HomeMy WebLinkAbout2022-03-01 PALM_DESERT_-_OPEN_Claim_RegisterReport Criteria: Tier2 Name = PALM DESERT and Feature Status <> C And Tier 1 = CJPIA And As-Of Transaction Begin Date = And As-Of Transaction End Date = And Loss Run? = Yes | Row Count:
12 | Report Run: 3/1/2022 05:48 AM
Policy Begin Date
7/1/2017
7/1/2019
7/1/2020
7/1/2020
7/1/2020
7/1/2020
7/1/2020
7/1/2020
7/1/2020
7/1/2021
7/1/2021
7/1/2021
Policy End Date
6/30/2018
6/30/2020
7/1/2021
7/1/2021
7/1/2021
7/1/2021
7/1/2021
7/1/2021
7/1/2021
6/30/2022
6/30/2022
6/30/2022
Claim Register - Feature Level
Claim Status
R
O
O
O
O
O
O
O
O
O
O
O
Claim Closed Date
Feature Status
R
O
O
O
O
O
O
O
O
O
O
O
Feature Closed Date
Location Code
0000PD05AQ
0000PD01HR
0000PD03SR
0000PD03SR
0000PD03SR
0000PD03SR
0000PD03SR
0000PD03TL
0000PD03SR
0000PD03SR
0000PD03MA
0000PD03SR
Location Name
PD - AQUATICS
PD - HUMAN RESOURCES
PD - STREETS/ROADS
PD - STREETS/ROADS
PD - STREETS/ROADS
PD - STREETS/ROADS
PD - STREETS/ROADS
PD - TREE/LANDSCAPE
PD - STREETS/ROADS
PD - STREETS/ROADS
PD - MAINTENANCE
PD - STREETS/ROADS
Claim Number
1985495
3007247
3012624
3012624
3012652
3012652
3015741
3020630
3026055
3027092
3029280
3030318
Client File Code
808
839
854
858
860
LOB
GENERAL LIABILITY
GENERAL LIABILITY
GENERAL LIABILITY
GENERAL LIABILITY
AUTO LIABILITY
AUTO LIABILITY
GENERAL LIABILITY
GENERAL LIABILITY
GENERAL LIABILITY
GENERAL LIABILITY
GENERAL LIABILITY
GENERAL LIABILITY
Coverage
LIABILITY PERSONAL INJURY
EMPLOYMENT PRACTICES
BODILY INJURY
LIABILITY PERSONAL INJURY
PROPERTY DAMAGE
BODILY INJURY
BODILY INJURY
BODILY INJURY
PROPERTY DAMAGE
PROPERTY DAMAGE
EMPLOYMENT PRACTICES
PROPERTY DAMAGE
Claimant Number
1
1
1
2
2
1
1
1
1
1
1
1
Claimant Name
JASKULSKI, HEIRS OF THOMAS
CONWAY, JAMES
MESA, SHERRY
MESA, RICK
FOREMAN, SYDENY
HOOVER, BRUCE E.
KLEIN, BRETT D.
Pisarczyk, Walter V.
Sandy, Margaret A.
Whitman, Dorene
Sarabia, Wendy Rocio
Hoffmann, Holly
Loss Causation
MEDICAL TREATMENT
EMPLOYMENT TERMINATION
SLIP/TRIP
SLIP/TRIP
HIT ANOTHER VEHICLE
HIT ANOTHER VEHICLE
VEHICLE ACCIDENT
FALLING TREE/LIMB
FALLING TREE/LIMB
VEHICLE ACCIDENT
EMPLOYMENT TERMINATION
EQUIPMENT USE
Date Of Loss
3/18/2018
11/17/2019
3/25/2021
3/25/2021
5/17/2021
5/17/2021
12/19/2020
4/4/2021
5/27/2021
10/1/2021
8/1/2021
9/5/2021
Claim Description
MAN HAD A HEART ATTACK DURING SCUBA CLASS AND DIED.
MALE EMPLOYEE ALLEGES HE WAS UNLAWFULLY TERMINATED.
WOMAN TRIPPED AND FELL IN A HOLE IN A PARKING LOT.
WOMAN TRIPPED AND FELL IN A HOLE IN A PARKING LOT.
Male motorist injured and vehicle damaged in collision with City driver.
Male motorist injured and vehicle damaged in collision with City driver.
MALE CYCLIST INJURED WHILE RIDING OVER UNEVEN SECTION OF ROADWAY.
Man injured when he walked into a tree branch at the park.
Woman's vehicle damaged by falling tree branch.
Woman's vehicle damaged in collision with post in parking lot.
Female contractor's employee alleges she was unlawfully terminated.
Woman's tire damaged driving over debris.
Legal
Y
Y
Y
Y
N
N
N
Y
N
N
Y
N
Claim Date Reported
9/17/2018
12/4/2020
5/7/2021
5/7/2021
5/17/2021
5/17/2021
6/11/2021
9/22/2021
10/18/2021
11/16/2021
1/20/2022
2/17/2022
Claimant Driver
Insured Driver
State
CA
CA
CA
CA
CA
CA
CA
CA
CA
CA
CA
Adjuster
Varon, Tim
Varon, Tim
Stroud, Laurie
Stroud, Laurie
Rice, William
Rice, William
Rice, William
Stroud, Laurie
Rice, William
Rice, William
Varon, Tim
Baluyut, Janice
Loss Reserve
50000
75000
250000
10000
10572.53
25000
100000
25000
7800
3300
75000
275
Expense Reserve
-1196
274202.57
39300.5
0
0
0
0
1544.5
0
0
207003.91
0
Gross Loss Paid
0
0
0
0
0
0
0
0
0
0
0
0
Gross Expense Paid
6541.3
76472.43
10704.5
0
0
0
0
955.5
0
0
4796.09
0
Recovery Loss Paid
0
0
0
0
0
0
0
0
0
0
0
0
Recovery Expense Paid
0
0
0
0
0
0
0
0
0
0
0
0
Total Incurred
55345.3
425675
300005
10000
10572.53
25000
100000
27500
7800
3300
286800
275