[ Claim Number:
400118163 ]
Claim Detail
Case:
Byron, -Jon P vs Napoli Indoor Auto Outlet
| Injury Date: |
10/08/2021 |
|
Filing District: |
Bridgeport |
| Injured Body Part (Primary): |
Head Injury - Multiple |
|
Claim Status: |
Closed |
| Date of Birth: |
|
|
Nature of Injury: |
Contusion |
| Form | Form Descr | Submitted By | Date Received | Status |
| STP | Stipulation | Claimant's Rep | 12/5/2023 | Approved |
| HR | Hearing Request | Claimant's Rep | 11/21/2023 | |
| HR | Hearing Request | Claimant's Rep | 7/6/2023 | |
| VA | Voluntary Agreement | Policy Ins | 6/26/2023 | Approved |
| 1A | Filing Status | Policy Ins | 6/26/2023 | |
| NOA | Notice of Appearance | MIP Agent | 5/30/2023 | |
| LIEN | Notice of Lien | MIP Agent | 5/30/2023 | Resolved |
| 36 | Discontinue Payment | Policy Ins | 5/15/2023 | Approved |
| HR | Hearing Request | Judge | 3/28/2023 | |
| HR | Hearing Request | Claimant's Rep | 3/10/2023 | |
| 36 | Discontinue Payment | Policy Ins | 3/9/2023 | Approved |
| HR | Hearing Request | Judge | 1/25/2023 | |
| HR | Hearing Request | Claimant's Rep | 12/8/2022 | |
| NOA | Notice of Appearance | Insurer's Rep | 10/11/2022 | |
| HR | Hearing Request | Claimant's Rep | 9/27/2022 | |
| MED | Medical Report (incl. Form 42) | Med Provider | 9/26/2022 | |
| NOA | Notice of Appearance | Claimant's Rep | 8/4/2022 | |
| 30C | Notice of Claim | Claimant | 10/27/2021 | |