| Department File Number : | M201679395 |
| Claim Number : | HMA00548 |
| Date Submitted : | 8/10/2016 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| CONTINENTAL CASUALTY COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 36-2114545 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Shauna | Jumper | |||
| Street Address | |||||
| 333 S Wabash Ave | |||||
| City | State | Zip | |||
| Chicago | IL | 60604 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (312) 822 - 5419 | Shauna.Jumper@cna.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | PRANATHI | BANDI | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 1750 Tamiami Trl Ste 100 | ||||
| City | State | Zip Code | County | ||
| Port Charlotte | FL | 33948 | Charlotte | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| DNC 0311639956 | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Dentistry | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| DN19096 | Dental General Practice - NOC | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Charlotte | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Other Location | Dental Office | ||||
| Name of Institution | Code | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Special Procedure Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 11/13/2011 | 3/22/2012 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Patient alleged negligent dental examination and referral to oral surgeon for treatment. Patient seen by oral surgeon who concurred with dx and who did full mouth extractions. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Oral examination and diagnosis of condition/referral to specialist. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Insured performed exam on 10/13/11 & she referred pt to oral surgeon. | |||||
| Severity Of Injury | |||||
| Permanent: Minor - Loss of fingers, loss or damage to organs. Includes non-disabling injuries. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| *NR | |||||
| County Suit Filed in | Date of Final Disposition | ||||
| *NR | 7/27/2016 | ||||
| Other Defendants Involved in this Claim | |||||
| Aspen Dental Management Inc | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| Within the pre-suit period as set forth in 766.106 (more than 90 days before suit is filed). | |||||
| Final Method of Claim Disposition | |||||
| Settled by parties | |||||
| Court Decision | Other | ||||
| No Court Proceedings. | |||||
| Arbitration | |||||
| Claim not subject to Arbitration. | |||||
| Date of Payment | |||||
| 7/18/2016 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $1,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $73,158 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $13,617 | ||||||||||||||||||||
| 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 and insurance personnel | |||||||||||||||||||||
| 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. PRANATHI BANDI, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. PRANATHI BANDI, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).