| Department File Number : | M201472028 |
| Claim Number : | 2012021022-DR |
| Date Submitted : | 6/29/2015 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| ALLIED WORLD SURPLUS LINES INSURANCE COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 51-0331163 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Michelle | Bedard | |||
| Street Address | |||||
| 1690 New Britain Avenue, Suite 101 | |||||
| City | State | Zip | |||
| Farmington | CT | 06032 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (860) 284 - 1942 | (860) 284 - 1943 | Michelle.Bedard@awac.com | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Craig | R | Wolff | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 290 RUE DES LACS | ||||
| City | State | Zip Code | County | ||
| Tarpon Springs | FL | 34688 | Pinellas | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 0306-3309 | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME77955 | Surgery - Orthopedic | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Hillsborough | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Other Outpatient Facility | Same day surgery center | ||||
| Name of Institution | Code | ||||
| LASER SPINE SURGICAL CENTER | 14960607 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Operating Suite | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 5/24/2011 | 1/27/2012 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Plaintiff alleges he suffers from low back pain and left thigh pain, sciatica pain, weakness and pain in the left foot with numbness and tingling, especially whenstanding, and nerve pain radiating into this left leg with a foot drop. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Laparoscopic surgery was done at the L5-S1 level. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Surgery provided temporary relief with recurrence of pain symptoms. | |||||
| 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 | ||||
| 7/18/2012 | 12 011383 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Hillsborough | 9/10/2014 | ||||
| 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 | |||||
| 9/16/2014 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $200,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $0 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Worked closely with counsel to resolve claim. | |||||||||||||||||||||
| Updates | ||||||||||
| Date of Change: | 3/4/2015 11:05:50 AM | |||||||||
| Reason for Change: | The Indemnity Paid by Insurer and Loss Adjust Expense amounts were changed to reflect only the portion allocated to the practitioner. | |||||||||
| ||||||||||
| Date of Change: | 6/29/2015 3:34:44 PM | |||||||||
| Reason for Change: | Change in the date of occurrence. | |||||||||
| ||||||||||
*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Does Dr. CRAIG R WOLFF, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. CRAIG R WOLFF, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).