Department File Number : | M199800490 |
Claim Number : | A97-17979-95 |
Date Submitted : | 2/20/1998 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
FIRST PROFESSIONALS INSURANCE COMPANY, INC | Excess | ||||
Insurer FEIN | Professional License Number | ||||
59-6614702 | |||||
Insurer Contact Information | |||||
Type | Entity Name | ||||
Entity | |||||
Street Address | |||||
City | State | Zip | |||
FL | |||||
Phone | Ext | Fax | E-Mail Address | ||
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | DONALD A. (ESTATE OF) | BOLT | |||
Insurer Type | Street Address of Practice | ||||
Licensed | *NR | ||||
City | State | Zip Code | County | ||
*NR | FL | 33304 | Broward | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
*NR | $250,000 | *NR | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
0023364 | Surgery - Plastic |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | *NR | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Other Outpatient Facility | |||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
No Response | |||||
Date of Occurrence | Date Reported to Insurer | ||||
1/27/1995 | 2/7/1997 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
*NR | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
*NR | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
*NR | |||||
Severity Of Injury | |||||
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
2/4/1997 | 00CACE 97-01696 | ||||
County Suit Filed in | Date of Final Disposition | ||||
2/11/1998 | |||||
Other Defendants Involved in this Claim | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Within 90 days of suit being filed. | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
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? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $70,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $4,994 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $697 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $70,000 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
*NR |
Updates | |
No updates found. |
Department File Number : | M199801698 |
Claim Number : | A97-18154-95 |
Date Submitted : | 7/17/1998 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
FIRST PROFESSIONALS INSURANCE COMPANY, INC | Excess | ||||
Insurer FEIN | Professional License Number | ||||
59-6614702 | |||||
Insurer Contact Information | |||||
Type | Entity Name | ||||
Entity | |||||
Street Address | |||||
City | State | Zip | |||
FL | |||||
Phone | Ext | Fax | E-Mail Address | ||
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | DONALD A. ESTATE OF | BOLT | |||
Insurer Type | Street Address of Practice | ||||
Licensed | *NR | ||||
City | State | Zip Code | County | ||
*NR | FL | 33304 | Broward | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
*NR | $250,000 | *NR | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
0023364 | Surgery - Plastic |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | *NR | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Prison | |||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
No Response | |||||
Date of Occurrence | Date Reported to Insurer | ||||
2/5/1995 | 4/1/1997 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
*NR | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
*NR | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
*NR | |||||
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 | ||||
9/2/1997 | 0097-11016 (14) | ||||
County Suit Filed in | Date of Final Disposition | ||||
7/10/1998 | |||||
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 | |||||
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $70,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $4,888 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $2,385 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $70,000 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
*NR |
Updates | |
No updates found. |
Does Dr. ESTATE OF DONALD A BOLT, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. ESTATE OF DONALD A BOLT, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).