Medical Malpractice Cases

Dr. JAN A SIMON, MD Medical Malpractice Cases, Lawsuits, and Complaints

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Phycicians Practice Address
Dr. JAN A SIMON, MD
13716 SW 84th Street
US

Court Case # 12 22077CA

Indemnity Paid: $100,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201574403
Claim Number : 7006845
Date Submitted : 4/27/2015
 
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
Rsoemont ID 60018
Phone Ext Fax E-Mail Address
(847) 653 - 8823   (847) 653 - 8485 janet.meyer@fortressins.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualJanASimon
Insurer TypeStreet Address of Practice
Licensed13716 SW 84th Street
CityStateZip CodeCounty
MiamiFL33183Dade
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
32270$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Dentistry 
License NumberSpecialty Code & ClassificationCertification Number
DN5781Dentists 

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MDade
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Physician's Office 
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
  
Date of OccurrenceDate Reported to Insurer
10/16/200410/12/2010
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
The patient originally presented in 2004 for orthodontic treatment. At that time he presented with a bilateral cross bite with a narrow upper jaw.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
The insured following a thorough examination and evaluation propsed a two phase treatment plan. The first phase treatment plan was initiated and completed in 2007. At that time the insured began the second phase of the agreed upon treatment plan.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
The patient alleged the need for additional surgery due to improper orthodontic care from 2004 thru 2010.
Severity Of Injury
Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
6/11/201212 22077CA
County Suit Filed inDate of Final Disposition
Dade3/27/2015
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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
4/7/2015
 
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$26,202
All Other Loss Adjustment Expense Paid$13,783
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
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.

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Frequently Asked Questions

Does Dr. JAN A SIMON, MD have any medical malpractice cases, lawsuits, or complaints?

Dr. JAN A SIMON, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).

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