Department File Number : | M201472433 |
Claim Number : | FP3964501 |
Date Submitted : | 10/23/2014 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
FIRST PROFESSIONALS INSURANCE COMPANY, INC | Primary | ||||
Insurer FEIN | Professional License Number | ||||
59-6614702 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Kelly | Andrews | |||
Street Address | |||||
12724 Gran Bay Parkway, W., Suite 400 | |||||
City | State | Zip | |||
Jacksonville | FL | 32258 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 360 - 3038 | kandrews@thedoctors.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Richard | A | Stevenson | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 6851 Belfort Oaks Place | ||||
City | State | Zip Code | County | ||
Jacksonville | FL | 32223 | Duval | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
FP-IN011554 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Dentistry | |||||
License Number | Specialty Code & Classification | Certification Number | |||
DN7159 | Dentists |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Duval | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Other Location | Dental Office | ||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Dental Office | ||||
Date of Occurrence | Date Reported to Insurer | ||||
7/6/2009 | 1/11/2010 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
The plaintiff visited our insured for routine prophylaxis and examination and has no complaints when her care as finalized. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
The patient underwent several teeth extractions with the subsequent greater involved in this case. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Plaintiff contends that the co-defendant failed to timely diagnose an ameloblastoma in the lower jaw region. | |||||
Principal Injury Giving Rise To The Claim | |||||
Failing to timely diagnose the ameloblastoma. | |||||
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 | ||||
8/15/2012 | 1B-2012-CA-00801B | ||||
County Suit Filed in | Date of Final Disposition | ||||
Duval | 9/25/2014 | ||||
Other Defendants Involved in this Claim | |||||
Hartley, Gregory | |||||
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 | |||||
No Payment Made | |||||
Court Decision | Other | ||||
Other | Voluntarily Dismissed | ||||
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 | $20,192 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $507 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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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. |
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Does Dr. RICHARD A STEVENSON, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. RICHARD A STEVENSON, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).