| Department File Number : | M201678103 |
| Claim Number : | 2014009429 |
| Date Submitted : | 5/5/2016 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| ALLIED WORLD SPECIALTY INSURANCE COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 56-0997452 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Joyce | M | Palmisano | ||
| Street Address | |||||
| 1690 New Britain Ave. Suite 101 | |||||
| City | State | Zip | |||
| Farmington | CT | 06032 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (860) 284 - 1382 | 1382 | (860) 284 - 1383 | Joyce.Palmisano@awac.com | ||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Harish | Kher | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 601 North Clyde Morris Boulevard Suite C | ||||
| City | State | Zip Code | County | ||
| Daytona Beach | FL | 32114 | Volusia | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 0001-0270 | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME42946 | Psychiatry - Child and Adolescent Psychiatry | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Volusia | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Other Location | Emergency Room | ||||
| Name of Institution | Code | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Radiology, Emergency Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 3/25/2014 | 5/16/2014 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Adjustment reaction with mixed emotional features. Dysthymic disorder. Mixed personality traits with features of passive/aggressive personality disorder.Emotional distress. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Claimant made suicidal statements and got angry during a telephone conversation with the Veteran's Administration. During the conversation he stated that he wanted to be euthanized. He stated that he was frustrated with the care he had received at the VA, and did not want to live anymore. Police were dispatched and he was Baker Acted for 3 to 5 days | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| Baker Acted for 3-5 days. | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Adjustment reaction with mixed emotional features. Dysthymic disorder. Mixed personality traits with features of passive/aggressive personality disorder.Emotional distress. | |||||
| Severity Of Injury | |||||
| Emotional Only - Fright, no physical damage | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| *NR | |||||
| County Suit Filed in | Date of Final Disposition | ||||
| *NR | 4/13/2016 | ||||
| Other Defendants Involved in this Claim | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| Claim or suit abandoned. | |||||
| Final Method of Claim Disposition | |||||
| Dropped before Action Filed | |||||
| 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? | No | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $0 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $11,848 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
| Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
| Deductible | $0 | ||||||||||||||||||||
| Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
| Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
| Had difficulty saving the Injury Information data screen portion of this claim. The only way I could get that section to save was to leave the drop down section, Name of Institution, blank. The name of the institution was HALIFAX HEALTH MEDICAL CENTER in Daytona Beech, FL 32114 | |||||||||||||||||||||
| Updates | |
| No updates found. |
*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Does Dr. HARISH KHER, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. HARISH KHER, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).