Claims can happen to anyone. If you find yourself facing one, take a deep breath—here's what the process looks like and how we're here to help you.
Posted in Claims Services on Tuesday, September 10, 2024
Imagine a typical day at your practice when a stranger walks in and hands you an envelope. You've been served with a lawsuit. What now? The steps you take next can significantly affect the outcome of your case.
Notify Your Insurance Provider
When you receive notice of a malpractice claim, contact your malpractice insurance provider ASAP. They can provide guidance and maybe even a sense of calm. Although it may be your first claim, your provider has been through this many times and can give some perspective and help you take a breath.
Do Not Alter Records
It's crucial not to alter or change any patient records. Altering records can severely damage your defense. If changes are necessary, they should be done through a proper addendum process, but only after consulting your legal counsel or claims representative.
The Role of Your Insurance Provider
Once you've notified your insurance provider (like NCMIC) of a malpractice claim, they will take several actions to protect you.
- Hiring an Attorney. Your insurer will select a defense attorney experienced in malpractice cases in your state.
- Discovery Process. This involves gathering all relevant medical records and evidence. This phase is crucial for understanding the allegations and preparing your defense.
- Expert Review. Your insurer will hire expert witnesses, such as doctors in your field or other specialists, to review the case details and provide testimony on whether the standard of care was met.
Your Responsibilities
Your primary responsibility during a malpractice claim is to cooperate fully with your insurer and legal team. This involves providing accurate information, responding promptly to requests from your attorney or insurer, participating in depositions and potentially a trial.
Your insurer will coordinate your defense, including legal representation and expert witness testimony, and cover all reasonable defense costs. With NCMIC, there are generally no limits on the defense expenses the insurer will pay for a covered malpractice claim, as long as they are deemed necessary for a successful defense.
Settlement, Trial or Dismissal
A malpractice claim can have several outcomes:
Settlement
The case may be settled out of court, often to avoid the costs and uncertainties of a trial. Settling a claim does not imply an admission of guilt, but it does require reporting to the National Practitioner Data Bank and potentially your state licensing board. This could lead to further questions or scrutiny from credentialing bodies, but your insurer will assist you through this process.
Trial and Defense Verdict
If the case goes to trial and the defense is successful, no settlement is paid, and the insurer covers all defense costs. It’s important to know that NCMIC offers a true “consent to settle" clause, meaning no case will be settled without your specific consent. Instead of rushing to a compromise, NCMIC will fight to clear your name at trial.
Dismissal
The case may be dismissed at any point if the claims are found to be without merit.
We're Here for You
Facing a malpractice claim can be daunting, but understanding the process and working closely with your insurer can help you better navigate it. Being proactive, maintaining thorough records, and cooperating with your defense team are crucial steps in achieving a favorable outcome. If you suspect a claim might be forthcoming or have any concerns, contacting your insurance provider early can provide the guidance needed to mitigate potential risks.