Department File Number : | M201990374 |
Claim Number : | 69798 |
Date Submitted : | 5/29/2020 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
NCMIC INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
42-0635534 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Michelle | R | Gould | ||
Street Address | |||||
14001 University Avenue | |||||
City | State | Zip | |||
Clive | IA | 50325 | |||
Phone | Ext | Fax | E-Mail Address | ||
(515) 313 - 4558 | (515) 313 - 4471 | mgould@ncmic.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Aaron | Broderick | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 9250 College Pkwy Ste 1 | ||||
City | State | Zip Code | County | ||
Fort Myers | FL | 33919 | Lee | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
DPL016777 | $1,100,000 | $300,000 | |||
Profession or Business | Other Profession or Business | ||||
Dentistry | |||||
License Number | Specialty Code & Classification | Certification Number | |||
DN19413 | Dentists |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Lee | ||||
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 | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
2/8/2016 | 3/16/2018 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Tooth pain | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Dental extraction of tooth #19 | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
alleged negligent extraction of tooth 19 | |||||
Principal Injury Giving Rise To The Claim | |||||
caused nerve injury | |||||
Severity Of Injury | |||||
Permanent: Minor - Loss of fingers, loss or damage to organs. Includes non-disabling injuries. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
6/22/2018 | 2018-021312-CA-01 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Dade | 9/24/2019 | ||||
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 subject to arbitration, but settlement reached in lieu of award. | |||||
Date of Payment | |||||
9/24/2019 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $32,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $66,203 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Unknown |
Updates | |
No updates found. |
Does Dr. AARON BRODERICK, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. AARON BRODERICK, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).