We understand that working in long-term care presents unique challenges and responsibilities. Providing compassionate, quality care to a vulnerable population means you operate under intense scrutiny from families, regulators and the public. When a liability claim is filed, the stakes are high. But rest assured, you are not alone.
Our goal is to help you respond efficiently and effectively, minimizing potential damage while protecting your organization, staff and reputation. Here is a step-by-step guide on what to do when faced with a new liability claim.
Step 1:
Recognize and Report Claims Immediately
Time is of the essence. Prompt notification is not only a requirement under the terms of your malpractice policy, but also key to mounting an effective defense.
Some claims, such as lawsuits or written demands for remuneration, are obvious. But you should also report any events or incidents that could reasonably be expected to generate a claim. Examples of incidents to be reported include:
- Hostile patients or family members who threaten to sue or demand a refund of medical bills
- Notification of a patient complaint made to state boards or regulators
- Requests for medical records from attorneys
- Unanticipated events or outcomes resulting in harm to a resident
- Accidents resulting in bodily injury or property damage on the premises
Even if you believe the claim lacks merit, notify us. Early reporting may provide the chance to manage the situation, which could prevent an actual claim from being filed. Contact us at 800.452.2120 as soon as you are aware of a potential or actual claim.
When you contact us, please be prepared to provide:
- A summary of the incident
- Date/time of the event
- Names of residents and staff involved
- Any correspondence received (e.g., resident complaints, records requests, letters of intent)
Step 2:
Stay Calm and Professional
When a claim arises it can trigger stress, fear or defensiveness. These are natural reactions, but it is crucial to remain calm and professional. Avoid emotional responses or assigning blame. Encourage staff to refrain from discussing the situation beyond what is required internally. Do not speak to the claimant or their attorney without first consulting us for guidance.
Step 3:
Preserve All Documentation and Evidence
Proper documentation can make or break a defense. Take immediate steps to secure all related records:
- Resident care plans and medical charts
- MARs and TARs
- Staff notes and shift reports
- Surveillance video and photographs (if available)
- Maintenance logs, incident reports, witness statements or emails related to the claim
Do not alter, add to, or delete any records after the fact. Plaintiff attorneys may accuse you of spoliation of evidence, which can lead to adverse evidentiary consequences and legal sanctions. With EMRs, plaintiff attorneys have become adept at scrutinizing audit trails to find evidence of alterations. If you are found to have improperly altered any records, your case may become indefensible.
One difficulty in defending long-term care claims is identifying and keeping in touch with staff members involved in resident care. To best assist your defense team, you can craft a timeline/summary of relevant events that includes the names and titles of involved staff, as well as contact information for staff who may no longer be at the facility.
Step 4:
Engage Your Defense Team
Upon notification, we will assign experienced defense counsel and claims professionals to guide you. These specialists understand the nuances of long-term care litigation, including common plaintiff tactics, applicable state laws, and how to present your side effectively.
Your cooperation with the defense team is critical. Maintain open, honest communication and provide timely responses to inquiries. Promptly provide requested documents and information. Assist in responding to discovery requests. Do not discuss the case with anyone outside the designated legal team and advise your staff to do the same.
Step 5:
Cooperate with the Investigation
A thorough investigation will be conducted by the claims professional and defense attorney. This may include:
- Interviewing staff
- Securing narrative statements
- Reviewing clinical records and facility protocols
- Evaluating internal quality control measures
- Assessing your compliance with regulatory standards
- Obtaining internal reviews from our expert consultants
Be proactive and transparent. It is important for us to know about potential weaknesses in the case, so be candid. Having all the information puts your legal team in the best position to achieve the best possible outcome.
Step 6:
Understand the Legal Process and Timelines
Litigation takes time. From filing responsive pleading, completing discovery, engaging in motion practice, attending mediation, and planning for trial, the process can span years. Throughout the process, your defense counsel and claims adjuster will keep you informed, help you prepare for each stage, and advocate for the most favorable outcome.
Not every case goes to court, and in many situations, early resolution through negotiation is the best path. We will help weigh your options based on the strength of the evidence, the potential exposure, and your organization’s goals.
Step 7:
Support Your Staff
A liability claim can take an emotional toll on your caregivers. Fear of being blamed or disciplined can affect morale and performance. Make sure your employees know they are supported, emphasize the importance of continued professional conduct, and involve them appropriately in the legal process without overwhelming them. When caregivers feel secure and respected, they are more likely to cooperate fully and represent the facility in a positive manner.
Conclusion:
Facing a liability claim is never easy, but you’re not facing it alone. LAMMICO’s purpose is to protect those who care for others. As your medical malpractice carrier, we are here to defend your interests, support your team, and ensure that your focus remains where it belongs: on providing safe, compassionate care to your residents.
If you ever have questions, concerns, or a potential claim to report, don’t hesitate to contact us. To report a claim, please call 800.452.2120.