What Is the Role of Insurance Coverage in Medical Malpractice Cases?

What Is the Role of Insurance Coverage in Medical Malpractice Cases?

Doctors, nurses, and other medical providers make serious mistakes with sometimes devastating and deadly consequences. However, between your medical injuries and the highly complicated nature of medical malpractice and negligence claims, you cannot navigate the legalities on your own.

If you or a person you love suffered an illness, injury, or other medical complication due to a medical provider’s carelessness or negligence, you may recover monetary compensation from the at-fault provider’s insurance company. Doctors and other medical providers must carry malpractice insurance at all times. If they make a mistake that leads to medical complications for a patient, you can recover compensation from their malpractice coverage.

Victims of medical negligence and malpractice have a limited time to file a claim or lawsuit against a negligent healthcare provider. Therefore, take legal action in your case right away. Once a medical malpractice lawyer enters an appearance for you, they can start advocating for your legal interests and pursuing the total monetary damages you deserve to recover in your case.

An experienced and compassionate Bronx medical malpractice lawyer in your area can handle all communications and negotiations with the at-fault medical provider’s insurance company and recover fair monetary compensation for you.

Medical Providers Who You Can Sue for Malpractice

Medical providers owe their patients a very high legal duty of care. When they violate that legal standard and a medical complication results, an injured patient can sue that provider for medical malpractice. After filing a claim or lawsuit against the negligent provider, the provider’s insurance coverage should come into play.

Several categories of medical providers may be subject to a medical malpractice claim or lawsuit.

Those providers include:

  • Medical doctors, including medical specialists
  • Mental health care providers
  • Physical therapists
  • Nurses

If you believe that you are the victim of medical negligence or malpractice at the hands of one of these healthcare providers, take legal action right away. A medical malpractice attorney can determine your eligibility for filing a medical malpractice claim against a healthcare provider.

If you can move forward with a legal claim, your attorney can assist you with every step of the claims filing or litigation process and help you achieve the best possible result in your case.

Statute of Limitations for Medical Malpractice Claims and Lawsuits

Victims of medical negligence and malpractice have a very limited amount of time to file a claim or lawsuit against a medical provider. For example, in New York, an injured patient must generally bring their malpractice claim within 2.5 years of the malpractice. The state statute of limitations for medical malpractice cases imposes this relatively short deadline.

Absent exceptional circumstances, if you fail to file your lawsuit within the prescribed amount of time, the courts will prevent you from recovering any monetary damages for your medical complications. In fact, if you file a lawsuit after the deadline has already expired, the court will dismiss your lawsuit right away, blocking your right to legal recovery.

The main purposes of a medical malpractice statute of limitations include maintaining credible evidence in the case and ensuring that witnesses remain available to testify in the case should the matter proceed to a civil jury trial. The more time that passes, the harder it may be for your attorney to obtain crucial evidence that can establish your legal burden of proof.

Moreover, in New York, the statute of limitations time clock does not start running until you actually discovered or reasonably should have discovered your adverse medical complication resulting from a healthcare provider’s malpractice or negligence.

An experienced medical malpractice attorney can help you file your claim or lawsuit well within the applicable statute of limitations. Your attorney can then get the negligent medical provider’s insurance company involved and begin negotiating favorable settlement compensation on your behalf.

In any claim or lawsuit for medical malpractice, the injured patient has the sole legal burden of proof in the case. The patient is responsible for demonstrating that a licensed medical provider committed an error or omission, breach of contract, act of negligence, or act of misconduct while rendering a health-related service.

Negligent medical providers can include primary care physicians (PCPs), nurses, medical specialists, anesthesiologists, and physical therapists. In addition to these individuals, a lawyer can hold whole medical facilities responsible for malpractice or negligence, including hospitals, free clinics, hospice care centers, and assisted living facilities.

If you bring a medical malpractice claim or lawsuit against a medical provider, you must establish several legal elements to recover monetary compensation through settlement or litigation.

First, you must demonstrate, through medical evidence, that a medical provider (or an entire medical facility) failed to act as a hypothetical reasonable and prudent healthcare provider under the circumstances. In other words, the provider must have acted unreasonably under the circumstances or deviated from the conventional degree of learning, skill, and care that a reasonable provider should typically exercise.

In addition to legally demonstrating that a medical provider deviated from the standard of care, the injured patient must show that this deviation was the actual and the foreseeable clause of the patient’s adverse medical complication, illness, or injury.

A patient who can establish these two legal elements can recover various types of monetary compensation and damages in their medical malpractice case. A medical malpractice attorney can help you establish the required illegal burden of proving your claim or lawsuit and pursue the maximum amount of monetary recovery possible.

The Importance of Expert Testimony in a Medical Malpractice Case

In every medical malpractice claim or lawsuit, expert testimony is extremely important. An expert in a medical malpractice case is typically a healthcare provider who practices in the same area as the at-fault medical provider.

For a patient to satisfy their legal burden of proof, the case expert must show that the at-fault provider failed to act reasonably under the circumstances – or that they failed to exercise the required degree of skill or knowledge that other medical providers in their field had.

The injured patient must also demonstrate that as a direct result of the medical provider’s negligence, they suffered one or more medical complications. In other words, had it not been for the medical provider’s negligence, those medical complications should not have otherwise occurred.

Experts are also an essential part of the process when a patient files their initial medical malpractice complaint in the court system.

