Department File Number : | M202091182 |
Claim Number : | 1045646-02 |
Date Submitted : | 1/21/2020 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
NATIONAL FIRE & MARINE INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
47-6021331 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Taffie | Hosler | |||
Street Address | |||||
5814 Reed Road | |||||
City | State | Zip | |||
Fort Wayne | IN | 46835 | |||
Phone | Ext | Fax | E-Mail Address | ||
(260) 492 - 4061 | taffie.hosler@medpro.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | ANITA | J | KLAUS | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 734 N 3rd Street, Ste 115 | ||||
City | State | Zip Code | County | ||
Leesburg | FL | 34748 | Sumter | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
HN005023 | $1,000,000 | $10,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME93120 | Radiology - interventional |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Sumter | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Outpatient Facility | |||||
Name of Institution | Code | ||||
RAMADAN HAND INST./LAKE BUTLER HOSPITAL | 100241 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Radiology Associates of Central Fl, LLC | ||||
Date of Occurrence | Date Reported to Insurer | ||||
1/13/2017 | 5/2/2017 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Bone density scan | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Reading of bone scan | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged failing to properly read scan | |||||
Principal Injury Giving Rise To The Claim | |||||
Missed abnormal findings | |||||
Severity Of Injury | |||||
Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 12/30/2019 | ||||
Other Defendants Involved in this Claim | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Settlement Reached Prior to Pre-Suit Period | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Award for plaintiff. | |||||
Date of Payment | |||||
12/30/2019 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $325,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $0 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $34,634 | ||||||||||||||||||||
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 | |||||||||||||||||||||
n/a |
Updates | |
No updates found. |
Does Dr. ANITA J KLAUS, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. ANITA J KLAUS, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).