Handling Claims and Our Unique Approach at Incision Indemnity

Incision Indemnity
2nd March 2024
6 mins read

How do you handle claims?

This is a question we encounter frequently and it’s one of those subjects no surgeon ever wants to think about, until it actually happens.

But sadly, it does happen. In a landscape where there is significant growth in private surgery (there are now 26% more private patients in 2023 than there were in 2019) the risk of claims is ever-present.

Picture this: an email arrives from an unfamiliar legal firm, alleging professional negligence. It’s a moment you never expected and undermines the years of hard work and reputation you’ve tirelessly built.

At first you might be shocked. Then angry. Then the worry of the implications of what this could mean for you sets in.

Our existing customers echo relief at having seasoned claims experts to guide them.

So, what sets us apart at Incision Indemnity?

Upon a claim’s notification, our dedicated in-house medico-legal team steps in, offering support from the outset.

Unlike many, we streamline the process, sparing you from repeating your story to multiple entities. Our experienced team, with over many years of combined experience, tailors advice to your needs. From managing legal requests for medical records to refining responses to complaints, we tailor advice to safeguard your interests. Should a Letter of Claim arrive, we swiftly secure legal representation to stand by you.

Time efficiency matters. Our experts work tirelessly to minimise the time you spend defending claims. We’re more than brokers; we’re dedicated allies throughout your journey. Our 24-hour inhouse medico-legal team offers expert recommendations and support, ensuring you’re never alone in facing challenges.

Over the years we have built strong relationships with underwriters and specialist lawyers. This enables effective negotiation on your behalf and ensures you receive the compensation you deserve. We collaborate with specialists to customise benefits that fit you perfectly. Our secure contracts, underwritten by Lloyd’s of London Syndicates and Medical Malpractice insurance companies, guarantee peace of mind.

Our education and resources library offers advice and guidance on best practices and insights from medical specialists, ensuring you’re equipped for success.

In addition to this support, we also offer a 21 years extended reporting period. Run-off cover can be triggered in the event of your death, permanent disablement or retirement, at no additional
expense, from day one.

We never want you to experience the worry of a new claim but in a world where many are looking for someone else to blame, and when private practice is expected to grow even further in the years to come, can you afford to take chances in the event it could happen to you?

Choose between time-consuming worries or the peace of mind that comes with our experienced  team. Whatever your decision, Incision Indemnity is here to protect and support your practice.
How long a claim takes to process and what’s required from a surgeon when this happens?

We aim to provide our members with clear insights into the duration and process of a claim to help you prepare and feel reassured should you encounter one.

Below is a timeline of what to expect:

On average, a claim takes three years to conclude from the initial request for records, however numerous factors influence the duration. Complexity and disputed amount are crucial in determining the timeline, yet our commitment remains unwavering throughout.

As we progress from initial stages through to trial, surgeons should allocate the following time:

Letter of Response to Letter of Claim:
2-4 hours, including discussions with the solicitor, addressing allegations, and proofreading. If an expert’s input is sought, an additional hour may be necessary to review and comment on the report.

Proceedings issued/ drafting the Defence:
6-10 hours, involving review of allegations in the Particulars of Claim, expert input, conference with solicitor, expert, and barrister (2-5 hours), and reviewing the Defence before submission.

Dispute Resolution:
Negotiations (mediation, arbitration, etc.) may require 10-25 hours over several months, involving discussion of case strengths and weaknesses, strategy and meetings with legal teams.

Typically a week for a clinical negligence civil trial, requiring the surgeon’s full attendance each day, with possible travel and overnight stays.

These timeframes are approximate, as review durations and meeting lengths can vary. Surgeons can now attend most pre-trial events remotely, with Zoom or Teams meetings being common.
Previously, travel to law firm offices was standard.

Cost and Duration of Claim Processing:
Our data reveals that the average cost to defend a claim stands at £17,783. This includes expenses from pre-action stages, typically costing between £1,000 to£2,000, to cases extending over several years, reaching five-figure sums.

Among these, 13 claims surpassed £100,000, with 2 claims exceeding £250,000 in defence expenses.

Estimating the processing time varies greatly based on claim complexity. Claims concluding preaction typically span up to four months, with finalisation contingent upon the expiration of the limitation period. Conversely, claims proceeding to trial may keep files open for a minimum of 3 years, often longer.

Most claims fall between these extremes, averaging 2-3 years from initial notification to conclusion.

Our Approach to Claim Processing:
Efficiency and simplicity are paramount in our approach to processing claims. We swiftly address low-value claims within a year if an incident of negligence is evident and the resulting injury is straightforward. However, in cases of factual disputes regarding negligence or severe injuries with complex future needs, the resolution process understandably extends. Here, our comprehensive approach ensures that every side is meticulously examined, allowing for a thorough and fair resolution.

Member Involvement and Support:
Upon receiving a Letter of Claim, our member’s input is sought to aid in drafting the Letter of Response, ensuring accuracy and precision. Meetings, whether virtual or in-person, are orchestrated efficiently with expert involvement. As proceedings advance, the need for our members’s involvement intensifies, necessitating their input for drafting a Defence and shaping future strategies. Throughout this process, our continuous support remains fixed, with regular meetings conducted to ensure alignment and progress.

Negotiation and Resolution:
Our system prioritises negotiation and resolution, utilising ADR (Alternative Dispute Resolution) methods such as mediation or settlement meetings. Even during these negotiations, our member’s expertise is invaluable, with their witness statement serving as a crucial component of the proceedings. While trials are a last resort, our preparedness remains unparalleled. In the rare
event that a trial becomes necessary, we support our members every step of the way, with trials typically lasting no more than two weeks due to our comprehensive pre-trial preparations.

Instances where claims did not progress further:
In the last 14 years, 79% of reported cases did not evolve into formal claims. While there is some room for error, as newer cases reported may potentially transition into claims, this statistic generally holds true. Many notifications serve as precautionary measures, providing practitioners with reassurance, although they may not necessarily materialise into formal claims.
At Incision, we redefine medical indemnity, offering comprehensive support, streamlined processes, and unwavering commitment to our clients’ needs.

Get in contact with our team for more information.