Claims

• We specialize in emergency and acute care coverages and deliver the best focused defense for all our insureds.
• Of all claims against our insureds, approximately 93% close without payment of indemnification to the plaintiff.
• Our track record, coupled with our commitment to our insureds, can give you the peace of mind you need as a practicing emergency or acute care physician or healthcare provider.

If you are a current Mutual insured facing a potential or actual claim, please contact the Claims Department.

We encourage our insureds to report any medical incident or occurrence they believe could result in a claim. Examples of such situations include:

• A patient or family expressing dissatisfaction with care
• Verbal indication that a patient may seek compensation or pursue legal action
• An unexpected adverse complication or outcome
• A request for the patient’s medical record
• Communication from hospital representatives regarding a patient complaint

In summary, please report any incident involving medical care about which you are uncomfortable or which you suspect may result in a future claim.

All claims need to be reported to The Mutual.  Claims include the following types of written notice, received from an attorney, patient or other claimant:

• Notice of Intent to file suit
• Written demand for compensation
• Complaint or other legal document initiating a lawsuit or pre-suit proceeding

All claims must be reported to The Mutual in writing. Failure to timely report a claim may jeopardize your coverage. Although we encourage you to call us to discuss any claim or potential claim, The Mutual only considers the claim to have been made for purposes of securing coverage under your policy when written notice is received via regular mail or email with the following information:

• Date, time and place of your treatment
• Facts and circumstances of your treatment
• Claimant’s name and patient’s name, age, and DOB/MRN (if available)

Please contact the Claims Department to report a claim.

If you have been served with a Summons & Complaint or other documentation indicating that a lawsuit has been initiated against you, either by mail or by process server, please contact The Mutual immediately with information concerning the lawsuit. This includes Small Claims Court suits. If you receive a Summons, please do not sign the form as requested; rather, contact the Claims Department for advice. Also, if you are uncertain regarding the nature of legal documents you receive, or what to report, please contact us and we will advise. 

The Mutual provides coverage for representation for disciplinary actions and administrative investigations, assuming the circumstances of the action or investigation meet the criteria for coverage under your insurance policy. Regardless of the circumstances, please report any and all actions or investigations to The Mutual without delay. Examples include, but are not limited to, the following types of matters:

• State Medical Board
• Medical Executive Committee
• Regulatory
• HIPAA
• Peer review

If you receive a subpoena or other notice or request to appear at a deposition, trial or other proceeding, please contact The Mutual to report this notice. In the event that the underlying case involves medical professional liability, depending on the circumstances and your particular involvement, The Mutual may provide an attorney to assist you.

The team at The Mutual fully understands the stresses which invariably go along with being named in a lawsuit, or even being concerned about a prospective claim.  We remain ready at all times to confer and to provide support and guidance.