Understanding the Anatomy of a Malpractice Claim in Chiropractic Practice

Understanding the Anatomy of a Malpractice Claim in Chiropractic Practice

What you should and shouldn't do when you're facing a malpractice claim.

Facing a malpractice claim can be a daunting experience for doctors, requiring them to navigate legal proceedings and defend their actions. Let’s delve into the anatomy of a chiropractic malpractice claim, shedding light on the role of doctors and what they can expect from NCMIC as their malpractice insurance provider. 

Notification of a Malpractice Claim

When a DC learns they are being sued for malpractice, there are several ways they may receive notification. There could be clues leading up to the claim, such as an unhappy patient requesting a refund or alleging injury due to treatment. Other indications may include receiving a letter from an attorney demanding monetary compensation or being served with legal papers.

Response to Claim Notification

Upon receiving notification of a malpractice claim or a request for records, it is crucial for doctors to immediately contact their malpractice insurance provider, such as NCMIC, where claims professionals are available to guide them through the process. If a records request is accompanied by a release form, the doctor is advised to send the records. Note: It is essential to never alter or change the records. If the claim escalates to a lawsuit, the insurance company would open a claim and hire defense counsel for the doctor.

Handling Discrepancies in Patient Records

Should a DC discover discrepancies or missing information in patient records after learning about a malpractice claim, it is crucial to seek guidance from the insurance company or legal counsel before taking any action. Altering records can be perceived as an attempt to manipulate evidence and will potentially damage the doctor’s defense. However, there are proper ways, such as signing and dating an addendum, to make additions or changes to records after the fact. It is essential to consult your claims professional or lawyer to determine the most appropriate course of action.

NCMIC's Process in Defending a Claim

Once NCMIC is informed that one of our policyholders is facing a lawsuit, we initiate our defense process. 

  • The first step typically involves selecting an attorney from our panel of experienced medical malpractice attorneys in the doctor’s state. 
  • The attorney will then contact the doctor, meet with them, and guide them through the process.
  • The next stage is called discovery. This is where medical records are obtained to assess the patient's allegations and gather evidence. 
  • NCMIC may also retain expert witnesses, such as chiropractors and specialists, to review the records and provide opinions on the standard of care and causation. 

Based on these evaluations, we gain a clearer understanding of whether the case can be defended through trial or if a settlement may be more appropriate.

Doctor's Involvement in Decision-Making

The doctor's input is highly valued regarding crucial decisions such as settlement or trial. Every policy with NCMIC includes a consent to settle clause, ensuring that settlements are never made without the doctor's express wishes. While we offer recommendations based on our expertise, the doctor's decision holds significant weight. If a doctor wishes to go to trial and believes they have expert support, NCMIC will support and defend that decision. It is important to note that settlements can have implications, such as mandatory reports to the National Practitioner Data Bank, which may require the doctor to answer questions about the claim in the future.

Doctor's Responsibilities

While claims professionals and lawyers will do a lot of the legwork on a claim, a DC does have several responsibilities.

  • Cooperate with attorneys and provide requested information and documentation during the discovery period, which involves an exchange of information. 
  • Potentially give depositions, where they are questioned by both the patient's attorney and their own. 
  • Maintain professionalism, including on social media accounts.
  • Prepare for the legal process with the help of attorneys. 

Role of Malpractice Insurers

Malpractice insurers play a crucial role in supporting doctors throughout the legal process. They aim to minimize the impact on a doctor's practice and personal life while providing guidance and assistance. Insurers typically hire attorneys to represent doctors and handle various aspects of the case, including preparation sessions before depositions and trial attendance. They work in the best interest of the doctor, seeking settlement options and utilizing mediation to reach a resolution.

Social Media and Online Presence

Doctors should be mindful of their social media presence and online content during a malpractice case. Attorneys often review a doctor's social media accounts and websites to identify potentially damaging information. State licensing boards may also take such information into consideration during their review process. Cooperation with legal advice and maintaining a professional online presence is essential to protecting one's interests.

Possible Outcomes

The outcomes of malpractice claims can vary. Settlements are a common outcome and do not necessarily imply admission of liability. Insurers usually include a clause of confidentiality in settlement agreements to protect doctors' reputations. Defense verdicts can be reached if the jury rules in favor of the doctor, resulting in no payment of settlement or damages. In such cases, insurers cover the defense costs.

Notifying State Licensing Boards

The notification of state licensing boards regarding malpractice claims depends on the specific state regulations. In some states, the opening of a claim is reported to the licensing board, while in others, it requires a settlement or a mandatory state report. When re-credentialing with insurances or applying for license renewals, doctors may need to disclose claims or settlements. It is important to answer such questions truthfully and seek assistance from insurers to navigate these processes effectively.

At NCMIC, our extensive experience in handling claims is a testament to our commitment to taking care of our own. We strongly encourage our doctors to reach out to us proactively rather than reactively. If you have a nagging feeling that something isn't right or anticipate a potential claim on the horizon, we urge you to pick up the phone and have a conversation with our claim staff. We are always here to listen, provide guidance, and offer valuable advice. Your peace of mind and satisfaction are our top priorities, and by working together, we can ensure that your interests are protected every step of the way.

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