Extract insurance certificate information from the following document.
insured_name must be the PERSON name of the physician/medic (beneficiary), NOT the institution or practice name.
Markdown content:
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## NORCAL Insurance Company Certificate of Insurance
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nn<br>Certificate Holder: Insured’s Name and Address: Producer:<br>San Diego Cardiac Center Medical Group, Hashim Ali Khan, M.D. Prevail Insurance Management Services,<br>Inc. 3131 Berger Avenue #200 Inc.<br>3131 Berger Avenue #200 San Diego, CA 92123 4202 Douglas Blvd<br>San Diego, CA 92123 Suite 300<br>Granite Bay, CA 95746<br>**----- End of picture text -----**<br>
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a<br>Policy Number: 713143N Effective Date: 07/01/2025 —_Expiration Date: 07/01/2026<br>aseemOe ee a<br>Insured Type: L] Named Insured Insured [J] Locum Tenens Coverage A Type: CL] Shared Limits [KX] Separate Limits<br>Specialty: Cardiology (Minor Surgery) - -<br>**----- End of picture text -----**<br>
## eee eee eee eeeeee ae
Important: This certificate certifies that the policy shown above has been issued and includes coverage for the Insured shown for the period indicated, subject to the policy’s provisions and the required payment of premium. It is not an insurance policy and is issued for informational purposes only. It confers no rights upon the certificate holder and does not create a contract between NORCAL Insurance Company (NORCAL) and the certificate holder, nor does it amend, extend, or alter the policy’s coverage. Notwithstanding any requirement or provision of any contract or other document with respect to which this certificate may be issued or may pertain, the insurance afforded by the policy is subject to the provisions of the policy.
The Insured is responsible for informing certificate recipients of any policy changes, including declination of issuance or cancellation before the expiration date. An Insured’s failure to provide such notice imposes no obligation or liability of any kind upon NORCAL, its agents or representatives.
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——eeeecneeeeeeee<br>**----- End of picture text -----**<br>
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Coverages and Limits of Coverage Provided<br>**----- End of picture text -----**<br>
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Coverage A: Medical Professional Limits of Coverage:<br>Liability Insurance - Claims Made<br>Retroactive Date: 07/01/2019 $1,000,000 Each Claim limit<br>$3,000,000 Aggregate Limit Per Policy Period<br>**----- End of picture text -----**<br>
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a<br>**----- End of picture text -----**<br>
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Coverage B: Administrative Defense Limits of Coverage:<br>Insurance - Claims Made<br>Retroactive Date: 07/01/2019 $50,000 Each Administrative Proceeding or Employment-Related Civil Action Limit<br>$50,000 Aggregate Limit Per Endorsement Period<br>**----- End of picture text -----**<br>
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Sv<br>By: NORCAL Insurance Company Date Issued: June 24, 2025<br>**----- End of picture text -----**<br>
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GU am Kethuup. dh. Nowble*. !<br>Robert D. Francis Kathryn A. Neville, J.D., CPCU<br>President Secretary<br>**----- End of picture text -----**<br>
HCPCOI-001 10/01/2023
Page 1 of 1
201 CALIFORNIA STREET, SUITE 600, SAN FRANCISCO, CA 94111 T 844.4NORCAL norcal-group.com
Pre-extracted NER entities:
- COVERAGE_AMOUNT: $1,000,000, $3,000,000, $50,000
- EFFECTIVE_DATE: 07/01/2025, 07/01/2026, 07/01/2019, 10/01/2023
- POLICY_NUMBER: Policy N, Policy P
Return ONLY a valid JSON object with: insured_name, insurance_company, policy_number, coverages (array of UNIQUE coverage types only, one per type - no duplicates), effective_date, expiration_date, is_signed (boolean). For limits use integers 0-999999999 only (e.g. 1000000 for $1M). No scientific notation or decimals. No other text or markdown.