Department File Number : | M201573421 |
Claim Number : | 2014115808 |
Date Submitted : | 2/10/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
NATIONAL UNION FIRE INSURANCE CO. OF PITTSBURGH, PA | Primary | ||||
Insurer FEIN | Professional License Number | ||||
25-0687550 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Connie | L | Peters | ||
Street Address | |||||
PO Box 52810 | |||||
City | State | Zip | |||
Bellevue | WA | 98015 | |||
Phone | Ext | Fax | E-Mail Address | ||
(425) 636 - 1000 | 1012 | (916) 781 - 5795 | cpeters@intercareins.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | John | J | Scalercio | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 6702 N University | ||||
City | State | Zip Code | County | ||
Tamarac | FL | 33321 | Broward | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
DSA 060249908 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Dentistry | |||||
License Number | Specialty Code & Classification | Certification Number | |||
DN17830 | Dentists - N.O.C. | 80211 |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Broward | ||||
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 | Dental Treatment Room | ||||
Date of Occurrence | Date Reported to Insurer | ||||
2/13/2013 | 1/19/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
The patient needed restorative treatment, including crowns and bridges. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Insured placed crowns and bridges | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
no misdiagnosis | |||||
Principal Injury Giving Rise To The Claim | |||||
alleged negligent crown placements and ill fitting bridge requireing further treatment. | |||||
Severity Of Injury | |||||
Temporary: Slight - Lacerations, contusions, minor scars, rash. No delay. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
5/13/2014 | 14-009116 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Broward | 2/6/2015 | ||||
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 | |||||
2/6/2015 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $49,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $15,896 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $348 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $49,000 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
No safety management steps taken |
Updates | |
No updates found. |
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Does Dr. JOHN J SCALERCIO, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. JOHN J SCALERCIO, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).