What's in the Fine Print: Consent to Settle and Arbitration

The fine print of your malpractice insurance policy can be a revealing read, especially if you look for the terms “consent to settle” and “arbitration.” These words can have significant impact on a malpractice allegations.

These words can have significant impact on your ability to work through malpractice allegations. They are also two areas that vary greatly as you compare malpractice insurance providers.


An arbitration agreement is often sold to D.C.s as a way to control costs if there is an allegation of malpractice. This means a patient cannot take their allegations to court, but rather must have them settled by a “neutral” third-party. There are several problems with an arbitration agreement, the most significant being you, the D.C., lose the option to have the allegation heard in court.This can be particularly troublesome because the arbitration process often favors compromise, which means you will likely be found at least partially at fault.

Similarly, you’ll find some malpractice insurance companies require doctors have patients sign a binding “arbitration agreement” before being treated. This eliminates your right and the patient’s right to a jury trial, and instead, an arbitrator resolves the case. This can cause the doctor/patient relationship to be strained from the start. You would need to decide if you turn away patients who refuse to sign the agreement.

Consent to Settle

Some insurance carriers will look to control the costs of their malpractice policies through a “consent to settle” clause. A true consent to settle cause means that you, the policyholder, must give consent for a settlement to occur. Yet, some insurance carriers will include additional language that will provide exceptions to when they need your approval, which theoretically means they can finalize a decision without your consent. To ensure your best interests are being represented, ask for clarifications surrounding the consent to settle clause.

Remember: the best way to make sure the malpractice policy is right for you is to be informed. Knowing what questions to ask before you purchase the policy goes a long way to preventing frustration should you ever face a claim. 

Don’t hesitate to contact NCMIC at 800-769-2000, ext. 3555. We can answer your questions and help you compare your options.

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