Whether you are facing an adverse outcome of medical treatment, receive a notice of a claim, lawsuit or disciplinary board investigation, please know that Physicians Insurance understands the stress or uncertainty you may be experiencing. Our goal is to provide you the highest claim service with the best possible outcome while providing you with the support you may need during a challenging time.
A few important things to know about our claims handling:
- When a new report is made to us, seasoned claims staff will contact you to discuss the details of the medical treatment and discuss next steps depending on the type of report. If the report requires no further action, we will maintain the report with no negative consequence to your claim record.
- If the report is a lawsuit or becomes a lawsuit, highly experienced medical negligence defense attorneys will be retained to represent you. In medical negligence cases, defense costs are outside of your policy limit.
- We have litigation and peer support programs staffed with people who can help you cope with the stress of an adverse event or lawsuit.
- We vigorously defend non-meritorious claims; we settle meritorious claims timely and fairly.
- We conduct a thorough investigation including consultant reviews of your care. The process and length of the investigation may vary from state to state.
- You are kept fully apprised of the investigation and when it is time to make a decision about how to resolve the claim, policyholders are always the decision makers whether to settle.
A claim or lawsuit is an unfortunate risk of practicing medicine but we hope you realize you are not alone. Our support, experience and defense strategies will guide you to a resolution while keeping you productive professionally and personally.
Talk to your claims representative or your counsel before you speak to anyone. In general, you should not discuss any malpractice incident, claim, or lawsuit with the patient or the patient’s attorney. This is important, because you do not want to prejudice your position in the matter. However, the laws in Washington, Oregon, and Idaho allow you, under certain circumstances, to offer a patient your apology for a bad outcome without making that apology evidence in any subsequent action. Your claims representative or your counsel can help you express yourself effectively in such a situation.
Also, do not discuss the patient with any of your colleagues except in the context of protected Quality Assurance programs. You can, and should, communicate as needed with any current treating physician regarding the continuing medical treatment of the patient.
We advise you not to discuss the details of the patient’s care with your office staff, or anyone in your administration, because conversations with them may not be considered privileged. However, we have found it helpful to your defense if your staff is aware of the existence of an incident, claim, or lawsuit. You should advise your staff not to release records or information on that patient to anyone without your knowledge and permission.
Yes. In fact, your Physicians Insurance policy requires that you report to us all actual claims, potential claims, and lawsuits. Early notification to us aids in our early evaluation, which will improve your chances of a successful defense. Our investigation affords us the opportunity to collect and record facts before time fades memories or witnesses disappear. In appropriate instances where settlement is warranted, we may be able to negotiate an early settlement with the patient before the filing of a lawsuit.
A claim is a demand for monetary compensation by a patient or the patient’s attorney to the physician or the liability carrier.
A lawsuit is formal litigation within the judicial system.
A potential claim is an incident that may culminate in a demand for compensation.
You can discuss your case at any time with your claims representative or defense counsel because of the privileged nature of these conversations. Conversations with your spouse, clergy, or counselor are also privileged. Conversations with anyone else may be discoverable. A plaintiff attorney might ask you to name everyone with whom you have had discussions regarding the case, and could subpoena those people for deposition.
Therefore, we strongly advise you to limit your communications regarding the case to only those people who are privileged to discuss the case with you.
Yes. Subject to certain exclusions, your Physicians Insurance policy provides reimbursement of legal expenses you incur arising out of an investigation by the state medical or osteopathic disciplinary agency. The investigation must arise from a medical incident involving direct patient treatment after your retroactive date.