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7 stages of the clinical negligence claims process

29 July 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.

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's 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.

Remember that a claim can be brought up to three years after an incident, sometimes even longer.

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.

Stage 3: Request for records

This request is typically made by an attorney but can also come from the patient themselves or a representative. If you receive a request for patient records it usually signals an intention to investigate. Most never become claims but we work to try to prevent things escalating so it's important to notify us right away.

Stage 4: Disclosure of records

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

Stage 5: Letter of demand or summons

In South Africa, you are much more likely to receive a summons (the initial court document) from a patient. On receiving a summons, you must contact us immediately as there are strict deadlines involved and we can then deal with it 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.  In this case, you must respond in the same way as a summons – contact us immediately.

Stage 6: Our investigations

We get to work on your behalf. We're meticulous in investigating the claim. Together with panel attorneys acting on your behalf, we will seek details of the allegations being made from the patient’s attorneys, 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. 1. Claim defended and closedThe claim against you ends.
  2. 2. Agree to settle the claimThe claim against you ends and we take care of the compensation and legal costs.
  3. 3. Claim defended and pursuedEven 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's why our expert team do everything they can to guide you through the process.

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.