| Department File Number : | M199600390 |
| Claim Number : | OMSCT94L0054 |
| Date Submitted : | 2/6/1996 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| SURGEONS' PROFESSIONAL LIABILITY SELF-IN.TRUST,INC | Excess | ||||
| Insurer FEIN | Professional License Number | ||||
| 65-6019915 | |||||
| Insurer Contact Information | |||||
| Type | Entity Name | ||||
| Entity | |||||
| Street Address | |||||
| City | State | Zip | |||
| FL | |||||
| Phone | Ext | Fax | E-Mail Address | ||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | A. KENT | SEBASTIAN | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | *NR | ||||
| City | State | Zip Code | County | ||
| *NR | FL | 33401 | Palm Beach | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| *NR | $250,000 | *NR | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| 0036245 | Surgery - Obstetrics - Gynecology | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | *NR | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| *NR | |||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Patients' Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 5/10/1994 | 5/17/1994 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| *NR | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| *NR | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| *NR | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 8/3/1995 | 000CL95 6111 AH | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| 11/29/1995 | |||||
| Other Defendants Involved in this Claim | |||||
| 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 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $250,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $1,215 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $1,345 | ||||||||||||||||||||
| Injured Person's Total Non-Economic Loss | $250,000 | ||||||||||||||||||||
| Deductible | $0 | ||||||||||||||||||||
| Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
| Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
| *NR | |||||||||||||||||||||
| Updates | |
| No updates found. |
| Department File Number : | M199701112 |
| Claim Number : | 96L001 |
| Date Submitted : | 5/12/1997 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| SURGEONS' PROFESSIONAL LIABILITY SELF-IN.TRUST,INC | Excess | ||||
| Insurer FEIN | Professional License Number | ||||
| 65-6019915 | |||||
| Insurer Contact Information | |||||
| Type | Entity Name | ||||
| Entity | |||||
| Street Address | |||||
| City | State | Zip | |||
| FL | |||||
| Phone | Ext | Fax | E-Mail Address | ||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | SEBASTIAN | A | KENT | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | *NR | ||||
| City | State | Zip Code | County | ||
| *NR | FL | 33401 | Palm Beach | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| *NR | $250,000 | *NR | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| 0036245 | Surgery - Obstetrics - Gynecology | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | *NR | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| *NR | |||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Labor and Delivery Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 1/11/1996 | 1/22/1996 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| *NR | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| *NR | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| *NR | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 5/31/1996 | 00000CL 96-4156 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| 12/31/1996 | |||||
| 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 subject to arbitration, but settlement reached in lieu of award. | |||||
| Date of Payment | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $208,750 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $32,861 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| *NR | |||||||||||||||||||||
| Updates | |
| No updates found. |
Does Dr. A. KENT SEBASTIAN, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. A. KENT SEBASTIAN, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).