Medical malpractice coverage is a specialized type of medical professional liability insurance that’s tailored to the unique needs of physicians and other healthcare professionals. It helps protect your finances and professional reputation from claims that you were negligent or provided substandard medical care, resulting in harm to a patient.
For patients, the consequences of medical malpractice can be life-altering, leading to additional medical expenses, prolonged recovery, or even permanent disability. The first step in the medical malpractice claim process is for the patient to discover the injury and attribute it to a healthcare provider's negligence. Once the patient discovers the injury, they may contact an attorney to review the claim and determine if they have a viable case.
Read on to learn what to expect with medical malpractice coverage, including the most common reasons for medical malpractice claims, what happens when a patient files a medical malpractice claim, and the 4 elements that patients must prove to win their case.
Medical malpractice occurs when a healthcare provider, such as a physician, nurse, or other medical professional, fails to deliver care that meets the accepted standard within the medical community, resulting in injury or harm to a patient. This can take many forms, including misdiagnosis, surgical mistakes, medication errors, or improper medical treatment. For patients, the consequences of medical malpractice can be life-altering, leading to additional medical expenses, prolonged recovery, or even permanent disability. When a patient believes they have suffered harm due to a healthcare provider’s negligence, they may file a medical malpractice claim to seek compensation for their injuries.
Many physicians will face a medical malpractice claim at some point during their careers. Every physician makes medical errors, but mistakes that another physician would not have made under the same circumstances might be seen as negligence, or even gross negligence. If a patient is harmed as a result of what they believe to be negligence, they may file a medical malpractice suit.
When confronted with a medical malpractice claim, physicians may feel uncertain about the next steps. Here’s what to expect, step by step:
After receiving notice of a patient’s intent to file a claim or lawsuit, it’s important to contact your medical malpractice provider (your insurance carrier) immediately. This will ensure the insurance company can appropriately respond to the lawsuit and begin preparing your defense.
In a malpractice case, the patient’s charts and records are key elements that help prove you met the standard of care. The records must not be altered in any way after you received notice of a potential claim. If you have a concern about anything in your medical record, then discuss it with your assigned defense counsel.
In some legal situations, a court order may be required to release or obtain certain medical records as part of the litigation process.
We published articles about charting with a jury in mind and charting by exception, read them both today!
The discovery phase begins after the lawsuit is filed and is a critical part of the medical malpractice claim process. During the discovery phase, both parties exchange information and gather evidence to build their case. Written discovery, such as interrogatories, allows one party to request information and documents from other parties involved in the case.
Parties engage in both written and oral discovery, including depositions, to collect facts and evaluate claims. Legal research is also conducted during the discovery phase to support legal arguments and case strategy. During this phase, depositions are conducted where parties answer questions under oath. Expect to gather related documents and cooperate with your assigned defense counsel in building your defense. The case may be dropped if there is insufficient evidence.
Your deposition is the opportunity for the plaintiff’s attorney, also referred to as the patient's attorney, to ask you questions while you are under oath. A deposition can make or break your defense. It’s the first opportunity the plaintiff’s attorney has to meet you and ask you questions about your care.
Be careful to prepare for your deposition with your assigned defense counsel who will have a good idea of the kinds of questions you will be asked and what aspects of your care and medical record to particularly focus on. A strong performance at your deposition will influence the expectations of the plaintiff’s attorney going forward and might even result in the dismissal of their case.
Mediation is a common form of settlement negotiation used to resolve medical malpractice claims. Settlement negotiations typically occur after the discovery process, and many med mal cases are resolved through settlement at this stage before going to trial.
During mediation, the parties engage in discussions to reach a mutually agreeable settlement. A mediator is a neutral third-party who helps the two sides in a lawsuit come to an agreement without going to court.
Only about 7% of medical malpractice cases proceed to a jury trial, with the majority being dismissed or settled out of court. If the case survives dismissal and the parties cannot agree on a settlement, the case will proceed to trial where evidence is presented to a jury. The trial date is important, as it impacts how both sides prepare their cases and manage scheduling complexities.
During a jury trial, you can expect to answer questions asked by both your defense team and the patient’s legal team. All witnesses who testify at trial, including the patient, will be similarly examined and a jury of your peers will then determine the outcome of the case. It is crucial for defendants to respond appropriately to legal notices; failing to do so can result in a default judgment in favor of the plaintiff.
