Department File Number :

M200430292

Claim Number :

83-007599

Date Submitted :

4/12/2004

 

Insurer Information

 

Insurer Name

Coverage Type

TRUCK INSURANCE EXCHANGE

Primary

Insurer FEIN

Professional License Number

95-2575892

 

Insurer Contact Information

Type

First Name

MI

Last Name

Individual

JULIE

L

BICKNELL

Street Address

P.O. BOX 4999

City

State

Zip

LOS ANGELES

CA

90051-4999

Phone

Ext

Fax

E-Mail Address

(323) 964 - 8271(323) 964 - 8271

 

(323) 937 - 1919(323) 937 - 1919

 

 

Insured Information

 

Type

First Name

MI

Last Name

Individual

HERNDON

P

HARDING, JR.

Insurer Type

Street Address of Practice

Licensed

2828 CASA ALOMA WAY, SUITE 200

City

State

Zip Code

County

WINTER PARK

FL

32792

Orange

Policy Number

Per Claim Policy Limits

Aggregate Policy Limits

0118089880000

$1,000,000

$3,000,000

Profession or Business

Other Profession or Business

Medical Doctor

 

License Number

Specialty Code & Classification

Certification Number

ME74794

Physciatry - Including Child

273583239

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

*NR

City

State

Zip Code

 

 

 

Location where injury occured

Other location where injury occured

Patient's Home

 

Name of Institution

Code

 

 

Location of Institutional Injury

Other Location of Institutional Injury

 

 

Date of Occurrence

Date Reported to Insurer

9/5/2000

8/29/2001

 

Diagnostic Information

 

Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition

Depression.

Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury

Alleged failure to diagnose and treat patient's depression, resulting in an early discharge from the hospital.

Diagnostic Code :

 

Misdiagnosis Made, If Any, Of Patient's Actual Condition

Depression.

Principal Injury Giving Rise To The Claim

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

1/11/2002

CIO0110322 DIV 40

County Suit Filed in

Date of Final Disposition

Orange

3/11/2004

Other Defendants Involved in this Claim

FARMER, M.D., SCOTT D
FLORIDA PHYSICIANS MEDICAL GROUP, INC
ADVENTIST HEALTH SYSTEM /SUNBERT, INC.,
CENTER FOR BEHAVIORAL HEALTH

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

 

 

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

$24,836

All Other Loss Adjustment Expense Paid

$74,899

Injured Person's Total Non-Economic Loss

$250,000

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

More in-depth review of patient's symptoms and discussion with staff and family members, as well as having a discharge interview with the patient.

 

Updates

 

No updates found.