| Department File Number : | M201990377 |
| Claim Number : | HMA79049 |
| Date Submitted : | 10/24/2019 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| CONTINENTAL CASUALTY COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 36-2114545 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | SHARI | R | MCGEE | ||
| Street Address | |||||
| 333 S. WABASH AVE. | |||||
| City | State | Zip | |||
| CHICAGO | IL | 60604 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (312) 822 - 2535 | shari.mcgee@cna.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Charles | E | Schutt | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 11512 Portside Dr | ||||
| City | State | Zip Code | County | ||
| Jacksonville | FL | 32225 | Duval | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| DNC 428137869 | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Dentistry | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| DN5795 | Dentists | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Duval | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Other Outpatient Facility | Dental Office | ||||
| Name of Institution | Code | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Special Procedure Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 4/18/2017 | 6/7/2017 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| ALLEGED IMPROPER PERFORMANCE RESULTED IN SINUSPERFORATION. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| ALLEGED IMPROPER PERFORMANCE RESULTED IN SINUSPERFORATION. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| ALLEGED IMPROPER PERFORMANCE RESULTED IN SINUSPERFORATION. | |||||
| Severity Of Injury | |||||
| Temporary: Major - Burns, surgical material left, drug side effect, brain damage. Recovery delayed. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 3/12/2019 | 2019CA1880 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Duval | 9/25/2019 | ||||
| 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 | |||||
| Claim not subject to Arbitration. | |||||
| Date of Payment | |||||
| 9/23/2019 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $150,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $23,911 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| INSURED DISCUSSED CASE WITH DEFENSE COUNSEL AND INSURANCE PERSONNEL. | |||||||||||||||||||||
| Updates | |
| No updates found. |
| Department File Number : | M201990874 |
| Claim Number : | HMA91217 |
| Date Submitted : | 12/16/2019 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| CONTINENTAL CASUALTY COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 36-2114545 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | SHARI | R | MCGEE | ||
| Street Address | |||||
| 333 S. WABASH AVE. | |||||
| City | State | Zip | |||
| CHICAGO | IL | 60604 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (312) 822 - 2535 | shari.mcgee@cna.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Charles | E | Schutt | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 7216 Merrill Road | ||||
| City | State | Zip Code | County | ||
| Jacksonville | FL | 32211 | Duval | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| DNC 428137869 | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Dentistry | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| DN5795 | Dentists | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Duval | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Other Outpatient Facility | Dental Office | ||||
| Name of Institution | Code | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Special Procedure Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 1/1/2018 | 3/27/2018 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Alleged complications from tooth extraction resulted in gum injury. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Alleged complications from tooth extraction resulted in gum injury. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Alleged complications from tooth extraction resulted in gum injury. | |||||
| Severity Of Injury | |||||
| Temporary: Major - Burns, surgical material left, drug side effect, brain damage. Recovery delayed. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| *NR | |||||
| County Suit Filed in | Date of Final Disposition | ||||
| *NR | 11/14/2019 | ||||
| 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 | |||||
| Claim not subject to Arbitration. | |||||
| Date of Payment | |||||
| 11/14/2019 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $80,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $6,488 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $2,713 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| ENFORCING GUIDELINES AND POLICIES TO PREVENT RISKS. | |||||||||||||||||||||
| Updates | |
| No updates found. |
| Department File Number : | M201679217 |
| Claim Number : | HMA52161 |
| Date Submitted : | 7/21/2016 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| CONTINENTAL CASUALTY COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 36-2114545 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Shauna | Jumper | |||
| Street Address | |||||
| 333 S Wabash Ave | |||||
| City | State | Zip | |||
| Chicago | IL | 60604 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (312) 822 - 5419 | Shauna.Jumper@cna.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Charles | E | Schutt | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 11512 Portside Dr | ||||
| City | State | Zip Code | County | ||
| Jacksonville | FL | 32225 | Duval | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| DNC 4028137869 | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Dentistry | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| DN5795 | Dental General Practice - NOC | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Duval | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Other Location | Dental Office | ||||
| Name of Institution | Code | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Special Procedure Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 10/29/2014 | 9/4/2015 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Alleged wrongful extraction of 3 teeth | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Patient went in for dental work | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| INSD REMOVED THREE TEETH WITHOUT PT CONSENT. | |||||
| Severity Of Injury | |||||
| Temporary: Major - Burns, surgical material left, drug side effect, brain damage. Recovery delayed. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| *NR | |||||
| County Suit Filed in | Date of Final Disposition | ||||
| *NR | 7/18/2016 | ||||
| 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 | |||||
| No Payment Made | |||||
| 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 | $0 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $250 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Insured discussed case with defense counsel and insurance personnel | |||||||||||||||||||||
| 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.
| Department File Number : | M201781591 |
| Claim Number : | HMA67356 |
| Date Submitted : | 3/30/2017 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| CONTINENTAL CASUALTY COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 36-2114545 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Shauna | Jumper | |||
| Street Address | |||||
| 333 S Wabash Ave | |||||
| City | State | Zip | |||
| Chicago | IL | 60604 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (312) 822 - 5419 | Shauna.Jumper@cna.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Charles | E | Schutt | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 800 Dunn Ave | ||||
| City | State | Zip Code | County | ||
| Jacksonville | FL | 32218 | Duval | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| DNC 428137869 | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Dentistry | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| DN5795 | Dental General Practice - NOC | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Duval | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Other Location | Dental Office | ||||
| Name of Institution | Code | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Special Procedure Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 10/1/2015 | 8/30/2016 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Alleges failure to secure an interpreter for dental patient, after her request. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Patient needed to have dental work performed. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Alleged failure to provide an interpreter. | |||||
| Severity Of Injury | |||||
| Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| *NR | |||||
| County Suit Filed in | Date of Final Disposition | ||||
| *NR | 3/23/2017 | ||||
| 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 | |||||
| No Payment Made | |||||
| 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 | $275 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Investigate and identify risks and reduce the liability exposure. | |||||||||||||||||||||
| 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. CHARLES E SCHUTT, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. CHARLES E SCHUTT, MD has at least 4 medical malpractice case(s), lawsuit(s), or complaint(s).