| Department File Number : | M202092366 |
| Claim Number : | HPT 1496 |
| Date Submitted : | 4/30/2020 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| Ailani, Rajesh | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 20-060470 | ME89115 | ||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Carol | Wiseheart | |||
| Street Address | |||||
| 747 S Ridgewood Ave | |||||
| 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 | Rajesh | Ailani | |||
| Insurer Type | Street Address of Practice | ||||
| Self-Insurer | 1055 N. Dixie Freeway, Suite 1 | ||||
| City | State | Zip Code | County | ||
| New Smyrna Beach | FL | 32168 | Volusia | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 02-55 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME89115 | Internal Medicine - No Surgery | ||||
| 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 | ||||
| N/A | 000000 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Patients' Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 3/16/2016 | 3/16/2018 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Sepsis, Pneumonia & Respiratory Failure | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Critical care provided. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Cardiac secondary to respiratory issues. | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 8/7/2018 | 2018 11336 CIDL | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Volusia | 3/31/2020 | ||||
| Other Defendants Involved in this Claim | |||||
| Girish Ghade, LLC Hassan, M.D., Syed A Inpatient Consultants of Florida, Inc. Venzon, M.D., Roy P Ghade, M.D., Girish Zacharis, M. D., Theodossis Select Specialty-Daytona Beach, Inc. PCCC of Volusia, LLC Nagarajan, M.D., Ravi Akshaya Balaji, LLC Lewis & Klancke Cardiology PA d/b/a Daytona Heart Group Memorial Hospital-West Volusia d/b/a Florida Hospital Deland | |||||
| 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 | |||||
| 3/20/2020 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $225,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $61,396 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Ongoing risk management | |||||||||||||||||||||
| Updates | |
| No updates found. |
| Department File Number : | M201885022 |
| Claim Number : | HPT 1483 |
| Date Submitted : | 4/12/2018 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| Ailani, Rajesh | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 20-060470 | ME89115 | ||||
| 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 | Rajesh | Ailani | |||
| Insurer Type | Street Address of Practice | ||||
| Self-Insurer | 1055 N. Dixie Freeway | ||||
| City | State | Zip Code | County | ||
| New Smyrna Beach | FL | 32168 | Volusia | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 02-55 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME89115 | Internal Medicine - Minor Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Volusia | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| 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 | ||||
| 4/1/2015 | 4/1/2016 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Multi-vessel coronary disease | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Planned transfer to VA facility for care. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| myocardial infarction | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| *NR | |||||
| County Suit Filed in | Date of Final Disposition | ||||
| *NR | 4/12/2018 | ||||
| Other Defendants Involved in this Claim | |||||
| FL Hospital Deland DIBELLO, CHRISTOPHER Pegoraro, Alfredo Abuaita, Alee George Morrison, Erika | |||||
| 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 | $3,319 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $750 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Ongoing Risk managemetn | |||||||||||||||||||||
| 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. RAJESH AILANI, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. RAJESH AILANI, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).