Department File Number : | M201574342 |
Claim Number : | HMA11190 |
Date Submitted : | 4/17/2015 |
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 | Juanetta | J | Moore | ||
Street Address | |||||
333. Wabash Ave | |||||
City | State | Zip | |||
Chicago | IL | 60685 | |||
Phone | Ext | Fax | E-Mail Address | ||
(312) 822 - 3353 | Juanetta.Moore@cna.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Randy | J | Goldfarb | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 951 NW 13th St., Suite 3A | ||||
City | State | Zip Code | County | ||
Boca Raton | FL | 33486 | Palm Beach | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
DLP 283684510 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Dentistry | |||||
License Number | Specialty Code & Classification | Certification Number | |||
DN15977 | Dentists |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Palm Beach | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Other Outpatient Facility | 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 | ||||
7/16/2013 | 7/16/2013 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Claimant presented for implants | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Implant failed at tooth #29 | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Paresthesia and numbness in the lower right side of claimant's face due to the placement of the implant | |||||
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 | 3/31/2015 | ||||
Other Defendants Involved in this Claim | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Within 90 days of suit being filed. | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
3/31/2015 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $80,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $8,116 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $2,155 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Investigate and identify risks and reduce the liability exposure. |
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.
Department File Number : | M201987752 |
Claim Number : | HMA56055 |
Date Submitted : | 1/29/2019 |
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 | SHARI | R | MCGEE | ||
Street Address | |||||
333 S. WABASH AVE. | |||||
City | State | Zip | |||
CHICAGO | IL | 60604 | |||
Phone | Ext | Fax | E-Mail Address | ||
(312) 822 - 2535 | shari.mcgee@cna.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Randy | J | Goldfarb | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 951 NW 13TH Street Suite 3A | ||||
City | State | Zip Code | County | ||
Boca Raton | FL | 33486 | Palm Beach | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
DLP 2083684510 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Dentistry | |||||
License Number | Specialty Code & Classification | Certification Number | |||
DN15977 | Dentists |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Palm Beach | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Other Outpatient Facility | 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 | ||||
5/7/2014 | 12/4/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Patient alleged that insured placed implant which resulted in permanent numbness. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Patient alleged that insured placed implant which resulted in permanent numbness. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Patient alleged that insured placed implant which resulted in permanent numbness. | |||||
Severity Of Injury | |||||
Temporary: Major - Burns, surgical material left, drug side effect, brain damage. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
7/7/2016 | 502016CA007605XXXXMB | ||||
County Suit Filed in | Date of Final Disposition | ||||
Palm Beach | 1/2/2019 | ||||
Other Defendants Involved in this Claim | |||||
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 | |||||
1/2/2019 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $50,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $19,731 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $5,173 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Enforcing guidelines and policies to prevent risks. |
Updates | |
No updates found. |
Does Dr. RANDY J GOLDFARB, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. RANDY J GOLDFARB, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).