How will my claim be handled?
All claims on your MedChoice insurance policy will be handled and serviced through Experix LLC in coordination with Nevada Docs Care, LLC. Experix is a wholly-owned subsidiary of Physicians Insurance and has a proven track record of successfully defending physicians and their practices.
There are a few important things to know about how Experix and Nevada Docs approaches claims:
- Every claim is unique and will develop in its own way.
- Your claim will be managed by professional and experienced staff.
- Experix and Nevada Docs will select attorneys who specialize in medical malpractice defense.
- Nevada Docs takes pride in our work and ability to serve the needs of our members.
- As a member, you are always the decision-maker on whether or not to settle your claim.
- The following stories highlight how the Physicians Insurance team provides claims administration for Experix and MedChoice.
What is a claim?
A claim is a demand for monetary compensation by a patient or the patient’s attorney to the physician or the liability carrier.
What is a potential claim?
A potential claim is an incident that may culminate in a demand for compensation.
What is a lawsuit?
A lawsuit is formal litigation within the judicial system.
Should I report claims, potential claims, and lawsuits to Nevada Docs?
Yes. In fact, your insurance policy with MedChoice requires that you report to us all actual claims, potential claims, and lawsuits. Early notification to MedChoice aids in their early evaluation, which will improve your chances of a successful defense. MedChoice’s investigation affords them the opportunity to collect and record facts before time fades memories or witnesses disappear. In appropriate instances where settlement is warranted, MedChoice may be able to negotiate an early settlement with the patient before the filing of a lawsuit.
Can I discuss a malpractice incident, claim, or lawsuit with the patient, my colleagues, or my staff?
Talk to your claims representative or your counsel before you speak to anyone. In general, you should not discuss any malpractice incident, claim, or lawsuit with the patient or the patient’s attorney. This is important, because you do not want to prejudice your position in the matter. Also, do not discuss the patient with any of your colleagues except in the context of protected Quality Assurance programs. You can, and should, communicate as needed with any current treating physician regarding the continuing medical treatment of the patient. We advise you not to discuss the details of the patient’s care with your office staff, or anyone in your administration, because conversations with them may not be considered privileged. However, we have found it helpful to your defense if your staff is aware of the existence of an incident, claim, or lawsuit. You should advise your staff not to release records or information on that patient to anyone without your knowledge and permission.
With whom can I discuss a malpractice incident, claim, or lawsuit?
You can discuss your case at any time with your claims representative or defense counsel because of the privileged nature of these conversations. Conversations with your spouse, clergy, or counselor are also privileged. Conversations with anyone else may be discoverable. A plaintiff attorney might ask you to name everyone with whom you have had discussions regarding the case, and could subpoena those people for deposition. Therefore, we strongly advise you to limit your communications regarding the case to only those people who are privileged to discuss the case with you.
Does my policy provide assistance to me if the state disciplinary agency investigates an aspect of my patient care?
Yes. Subject to certain exclusions, your MedChoice policy provides reimbursement of legal expenses you incur arising out of an investigation by the state medical or osteopathic disciplinary agency. The investigation must arise from a medical incident involving direct patient treatment after your retroactive date. You must notify MedChoice within 30 days of your receipt of a notice of investigation by the state agency in order to obtain this coverage. There is a limit of $50,000 per year, no matter how many investigations there may be.