Department File Number : | M201781549 |
Claim Number : | 7030091255 |
Date Submitted : | 3/27/2017 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
LANDMARK AMERICAN INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
73-0994137 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Jim | Dapolite | |||
Street Address | |||||
945 East Paces Ferry Rd, Suite 1800 | |||||
City | State | Zip | |||
Atlanta | GA | 30326 | |||
Phone | Ext | Fax | E-Mail Address | ||
(404) 682 - 7683 | (404) 262 - 4437 | jdapolite@rsui.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | JAMES | MAGEE | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 5892 RED BUG LAKE ROAD | ||||
City | State | Zip Code | County | ||
Winter Springs | FL | 32708 | Seminole | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
LHM751311 | $500,000 | $1,500,000 | |||
Profession or Business | Other Profession or Business | ||||
Dentistry | |||||
License Number | Specialty Code & Classification | Certification Number | |||
DN14615 | Dentists |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Seminole | ||||
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 | ||||
Date of Occurrence | Date Reported to Insurer | ||||
4/29/2015 | 8/19/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Dental cleaning and checkup. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Dentist filled 10 cavities and performed placement of Invisaline. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Plaintiff complained of pain in her tongue. | |||||
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 | 3/3/2017 | ||||
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 | |||||
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 | $5,815 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Not known. |
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. JAMES MAGEE, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. JAMES MAGEE, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).