| Department File Number : | M201573142 |
| Claim Number : | 2013-113659 |
| 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 | Phillip | D | Strickland | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 4001 Confederate Point Rd. Ste 3 | ||||
| City | State | Zip Code | County | ||
| Jacksonville | FL | 32210 | Duval | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| DSA 060249809 | $500,000 | $1,500,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Dentistry | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| DN13669 | 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 Center | ||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 4/23/2012 | 4/10/2013 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Patient presented with pain in the lower left molar | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Extraction of #18 | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| No misdiagnosis | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Patient alleged insured failed to dianose infection aftr 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, JR | |||||
| 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 | $20,096 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $5,735 | ||||||||||||||||||||
| 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. PHILLIP D STRICKLAND, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. PHILLIP D STRICKLAND, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).