
Yes |
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Indemnity Paid by Insurer on behalf
of Insured |
$250,000 |
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Loss Adjust Expense Paid to Defense
Counsel |
$59,459 |
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All Other Loss Adjustment Expense
Paid |
$96,313 |
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Injured Person's Total Non-Economic
Loss |
$250,000 |
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Deductible |
$0 |
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Injured Person's Total Economic Loss |
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Safety Management Steps Taken by
Insured to Make Similar Occurrence Less Likely |
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Member discussed claim with insurance
company personnel, and medical experts. |
Updates |
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No updates found. |