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Report a claim

What to report

Your policy requires you to notify TMLT as soon as reasonably possible after becoming aware of a claim covered by your policy. Please notify TMLT immediately if you receive any of the following:

A demand for compensation — any written communication from or on behalf of a patient that seeks monetary payment or other compensation because of a perceived error in treatment or an unexpected outcome.

A notice of claim letter — a letter that refers to Civil Practice and Remedies Code Section 74.052 or refers to a notice of claim. Upon receipt of a 74.052 letter, a physician and his or her insurer have 60 days to investigate and evaluate the patient's claim.

A lawsuit — will contain a citation (which informs you of a lawsuit) and a petition (which lists the plaintiff versus the defendant). A lawsuit will also include the allegations made against you. Once you are served with a citation and petition, TMLT has a limited time to respond by retaining a defense attorney to file an answer on your behalf.

Records request — a request for a patient's medical records may come from the patient, the patient's spouse, an attorney, a record service, or from a court reporting service in the form of a subpoena. Requests for records should include an authorization signed by the patient or by the patient's legal representative. It is best to respond to a request as soon as possible.

Request for deposition — a deposition is testimony given under oath before a court reporter. You may be served a subpoena for oral deposition, or you may be contacted by an attorney directly. If you are asked to give testimony regarding a patient, particularly if that patient is suing another health care professional, please contact the TMLT claim department immediately. Depositions can potentially become claims and you should be properly represented at any such proceeding.

In the event of a claim, it is essential that you contact the TMLT claim department as soon as possible. In many cases, we will have limited time to investigate and evaluate the claim. Any delay in reporting could compromise your defense.

How to report a claim

If you have received a notice of claim, a lawsuit, a medical records request, or a request for deposition, immediately do all of the following:

  1. Report the claim to TMLT by calling 800-580-8658. Please allow about 20 minutes for the report and have whatever notice you received available for reference. It may also be helpful to have the patient's medical record available.

  2. Fax or send by overnight mail a copy of the notice of claim letter or the lawsuit. Do not fax your medical records. Note that if you are served with a lawsuit, the TMLT policy requires as a condition of coverage that all such lawsuit papers be delivered to TMLT within ten (10) days of service or receipt of the lawsuit papers, and that you must obtain a delivery receipt from TMLT. "Delivery of lawsuit papers means sending by certified mail, return receipt requested, or by personal delivery or by messenger. Proof of delivery of the lawsuit papers may only be established by the written receipt of such delivery."

  3. Gather a complete and unaltered copy of all pertinent medical records, including a copy of the hospital chart and any prior or subsequent treatment records. Mail a copy of these records to TMLT as soon as possible.

What to do after reporting to TMLT

  1. Do not discuss the case with anyone except a TMLT claims representative or the attorney assigned to defend you.

  2. Maintain your original medical records in a secure place for future reference. Do not make any additions, deletions, or any other type of alteration to the medical records. Secure any other pertinent information or items in your possession, such as billing records, x-rays, hospital charts, etc.

  3. All correspondence to and from TMLT and your assigned attorney should be kept in a separate and secure file. These items should not be co-mingled with the original medical chart on the patient. Do not release these materials to anyone unless cleared through your assigned attorney or the TMLT claim department.

  4. The TMLT claims representative assigned to your case will keep you fully informed as the case proceeds, both directly and through your assigned attorney. If you have questions, do not hesitate to call the assigned claim supervisor.

  

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