Medical Malpractice

Responding to legal claims in healthcare: why should you notify your insurer?

Receiving a legal document within the healthcare industry can be anxiety-inducing to say the least. Whether you’re a medical practitioner or a medical facility, it’s important to understand the correct course of action should you be confronted with a lawsuit. Ignoring a summons is not an option, so here’s what you need to do instead:

First inform your insurer

Should you receive a legal document or any communication containing legal demands, your initial step should be to tell your insurer as soon as possible. This action isn’t merely a formality; it’s your lifeline in a legal battle. Most insurance policies mandate immediate notification, for several good reasons:

  1. To secure evidence and witnesses. Upon notification of a summons, your insurer will assign an attorney who will work closely with you to secure physical or documentary evidence related to your claim. For instance, if the issue involves faulty equipment, it should be taken offline and stored securely for future inspection. Promptly seeking the necessary assistance to secure the right evidence can be a game-changer.
  2. To secure witnesses. Your insurer will also need time to gather contact information for witnesses. Some cases can span years and locating witnesses later on may prove challenging, so securing witnesses needs to start as soon as possible. Even if you have a strong case, lacking the evidence or witnesses to support it by the time the matter is heard can result in your case falling short.
  3. To secure expert witnesses. Your case may require expert witnesses who are often in high demand and short supply. Your attorney likely has a network of exceptional experts, but securing their expertise can be challenging due to their availability. Early notification means your attorney can procure the right expert opinion in a timely manner, avoiding unnecessary delays with your case.

Notification before a summons

It’s essential to notify your insurer immediately about any form of legal notification, even before an actual summons. In fact, early assistance before a summons can sometimes prevent one altogether. For instance, receiving a letter of demand prior to a summons can provide you with a strategic advantage in that it allows you to prepare and gather evidence and witnesses more effectively. Plaintiffs often conduct thorough research before issuing a summons, which puts the defence at a disadvantage. However, a letter of demand allows you to initiate preparations before a summons is issued, which levels the playing field.

What happens if you don’t tell your insurer?

Failure to notify your insurer of legal communications can place you at a disadvantage and limit your ability to prepare adequately with the legal assistance your insurer provides. Even worse, ignoring a summons entirely can lead to the worst-case scenario: an automatic default judgment against you. In such a scenario, the plaintiff wins the case and claims the full amount they are seeking, leaving you personally liable. Your insurance will not cover this if you failed to notify them in a timely manner. While it is possible to attempt to overturn a default judgment, it’s a costly process that requires valid reasons for not initially defending the case.

In the realm of healthcare, the lesson is clear: never disregard a summons, and always notify your insurer as swiftly as possible. Neglecting this obligation can leave you vulnerable and at a significant disadvantage. On the other hand, taking a proactive approach can be the deciding factor between your successful defence and a catastrophic legal defeat.

To learn more about summons and how best to manage them as a healthcare practitioner, listen to this interview with specialist attorneys Justin Malherbe and Sandra Sithole.

(Taken from: Summons, Not what the Doctor Ordered)

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