Claim Management 101
How to Handle a Claim
Malpractice? Me? The very thought is terrifying. In the event of a possible malpractice incident or a formal professional liability claim or lawsuit, you should contact LAMMICO right away.
Malpractice Claim Management
If someone files a malpractice claim against you, you will participate in the process along with your defense team: you, your claim representative and your defense attorney. As a LAMMICO policyholder, you may help choose your defense attorney from a list of approved counsel.
LAMMICO is responsible for payment of any settlement or judgment on behalf of you, the insured, up to the policy limit. It is also our responsibility to investigate and defend the claim. You can be assured that no medical professional liability claim against you will be settled without your consent, subject to the terms of your policy.
Examples of incidents to report to LAMMICO
Examples may include:
- Subpoenas or requests for medical records from attorneys, particularly those who are known as plaintiff advocates in malpractice actions
- Contact from an attorney, even if it appears to be informal
- A diagnostic or therapeutic event resulting in injury
- Verbal or written notification of a patient complaint from the state board of medical examiners, patient’s healthcare insurer, or other entity
- A patient who expresses unhappiness related to his or her care
- Hostile patients or family members who threaten to sue.
- Patients or family members who demand that bills be forgiven
- Unanticipated events or outcomes, such as a surgical complication, a medication error, an incorrect or missed diagnosis, or a failed treatment
- Accidents resulting in bodily injury or property damage on the premises
LAMMICO encourages you to report incidents as soon as possible. Incidents that do not end up as claims will not be reflected on a credentialing claims history, nor should it affect your insurability at that level.
To report an incident or claim, contact LAMMICO’s Claim Department at 800.452.2120.
How to Report a Malpractice Claim or a Potential Claim
Lawsuits (and Louisiana PCF notices) have deadlines. To protect your interests, call a LAMMICO Claim Representative right away so we can evaluate every facet of the claim—and ultimately provide you with the best defense.
Any incident that suggests a medical malpractice claim may be filed, should be reported to LAMMICO as soon as possible, even if only as a precaution. Early reporting may provide the chance to manage the situation, which could prevent an actual claim from being filed. But the most important advantage is that with early reporting, you can be sure that your coverage is in effect when the incident happened.
As a policyholder, you must notify the LAMMICO Claim Department if a claim is made by:
- 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, even if it appears to be informal, should be reported immediately. Subpoenas or requests for medical records from attorneys, particularly those who are known as plaintiff advocates in malpractice actions.
- 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. You must respond immediately in writing.
Why Report Early?
When you let LAMMICO know that an incident has occurred, you ensure that your coverage is in effect at the time the incident is reported. Incidents that remain incidents and do not end up as claims will not be reflected on a credentialing claims history, nor should it affect your insurability at that level.
Reporting early helps you get advice on how to manage the situation. It could prevent a formal claim from being filed. If necessary, LAMMICO can investigate the matter while the details are fresh and witnesses are available.