Department File Number : | M202092592 |
Claim Number : | 375021 |
Date Submitted : | 6/4/2020 |
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 | Angela | LaFrance | |||
Street Address | |||||
12724 Gran Bay Pkwy., W., Suite 400 | |||||
City | State | Zip | |||
JACKSONVILLE | FL | 32258 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 360 - 3045 | alafrance@thedoctors.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | MARITZA | T | LAZCANO | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 11049 McCormick, Apt. 301 | ||||
City | State | Zip Code | County | ||
N. Hollywood | CA | 91601 | Out of state | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
0970362 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Dentistry | |||||
License Number | Specialty Code & Classification | Certification Number | |||
DN18205 | Dentists |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Broward | ||||
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 | Insured's office | ||||
Date of Occurrence | Date Reported to Insurer | ||||
7/13/2015 | 10/15/2018 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Orthodontic treatment. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Insured general dentist provided orthodontic care. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Teeth were extracted by another dentist and insured referred patient to an orthodontist and a periodontist for additional evaluation and advised she needed surgery prior to having braces installed. However, patient alleged unnecessary extractions, that she was never referred to an orthodontist and insured failed to recognize patient required surgery. Patient stopped presenting to insured for scheduled appointments without explanation. | |||||
Severity Of Injury | |||||
Temporary: Slight - Lacerations, contusions, minor scars, rash. No delay. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
1/3/2019 | CACE 19000162 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Broward | 5/28/2020 | ||||
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 | |||||
5/7/2020 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $23,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $22,092 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $9,714 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Insurance company staff consulted with insured to discuss preventative measures. Patient safety referral is made if appropriate. |
Updates | |
No updates found. |
Does Dr. MARITZA T LAZCANO, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. MARITZA T LAZCANO, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).