Medical Malpractice and Wrongful Death Characteristics Claim characteristics

Medical Malpractice and Wrongful Death Characteristics Claim characteristics

Insurance payouts: Insurance claim closed with claimant being compensated for losses sustained from malpractice injury. Losses can include economic (lost wages and medical expenses), noneconomic (emotional or pain and suffering), and attorney fees and costs.

Claimant: Party filing medical malpractice claim with insurance carrier seeking compensation for alleged injury committed by the negligent acts or omissions of physician, surgeon, or other health care provider.

Defendant: Physician, surgeon, or other health care provider named by claimant in medical malpractice insurance claim as responsible for the claimant's injury.

Insurance carrier: Company that provides malpractice coverage to physician, surgeon, or other health care provider.

Loss adjustment: The amount insurance companies pay to their legal counsel for investigating and settling insurance claims, including defending a lawsuit in court. In some states loss adjustments have a broader definition and include other administrative costs for processing insurance claim.

State Insurance Commissioner: State insurance regulator responsible for managing the insurance industry and market for a particular state.

Claim disposition

Settled prior to lawsuit filed: Refers to insurance claims that are settled by the parties for specified dollar amounts prior to the claim being filed as a lawsuit in state or federal trial court.

Settled after lawsuit filed: Refers to insurance claims that are settled by the parties for specified dollar amounts after the claim is filed as a lawsuit in state or federal trial court but before the claim reaches a trial decision.

Trial verdict or judgment: Refers to insurance claims that are closed after a jury or judge(bench)trial has reached a verdict or judgment.

Claim processing time

Injury to reporting date: Time period between date health care provider's malpractice act/omission caused injury to the claimant and date claimant files claim with the insurance carrier seeking compensation.

Reporting to closing date: Time period between date health care provider's insurance carrier received medical malpractice claim to the date the health care provider's insurance carrier closed the claim. The closing date can refer to the date the insurance carrier paid out on the policy, the date the claimant abandoned the claim, or the date of administrative closure.