We published a white paper that takes an exhaustive look at being a medical malpractice insurance expert witness, read it here today!
A malpractice claims investigation is a comprehensive process designed to uncover the facts surrounding a medical malpractice claim. This investigation typically begins with the collection of all relevant medical records, which are carefully reviewed to identify any deviations from the standard of care.
In addition to medical documentation, the investigation may include gathering witness statements, consulting with expert witnesses, and analyzing the sequence of events that led to the patient’s injury.
Statutes of limitations are laws that set a deadline for beginning legal action. Their purpose is to ensure claims are filed in a timely manner, before relevant evidence gets lost or witnesses' memories become unreliable. Once the deadline has passed, it’s no longer possible to take legal action.
The medical malpractice statute of limitations varies from state to state. Depending on where you practice, patients may have anywhere from one year to five years to bring a malpractice claim.
The clock for the statute of limitations starts typically running on the date the alleged malpractice event occurred. However, the clock can be extended in certain circumstances. If a patient has no way of knowing about the malpractice when it first occurred, the clock may not start until they discover the harm. For minors, the clock will typically not start until they reach age 18, often many years after the event giving rise to the claim occurred. This is why it’s important to understand your insurance policy and particularly, your tail coverage, if applicable.
Want to know more about protecting yourself with tail coverage? Read our exhaustive blog here!
Patients may file medical malpractice claims for a wide variety of reasons, such as neglecting to obtain informed consent. Some of the more common reasons for a malpractice lawsuit are:
Medicine is not an exact science, and even the best doctors can make errors in diagnosis. Failure to diagnose or misdiagnosing a serious condition is a leading cause of medical malpractice claims. The majority of such serious issues involve vascular events, infections, including healthcare associated infections, and cancer misdiagnosis.
Surgery has inherent risks for both patients and their physicians. Surgical errors are the second-most common reason for malpractice claims, after diagnosis-related issues. Often, patients allege their surgeon lacked technical skill or failed to use good judgment. Less commonly, lawsuits are filed due to retained surgical items or wrong-site surgery.
Medications have the potential to cause serious harm when they’re used incorrectly. Some common medication errors include prescribing the wrong medication or the wrong dosage, or administering a medication through an incorrect route.
Out of all medical specialties, obstetricians are the most likely to face medical malpractice lawsuits, with 62.4% being sued at some point during their careers. Some of the more common reasons for lawsuits include inadequate prenatal care and the failure to timely respond to complications for the fetus and/or mother during labor and delivery.
We wrote an entire blog on birth injury medical malpractice, read it today!
There are four elements of a medical malpractice claim. A patient who brings a claim must prove all four elements. The physician, on the other hand, must only defeat one element to successfully defeat the claim.
Confused by terms like "breach of duty," "duty of care," and "standard of care"? Read our blog explaining the differences between all three.
Typically, patients must show that a doctor-patient relationship existed. Physicians are required to meet the standard of care for their patients, meaning that they use the same level of care and skill as a reasonably careful physician with the same training.
After showing that a physician owed them a duty of care, patients must next prove that the physician did not meet the duty of care, i.e. the physician was negligent. That means the patient must prove that a reasonably careful physician under the same circumstances would have acted differently.
Together, the first two elements prove that medical negligence occurred. For a patient to prevail in a medical malpractice case, they must also prove that the negligence caused them injuries, i.e. damages, and that those damages would have been avoided if negligence had not occurred.
The patient must prove damages that are recoverable as a result of the negligence. Damages include past and future medical bills, lost wages, and any pain, suffering, or disfigurement. If appropriate, the defense will contest the reasonableness of any claimed damages and whether they are genuinely the result of negligence or something else.
From "nuclear verdicts," to the effect your medical specialty can have on damages, to the variability of medical malpractice payouts by state, monetary decisions are all over the place today. Read more about these topics today!
Medical malpractice insurance offers crucial coverage and support for physicians navigating medical malpractice claims. Indigo streamlines the process of getting medical malpractice coverage so you can focus on what you do best: seeing patients.
Indigo leverages robust data sets and artificial intelligence in its proprietary underwriting model to quickly analyze thousands of data points, providing individualized pricing to physicians in all medical specialties. Indigo rewards physicians that practice good medicine with bigger potential savings.
Request your quote today.
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