The long life (and low payment) of a Medical Malpractice Lawsuit.

According to John Gever, Editor of MedPage Today, plaintiffs just aren’t winning that many lawsuits against physicians.

It is widely reported amongst the main medical malpractice insurance companies in the country that most  Malpractice Cases settle in favor of the physician. In fact, only 4.5 % of the claims foiled ever to a jury verdict.

And, of the claims that do go to a jury, the great majority (approximately 80 % ) settle in favor of the physician, MedPage analyzed more than 10,000 closed claims from around the United States and proved that over 50 % of the claims filed in court settled, most in favor of the physicians, early dismissals or nominal expenses paid.

Most malpractice cases do drag on however,  they just don’t ‘go away’ and, if you are with a company that is quoting you inexpensive premiums to attract your business, downplaying the importance of the complicated and detailed process of paying claims, stop, read, ask questions and pay attention.

There is a reason state and federal regulatory bodies require that companies reserve for future claims.  A quick digression:  Reserves are important to discuss and understand:

Claims Reserves
Under a claims-made policy, claims reserves are funds set aside to satisfy those claims that have been reported to the company but have not yet been resolved or paid. Under an occurrence policy, an additional reserve must be set aside for incidents that occurred but were not formally reported during the policy year and are expected to be reported after the close of the policy year. A company that underestimates its claims reserves may face future financial difficulties.

Back to the reason to carefully consider reserves:  the process takes more than one year.. be very very concerned about one year promises of low cost solutions:

Claims won by the physician took 39 months before a verdict; those the plaintiff won took 43.5 months. That is close to 4 years.  The question should most certainly be; Do you  have enough in reserves (some Trusts boldly just do not reserve for future claims, hoping, hoping that they recruit enough new business to pay for the old claims.  Essentially these companies have unfunded liabilities.

"While most claims were ultimately decided in a physician's favor, that resolution came only after months or years," Jena and colleagues wrote.

The researchers studied claims from 2002 to 2005, that involved claims closed with some payment in eight specialties:

  • Internal medicine and subspecialties
  • Anesthesiology
  • General surgery and subspecialties
  • Diagnostic radiology
  • Ob/gyn
  • Pediatrics
  • Pathology
  • Other

The statistics were consistent, close to 50 % did not progress to litigation.  The highest rates of dismissal, over 55 % involved the specialties of Ane and Internal Med.  Somewhat surprisingly, Pathologists went to trial almost twice as much as the other specialties and a lower percentage settled without a verdict/payment.  As we move into the summer, the industry is concerned and somewhat buoyed by the leveling of the number of lawsuits, and, still there is some reason for concern:  The substantial portion of litigated claims and the length of time required to resolve litigated claims are an important source of concern to physicians.

 

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