REPORTING
A CLAIM
The
Claims Department is primarily responsible
for accepting reports of claims made against insureds and
investigating those claims.
The
Claims staff works very closely with defense counsel to determine
the best strategy for each case.
Insureds
should call the Claims Department (Ext. 218) to report the
following types of claims:
The
caller must have available the legal papers, if any, and the
medical and billing records of the patient.
ONLY
WRITTEN NOTICE TRIGGERS COVERAGE UNDER THE POLICY.
| 1. |
Suits/Subpoenas |
| |
The
service of any legal papers in a medical malpractice
action requires prompt notice to the Claims Department
in order to properly protect your interests. A Summons
is served to initiate the commencement of an action
(lawsuit). A Subpoena issued by a Court requiring
a witness to produce records or requiring testimony
in a medical malpractice action.
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| 2. |
Letters
of Claim |
| |
Oftentimes
a patient or their representative will make a written
claim, excluding a SUIT for monetary damages. This type
of ASSERTED CLAIM is treated similarly to a lawsuit.
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| 3. |
Administrative
Actions |
| |
As
of 12/11/98, PRI provides defense coverage for a physician
who receives an investigatory letter from a State licensing
agency, i.e., Office of Professional Medical Conduct.
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| 4. |
Potential
Incidents, Adverse Outcomes, and Related Record Requests |
| |
PRI
encourages the reporting of an incident that may give
rise to a future medical malpractice lawsuit such as
an adverse outcome in treatment or the request for the
records by an attorney.This is particularly favorable
to insureds with Claims-Made Policies.If you would like
to report a potential medical malpractice incident,
you may complete and sign the "Incident Reporting Form"
— IRF.
If
you have received a request for your records, kindly
include a copy of your medical and billing records together
with the "Incident Reporting Form" and forward it directly
to the Claims Department, Physicians' Reciprocal Insurers,
111 East Shore Road, Manhasset, NY 11030 or fax to (516)
365-5342 or (516) 365-5714.
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