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7 stages of the clinical negligence claims process

12 November 2020

Receiving a clinical negligence claim can be a stressful experience. If it happens to you, having the right support can make things a lot less daunting.

As a Medical Protection member, we can provide you with expertise and reassurance as we manage your case at every step. We will assign a dedicated medicolegal consultant and claims manager to your case who will be with you every step of the way through this process.

This article will take you through how the claims process usually works and how we can be there for you. Not every claim follows the same process, but in most claims you can expect to go through the following stages.

Stage 1: Incident

It is vital you make us aware of an incident as soon as it occurs, as we may be able to prevent it from escalating to a claim.

Depending on the Jurisdiction a claim can be brought between three to six years after an incident, however this can be even longer in certain circumstances.

Step 2: Complaint made

Often, a complaint will be made before you receive a claim. This can be a verbal or written complaint. A claim can even come from a complaint that you thought was already resolved. Medical Protection has close relationships with several law firms in the Caribbean and Bermuda, who have experience and expertise in medicolegal matters, and with whom we have worked over several years. Our team will instruct one of these panel law firms and together we will assist in preparing the response to the complaint and attempt to prevent the matter escalating.

In some circumstances the patient will make a complaint to the Medical Council of the Jurisdiction. If this occurs, we will work with the solicitors to assist and represent you during the investigation.

Stage 3: Request for records and/or a medical report

This request is typically made by a solicitor but can also come from the patient themselves or a representative. If you receive a request for patient records and/or a medical report it usually signals an intention to investigate a potential claim. Most never become claims but we work to try to prevent things escalating so it is important to notify us immediately. We will instruct solicitors to assist you with communication with the patient or their representatives and in preparing the medical report.

Stage 4: Disclosure of records and/or a medical report

At this stage there are two possible outcomes: no further action or a claim being made

Stage 5: Letter of demand/claim or claim form/summons

A claim form/summons is a legal document that commences civil proceedings against you. On receiving a claim form/summons, you must contact us immediately as there are strict deadlines involved. We will instruct solicitors to represent you during the proceedings and deal with the necessary deadlines on your behalf.

The more information you can provide the quicker we can respond.

A patient may intimate a claim to you by way of a letter of demand or letter of claim.  This is a formal letter that contains allegations of negligence against you. In this case, you must respond in the same way as a claim form/summons and contact us immediately. Follow the guidance on how to report a claim

Stage 6: Our investigations

We get to work on your behalf. We are meticulous in investigating the claim. Together with solicitors acting on your behalf, we will seek details of the allegations being made from the patient’s solicitor, and any further clinical records required, to allow us to fully understand and investigate the claim.

Stage 7: We prepare a response

If required, we seek expert opinion on the allegations made and prepare a response that either defends the claim or makes a settlement offer to the patient.

We ensure you are fully involved in this process and agree with the response being sent.

Our response to the allegations can lead to one of three outcomes:

1. Claim defended and closed - The claim against you ends.

 2. Agree to settle the claim - The claim against you ends and we take care of the compensation and legal costs.

3. Claim defended and pursued - Even at this stage most claims can be resolved without a court hearing.

We are here to support you through this process and we never stop working to find a solution

Practise with confidence

We know that being the subject of a claim can be distressing. That is why our expert team do everything they can to guide you through the process and will have input into every decision that is made. Both your medicolegal consultant and claims manager are experienced practitioners in medical negligence Law

Our primary concern at every step is to secure the best possible outcome for you, so you can get back to doing what you do best.