Department File Number : | M201573115 |
Claim Number : | 2013-113324 |
Date Submitted : | 1/8/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
NATIONAL UNION FIRE INSURANCE CO. OF PITTSBURGH, PA | Primary | ||||
Insurer FEIN | Professional License Number | ||||
25-0687550 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Connie | L | Peters | ||
Street Address | |||||
PO Box 52810 | |||||
City | State | Zip | |||
Bellevue | WA | 98015 | |||
Phone | Ext | Fax | E-Mail Address | ||
(425) 636 - 1000 | 1012 | (916) 781 - 5795 | cpeters@intercareins.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | JR | A | STRICKLAND | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 4001 Confederate Pt Rd | ||||
City | State | Zip Code | County | ||
Jacksonville | FL | 32210 | Duval | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
DNU 060250506 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Dentistry | |||||
License Number | Specialty Code & Classification | Certification Number | |||
DN9332 | Dental General Practice - NOC | 80211 |
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 | ||||
Physician's Office | |||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Dental Treatment Room | ||||
Date of Occurrence | Date Reported to Insurer | ||||
4/23/2012 | 2/27/2013 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
The patient presented with pain in leeft sisde of mouoth near the loswer left molar. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
The prationer extracted #18 foro othe patient | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
There was no misdiagnosis | |||||
Principal Injury Giving Rise To The Claim | |||||
PAtient alleged the practitioner failed to diagnose infection after extraction of #18 which lead to an abcess and the need for hospitalization. | |||||
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 | 12/23/2014 | ||||
Other Defendants Involved in this Claim | |||||
Strickland, Phillip D | |||||
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 | |||||
12/2/2014 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $81,250 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $9,661 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $5,118 | ||||||||||||||||||||
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 | |||||||||||||||||||||
No safety management steps taken |
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. JR A STRICKLAND, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. JR A STRICKLAND, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).