Q. Exactly what is a malpractice claim?

A. A claim, for purposes of your insurance policy, is any demand by a patient, or the patient’s representative, for compensation of any sort due to the actions, or lack thereof, by the physician or a member of the physician’s staff.  This compensation may be as minor as a request to reduce or eliminate a service bill, or as serious as a demand for monetary consideration to be paid.  These demands may be oral, or may be made in writing. 

At HUOH we encourage the early reporting of any incident that you may believe has the potential to be a claim.  In some cases, early reporting gives our defense team an opportunity to help you head off a claim before it is made.  There is no downside to reporting early.  Incidents you report do not necessarily become claims.  If you are concerned about a situation and unsure what to do, please feel free to call the claims department for guidance.  This is your company.  Our defense team works for you.

Q. When do I contact HUOH?  And who should I contact?

A. There are certain situations, where you are required to contact HUOH to make sure your coverage is properly applied.  These are described more precisely in the answer to the last question and in the next paragraph.  As a rule of thumb, however, you should contact the company any time you have a concern about a situation in your practice.  When you do, you will receive guidance from either our Claims, or our Risk Management Department, depending on the situation.

More specifically, whenever you receive any specific written or oral demand from a patient or the patient’s representative that stems from medical treatment rendered, or treatment that should have been rendered, it is the right time to contact HUOH.  Any letters from a patient making a demand, any notice of litigation, arbitration, or other alternative dispute resolution demand requires that contact be made with HUOH.  Additionally, if the physician reasonably believes that an adverse medical event occurred that may result in such a demand, it is also required that HUOH be contacted.

Contact with HUOH Claims can be made in a variety of ways – phone, fax, or email.  To make direct telephone contact:

William Ludwig, Vice President and Chief Claims Officer
Healthcare Underwriters Group
Toll Free Phone: (866) 379-4600
Toll Free Fax: (866) 484-5719
bludwig@HUGroups.com

Q. Will I have legal representation to defend against the allegations of negligence my patient makes?

A. Certainly.  Defense is what HUOH is all about. 

Through our extensive experience and contacts in medical professional liability, HUOH has identified a number of well experienced defense attorneys in strategic geographical locations around the state that will serve as learned counsel for our insured physicians.  As in the world of medicine, the world of malpractice defense has honed legal specialists that have years of experience in defending health care providers. They specialize in malpractice defense, and thus have in-depth knowledge of the litigation process surrounding medical liability matters. The Claims Department will determine early the need for, and will retain the services of, such an experienced defense attorney.

Q. Who determines if there was any medical negligence ?

A. Practicing physicians.

Healthcare Underwriters Group’s defense counsel will seek and retain medical experts in the same specialty as the defendant physician to ascertain if there was any breach in the standard of care.  Many times, our counsel will seek the medical advice and testimony of a variety of specialists to bolster the defense against the allegations made. 

In addition to the medical experts retained by your defense attorney, Healthcare Underwriters Group’s Claims Committee, consisting of member physicians, will review claims presented to the Company.  This Committee, consisting of a geographic and specialty mix of member physicians, meet regularly throughout the year to review and advise the Claims Department as to the medical defensibility of a claim or suit.  Through the tenure of a claim or suit, both your defense attorney and the Claims Department will keep you advised of the status of the case and will solicit your input and assistance in the continued defense of the allegations made.

Q. How long does a claim or suit take to resolve?

A. Unfortunately, there is no definitive answer to that question.  Some relatively minor claims are resolved, or abandoned by the patient, in the first few months after making the claim.  Conversely, lawsuits that have complicated medical issues and/or a number of defendants may take up to four or five years before final resolution.  The duration of any claim is solely dependant upon the severity and nature of the allegations being made.

Q. Why does HUOH take such a strong position on the defense of a claim?  Isn’t it cheaper to settle early on in the process?

A. Simply put, HUOH is building its reputation by defending yours.  We have found that once contingency fee attorneys realize that they can not simply write a letter and get a check from your insurer, they are more inclined to look elsewhere for satisfaction.  Over time, it may in fact be far less expensive to provide you with a vigorous defense.
 
Historically, about 80% of all claims and suits made against health care providers are ultimately found to be without medical merit. Due to our years of experience in the field of malpractice defense, we have recognized paying a plaintiff for injuries not caused by true medical negligence only promotes further and future claims to be brought.  Paying on “nuisance claims” or claims without medical merit solely to avoid the legal hassles and the accompanying expenses does not serve the physician’s reputation well, nor does it fulfill the purpose of belonging to a physician-owned insurance company.
 
Thus, by providing a strong defense through using experienced, specialized defense attorneys and recognized medical experts that the plaintiff attorneys realize that to bring an action against a HUOH insured physician, they must have overwhelming evidence of medical negligence.
Our insureds/owners prefer to be defended.

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