Department File Number : | M201677728 |
Claim Number : | 1029400-01 |
Date Submitted : | 3/30/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
FLORIDA MEDICAL MALPRACTICE JUA | Primary | ||||
Insurer FEIN | Professional License Number | ||||
59-1625412 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | SUSAN | SPIELMAN | |||
Street Address | |||||
5814 Reed Street | |||||
City | State | Zip | |||
Fort Wayne | IN | 46835 | |||
Phone | Ext | Fax | E-Mail Address | ||
(260) 486 - 0340 | (260) 486 - 0782 | SUSAN.SPIELMAN@MEDPRO.COM |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Jeffrey | P | Feingold | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 200 W Cypress Creek Road, Ste 500 | ||||
City | State | Zip Code | County | ||
Fort Lauderdale | FL | 33309 | Broward | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
FL003610 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Dentistry | |||||
License Number | Specialty Code & Classification | Certification Number | |||
DN5487 | Dentists - N.O.C. |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | St. Lucie | ||||
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 | ||||
5/13/2013 | 10/6/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Dental issues | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Oral surgery | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Patient allergic to prescribed medication | |||||
Principal Injury Giving Rise To The Claim | |||||
Shortness of breath; hives | |||||
Severity Of Injury | |||||
Temporary: Slight - Lacerations, contusions, minor scars, rash. No delay. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
9/25/2015 | 562015SC001726C3 | ||||
County Suit Filed in | Date of Final Disposition | ||||
St. Lucie | 3/22/2016 | ||||
Other Defendants Involved in this Claim | |||||
Fotek, P | |||||
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 | Dismissal | ||||
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 | $2,150 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $258 | ||||||||||||||||||||
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 | |||||||||||||||||||||
N/A |
Updates | |
No updates found. |
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Does Dr. JEFFREY P FEINGOLD, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. JEFFREY P FEINGOLD, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).