Department File Number : | M201472632 |
Claim Number : | 187922 |
Date Submitted : | 11/11/2014 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
PROASSURANCE CASUALTY COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
38-2317569 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Nicholas | M | Adams | ||
Street Address | |||||
100 Brookwood Place | |||||
City | State | Zip | |||
Birmingham | AL | 35209 | |||
Phone | Ext | Fax | E-Mail Address | ||
(205) 439 - 7917 | nadams@proassurance.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | MICHAEL | W | ENGELMAN | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 3000 North University Dr. | ||||
City | State | Zip Code | County | ||
Coral Springs | FL | 33065 | Broward | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
MP36624 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME37097 | Dermatology - 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 | ||||
Physician's Office | |||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Front Desk, reception area | ||||
Date of Occurrence | Date Reported to Insurer | ||||
3/15/2013 | 7/8/2013 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Patient fell after undergoing skin cancer removal, under local anesthesia, and is requesting reimbursement for ER costs. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
skin cancer removal | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
60 Y/O patient fainted and fell near front desk while leaving an appointment. | |||||
Severity Of Injury | |||||
Temporary: Slight - Lacerations, contusions, minor scars, rash. No delay. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 11/5/2014 | ||||
Other Defendants Involved in this Claim | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Claim or suit abandoned. | |||||
Final Method of Claim Disposition | |||||
Dropped before Action Filed | |||||
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 | $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 | |||||||||||||||||||||
Insured discussed case with defense counsel, insurance personnel, and medical experts. |
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. MICHAEL W ENGELMAN, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. MICHAEL W ENGELMAN, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).