M200221796

Insurer Information

Insurer Name				Coverage Type
DOCTORS' COMPANY, AN INTERINSURANCE EXCHANGE (THE)				Primary
Insurer FEIN		Professional License Number
95-3014772
Insurer Contact Information
Type		Entity Name
Entity		THE DOCTORS COMPANY
Street Address
13450 W. Sunrise Boulevard, Suite 160
City				State	Zip
Sunrise				FL	33323
Phone	Ext	Fax	E-Mail Address
(954) 858 - 0213		(954) 838 - 7480	ahinkson@thedoctors.com

Insured Information

Type	First Name		MI	Last Name
Individual	ASHIT			VIJAPURA
Insurer Type		Street Address of Practice
Licensed		1601 W REYNOLDS ST STE 102
City		State	Zip Code	County
PLANT CITY		FL	33563-4708	Hillsborough
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
15298		$1,000,000		$3,000,000
Profession or Business			Other Profession or Business
Medical Doctor
License Number		Specialty Code & Classification		Certification Number
ME0050556		Physciatry - Including Child		0000000000

Injured Person Information

First Name	MI	Last Name		Date of Birth

Street Address			Gender	County where Injury Occurred
			M	*NR
City			State	Zip Code

Location where injury occured		Other location where injury occured
Hospital Inpatient Facility
Name of Institution		Code
CHARTER BEHAVIORAL HEALTH SYSTEM OF TAMPA BAY AT TAMPA		104012
Location of Institutional Injury		Other Location of Institutional Injury
Patients' Room
Date of Occurrence		Date Reported to Insurer
8/27/1996		3/18/1999

Diagnostic Information

Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Chronic paranoid schizophrenia.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Failure to monitor.
Diagnostic Code :	710
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None.
Principal Injury Giving Rise To The Claim
Suicide.
Severity Of Injury
Permanent: Death.

Legal Information

Date of Suit	Circuit Court Case Number
4/19/1999	97-5630 F
County Suit Filed in	Date of Final Disposition
Hillsborough	7/31/2002
Other Defendants Involved in this Claim

Stage of Legal System at which Settlement was Reached or Award Made
After court verdict and prior to filing of notice of appeal.
Final Method of Claim Disposition
Disposed of by Court
Court Decision	Other
Judgment for the plaintiff.
Arbitration
Claim not subject to Arbitration.
Date of Payment

Financial Information

Was there a settlement Resulting in payment to the Plaintiff?

Yes

Indemnity Paid by Insurer on behalf of Insured

$120,000

Loss Adjust Expense Paid to Defense Counsel

$61,610

All Other Loss Adjustment Expense Paid

$38,700

Injured Person's Total Non-Economic Loss

Deductible

Injured Person's Total Economic Loss

Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely

Unknown.

Updates

No updates found.