Medical Malpractice Claims: Understanding the Practical Process

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 provided substandard care, resulting in harm to a patient.

Read on to learn what to expect with coverage, including the most common reasons for medical malpractice claims, what happens when a patient files a medical malpractice claim, and the four elements that patients must prove to win their case.

Understanding Medical Malpractice Claims Process

Many physicians will face a medical malpractice claim at some point during their careers. Everyone makes mistakes sometimes, but mistakes that another physician would not have made under the same circumstances might be seen as 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 throughout the claims process, step by step:

1. Notify your medical malpractice insurance provider.

After receiving notice of a patient’s intent to file a claim or lawsuit, it’s important to contact your medical malpractice provider immediately. This will ensure the insurance company can appropriately respond to the lawsuit and begin preparing your defense.

2. Preserve the medical records.

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.

3. Participate in the discovery process.

Discovery is the formal process of exchanging information between both sides of a lawsuit. 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.

4. Prepare for your deposition.

Your deposition is the opportunity for the plaintiff’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.

5. Attend mediation.

Mediation is a common way medical malpractice claims are resolved. A mediator is a neutral third-party who helps the two sides in a lawsuit come to an agreement without going to court.

6. Be prepared to go to trial, if necessary.

Only about 7% of medical malpractice cases go to trial. During a 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.

What Is the Statute of Limitations for Medical Malpractice?

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 witness’s memories become unreliable. Once the deadline has passed, it’s no longer possible to take legal action.

The statute of limitations for medical malpractice 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.

The 4 Most Common Medical Malpractice Claims

Patients may file medical malpractice claims for a wide variety of reasons, such as neglecting to obtain patient informed consent. Some of the more common reasons for a malpractice lawsuit are:

1. Diagnosis-related claims

Medicine is not an exact science, and even the best doctors can make errors in diagnosis. Failing to diagnose or misdiagnosing a serious condition is a leading cause of medical malpractice claims. The majority of serious misdiagnoses involve vascular events, infections, and cancers.

2. Surgery-related claims

Surgery has inherent risks for both patients and their physicians. It’s 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.

3. Medication-related claims

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. 

4. Childbirth-related claims

Out of all medical specialties, obstetrician-gynecologists 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.

The Elements of a Medical Malpractice Claim

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.

The physician owed the patient a duty of care.

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.

The physician failed to meet the duty of care.

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.

The failure to meet duty of care caused injury.

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 Damages.

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 and 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.


Get a Medical Malpractice Quote

Medical malpractice insurance offers crucial coverage and support for physicians navigating medical malpractice claims. Indigo streamlines the process of getting medicalmalpractice 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.

Disclaimer: This article is provided for informational purposes only. This article is not intended to provide, and should not be relied on for, legal advice. Consult your legal counsel for advice with respect to any particular legal matter referenced in this article and otherwise.