Reporting a Claim
The Claims Department is primarily responsible for accepting reports of claims made against insureds and investigating those claims.
The Claims staff works very closely with defense counsel to determine the best strategy for each case.
Insureds should call the Claims Department (Ext. 218) to report the following types of claims:
- Suits/Subpoenas
- Letters of Claim
- Administrative Actions
- Potential Incidents, Adverse Outcomes, and Related Record Requests
The caller must have available the legal papers, if any, and the medical and billing records of the patient.
Only written notice triggers coverage under the policy.
Suits/Subpoenas
The service of any legal papers in a medical malpractice action requires prompt notice to the Claims Department in order to properly protect your interests. A Summons is served to initiate the commencement of an action (lawsuit). A Subpoena issued by a Court requiring a witness to produce records or requiring testimony in a medical malpractice action.
Letters of Claim
Oftentimes a patient or their representative will make a written claim, excluding a SUIT for monetary damages. This type of ASSERTED CLAIM is treated similarly to a lawsuit.
Administrative Actions
As of 12/11/98, PRI provides defense coverage for a physician who receives an investigatory letter from a State licensing agency, i.e., Office of Professional Medical Conduct.
Potential Incidents, Adverse Outcomes, and Related Record Requests
PRI encourages the reporting of an incident that may give rise to a future medical malpractice lawsuit such as an adverse outcome in treatment or the request for the records by an attorney.This is particularly favorable to insureds with Claims-Made Policies.If you would like to report a potential medical malpractice incident, you may complete and sign the "Incident Reporting Form" - IRF.
If you have received a request for your records, kindly include a copy of your medical and billing records together with the "Incident Reporting Form" and forward it directly to the Claims Department, Physicians' Reciprocal Insurers, 1800 Northern Boulevard, Roslyn, NY 11576 or fax to (516) 365-5342 or (516) 365-5714.