2007 PLUS MEETING Anatomy of a Claim - From Both Sides M. Anthony Luttrell May 2007 Presented by 2007 PLUS MEETING Seattle, WashingtonDirector, Northwest.

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Presentation transcript:

2007 PLUS MEETING Anatomy of a Claim - From Both Sides M. Anthony Luttrell May 2007 Presented by 2007 PLUS MEETING Seattle, WashingtonDirector, Northwest Regional Office

2 How Plaintiff Attorneys Obtain Clients (It’s a Numbers Game) Referrals from Past Clients Referrals from Other Attorneys Advertising (Based on Venue Laws) Local Bar Associations

3 Selecting Clients Receives anywhere from Telephone Calls per Month Looks for the Three Elements: Liability, Causation and Damages May Choose Only 5 Cases per Month Calls Client in for In-person Meeting

4 Conduct Preliminary Investigation Obtain Copy of Pertinent Medical Records Meet Briefly with Potential Experts If Experts are supportive of malpractice claim, send out Notice of Intent to Sue or file suit. Signing the Retainer

5 Claim or Incident What is a Claim? A Claim is a Demand for Monetary Damages May be in the Form of a Demand Letter from Plaintiff a Notice of Intent to Sue or a Lawsuit What is an Incident? An Incident is an Event that may lead to a Claim

6 Management’s Role Evaluate for coverage Assign to Claims Specialist Set initial reserve Monitor future activity Participate in evaluation of claims Provide settlement authority when applicable

7 Conduct Preliminary Investigation – Obtain Copy of Records – Contact Plaintiff’s Attorney – Meet with Insured (Interview ) Claim Representative’s Role

8

9 Obtain Expert Review Refute Liability Or Attempt Resolution

10 Plaintiff’s Settlement Demand – Why? Any interest from the Defense? Statutory Considerations Save Litigation Costs if Matter Resolves Earlier

11 Obtain Consent if Settlement is Contemplated Obtain Settlement authority Attend Informal Settlement Conference or Mediation Claim Representative’s Role Continued

12 Claim Representative’s Role Continued –If Litigation Follows –Retain Defense Lawyer –Monitor Reserves as needed during Litigation –Evaluate Exposure as Discovery/Lawsuit proceeds –Claim Representative is given written Summaries of all Depositions/Material Developments in Case –Defend vs. Settle is a constant throughout litigation process

13 Pleadings: Written response to complaint/allegations and present affirmative defense Exchange of Written Discovery Acknowledge/Confirm undisputed facts Deposition Phase Testimony of all pertinent witnesses, including Defendant (doctor) and Plaintiff (patient) Stages of Litigation

14 Stages of Litigation Continued Expert Deposition Testimony of all retained (paid) experts who render opinions regarding liability Pre – Trial Judge determines what evidence is admissible (can be presented to the jury)

15 Trial Case is presented to Judge, Jury or Arbitrator to determine negligence, causation and damages Post – Trial Judge decides if law was applied correctly when the verdict is achieved.

Why We Care? “The Best Offense is a Good Defense” Knowing Plaintiff Attorney’s Strategy Can Determine Our Best Course of Defense Action Without Knowledge Often Leads to Untoward Outcomes

17 Questions and Answers Thank You, M. Anthony Luttrell