Legal Defense 101

What to Expect From LAMMICO's Legal Defense of a Claim

What to Expect From LAMMICO's Legal Defense of a Claim

View the article on How To Be More Effective at Your Deposition by Marc Judice, J.D., of Judice & Adley in Lafayette, LA.


In Louisiana, LAMMICO separates 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. To reference additional insights, view the article on How To Be More Effective at Your Deposition by Marc Judice, J.D., of Judice & Adley in Lafayette, LA.
 

Examples
Your coverage depends on the allegations raised and the facts and circumstances of each individual claim. For this example, consider a policyholder who bought limits of $1 million/$3 million:

  • Claims Category 1: LAMMICO defends claims reported in the same policy period until the company has paid judgments and/or settlements totaling $300,000, regardless of the number of claims reported during the policy period and subject to a $100,000 limit per claim. Once $300,000 in judgments and/or settlements has been paid, LAMMICO’s duty and obligation to pay judgments and/or settlements on any remaining capped claims ends.
  • Claims Category 2: LAMMICO defends claims reported in the same policy period until the company has paid judgments or settlements totaling $3 million, regardless of the number of claims reported during that policy period and subject to a $1 million limit per claim. Once $3 million in judgments and/or settlements has been paid, LAMMICO’s duty to defend and obligation to pay judgments and/or settlements on any remaining claims ends.

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. Both live lecture workshops and online education are available for our policyholders to assist them in dealing with litigation stress.


Legal Defense Glossary

Admissible evidence may be properly introduced in a legal proceeding. Determination of admissibility is based on legal rules of evidence and is made by the trial judge or screening panel.


A legal document containing a defendant’s written response to a Complaint or Declaration in a legal proceeding.


The sum of money a court or jury awards as compensation for a tort.


The process of questioning a person under oath.


A formal investigation, governed by court rules, that is conducted before a trial.


Written questions submitted by one party for another party to answer, as part of the discovery process.


A pretrial request for judgment based on legal arguments only and where no material facts are in dispute. Defendants may move for summary judgment in order to have the case dismissed.


The first phase of a lawsuit, during which the issues in dispute are identified and clarified, including the plaintiff’s cause of action and the defendant’s grounds of defense.


A series of factual statements served by one party to the other that must be admitted or denied in writing, under oath, within a certain time frame.


An insurer’s notification to an insured that coverage for a claim may not apply. Such notification allows an insurer to investigate (or even defend) a claim to determine whether coverage applies (in whole or in part) without waiving its rights to later deny coverage based on information revealed by the investigation.


Retroactive date definition: In a claims made policy, this is the date after which an incident must occur in order for coverage to apply.


A standard of care holds a person of exceptional skill or knowledge to a duty of acting in the manner of a reasonable and prudent person possessing the same or similar skills or knowledge under similar circumstances.


A civil wrong for which an action can be filed in court to recover damages for personal injury or property damage resulting from negligent acts or intentional misconduct.


Civil liability for the torts of others. Physicians may be vicariously liable for the negligent acts of their employees committed within the scope of their employment.