Medical Malpractice Cases

Dr. Jon M Baumbauer Medical Malpractice Cases

Court Case # 2009-20990-CINS

Indemnity Paid: $10,000.00

Medical Malpractice Closed Claims Report

Department File Number :M201160196
Claim Number :1005525
Date Submitted :8/18/2011
Insurer Information
Insurer NameCoverage Type
Insurer FEINProfessional License Number
Insurer Contact Information
TypeFirst NameMILast Name
Street Address
5814 Reed Street
Fort WayneIN46835
PhoneExtFaxE-Mail Address
(260) 486 - 0340 (260) 486 - 0782SUSAN.SPIELMAN@MEDPRO.COM
Insured Information
TypeFirst NameMILast Name
Insurer TypeStreet Address of Practice
Licensed751 East 3rd Avenue
CityStateZip CodeCounty
New Smyrna BeachFL32169Volusia
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
Profession or BusinessOther Profession or Business
License NumberSpecialty Code & ClassificationCertification Number
DN7084Dental General Practice - NOC 

Medical Malpractice Closed Claims Report

Injured Person Information
First NameMILast NameDate of Birth
Street AddressGenderCounty where Injury Occurred
CityStateZip Code
Location where injury occuredOther location where injury occured
Physician's Office 
Name of InstitutionCode
Location of Institutional InjuryOther Location of Institutional Injury
Date of OccurrenceDate Reported to Insurer
Diagnostic Information
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Decayed teeth
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Unspecified negligence
Principal Injury Giving Rise To The Claim
Pain and suffering, possible need for corrective treatment
Severity Of Injury
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed.

Medical Malpractice Closed Claims Report


Legal Information
Date of SuitCircuit Court Case Number
County Suit Filed inDate of Final Disposition
Other Defendants Involved in this Claim
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
No Court Proceedings. 
Claim not subject to Arbitration.
Date of Payment
Financial Information
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$10,000
Loss Adjust Expense Paid to Defense Counsel$21,493
All Other Loss Adjustment Expense Paid$9,008
Injured Person's Total Non-Economic Loss$6,000
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Date of Change:8/18/2011 10:34:53 AM
Reason for Change:Update ALE
Field ChangedFormer ValueNew Value
Amount of Loss Adjustment Expense Paid to Defense Counsel1265921493
All Other Loss Adjustment Expense Paid45689008



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