| Department File Number : | M201884929 |
| Claim Number : | 7010718 |
| Date Submitted : | 4/3/2018 |
| 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 | Florence | R | Marafatsos | ||
| Street Address | |||||
| 6133 N River Road Ste 650 | |||||
| City | State | Zip | |||
| Rosemont | IL | 60018 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (800) 522 - 6675 | 8466 | (847) 653 - 8486 | florence.marafatsos@fortressins.com | ||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Jeffrey | J | Auerbach | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 4924 South University Drive | ||||
| City | State | Zip Code | County | ||
| Davie | FL | 33328 | Broward | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 32390 | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Dentistry | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| DN7198 | 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 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 5/11/2013 | 7/26/2013 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| The patient was treated over the course of several years for general care and treatment (routine cleaning and exams). | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Routine cleaning and exams. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| Plaintiff alleged failure to diagnose and treat. | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Additional care and treatment to teeth #'s 3, 12, 13, 14, 15, 18, 19, 29, 30 and 31. | |||||
| Severity Of Injury | |||||
| Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 5/5/2014 | 14-008618 (18) | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Broward | 3/14/2018 | ||||
| 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 | ||||
| Other | voluntary dismissal | ||||
| Arbitration | |||||
| Claim not subject to Arbitration. | |||||
| Date of Payment | |||||
| 3/27/2018 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $160,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $11,891 | ||||||||||||||||||||
| 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. |
This page is not displaying certain sensitive information.
| Department File Number : | M201781241 |
| Claim Number : | 7010717 |
| Date Submitted : | 2/20/2017 |
| 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 | ||
| (800) 522 - 6675 | (847) 653 - 8485 | janet.meyer@fortressins.com | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Jeffrey | J | Auerbach | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 4294 South University Drive | ||||
| City | State | Zip Code | County | ||
| Davie | FL | 33328 | Broward | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 32390 | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Dentistry | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| DN7198 | 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 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 5/11/2013 | 7/26/2013 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| General dental care from 1998 thru 2012. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| General dental care. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Patient alleged that the insured failed to treat recognizable caries which has lead to the need for additional treatment. | |||||
| Severity Of Injury | |||||
| Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 6/11/2014 | CACE14008702 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Broward | 1/20/2017 | ||||
| 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 | |||||
| 2/3/2017 | |||||
| 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 | $6,593 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $2,152 | ||||||||||||||||||||
| 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 | |||||||
| Date of Change: | 2/20/2017 10:56:22 AM | ||||||
| Reason for Change: | Legal Case number entered wrong. | ||||||
| |||||||
*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 : | M201781244 |
| Claim Number : | 7010732 |
| Date Submitted : | 2/20/2017 |
| 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 | ||
| (800) 522 - 6675 | (847) 653 - 8485 | janet.meyer@fortressins.com | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Jeffrey | J | Auerbach | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 4294 South University Drive | ||||
| City | State | Zip Code | County | ||
| Davie | FL | 33328 | Broward | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 32390 | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Dentistry | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| DN7198 | 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 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 5/11/2013 | 7/30/2013 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| General dental care from 1997 thru 2012. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| General Dental Care. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Patient alleged the insured was negligent in his care of her which has resulted in the need for additional treatment. | |||||
| Severity Of Injury | |||||
| Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 6/11/2014 | CACE 14-008702 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Broward | 1/20/2017 | ||||
| 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 | |||||
| 2/3/2017 | |||||
| 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 | $8,083 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $9,053 | ||||||||||||||||||||
| 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 : | M201782546 |
| Claim Number : | 7010715 |
| Date Submitted : | 7/13/2017 |
| 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 | ||
| (800) 522 - 6675 | (847) 653 - 8486 | janet.meyer@fortressins.com | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Jeffrey | J | Auerbach | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 4294 South University Drive | ||||
| City | State | Zip Code | County | ||
| Davie | FL | 33328 | Broward | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 32390 | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Dentistry | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| DN7198 | Dentists | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Broward | ||||
| 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 | ||||
| 5/11/2013 | 7/26/2013 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| General dental care. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| This insured provided this patient with general dental care with occasional referrals to specialists for various reasons over a thirty year period. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| The claimant alleged negligent diagnosis and treatment of periodontal disease and caries, which required subsequent surgical intervention. | |||||
| Severity Of Injury | |||||
| Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 6/11/2014 | CACE-14-008269 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Broward | 6/20/2017 | ||||
| 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 | |||||
| 6/13/2017 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $40,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $10,865 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $7,247 | ||||||||||||||||||||
| 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. JEFFREY J AUERBACH, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. JEFFREY J AUERBACH, MD has at least 4 medical malpractice case(s), lawsuit(s), or complaint(s).