Department File Number : | M201780955 |
Claim Number : | 7011688 |
Date Submitted : | 1/26/2017 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
FORTRESS INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
36-4159841 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Janet | L | Meyer | ||
Street Address | |||||
6133 North River Road, Suite 650 | |||||
City | State | Zip | |||
Rosemont | IL | 60018 | |||
Phone | Ext | Fax | E-Mail Address | ||
(847) 653 - 8823 | (847) 653 - 8485 | janet.meyer@fortressins.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Francis | J | Ducoin | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 808 SE Ocean Blvd. | ||||
City | State | Zip Code | County | ||
Stuart | FL | 34994 | Martin | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
32135 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Dentistry | |||||
License Number | Specialty Code & Classification | Certification Number | |||
DN9594 | Dentists |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Martin | ||||
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 | ||||
Date of Occurrence | Date Reported to Insurer | ||||
4/8/2014 | 4/16/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Patient presented to the insured seeking cosmetic restoration of her teeth due to tetracycline damage. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
The insured provided lumineers and crowns in the process of restoring the patient's teeth. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Patient alleged lumineers were unsuitable and effected occlusion, which caused decay and perios inflammation as well as TMJ pain. | |||||
Severity Of Injury | |||||
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
8/14/2015 | 15-936CA | ||||
County Suit Filed in | Date of Final Disposition | ||||
Martin | 1/25/2017 | ||||
Other Defendants Involved in this Claim | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
After court verdict and prior to filing of notice of appeal. | |||||
Final Method of Claim Disposition | |||||
Disposed of by Court | |||||
Court Decision | Other | ||||
Judgment notwithstanding the verdict for plaintiff. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
12/29/2016 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $100,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $23,713 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $53,609 | ||||||||||||||||||||
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.
Does Dr. FRANCIS J DUCOIN, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. FRANCIS J DUCOIN, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).