Department File Number : | M201886041 |
Claim Number : | 192257 |
Date Submitted : | 10/29/2018 |
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 | Denise | Stokes | |||
Street Address | |||||
100 Brookwood Place | |||||
City | State | Zip | |||
Birmingham | AL | 35209 | |||
Phone | Ext | Fax | E-Mail Address | ||
(205) 802 - 4790 | (205) 802 - 4710 | claimscompliancereporting@proassurance.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Natalie | L | Monticciolo | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 4546 Grand Blvd | ||||
City | State | Zip Code | County | ||
New Port Richey | FL | 34652 | Pasco | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
MP49469 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Osteopathic Physician | |||||
License Number | Specialty Code & Classification | Certification Number | |||
OS7718 | Dermatology - All Other |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Pasco | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Physician's Office | |||||
Name of Institution | Code | ||||
N/A | 000000 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
5/11/2011 | 1/28/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Assessment of skin lesions | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Assessment of skin lesions and treatment of keratosis with liquid nitrogen with patient told to follow-up timely. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
No misdiagnosis | |||||
Principal Injury Giving Rise To The Claim | |||||
Plaintiff alleged delay in diagnosis of basal cell carcinoma and squamous cell carcinoma. | |||||
Severity Of Injury | |||||
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
1/13/2014 | 2013-CA-006279 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Pasco | 7/27/2018 | ||||
Other Defendants Involved in this Claim | |||||
Prestige Dermatology Inc | |||||
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 | $62,500 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $67,719 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $17,749 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $62,500 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Insured discussed case with defense counsel, insurance personnel, and medical experts. |
Updates | |||||||||||||
Date of Change: | 8/9/2018 1:11:12 PM | ||||||||||||
Reason for Change: | Updated ALAE information | ||||||||||||
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Date of Change: | 8/13/2018 4:27:59 PM | ||||||||||||
Reason for Change: | Updated ALAE Inforrmation | ||||||||||||
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Date of Change: | 10/29/2018 2:18:59 PM | ||||||||||||
Reason for Change: | updated alae | ||||||||||||
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Does Dr. NATALIE L MONTICCIOLO, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. NATALIE L MONTICCIOLO, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).