Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
*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 : | M201472503 |
Claim Number : | 7003242 |
Date Submitted : | 11/3/2014 |
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 | ID | 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 | Robert | Faine | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 5975 Sunset Drive, Suite 502 | ||||
City | State | Zip Code | County | ||
Miami | FL | 33143 | Dade | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
32051 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Dentistry | |||||
License Number | Specialty Code & Classification | Certification Number | |||
DN5193 | Dentists |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Dade | ||||
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 | ||||
4/30/2007 | 12/12/2007 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
The patient presented to the insured for an initial oral examination with a complaint of a chipped veneer and seeking whitening treatment. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
The insured following an examination and evaluation of the patient presented a treatment plan. The agreed upon treatment plan consisted of crowns on #'s 2, 3, 19, 20, 30 & 31 with applied veneers on #'s 5 thru 12 followed by whitening treatment to the entire mouth. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Patient alleges additional treatment needed due to the alleged improper placement of veneers 6 - 11 and crown on #3. | |||||
Severity Of Injury | |||||
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
11/12/2008 | 08-69474 CA 05 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Dade | 9/26/2014 | ||||
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 | |||||
10/10/2014 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $5,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $91,060 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $8,630 | ||||||||||||||||||||
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 : | M201472504 |
Claim Number : | 7003245 |
Date Submitted : | 11/3/2014 |
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 | Robert | Faine | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 5975 Sunset Drive, Suite 502 | ||||
City | State | Zip Code | County | ||
Miami | FL | 33143 | Dade | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
32051 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Dentistry | |||||
License Number | Specialty Code & Classification | Certification Number | |||
DN5193 | Dentists |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Dade | ||||
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 | ||||
11/3/2006 | 12/12/2007 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
The patient presented to the insured for an initial oral examination with a complaint of a chipped veneer and seeking a whitening treatment. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
The insured following an examination and evaluation of the patient , presented a treatment plan. The agreed upon treatment plan consisted of the extraction of tooth #15, crowns, veneers, periodontal treatment, whitening and floride treatments. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
The patient alleges the need for additional treatment due to improper placement of crowns. | |||||
Severity Of Injury | |||||
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
11/12/2008 | 08-69464 CA 20 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Dade | 9/26/2014 | ||||
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 | |||||
10/10/2014 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $5,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $45,192 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $4,433 | ||||||||||||||||||||
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. ROBERT FAINE, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. ROBERT FAINE, MD has at least 3 medical malpractice case(s), lawsuit(s), or complaint(s).