Department File Number : | M201887457 |
Claim Number : | 2018014813 |
Date Submitted : | 12/28/2018 |
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 | Joyce | M | Palmisano | ||
Street Address | |||||
1690 New Britain Ave. Suite 101 | |||||
City | State | Zip | |||
Farmington | CT | 06032 | |||
Phone | Ext | Fax | E-Mail Address | ||
(860) 284 - 1382 | 1382 | (860) 284 - 1383 | Joyce.Palmisano@awac.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | JAMES | PIKO | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 6053 South Eagle Street | ||||
City | State | Zip Code | County | ||
Centennial | CO | 80016 | Out of state | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
0311-3017 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
OS11194 | Radiology - Diagnostic - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Broward | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Other Outpatient Facility | Plantation Open MRI LLC | ||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Radiology, Emergency Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
5/10/2017 | 6/27/2018 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Right middle finger injury | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
X-ray | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Failure to initially diagnose right middle finger distal phalanx fracture with partial displacement in a right-handed 70 year old female patient. | |||||
Principal Injury Giving Rise To The Claim | |||||
Fracture in finger healed with permanent mallet finger deformity. Patient advised to wear splint for protection if she's having pain when her finger is hit. | |||||
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 | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 12/27/2018 | ||||
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 | |||||
12/27/2018 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $55,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $17,248 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $55,000 | ||||||||||||||||||||
Deductible | $7,752 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Worked closely with defense counsel to resolve claim. |
Updates | |
No updates found. |
Does Dr. JAMES PIKO, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. JAMES PIKO, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).