Department File Number : | M201680512 |
Claim Number : | HPT 1481 |
Date Submitted : | 12/1/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
Seltzer, Norman | Primary | ||||
Insurer FEIN | Professional License Number | ||||
59-2089594 | ME37891 | ||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Carol | Wiseheart | |||
Street Address | |||||
747 S. Ridgewood Ave, Suite 111 | |||||
City | State | Zip | |||
Daytona Beach | FL | 32114 | |||
Phone | Ext | Fax | E-Mail Address | ||
(386) 310 - 7969 | (386) 310 - 7973 | cwiseheart@halifaxins.org |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Norman | Seltzer | |||
Insurer Type | Street Address of Practice | ||||
Self-Insurer | 614 Peninsula Dr. | ||||
City | State | Zip Code | County | ||
Daytona Beach | FL | 32114 | Volusia | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
00-17 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME37891 | Surgery - Orthopedic |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Volusia | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
MEMORIAL HOSPITAL - ORMOND BEACH | 100169 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
7/1/2014 | 5/21/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Medial meniscus tear | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Alleged iatrogenic injury | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Medial meniscus tear | |||||
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 | 12/1/2016 | ||||
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 | $704 | ||||||||||||||||||||
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 | |||||||||||||||||||||
On going risk management |
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. NORMAN SELTZER, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. NORMAN SELTZER, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).