Medical Malpractice Insurance. Randy Jenkins, Esq., Coordinator of Insurance and Risk for UF Self-Insurance Program Introduction: Patch Adams Video Clip See Health Law Cases, Materials and Problems, 3 rd edition by Barry Furrow et.al. for additional information and specific cites. .
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a. Reduced statute of limitations
b. Controlling legal fees
c. Payment of costs for frivolous claims
a. Elimination of the ad damnum clause- states the total monetary claim requested
b. Periodic Payments- convert awards for future losses from lump sum to periodic
c. Collateral Source Rule-prevents jury from learning of sources of compensation
d. Limits on Liability-Noneconomic cap
a. Res Ipsa loquitur- Modified to require expert testimony to establish negligence
b. Expert Witness rules- Expert qualified in particular specialty to reduce hired guns
c. Standards of care- From locality rule to National Standard
a. Pretrial screening- panels rule on merits of case before it can proceed to trial and promote settlement by pricing case
b. Arbitration- intended to replace jury trials rather than supplement
3) State Constitutional Provisions
- Challenge administrative mechanisms that supplant or replace right to a jury trial
- Caps on damages as invading the province of the jury
- Engalla v. the Permantente Medical Group: Arbitration system involving K between provider and patient re: method of resolution if injury
- Appellate court reversed trial court and upheld arbitration system
1. The Tort System fails to compensate injured patients
2. The Tort System sends an inaccurate deterrence signal
3. The administrative/social costs of the Malpractice System
4. Patient access impaired by Malpractice costs
- The current system compensates far fewer patients than actually suffer injury
- Fewer than 2% of negligent adverse events resulted in claims
- Current system functions for larger claims- e.g. bad baby case
-Random jury awards bearing little relationship to physician negligence fail to influence providers to reform their practice
-Anesthesia related injuries study found payment made in more than 80% of claims where pt received substandard care but payment also made in 40% of claims when anesthesia care appropriate…Is the false positive rate fair?
- Excessive costs of Tort system leaves little of the malpractice premium dollar going to the plaintiff
- Rising malpractice exposure, such as in obstetrics has driven physicians out of state leaving rural communities without
-Rising premium costs have altered physician practice patterns
-Guidelines treated as standard of care and could be treated as negligence per se or treated as rebuttable presumption
1)Insurers have improved ability to price insurance since problems with high risk specialties eliminated
2) Physicians no longer face fluctuating premiums
3) Physicians freed from psychological stress inflicted by being a defendant
4) Administrative and litigation costs reduced by only having one defendant
5) Patterns of poor medical practice deterred by placing liability on institutions rather than individuals since institutions have better management tools for managing risks
1. Caps in “Routine” medical malpractice cases…but do exceptions swallow the rule?
2. Caps in Emergency Room Situations
3. Good Samaritan Immunity
4. Pre-suit reforms and much more!