Medmal claims are legal actions against medical professionals, such as doctors, nurses, and hospitals, for providing care that falls below the accepted standard of practice in the medical community, resulting in injury or harm to a patient. These claims can be brought by patients or their families, resulting in civil and criminal penalties for the medical professional or facility. The types of medical malpractice claims include misdiagnosis, surgical errors, failure to diagnose, birth injuries, and many others. The main goal of medical malpractice claims is to hold medical professionals accountable for their actions and compensate patients for any harm or injury they may have suffered due to that care.
Criminal penalties for medical professionals can include fines and imprisonment. Examples of prohibited conduct that can lead to penalties include:
Health care fraud: billing for services or procedures that were not provided or misrepresenting the nature or cost of services offered.
Prescription drug offenses: illegally prescribing or distributing controlled substances or diverting drugs for personal use or sale.
Assault or battery: physically harming a patient through negligence or intent.
Manslaughter or murder: causing a patient's death through negligence or intent.
False statements: providing false information on a license application or in other official documents.
Insurance fraud: submitting false claims or information to insurance companies in order to collect fraudulent payments.
Obstruction of justice: tampering with evidence or obstructing an investigation into illegal conduct.
Diversion of controlled substances: illegally obtaining or providing controlled substances to others.
Insurance companies handle medical malpractice claims by first determining if the policyholder (the medical professional or facility) has coverage for the type of incident that is being reported. If the policyholder does have coverage, the insurance company will investigate the claim to determine if the policyholder is liable for the alleged malpractice. If the policyholder is found responsible, the insurance company will pay out any damages awarded due to the claim up to the policy limit. If the policyholder is not found liable, the claim will be denied, and no payment will be made. At SelectFirst Insurance, we would love to be one to help you with your medical malpractice claims. Connect with us to help evaluate these exposures and ensure that you have the proper protection and coverage in place. Get your FREE quote today!