Department File Number : | M201575640 |
Claim Number : | 266246 |
Date Submitted : | 8/26/2015 |
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 | 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 | Andrew | H | Borom | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 3334 Capital Medical Boulevard | ||||
City | State | Zip Code | County | ||
Tallahassee | FL | 32308 | Gadsden | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
0074046 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME85372 | Surgery - Orthopedic |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Leon | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Physician's Office | |||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Physician's Office | ||||
Date of Occurrence | Date Reported to Insurer | ||||
2/24/2006 | 12/9/2008 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Patient presented with complaint of pain in ankles, wrists and head. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Patient was seen by PA who noted impression of capsular avulsion fracture and prescribed a walker boot. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Coronal fracture through talar bone of left ankle. | |||||
Severity Of Injury | |||||
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
11/25/2009 | 2009-CA-3095 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Leon | 8/25/2015 | ||||
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 | 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 | $55,000 | ||||||||||||||||||||
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. |
*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Department File Number : | M201576243 |
Claim Number : | FP4215001 |
Date Submitted : | 11/4/2015 |
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 | ANDREW | H | BOROM | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 3334 Capitol Medical Blvd. | ||||
City | State | Zip Code | County | ||
Tallahassee | FL | 32317 | Leon | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
FP-CL100707 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME85372 | Surgery - Hand |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Leon | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Physician's Office | |||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Physician's Office | ||||
Date of Occurrence | Date Reported to Insurer | ||||
1/18/2010 | 9/6/2011 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Right isolated malleolar fracture at the tip of the medial malleolus. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Application of boot cast with follow-up evaluations and x-rays. When mild swelling and tenderness were noted, and urgent venous Doppler was ordered which was negative. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Disputed allegations of failing to timely diagnose DVT. | |||||
Principal Injury Giving Rise To The Claim | |||||
Hospitalization and further outpatient treatment for DVT. | |||||
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 | ||||
2/29/2012 | 2012-CA-00571 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Leon | 10/20/2015 | ||||
Other Defendants Involved in this Claim | |||||
Tallahassee Orthopedic Clinic Thomas Cureton, PA | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Claim or suit abandoned. | |||||
Final Method of Claim Disposition | |||||
No Payment Made | |||||
Court Decision | Other | ||||
Other | Voluntary Dismissl with prejudice | ||||
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 | $39,500 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $11,943 | ||||||||||||||||||||
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. |
This page is not displaying certain sensitive information.
Does Dr. ANDREW H BOROM, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. ANDREW H BOROM, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).