Insurance in Medical Malpractice Cases

insurance medical malpractice

Insurance in Medical Malpractice Cases

A patient goes to a doctor for a checkup. The doctor tells the patient that he or she needs a certain medical procedure. The doctor counsels the patient and provides various reading material about the procedure. The patient decides to undergo the procedure and signs numerous waivers stating that he or she understands the nature of the procedure and the risk involved. Shortly after the completion of the procedure, the patient feels that something is wrong. The patient speaks to a medical malpractice lawyer who files a suit against the doctor and the doctor’s insurance company; claiming negligence. In addition, the patient obtains an affidavit from another medical professional who states that the procedure was performed incorrectly and is the cause of the patient’s current problems. As the case moves into the discovery stage and eventually into trial, the doctor generally has little involvement in the case. Instead, the doctor’s insurance company becomes the primary entity calling the shots. The attorney hired by the doctor’s malpractice insurance company handles the case. This is due to the relationship between the doctor and the insurance company.

Independent Observations

For medical malpractice suits that involve insurance companies, it is imperative to perform independent research. Often, insurance companies claim that there is no cause of action. It supports this claim by hiring other medical professionals to say that the doctor did nothing wrong.  This is sometimes persuasive to a jury even though the hired doctor is being paid to give his or her testimony.  Therefore, it is best to independently evaluate the merits of a case.

Settlement Decisions

Under the Georgia rules of Professional Responsibility, the client makes the decision whether to settle or continue court action. While the lawyer can advise the client regarding what the lawyer believes is the best path for the client, it is ultimately a client decision. During a medical malpractice suit, the party making the decision to settle or continue court action is usually the insurance company. However, some malpractice policies allow the doctor discretion to reject a settlement even if his insurer and attorney recommend otherwise. Note that the relationship between the doctor and insurance company has a significant impact as to how the parties handle settlements. Insurance contracts between doctors and insurance companies usually have a cap. That is, there is a dollar limit that an insurance company is obliged to pay. The insurance company has no more liability beyond that dollar amount unless it acts in bad faith by refusing to settle and protect the doctor (its insured) from an excess judgement. For instance, the contract states that the insurance company is only liable up until $2 million per lawsuit. If the patient offers to settle the case for $2 million, the insurance company may reject that offer because it would not have the incentive to settle (i.e. that is the most it could lose in most scenarios). If the case goes to trial and the jury awards the patient more than $2 million, the insurance company would only be liable for $2 million. If the jury awards less, the insurance company would pay less to the patient. As such, when negotiating with an insurance company in a medical malpractice case, it is important to understand the contractual nuances governing the agreement between the doctor and the insurance company. The patient can determine this information by gaining access to the contract during the discovery phase of a medical malpractice lawsuit.

Contact Williams Elleby Howard & Easter if you are a Victim of Medical Malpractice

If you are a victim of medical malpractice, contact the personal injury attorney Marc Howard, a Georgia lawyer who fights for injury victims. If you have questions or would like to discuss your case, please call our office today at 833-LEGALGA for a free consultation.

How to Find Complaints Against a Medical Professional (Avoiding Medical Malpractice)

Ga Trial Attorney for Medical Malpractice Wrongful Death Case

How to Find Complaints Against a Medical Professional (Avoiding Medical Malpractice)

Daytime television is full of commercials telling people who suffer from injuries how they can sue the party who injured them. These commercials feature law firms that claim to specialize in personal injury and medical malpractice. The message is that the injured person deserves to be compensated and the lawyer will stop at nothing to obtain just compensation.  These mega advertising firms rarely disclose the astronomical number of cases they handle thereby giving an unsuspecting caller the impression that their case will receive specialized attention.

Each case is different and needs careful evaluation to determine the best way of maximizing the recovery.  While a lawsuit is an option, it is not the only option. A patient injured due to medical malpractice can use alternative methods to obtain fair compensation. Often, alternative methods are the best options.

Here, we discuss the following alternatives to medical malpractice suits:

  1. Alternative dispute resolution
  2. Filing an insurance claim
  3. Direct settlement

Alternative Dispute Resolution

Alternative Dispute Resolution, or ADR, is a process wherein the parties go to an unattached third party to settle the dispute. One ADR method is through the use of a mediator who is knowledgeable in medical malpractice cases. The mediator will meet with the parties, both separately and together, and attempt to come to a settlement. The mediator will stress how a court will likely rule and explain that settling can avoid costly litigation.

Another common ADR method is binding arbitration. Similar to mediation, there is an unattached third party who is knowledgeable in medical malpractice and its nuances. Because it is binding, the parties contractually agree to the arbitrator’s ruling. It’s less formal and less costly than a trial but produces a final outcome. While a court can overturn an arbitrator’s ruling, courts are very unlikely to do so.

Filing an Insurance Claim

In most cases, the entity calling the shots in a medical malpractice case is the doctor’s insurance company, not the doctor. The doctor’s malpractice insurance usually covers these types of lawsuits, even if the doctor is guilty of negligence. As a result, contacting the insurance company and filing a claim may compel the insurance company to try and settle the case. The insurance company may be willing to cut a deal instead of going to litigation. Although a doctor is unlikely to reveal which insurance company provides medical malpractice coverage, a lawyer who conducts a thorough search would likely discover this information.  Although this approach sometimes works in clear liability cases, it rarely works if the doctor or the insurer has a reasonable defense.

Direct Settlement

Under some circumstances, a doctor may be willing to settle a case instead of referring the case to an insurance company. Under Georgia law, a doctor is required to report all medical malpractice claims against him. The insurance companies have access to these reports. As a result of these reports, doctor malpractice insurance premiums increase. As such, a doctor may prefer that the plaintiff not report the claim and instead settle for a cash amount. This helps the doctor avoid reporting the claim and avoid trial; it provides the injured patient with immediate cash and avoids trial risk.

Similarly, doctor malpractice premiums may carry high deductibles, so doctors may be willing to satisfy smaller patient’s claim in lieu of paying the deductible.

Contact Attorney Joel Williams if you are a Victim of Medical Malpractice

If you are a victim of medical malpractice, contact the personal injury law firm of Joel Williams, a Cobb County, Georgia lawyer who will tailor a plan for you. If you have questions or would like to discuss your case, please call our office today at 833 – LEGALGA for a free consultation.