Department File Number : | M201887165 |
Claim Number : | 24764-01 |
Date Submitted : | 11/30/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
PODIATRY INSURANCE COMPANY OF AMERICA | Primary | ||||
Insurer FEIN | Professional License Number | ||||
58-1403235 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Angeline | Schave | |||
Street Address | |||||
3000 Meridian Blvd. Ste. 400 | |||||
City | State | Zip | |||
Franklin | TN | 37067 | |||
Phone | Ext | Fax | E-Mail Address | ||
(615) 371 - 8776 | 2998 | (615) 986 - 1945 | aschave@picagroup.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | William | C | Burmeister | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 681 Goodlette Rd. N., Ste. 160 | ||||
City | State | Zip Code | County | ||
Naples | FL | 34102 | Collier | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
1PD0055285 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Podiatric Physician | |||||
License Number | Specialty Code & Classification | Certification Number | |||
PO3714 |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Collier | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Physician's Office | |||||
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 | ||||
10/8/2015 | 12/27/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Pain involving posterior left heel | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Achilles tendinitis | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Patient presented to the insured with pain. Insured diagnosed Achilles Tendonitis. Insured treated the patient conservatively and the patient suffered an Achilles Tendon Rupture. Patient alleged that the insured's treatment was improper. Patient dismissed the claim due to lack of merit. | |||||
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 | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 11/12/2018 | ||||
Other Defendants Involved in this Claim | |||||
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 | $89,376 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $2,320 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Specialty code - 80993 |
Updates | |
No updates found. |
Does Dr. WILLIAM C BURMEISTER, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. WILLIAM C BURMEISTER, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).