Department File Number : | M201676932 |
Claim Number : | 329400 |
Date Submitted : | 1/27/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE) | Primary | ||||
Insurer FEIN | Professional License Number | ||||
95-3014772 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | AUDRA | M | FLOYD | ||
Street Address | |||||
13450 WEST SUNRISE BLVD | |||||
City | State | Zip | |||
SUNRISE | FL | 33323 | |||
Phone | Ext | Fax | E-Mail Address | ||
(877) 320 - 0748 | 3111 | (866) 636 - 5421 | afloyd@thedoctors.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Edmond | J | Allison | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 1527 SE 16th Place | ||||
City | State | Zip Code | County | ||
Cape Coral | FL | 33990 | Lee | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
0951340 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Dentistry | |||||
License Number | Specialty Code & Classification | Certification Number | |||
DN11550 | Dental General Practice - NOC |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Lee | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Physician's Office | |||||
Name of Institution | Code | ||||
N/A | 000000 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Physician's Exam Room | ||||
Date of Occurrence | Date Reported to Insurer | ||||
4/23/2013 | 4/22/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Chipped tooth #17. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Restoration of chipped tooth #17. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
None. | |||||
Principal Injury Giving Rise To The Claim | |||||
Patient alleges infection an pain following minor dental procedure. Case has been dismissed. | |||||
Severity Of Injury | |||||
Emotional Only - Fright, no physical damage |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
4/22/2015 | 15-CA-001033 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Lee | 1/26/2016 | ||||
Other Defendants Involved in this Claim | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Within 90 days of suit being filed. | |||||
Final Method of Claim Disposition | |||||
No Payment Made | |||||
Court Decision | Other | ||||
Other | Dismissal with Prejudice for the Defendant | ||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | No | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $0 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $27,000 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Unknown. |
Updates | |
No updates found. |
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Does Dr. EDMOND J ALLISON, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. EDMOND J ALLISON, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).