Notification of an Incident or a Claim

It is essential that you notify your Regional Claims Office immediately if any incident occurs that may lead to action against you.

The more familiar you are with the following information and guidelines, the better able we will be to provide you with expert claims handling.

What Should You Report to Your Regional Claims Office of The Doctors Company?

 
  • Demand for money
  • Verbal or written threat of legal action
  • Formal paper naming you as a defendant or witness
  • Attorney’s letter of intent or 90-day notice
  • Request for arbitration
  • Request for deposition or interview
  • Subpoena, summons, complaint, notice of a lawsuit, or small claims court notice

What Types of Incidents Lead to Claims and Should Be Reported to Your Regional Office?

Report any incident related to diagnosis or treatment that could be construed as a contributory factor to:
 
  • Death
  • Diminished life expectancy
  • Birth injuries
  • Loss of an extremity
  • Injury to or impairment of a body organ
  • Loss or impairment of any of the five senses
  • Severe disfigurement
  • Verbal or written threats
  • Harassment by patient or family

How to Report an Incident to The Doctors Company:

 
  • Report an incident or claim in writing to the Claims Department of your regional office, (You can find contact information for your Regional Claims Office, and a First Report of New Incident or Claim form at www.thedoctors.com/claims.)
  • Reports may be faxed or mailed.
  • Be ready to relate the facts of the event.
  • Provide all relevant documents (including any demand, notice of intent to sue, complaint, or other document you receive that relates to the incident or claim).
  • You may also wish to discuss the incident with your Regional Claims Office or patient safety/risk manager, but this would NOT constitute notice to the company.

Additional Recommendations to Ensure Defensibility:

 
  • Do not add to, delete from, or otherwise alter a medical record.
  • Place the medical record in a safe place.
  • After making a report to us, keep copies of your correspondence in a safe place—not in the patient’s chart—for future consultation.
  • Always require the patient’s or the patient’s legal representative’s signature to release a copy of the medical record or any information within it.
  • Do not discuss the event with anyone other than your claims representative or defense attorney.
  • Do not make contact with anyone associated with the case except your claims representative or defense attorney.

When we receive your written report, we will send you an acknowledgment and will carefully review your report. If no action is required in the case of an incident, we will inform you that the report and medical records have been filed for reference in the event that a claim should develop. Depending on the facts and circumstances of the event, a claims representative may need more information from you. In the case of a lawsuit or a demand for arbitration, we will send you an acknowledgment along with specific instructions for future handling. Call your Regional Claims Office or speak with your claims representative at any time to ask questions or to receive an update on your case.

Our Commitment to You

In the event that a suit is brought against you, remember that The Doctors Company’s experienced, professional claims experts are with you every step of the way. We will provide vigorous defense against nuisance suits or work with you to pursue speedy and fair resolution for meritorious claims. Our Claims and Patient Safety/Risk Management Departments are dedicated to your protection.

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About the Author

Paula A. Jenkins, senior vice president of The Doctors Company Claims, oversees the company’s national claims operations. Ms. Jenkins has been with The Doctors Company since 1987 and has more than 20 years of experience with health care liability claims. She holds a bachelor of arts degree from California State University, Los Angeles, and has a graduate degree in executive business management from the University of California, Los Angeles.

 


 

The guidelines suggested here are not rules, do not constitute legal advice, and they do not ensure a successful outcome. They attempt to define principles of practice for providing appropriate care. The principles are not inclusive of all proper methods of care nor exclusive of other methods reasonably directed at obtaining the same results. The ultimate decision regarding the appropriateness of any treatment must be made by each health care provider in light of all circumstances prevailing in the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.


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