M200430764

Insurer Information

Insurer Name				Coverage Type
PODIATRY INSURANCE COMPANY OF AMERICA, A MUTUAL COMPANY				Primary
Insurer FEIN		Professional License Number
58-1403235
Insurer Contact Information
Type	First Name		MI	Last Name
Individual	DEBBIE		E	PHILLIPS
Street Address
110 Westwood Place, Suite 100
City				State	Zip
Brentwood				TN	37027
Phone	Ext	Fax	E-Mail Address
(615) 371 - 8776	2063	(888) 329 - 7422	dphillips@picagroup.com

Insured Information

Type	First Name		MI	Last Name
Individual	KENNETH			SABACINSKI, DPM
Insurer Type		Street Address of Practice
Licensed		1150 NO. 35TH AVE., #255
City		State	Zip Code	County
HOLLYWOOD		FL	33021	Broward
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
10354		$250,000		$750,000
Profession or Business			Other Profession or Business
Podiatric Physician
License Number		Specialty Code & Classification		Certification Number
2030				N/A

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
Other Outpatient Facility
Name of Institution		Code

Location of Institutional Injury		Other Location of Institutional Injury

Date of Occurrence		Date Reported to Insurer
6/13/2000		4/1/2002

Diagnostic Information

Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Painful buions and trailor's bunions, bilaterally
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Modified McBride bunionectomy and non-fixated 5th met osteotomy, bilaterally
Diagnostic Code :
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None
Principal Injury Giving Rise To The Claim
Continued pain
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
8/27/2002	02016560CA25
County Suit Filed in	Date of Final Disposition
Broward	3/16/2004
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

$36,382

All Other Loss Adjustment Expense Paid

$7,004

Injured Person's Total Non-Economic Loss

Deductible

Injured Person's Total Economic Loss

Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely

None

Updates

No updates found.