Two Insurance Problems That Can Reduce Your Medical Malpractice Award

In general, it's better to file malpractice lawsuits against medical professionals who have insurance to cover the incidents. It's easier to collect damages from insurance companies with billions of dollars in assets than from individuals who may have more debt than cash. However, there are things that can impact the amount of money you receive from an insurance company. Here are two issues you should be aware of.

Coverage Limitations

One common issue that affects the amount you actually receive from the insurance provider is coverage limits. Many policies have per incident and aggregate ceilings on the amount of money that's paid out for malpractice claims. For instance, the provider may only pay $1 million per incident and up to $3 million total for all claims that occur within the year. If the insurance company has already paid $2.5 million for malpractice claims, there will only be half a million left for yours.

That's not the only problem, though. Your total payout may also be reduced if the coverage limitation includes attorney's fees and court costs. The court orders the defendant to pay $1 million in damages plus your attorney and court fees of $100,000, for example. If the coverage limit is $1 million, that's all the insurance provider is going to pay. In the end, you'll only get $900,000 since the attorney's and court costs will come out of the money you receive.

You may be able to avoid this by checking whether the medical professional is covered by an umbrella policy. Sometimes the medical facility the individual works for will have an overarching insurance policy that kicks in when the person's coverage maxes out.

Multiple Claims Lumped Together

Another insurance problem that can affect your payout is if the provider lumps multiple occurrences of malpractice into a single claim. This can happen if each incident is factually related. For instance, a doctor improperly treats your medical condition in the office and then prescribes the wrong medication. These incidents can be sued for separately, but the insurance company may treat them as a single claim because the facts of the case will likely apply to both issues.

If multiple occurrences are treated as a one claim, the maximum amount you can collect is whatever the coverage limitation is for a single incident. The only way to break out of this situation is to prove each incident is completely separate from the other.

There's a lot of complexity inherent in litigating medical malpractice claims. Contact a personal injury attorney, like R.J. Marzella & Associates, P.C., who can help you navigate the challenges and get the compensation you deserve.

Share