M200432171

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	Deanon			Davis
Street Address
4601 Wilshire Blvd., Suite 100
City				State	Zip
Los Angeles				CA	90010
Phone	Ext	Fax	E-Mail Address
(323) 930 - 6346			deanon.davis@farmersinsurance.com

Insured Information

Type	First Name		MI	Last Name
Individual	GUILLERMO			PAREDES
Insurer Type		Street Address of Practice
Licensed		10251 SW 20TH ST
City		State	Zip Code	County
DAVIE		FL	33324	Broward
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
0118066180000-0003		$250,000		$750,000
Profession or Business			Other Profession or Business
Medical Doctor
License Number		Specialty Code & Classification		Certification Number
ME54798		Pediatrics - Minor Surgery

Injured Person Information

First Name	MI	Last Name		Date of Birth

Street Address			Gender	County where Injury Occurred
			F	Leon
City			State	Zip Code

Location where injury occured		Other location where injury occured
Physician's Office
Name of Institution		Code

Location of Institutional Injury		Other Location of Institutional Injury
Other		PHYSICIAN'S OFFICE
Date of Occurrence		Date Reported to Insurer
3/14/2002		6/17/2003

Diagnostic Information

Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
FAILURE TO DIAGNOSE MENINGITIS.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
N/A
Diagnostic Code :
Misdiagnosis Made, If Any, Of Patient's Actual Condition
FAILURE TO DIAGNOSE MENINGITIS, WHEN SYMPTOMS WERE PRESENT.
Principal Injury Giving Rise To The Claim
FAILURE TO DIAGNOSE MENINGITIS, WHICH CAUSED THE DEATH OF A THREE (3) MONTH OLD INFANT.
Severity Of Injury
Permanent: Death.

Legal Information

Date of Suit	Circuit Court Case Number
3/1/2004	03018645-CA-03
County Suit Filed in	Date of Final Disposition
Broward	6/25/2004
Other Defendants Involved in this Claim

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
6/28/2004

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

$16,051

All Other Loss Adjustment Expense Paid

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

INSURED IS BEING MORE CAREFUL WHEN EXAMINING PATIENTS.

Updates

No updates found.