Department File Number : | M201574618 |
Claim Number : | 305278 |
Date Submitted : | 5/14/2015 |
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 | Tiffany | D | Taylor | ||
Street Address | |||||
13450 West Sunrise Blvd | |||||
City | State | Zip | |||
Sunrise | FL | 33323 | |||
Phone | Ext | Fax | E-Mail Address | ||
(877) 320 - 0748 | TTaylor@thedoctors.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Jorge | Hernandez | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 6080 SW 40th Street #8 | ||||
City | State | Zip Code | County | ||
Miami | FL | 33155 | Dade | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
0907627 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
DN11612 | Dentists |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Dade | ||||
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 | Practitioner's Office | ||||
Date of Occurrence | Date Reported to Insurer | ||||
3/14/2010 | 4/22/2013 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
The patient sought treatment for periodontal disease and poor oral hygiene. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
The patient underwent extractions of teeth and placement of crowns and bridges. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged failure to provide appropriate and properly fitting bridges and crowns. | |||||
Principal Injury Giving Rise To The Claim | |||||
Infection of gums and teeth. | |||||
Severity Of Injury | |||||
Permanent: Minor - Loss of fingers, loss or damage to organs. Includes non-disabling injuries. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
9/10/2013 | 13-028410 CA 01 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Dade | 5/4/2015 | ||||
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 Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
5/7/2015 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $115,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $0 | ||||||||||||||||||||
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 | |||||||||||||||||||||
The insured conferenced with his attorneys and claims adjuster. |
Updates | |
No updates found. |
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Department File Number : | M202091482 |
Claim Number : | 347833 |
Date Submitted : | 2/14/2020 |
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 | Dawn | Owens | |||
Street Address | |||||
12724 GRAN BAY PKWY W, Suite 400 | |||||
City | State | Zip | |||
JACKSONVILLE | FL | 32258 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 360 - 3044 | dowens@thedoctors.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Jorge | O | Hernandez | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 6080 Bird Road, Suite 8 | ||||
City | State | Zip Code | County | ||
Miami | FL | 33155 | Dade | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
0907627 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Dentistry | |||||
License Number | Specialty Code & Classification | Certification Number | |||
DN11612 | Dental General Practice - NOC |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Dade | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Other Hospital/Institution | Heartland of Boynton Beach, FL, LLC | ||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Physician's Office | ||||
Date of Occurrence | Date Reported to Insurer | ||||
12/11/2014 | 9/29/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
The patient presented for an upper bridge. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
The patient alleged the bridge had open margins and was ill fitting and compromised the teeth. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
The patient alleged the bridge compromised her teeth. | |||||
Severity Of Injury | |||||
Temporary: Slight - Lacerations, contusions, minor scars, rash. No delay. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
6/13/2017 | 17-11317-CA 01 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Dade | 2/13/2020 | ||||
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 Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
2/13/2020 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $48,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $58,489 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $58,111 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $48,000 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate. |
Updates | |
No updates found. |
Does Dr. JORGE HERNANDEZ, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. JORGE HERNANDEZ, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).