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Department File Number : |
M200116325 |
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Claim Number : |
60-596363 |
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Date Submitted : |
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Insurer Information |
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Insurer Name |
Coverage Type |
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NATIONAL FIRE INSURANCE COMPANY OF |
Primary |
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Insurer FEIN |
Professional License Number |
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06-0464510 |
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Insurer Contact Information |
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Type |
First Name |
MI |
Last Name |
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Individual |
ROBERT |
J |
SCHOENBORN |
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Street Address |
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City |
State |
Zip |
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FL |
33602-2468 |
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Phone |
Ext |
Fax |
E-Mail Address |
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(813) 204 - 2206 |
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(813) 204 - 2222 |
Robert.Schoenborn@cna.com |
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Insured Information |
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Type |
First Name |
MI |
Last Name |
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Individual |
LESTER |
S |
PERMESLY |
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Insurer Type |
Street Address of Practice |
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Licensed |
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City |
State |
Zip Code |
County |
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FL |
34239 |
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Policy Number |
Per Claim Policy Limits |
Aggregate Policy Limits |
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PSC0004822443 |
$1,000,000 |
$3,000,000 |
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Profession or Business |
Other Profession or Business |
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Medical Doctor |
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License Number |
Specialty Code & Classification |
Certification Number |
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ME37872 |
Physciatry - Including Child |
02 |
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Injured Person Information |
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First Name |
MI |
Last Name |
Date of Birth |
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Street Address |
Gender |
County where Injury Occurred |
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M |
*NR |
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City |
State |
Zip Code |
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Location where injury occured |
Other location where injury occured |
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Hospital Inpatient Facility |
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Name of Institution |
Code |
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*NR |
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Location of Institutional Injury |
Other Location of Institutional
Injury |
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Patients' Room |
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Date of Occurrence |
Date Reported to Insurer |
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8/13/1989 |
8/6/1993 |
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Diagnostic Information |
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Final Diagnosis For Which Treatment
Was Sought Including Patient's Actual Condition |
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Admitted to hospital for symptoms
including phobias, tantrums & depressions. |
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Operation, Diagnostic, Or Treatment
Procedure Rendered Causing The Injury |
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Psychological testing only. |
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Diagnostic Code : |
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Misdiagnosis Made, If Any, Of
Patient's Actual Condition |
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None. Discharged with diagnosis of
Axis I Atypical Psychosis & Axle II Schizotypal Personality Disorder. One
of the parents claim that child was committed without the full consent of the
other. Parents were in the process of a divorce during that time. |
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Principal Injury Giving Rise To The
Claim |
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Emotional distress only. |
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Severity Of Injury |
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Emotional Only - Fright, no physical
damage |
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Legal Information |
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Date of Suit |
Circuit Court Case Number |
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7/23/1993 |
93-2512-CI-7 |
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County Suit Filed in |
Date of Final Disposition |
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Pinellas |
5/17/2000 |
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Other Defendants Involved in this
Claim |
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N.M.E. HOSPITALS INC. D/B/A MEDFIELD
CENTER |
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Stage of Legal System at which
Settlement was Reached or Award Made |
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After appeal. |
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Final Method of Claim Disposition |
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Settled by parties |
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Court Decision |
Other |
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No Court Proceedings. |
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Arbitration |
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Claim subject to arbitration, but
settlement reached in lieu of award. |
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Date of Payment |
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Financial Information |
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Was there a settlement Resulting in
payment to the Plaintiff? |
Yes |
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Indemnity Paid by Insurer on behalf
of Insured |
$7,500 |
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Loss Adjust Expense Paid to Defense
Counsel |
$16,305 |
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All Other Loss Adjustment Expense
Paid |
$14,570 |
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Injured Person's Total Non-Economic
Loss |
$7,500 |
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Deductible |
$0 |
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Injured Person's Total Economic Loss |
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Safety Management Steps Taken by
Insured to Make Similar Occurrence Less Likely |
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None. Case settled based on economics
only. |
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Updates |
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No updates found. |