| Department File Number : | M201884478 |
| Claim Number : | 52402 |
| Date Submitted : | 3/23/2018 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| MAG MUTUAL INSURANCE COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 58-1449198 | |||||
| Insurer Contact Information | |||||
| Type | Entity Name | ||||
| Entity | MAG MUTUAL INSURANCE COMPANY | ||||
| Street Address | |||||
| 8427 South Park Circle Suite 130 | |||||
| City | State | Zip | |||
| Orlando | FL | 32819 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (407) 370 - 3813 | (404) 842 - 3319 | ctschanz@magmutual.com | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Shiv | K | Aggarwal | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 5522 Trouble Creek Rd., Ste. 100 | ||||
| City | State | Zip Code | County | ||
| New Port Richey | FL | 34652 | Pasco | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| PSL 1600144 14 | $500,000 | $1,500,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME61805 | Internal Medicine - No Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Polk | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| MEDICAL CENTER OF TRINITY WEST PASCO CAMPUS | 23960110 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Patients' Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 7/8/2014 | 2/16/2015 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Cervical spinal cord compression | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| No iatrogenic injury | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| Alleged delay in diagnosis and treatment of cervical spinal cord compression | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Quadriplegia | |||||
| Severity Of Injury | |||||
| Permanent: Grave - Quadraplegia, severe brain damage, lifelong care or fatal prognosis. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 5/15/2015 | 2015-CA-1443-WS | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Pasco | 3/6/2018 | ||||
| Other Defendants Involved in this Claim | |||||
| Johnstone, MD, Carolyn E Medical Center of Trinity Florida Emergency I Medical Services, PA Baxley Emergency Physicians LLC Bay VIew Neurology Nuss, MD, Jennifer D Shah, MD, Siddharth H | |||||
| 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 | |||||
| 2/19/2018 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $99,999 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $79,507 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $85,987 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Risk Management has counseled the insured | |||||||||||||||||||||
| Updates | |||||||
| Date of Change: | 3/23/2018 12:56:43 PM | ||||||
| Reason for Change: | Report updated to reflect Court Document final disposition date of 03/06/18 | ||||||
| |||||||
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| Department File Number : | M199601714 |
| Claim Number : | A95-16821-94 |
| Date Submitted : | 7/18/1996 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| FIRST PROFESSIONALS INSURANCE COMPANY, INC | Excess | ||||
| Insurer FEIN | Professional License Number | ||||
| 59-6614702 | |||||
| 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 | SHIV | K | AGGARWAL | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | *NR | ||||
| City | State | Zip Code | County | ||
| *NR | FL | 34652 | Pasco | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| *NR | $500,000 | *NR | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| 0061805 | Internal Medicine - No Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | *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 | ||||
| 1/14/1994 | 10/3/1995 | ||||
| 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: Minor - Loss of fingers, loss or damage to organs. Includes non-disabling injuries. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 4/19/1996 | 000096-1381CA-4 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| 5/29/1996 | |||||
| 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 | $25,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $4,062 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $492 | ||||||||||||||||||||
| Injured Person's Total Non-Economic Loss | $25,000 | ||||||||||||||||||||
| 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. |
Does Dr. SHIV K AGGARWAL, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. SHIV K AGGARWAL, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).