HomeMy WebLinkAbout2023-04-01 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:
8 | Report Run: 4/1/2023 04:28 PM
Policy Begin Date
7/1/2017
7/1/2019
7/1/2020
7/1/2020
7/1/2021
7/1/2021
7/1/2022
7/1/2022
Policy End Date
6/30/2018
6/30/2020
6/3/2021
6/3/2021
6/30/2022
6/30/2022
6/30/2023
6/30/2023
Claim Register - Feature Level
Claim Status
R
O
O
O
O
O
O
O
Claim Closed Date
Feature Status
R
O
O
O
O
O
O
O
Feature Closed Date
Location Code
0000PD05AQ
0000PD01HR
0000PD03SR
0000PD03SR
0000PD03MA
0000PD03SR
0000PD03SR
0000PD03SR
Location Name
PD - AQUATICS
PD - HUMAN RESOURCES
PD - STREETS/ROADS
PD - STREETS/ROADS
PD - MAINTENANCE
PD - STREETS/ROADS
PD - STREETS/ROADS
PD - STREETS/ROADS
Claim Number
1985495
3007247
3012652
3012652
3029280
3031853
3041664
3042851
Client File Code
808
839
LOB
GENERAL LIABILITY
GENERAL LIABILITY
AUTO LIABILITY
AUTO LIABILITY
GENERAL LIABILITY
GENERAL LIABILITY
GENERAL LIABILITY
GENERAL LIABILITY
Coverage
LIABILITY PERSONAL INJURY
EMPLOYMENT PRACTICES
BODILY INJURY
PROPERTY DAMAGE
EMPLOYMENT PRACTICES
BODILY INJURY
BODILY INJURY
PROPERTY DAMAGE
Claimant Number
1
1
1
2
1
1
1
1
Claimant Name
JASKULSKI, HEIRS OF THOMAS
CONWAY, JAMES
HOOVER, BRUCE E.
FOREMAN, SYDENY
Sarabia, Wendy Rocio
Cracknell, Victoria
Meza, Ricardo
Rubio, Eduardo
Loss Causation
MEDICAL TREATMENT
EMPLOYMENT TERMINATION
HIT ANOTHER VEHICLE
HIT ANOTHER VEHICLE
EMPLOYMENT TERMINATION
SLIP/TRIP
VEHICLE ACCIDENT
POTHOLE DAMAGE
Date Of Loss
3/18/2018
11/17/2019
5/17/2021
5/17/2021
8/1/2021
3/1/2022
12/28/2022
1/2/2023
Claim Description
MAN HAD A HEART ATTACK DURING SCUBA CLASS AND DIED.
MALE EMPLOYEE ALLEGES HE WAS UNLAWFULLY TERMINATED.
Male motorist injured and vehicle damaged in collision with City driver.
Male motorist injured and vehicle damaged in collision with City driver.
Female contractor's employee alleges she was unlawfully terminated.
Woman tripped and fell on raised section of parking lot.
Male and female motorists injured in traffic collision. Dangerous design of the roadway alleged.
Man's vehicle damaged by a pothole.
Legal
Y
Y
Y
Y
Y
Y
N
N
Claim Date Reported
9/17/2018
12/4/2020
5/17/2021
5/17/2021
1/20/2022
4/11/2022
1/3/2023
1/25/2023
Claimant Driver
Insured Driver
State
CA
CA
CA
CA
CA
CA
CA
Adjuster
Varon, Tim
Varon, Tim
Stroud, Laurie
Rice, William
Varon, Tim
Stroud, Laurie
Zapf, Mel
Rice, William
Loss Reserve
50000
75000
150000
10572.53
75000
150000
1
200
Expense Reserve
8084.2
171866.57
141645.3
0
192510.83
0
0
0
Gross Loss Paid
0
0
0
0
0
0
0
0
Gross Expense Paid
13560.8
178808.43
11364.7
0
19289.17
0
0
0
Recovery Loss Paid
0
0
0
0
0
0
0
0
Recovery Expense Paid
0
0
0
0
0
0
0
0
Total Incurred
71645
425675
303010
10572.53
286800
150000
1
200