At the same time they file their initial complaint – or within 90 days after that – the patient must submit a certificate that states:

  • That a medical malpractice attorney has reviewed the case facts
  • That the attorney has spoken with at least one medical expert
  • That the medical expert, based on their consultation and review, has determined that the patient’s medical malpractice claim has some merit – and that it is worthy of adjudication in the court system

For an individual to be qualified to testify as an expert in a medical malpractice case, they must hold a medical license and have relevant experience. Your attorney should have a network of medical professionals who can serve as experts in malpractice cases.

Potential Monetary Damages in Medical Malpractice Claims and Lawsuits

Victims of medical negligence can recover various types of monetary compensation and damages in their malpractice cases. The total damages an injured patient can recover will depend on the nature and extent of their medical complications, the scope of the medical provider’s negligence, and the need for additional medical procedures or treatment to correct the medical provider’s mistake.

First, a victim of medical malpractice may be eligible to recover various compensatory damages in their case. The main purpose of compensatory damages is to put an injured patient back into the position they would have been in had the malpractice incident never occurred in the first place.

Medical malpractice victims may recover compensation for their prescription fees, medical bills, physical therapy costs, nursing costs, and lost income stemming from their inability to work following the incident of malpractice.

In addition to these compensatory or economic damages, medical malpractice victims may be eligible to recover various non-economic damages to compensate them for various intangible losses.

These non-economic damages may compensate malpractice victims for all of their:

  • Anticipated medical costs
  • Future lost earnings
  • Loss of life enjoyment
  • Pain and suffering
  • Loss of spousal companionship and consortium

Finally, an injured patient may recover punitive damages in medical malpractice claims and lawsuits. Punitive damages punish a medical provider who acted in a particularly dishonest, egregious, or reckless manner. Punitive damages also discourage other medical providers from behaving similarly.

The right medical malpractice attorney can determine your eligibility for recovering these various damages. Your lawyer can then help you file a medical negligence claim or, if necessary, file a lawsuit in the court system to pursue the full monetary recovery you deserve for your medical complications.

Filing a Claim or Lawsuit for Medical Malpractice

Victims of medical negligence or malpractice can pursue a claim or lawsuit against a medical provider or their insurance company. A knowledgeable medical malpractice lawyer can assist you with the claims-filing process and help you submit the necessary documents to the insurance company.

Important documents in a medical malpractice case usually include medical treatment records and notes from the at-fault medical provider. If the medical provider's insurance company ultimately admits fault, your attorney can begin negotiating a fair settlement offer on your behalf.

In medical malpractice claims and lawsuits, insurance companies are notoriously difficult. These insurance companies want to try and save themselves as much money as possible by paying out the smallest amount of monetary compensation necessary to resolve your claim. However, a seasoned medical malpractice attorney can aggressively negotiate with the insurance company on your behalf and work to maximize your monetary settlement.

If the insurance company does not offer you the full and fair damages that you deserve to recover, your lawyer can threaten them with courtroom litigation. Moreover, your attorney can explain your legal options and help you decide on the best course of action for your medical malpractice case.

If you must litigate your case through the court system, your attorney can help you with every stage of the process. After filing a lawsuit, the defense attorney representing the medical provider will file a formal Answer. The parties will then engage in a process known as discovery, during which time they find out more information about each other's cases.

For example, the parties will typically answer written questions, called Interrogatories, and the defense lawyer may note the injured patient's discovery deposition.

At a deposition, the lawyer will usually ask questions about the patient's medical treatment and their pre-existing medical conditions, if any. Following deposition, the insurance company adjuster may increase their settlement offer. Sometimes, the matter may need a civil jury trial for a resolution. At a jury trial, the jury will decide the outcome of all then-disputed issues.

In New York, the parties can take their medical malpractice case to an arbitration proceeding. Arbitration is a type of alternative dispute resolution (ADR). During this proceeding, a neutral arbitrator will listen to the evidence that the parties present and decide the issue of damages.

Your attorney can help you determine whether you should accept a pending settlement offer from the insurance company or litigate your medical malpractice case to a conclusion in the court system.

Consult a Skilled Medical Malpractice Lawyer Near You Today

Ivan Diamond, Medical Malpractice Attorney near Bronx, NY area
Ivan Diamond, Medical Malpractice Lawyer in Bronx

If you believe that you may be the victim of medical negligence, time is of the essence in your case. A personal injury law firm in Bronx can take prompt legal action on your behalf, involve the necessary experts, file a lawsuit against the offending healthcare provider, and pursue the maximum monetary compensation you deserve to recover for your resulting medical complications.

Why Hire an Experienced
Attorney Like Ivan Diamond

If you want to recover the maximum compensation that you deserve, you need an experienced personal injury attorney like Ivan Diamond on your side.

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If you want to recover the maximum compensation that you deserve, you need an experienced personal injury attorney like Ivan Diamond on your side.

Someone who understands the tactics insurance companies and opposing lawyers sometimes use to avoid liability and paying settlements.

Insurance adjusters, in particular, know that you’re going through a difficult time. They may try to take advantage by offering you a lowball settlement, hoping you’ll jump at quick money before you talk to a lawyer. Don’t help them out. Instead, let an experienced attorney handle the negotiations.

The same goes for preparing your claim. A skilled, knowledgeable litigator like me understands what facts and arguments are most important to prove your claim to a judge and jury, if it comes to taking a case to trial. I know how to guide my clients through depositions, discovery, and efforts by opposing lawyers to trap them into saying things that might undermine their case.

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