Claims Handling

Malpractice Defined

Black’s Law Dictionary defines medical malpractice as "a doctor’s failure to exercise the degree of care and skill that a physician or surgeon of the same medical specialty would use under similar circumstances." Today, this same concept applies to physicians and ancillary healthcare providers alike.

A legal determination of malpractice requires the presence of four distinct elements:

Duty One party owes a duty to another. For example, a direct provider-patient relationship must exist or an implied duty of care must pertain to the relationship.

Negligence Negligence is defined as a departure from acceptable standards of medical care.

Damages The claimant must have suffered verifiable damages.

Causation The defendant healthcare provider’s negligence caused the claimant’s damages.

All elements must be proven by a preponderance of evidence (greater than 50 percent) in determining that medical malpractice occurred.

Promptly contact a NORCAL claims representative if you receive formal notification of a claim, or if an incident occurs that could potentially lead to a claim.