| Department File Number : | M201573329 |
| Claim Number : | 1018745 |
| Date Submitted : | 9/18/2015 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| NATIONAL FIRE & MARINE INSURANCE COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 47-6021331 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Myra | J | Lassen | ||
| Street Address | |||||
| 5814 Reed Road | |||||
| City | State | Zip | |||
| Fort Wayne | IN | 46835 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (260) 486 - 0340 | reportaclaim@medpro.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Stephan | Strasser | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 100 S Ashley Dr | ||||
| City | State | Zip Code | County | ||
| Tampa | FL | 33602 | Hillsborough | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| HN006099 | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME103634 | Radiology - Diagnostic - No Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Polk | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Physician's Office | |||||
| Name of Institution | Code | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Radiology, Emergency Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 10/5/2012 | 4/4/2014 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Back pain | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Bone scan read | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| Failure to diagnose T1 plasmacytoma. | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Extensive surgery, increased morbidity. | |||||
| 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 | ||||
| 7/14/2014 | 2014CA002912 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Polk | 1/7/2015 | ||||
| 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 | |||||
| 1/7/2015 | |||||
| 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 | $35,735 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| N/A | |||||||||||||||||||||
| Updates | |||||||
| Date of Change: | 9/2/2015 7:37:08 AM | ||||||
| Reason for Change: | Update issue company | ||||||
| |||||||
| Date of Change: | 9/18/2015 8:41:58 AM | ||||||
| Reason for Change: | Updated ALE | ||||||
| |||||||
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Does Dr. STEPHAN STRASSER, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. STEPHAN STRASSER, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).