News & Insights

Legal Defense 101

April 12, 2017

Legal Defense 101

The stress of a malpractice claim can be overwhelming, and that’s why LAMMICO provides unparalleled service so that policyholders can focus on what’s important: the patient’s needs. While LAMMICO is here to do the heavy lifting, a basic understanding of the legal defense process is beneficial to the policyholder. In this edition of LAMMICO Weekly, we offer a refresher of a few fundamental concepts to help you better understand your legal defense.

How do I report a malpractice claim or potential claim?

Call 800.452.2120. Don't email or fax. Call. Leave us the best phone number to reach you directly. We respect your privacy and the sensitivity of the issue. We want to ensure strict confidentiality when we communicate with you. To protect your interests, speak with a LAMMICO Claim Department representative promptly, so we can evaluate your situation – and ultimately provide you with the best defense. Remember: lawsuits have short 15-day deadlines that require prompt response by an attorney. It is important that your office staff knows this.

As a policyholder, you are required to notify the LAMMICO Claim Department if a claim is made by:

  • Lawsuit - Malpractice lawsuits are typically served by the Sheriff's Office. You must respond within 15 days or risk a default judgment.
  • Plaintiff's Attorney Contact - Contact from an attorney regarding any untoward event, even if it appears to be informal, should be reported immediately.
  • Patient's Compensation Fund (PCF) Notice - In Louisiana, this kind of notice indicates that a request for a Medical Review Panel has been filed. This is typically presented by certified mail.

Protect yourself by calling us immediately when incidents such as these occur:

  • Subpoenas or requests for medical records arrive from attorneys involving patients for which you believe a malpractice claim may be filed
  • A diagnostic or therapeutic event results in injury or an unanticipated outcome
  • You receive verbal or written notification of a patient complaint from the State Board of Medical Examiners, patient’s healthcare insurer, or other entity
  • A patient expresses unhappiness related to his or her care
  • Hostile patients or family members threaten to sue
  • Patients or family members demand that bills be forgiven

When you give notice to LAMMICO that an incident has occurred, it satisfies the reporting requirement for your Claims-Made or Occurrence coverage. Incidents that do not develop into a formal claim will not be reflected on a credentialing claim history, nor should it affect your insurability. Obtain advice on how to manage the situation from a LAMMICO Claim Representative. It could prevent a formal claim from being filed.

If a malpractice claim is filed against you, you will participate in the process along with your defense team, comprised of your claim representative and your defense attorney. As a LAMMICO policyholder, you may take part in the selection of a defense attorney from a list of approved counsel. LAMMICO has the responsibility subject to the terms of the insurance policy for payment of any settlement or judgment on behalf of you, the insured, up to the policy limit. The company also has the responsibility of investigating and defending the claim and you can be assured that medical professional liability claims against you will not be settled without your consent, subject to the terms of your policy.

What are the different types of claims?

In Louisiana, LAMMICO separates healthcare provider claims into two broad categories:

  • Category One (1) consists of claims that are capped pursuant to the Louisiana Medical Malpractice Act (or would have been capped had the policyholder been PCF-qualified).
  • Category Two (2) consists of all uncapped claims except those that are uncapped solely because the policyholder was not PCF-qualified.

Claims in the first category are subject to $100,000/$300,000 limits, and claims in the second category are subject to the maximum limits purchased by a policyholder.

How to deal with the stress of litigation?

LAMMICO offers comprehensive resources to LAMMICO insureds and is keenly aware of the additional burden a malpractice claim can place on an already taxed healthcare provider. This is precisely why our Risk Management and Patient Safety Department developed products and services related to emotionally preparing for litigation. LAMMICO is here to support healthcare providers experiencing anxiety during the malpractice litigation process. 

Additional Resources

To reference additional insights related to legal defense of malpractice claims, including a legal defense glossary and the article “How To Be More Effective at Your Deposition” by Marc Judice, J.D., of Judice & Adley in Lafayette, LA, please click here.

 

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