Claims FAQ
The following information contains answers to frequently asked questions related to claims. If you need additional assistance, or your specific question does not appear, please contact us.
After reporting a claim you will be given a list of precautions to follow. It is important that you adhere to these admonitions, as they will help to preserve the integrity of your case. Do not ignore any legal papers you receive pertaining to your lawsuit. Forward all materials to ProAd immediately.
- Do not respond to any legal papers before contacting ProAd
- Do not discuss the circumstances surrounding the incident with anyone other than the attorney representing you or a ProAd Claims Representative
- Do not make any additions or deletions to the patient's records
- Do not attempt to contact the patient filing the lawsuit in any way
- Do not review any medical literature specific to alleged or potential claim
ProAd has a listing of law firms throughout the region that have been approved by our Claims Department. These firms specialize in the advocacy of Physicians and their performance is monitored to ensure that they follow our guidelines and defense philosophy. We will make every effort to work with you to provide counsel you feel comfortable with.
You can submit a written request for a Claims History. The request should include your name, license number, policy number (if not insured under your own name) and the specific years that the history should address. The written request requires your signature. You may fax your signed request to 410-771-0177. You can also request a Claims History from the secure section of the ProAd web site.
*The Claims History will be mailed or faxed to the current address on your policy, unless you request otherwise. The Claims History will also be mailed directly to the requesting institution.
There are several ways to contact us to report a claim, lawsuit or incident: Telephone - Call us at 800-492-0193 (toll free) and inform the operator that you are an Insured reporting a new claim. Online - Click here to login to the secure area of the site and report a claim. Fax - Fax any documents you receive to (443)-689-0263
As a general rule, you must release a copy of the records upon receipt of an authorization signed by the patient. You should not prepare new or additional chronologies or reports, even if requested. If you have any questions about releasing your records, call our Claims Department at 888-411-0444 (toll free). Should you have any suspicion that your treatment could lead to a claim or suit for medical negligence, you should request ProAd’s assistance prior to further action.
First, you will be contacted to schedule an initial interview with your attorney and/or your ProAd Claims Representative. During this meeting you will be advised what to expect from the litigation process as well as discuss your case specifically. It is helpful if you have the original medical chart and a copy of your CV.
The ProAd Claims Department will need your assistance in providing some necessary preliminary information. This information includes:
- Names of other Physicians involved in care
- Names of any involved hospitals, clinics, etc.
- Chronology of medical treatment, including dates of treatment
- Any information available regarding the nature of the claim
In general, three elements must be present to prove a claim of medical malpractice:
- Negligence - defined as a departure from the accepted standard of care
- Causation - there must be a a causal link between the negligence of the defendant and the damages suffered by the claimant
- Damages - which must be verifiable and suffered by the claimant(s)
Contact the ProAd Claims Department. Do not attend the deposition without first contacting and consulting with a member of the ProAd Claims Department.
The information is reported to the NPDB only when the Company makes a payment on behalf of an Insured.
You should immediately notify Professionals Advocate of any incident thta may lead to or trigger a medical negligence claim. You should also contact ProAd to dicuss any requests to meet with attorneys regarding your care of a patient. In the event you receive a notice of a lawsuit, or a claim letter from an attorney, swift reporting is crucial to allow ProAd to respond within the allotted time frame.
ProAd will not settle a case without your knowledge. After a thorough examination of a large number of factors, including all applicable laws and relevant medical standard of care issues, our claims team will determine the best legal response to a claim. You are an active participant in the claim process and your opinions and preferences will be fully considered. It is the policy of ProAd not to settle without the express written consent of the Insured.
No. Simply reporting an incident for which there has been no request for compensation has no impact on your premium.