FAQ: Claims

How do I report a claim?

The insured or a member of your office staff should telephone the Claim Department at 800 445-1212. We ask that claims and/or incidents be reported to PMSLIC by telephone to allow the claim staff an opportunity to obtain additional information and to ensure timely receipt of your report of a claim.

What type of information should be reported to PMSLIC?

So that we may best protect your interests, it is essential that the Claim Department be notified immediately in the event of any of the following:

  • You receive a Writ of Summons or a Complaint or other document indicating that you have been sued.
  • You receive a claim letter from a patient or a patient's attorney.
  • You become aware of an incident that may potentially result in a medical malpractice claim in the future.

Timely reporting is crucial to protecting your legal rights.

Physicians and/or their office staffs are encouraged to contact us with questions or concerns regarding the reporting of an incident or claim.

Do I need to notify an attorney?

No. Upon receiving notice from you, PMSLIC will assign defense counsel to represent your interests in a covered claim.

Can I Select My Own Attorney?

PMSLIC will assign the defense of your case to an approved attorney with experience in medical malpractice litigation. You will be provided an opportunity to discuss selection of your defense counsel with PMSLIC's claim staff when you report your claim.

You have the right to retain counsel to represent your personal interests at any time throughout the litigation process at your own expense. Both PMSLIC and defense counsel will cooperate fully with your personal counsel in representing your interests.

What is involved in the claim and litigation process?

Documents filed with the court are known as pleadings. A Writ of Summons or a Complaint is an initial pleading. A Writ of Summons is usually a one-page document notifying you of a lawsuit. A Complaint provides more detail and generally sets forth the factual background of the claim and the allegations of negligence as to the care provided. Either document may serve as notification that you are being sued.

Under current Pennsylvania law, a "Certificate of Merit" must be filed within 60 days of the filing of the Complaint. The Certificate of Merit is a verification that the plaintiff's attorney has had the case reviewed by the appropriate licensed professional who has determined that a potentially valid malpractice claim exists. If a Certificate of Merit is not filed in a timely manner, the case could be dismissed.

When a suit is filed, PMSLIC will assign defense counsel to represent your interests in the case. One of the first actions taken in the litigation process is to prepare a response to the initial pleadings. Your defense counsel will request your assistance and input in preparing a response.

After the Complaint has been answered, the discovery process begins. The purpose of discovery is to permit both sides to proceed to trial with full knowledge of the facts of the case and to provide a level playing field for all parties named in the Complaint.

The discovery process is conducted utilizing a number of tools. Generally, the primary tools are interrogatories, requests for production of documents, requests for admissions, depositions, independent medical examinations and the exchange of expert reports.

After the discovery process is complete, the case is then ready for disposition, either by way of settlement, dismissal or trial.

What type of support will PMSLIC provide during the litigation process?

  • Experienced medical malpractice claim representative to handle your case.
  • Your defense counsel and PMSLIC claim representative are available to you by phone or e-mail.
  • The claim representative managing your case will schedule a meeting with you upon receiving notice of your claim.
  • Additional meetings may be scheduled at other pertinent times during the litigation process, for example, at the time of deposition or prior to trial.
  • We will mail you a litigation support package within a few days after we receive notice of your claim. Your PMSLIC claim representative and defense counsel will review the contents of the package with you at the initial meeting.
  • PMSLIC offers confidential counseling service to insureds to help them deal with the stress of litigation. Information regarding the service is included in the litigation support package.
  • Your PMSLIC claim representative will provide frequent written updates on the current status of your case and will be available to answer your questions/concerns via telephone and/or e-mail.
  • In the event your case proceeds to trial, your claim representative will be in attendance to provide support and answer questions.
  • PMSLIC also offers phone and/or face-to-face contact with its physician board members, if desired.

What if I want to defend a case and PMSLIC wants to settle?

It's important to understand that PMSLIC will not undertake any negotiations to settle on your behalf without your written consent.

How can I obtain a claim history?

Written authorization dated within one year is required by you in order to release claim history information. If you are currently insured with PMSLIC you may request that a claim history be released directly to you. The information is provided at no cost. PMSLIC also provides claim histories to previous insureds or third parties (hospitals, managed care entities, etc.) for a processing fee of $20. Sorry, we cannot accept credit cards. Payment should be made by check payable to PMSLIC. Please contact the Claim Department for assistance.

More information.

When is PMSLIC required to report to the National Practitioner Data Bank (NPDB)?

If there is a written request for compensation and a settlement or judgment is paid by PMSLIC on your behalf, we are required by federal law to make a report to the NPDB within 30 days of payment.

Additional information on the NPDB is available online below.

http://www.npdb-hipdb.hrsa.gov/

For Policyholders
For More Information
Medical Liability Reform
Certificate of Insurance
For Defense Counsel
Loss Prevention Discount Program