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When to Report a Claim

Formal Notification
Depending on the state in which you live, there are several ways in which you could be notified of a medical malpractice claim or lawsuit.

Promptly contact a NORCAL Mutual claims representative if you receive any of the following:

California

» Summons and Complaint
» 90-day Notice
» Subpoena, request for records or request for deposition
» Demand Letter
» Communication from and Local, State or Federal Licensing Board, or privileging body

New Mexico

» Summons and Complaint
» Notice of Intent to Sue
» Subpoena, request for records or request for deposition
» Demand Letter
» Communication from and Local, State or Federal Licensing Board, or privileging body

Arizona

» Summons and Complaint
» Notice of Intent to Sue
» Subpoena, request for records or request for deposition
» Demand Letter
» Communication from and Local, State or Federal Licensing Board, or privileging body



Early Reporting of Incidents
There are several key indicators that can signal future legal action because of a procedural complication or patient dissatisfaction.

Early reporting of potential claims, or "incidents," can make all the difference in NORCAL Mutual’s ability to evaluate and defend actions initiated against you. NORCAL Mutual features a "good faith" early reporting policy, so there will be no adverse impact on the insurability of your practice.

Promptly contact a NORCAL Mutual claims representative if you experience any of the following:

Complication
Any unanticipated bad result that you believe could precipitate a malpractice claim.

Dissatisfaction
A direct or indirect expression of displeasure by either a patient or a patient’s family member about the care rendered.

Notification of Patient Complaint
Any written or verbal notice from your local medical society or other organization concerning a patient report or complaint about your treatment.

Request for Medical Records
A written or verbal request by a patient’s attorney, copy service or the patient, even on an "informal" basis. Any request to release records must be accompanied by a valid written Authorization, signed by the patient or legal custodian.

Medical-Legal Situation
Any situation in which a potential claim could be avoided with your appropriate action or response.

Physicians Administrative Defense (PAD) Reimbursement Coverage
Promptly contact a NORCAL Mutual claims representative if you receive any of the following:

  • Written notice of an administrative proceeding involving credentialing, privileges, managed care, licensure or other state or federal reviews.
  • Written receipt of notification of an employment-related civil action.

Read highlights of our Physicians Administrative Defense Coverage in the Coverages section.

The Claims Process:

» When to Report     » The Claims Team     » Discovery     » Evaluation and Resolution     » The Trial

Disclaimer: The information presented here is not intended to replace case-specific advice from either your legal counsel or NORCAL Mutual Insurance Company.