Medical Malpractice News

Receiving a Medical Malpractice Insurance Claim

Tags: | Comments: 0 | March 16th, 2011

Medical practices today strive to provide the highest quality services to their patients. Unfortunately mistakes happen and not all patients are satisfied with the outcome of their medical situation. This is why physicians, surgeons, nurse practitioners, physician assistants, and other medical providers carry physician malpractice insurance. The unfortunate side of our industry is when a physician or medical provider receives a claim or an incident happens.  The first thing I always tell my physicians is that this is why you have paid for medical malpractice insurance coverage, so use it.  The first thing you, as a physicians, should do is contact your broker or the medical liability insurance carriers legal/claims department immediately. Once you have contacted your broker or carrier, the next step is to speak to no one else.

Seek Guidance During the Claim Process

It is very important to be careful what you say and what you write once you have received a claim. The risk management and legal departments at physician malpractice insurance companies will guide you on how you should communicate with the patient and other parties involved. It is critically important the doctor or medical provider does not change or alter the patient’s medical records in effort to shield oneself from wrong doing. The plaintiff attorney will send information and requests directly to the doctor, including requests for medical records. It is important to make sure you consult with your medical malpractice insurance claims department before responding to these requests. It is always best to have the appropriate attorney present for depositions, or anytime you will be communicating with the patient of plaintiff’s attorney.

In buying the policy, you have ceded responsibility for the claim and its defense to the medical malpractice insurance carrier, and they have a refined process that will act expeditiously to handle the claim.  The medical liability insurance company will usually request a copy of a summons and petition that the physician received. The majority of medical malpractice insurance companies will usually ask the physician or surgeon to write a narrative as to what happened from your perspective. The insurance company will also need you to provide other supporting documentation that may support your case.  You will typically receive a confirmation of receipt of the claim and possibly a request for additional information.  Timeliness is very important in this process, as a wise man once said to me, “claims are not like a good wine, they do not get better with age…”

Rely on Strong Representation

While a lawsuit is a very difficult, emotional process to go through, please keep in mind that on average, 90% of claims end in dismissal with no indemnity payment made to the plaintiff.  While the process is still difficult to endure, strong legal representation will make the difference.  When considering a medical liability insurance carrier for your coverage, ask about the success rate of their claims process, average time to adjudicate a claim, average indemnity payment and the attorneys they use.  The art of defending a medical malpractice insurance claim is a complex process and deserves a specialist in this area.

Physicians often ask if the physician malpractice insurance carrier will allow them to choose their own attorney. This is often not a good decision. Medical liability insurance carriers are mutually aligned with the doctor. Both the insurance company and the doctor want the claim to go away as fast as possible with as little cost as possible. Medical malpractice insurance companies have immense amounts of data regarding which medical malpractice defense attorneys are the best and which attorney is the best suited to use for certain cases. They know which attorneys have the best defense records in certain counties, as well as records against certain plaintiff attorneys. In most cases it is best for the physician to allow the medical malpractice insurance carrier to choose the best defense attorney for the case.  Keep in mind that many of the medical liability insurance claims can last for several years. Your carrier will know which attorney is best to defend your claim.