How Medical Malpractice Lawyers Negotiate with Insurance
Medical malpractice lawyers are a valuable resource for navigating through the complexities of a medical malpractice claim in New Mexico. One of the biggest headaches you might encounter if you need to sue a medical provider or healthcare facility is their insurance company.
Insurance companies play a significant role in handling medical negligence cases for their customers. Their involvement is typically tied to a healthcare provider’s professional liability insurance. It’s designed to cover individual practitioners and healthcare facilities in the event they’re sued for malpractice.
It’s the duty of an insurance company to provide financial protection, claim evaluation, negotiation, and settlement offers for their clients. They may even have to provide support if a medical malpractice claim ends up in the courts.
In our latest blog, we explore the ways in which medical malpractice lawyers negotiate with insurance companies to ensure you get fair compensation for your injuries. We answer some of the most common questions, including:
- How do medical malpractice lawyers engage with insurance companies?
- What factors influence negotiations with insurance companies?
- How do lawyers determine the value of a medical malpractice claim?
- Do insurance companies always offer settlements?
- What strategies do attorneys use to maximize settlements?
- How long does the negotiation process take?
- What should you look for in a medical malpractice lawyer?
How do medical malpractice lawyers engage with insurance companies?
Medical malpractice lawyers are your first line of defense against insurance companies for medical providers and healthcare facilities. When you’re injured because of medical negligence, you have a right to fair compensation.
Insurance companies for doctors and hospitals can quickly become roadblocks in your pursuit of adequate reparations for your injuries. If you try to engage them yourself, they’re likely to exploit your inexperience in such matters.
Medical malpractice lawyers ensure your rights are protected by engaging with insurance companies in several ways.
- Consulting on the case. One of the first things you should do upon discovering you’re a victim of medical malpractice is to consult with an attorney with experience and expertise in these kinds of cases. Never talk to the insurance company or another representative of the at-fault medical provider without first consulting a medical malpractice lawyer.
- Gathering evidence. Once you hire an attorney for your case, they’ll begin collecting all relevant medical records, documentation, and other evidence that supports your claim of negligence. They may consult with medical experts to review your case and provide opinions on whether malpractice occurred.
- Preparing a demand letter. If the evidence supports your claims, the next step is for your attorney to send a demand letter to the at-fault party’s legal counsel. The document outlines your injuries, damages, and alleged negligence of the healthcare provider or facility. Sometimes your attorney may include supporting evidence to encourage a speedy settlement.
- Negotiating a settlement. Most medical malpractice lawyers push for a settlement because it’s easier on their clients than enduring a trial.
- Representing you in court. If negotiating a settlement is unsuccessful, your attorney begins preparing for trial.
What factors influence negotiations with insurance companies?
Negotiating with insurance companies in medical malpractice cases is a complex process. Several factors influence the outcome of any talks between your medical malpractice lawyer and representatives for the at-fault party.
Both sides consider these variables when working toward a settlement (or ending up in a courtroom).
- The strength of liability evidence. Medical malpractice cases are built on the clarity and strength of evidence that supports your claim of medical negligence. Medical records, expert opinions, and documented breaches of standard of care put pressure on the at-fault party to settle.
- The severity of injuries and damages. The extent and seriousness of your injuries impacts negotiations significantly. Severe injuries that require ongoing medical treatment and cause substantial pain and suffering often lead to higher settlement demands.
- The potential jury verdict. Sometimes insurance companies for at-fault parties go to court, only to decide the risk outweighs the reward once the trial gets underway. It’s not uncommon for insurance company representatives to offer a settlement after a trial has begun if they think the court is likely to award more in damages than your attorney requested.
- The costs of litigation. Insurance companies may decide it’s less costly to meet your settlement demands than endure a medical malpractice trial.
- The insurance policy limits. The limits of the healthcare provider’s liability insurance policy impact the maximum amount you can receive in a settlement. If the damages exceed the policy limit, it can complicate negotiations and potentially lead to a lawsuit against the provider personally.
Other factors influence negotiations, but these are the most pressing. Your medical malpractice lawyer can explain all the considerations during your consultation.
How do lawyers determine the value of a medical malpractice claim?
Determining the value of a medical malpractice claim is a complex process that requires the thorough analysis of several factors. Medical malpractice lawyers use their expertise to assess the potential damages and losses you’ve suffered because of medical negligence.
Here’s how New Mexico medical malpractice attorneys typically determine the value of your claim.
- Medical expenses. Your attorney calculates your past, current, and future medical expenses from your injuries. They include the costs for hospital stays, surgeries, medications, rehabilitation, therapy, and any ongoing medical care for temporary or permanent disabilities.
- Lost wages and earning capacity. Your attorney evaluates how your injuries impact your current and future ability to earn income. Some injuries may prevent you from returning to your normal duties at work, which can affect your hourly or annual wage potential.
- Pain and suffering. A subjective assessment, your attorney determines the physical, emotional, and mental anguish caused by your injuries based on their severity.
- Economic and non-economic damages. Lawyers differentiate between economic damages (tangible financial losses) and non-economic damages (pain and suffering). They then combine the two types of damages to reach a comprehensive value for your claim.
Other factors come into play, but these are among the most influential. Your attorney can explain everything they use to determine the value of your claim during your consultation in more detail.
Do insurance companies always offer settlements?
No. Insurance companies don’t always offer settlements in medical malpractice cases. They consider the strength of your case, the evidence presented with your demand letter, and the potential costs of litigation.
Some of the other factors that influence a decision about a settlement include:
- Damages and injuries. Insurance companies weigh the extent and seriousness of your injuries before deciding whether a settlement offer is appropriate.
- Disputes over liability. If liability is disputable, the insurance company might feel less motivated to settle. They may want to fight the case in court if they believe they have a strong defense.
- Policy limits. The limits of the healthcare provider’s liability insurance policy play a significant role in any settlement offers. If the potential damages exceed the policy limits, the insurance company might offer a settlement within the limits to avoid personal liability for the healthcare practitioner.
What strategies do attorneys use to maximize settlements?
Medical malpractice lawyers use several strategies to maximize settlements in cases involving medical negligence. Their goal is to use the strengths of your case, present compelling evidence, and demonstrate the potential risks for the at-fault party if the case goes to trial.
Thorough case preparation is the most important part of a medical malpractice lawsuit. Your attorney conducts meticulous research and gathers all relevant evidence, including medical records, expert opinions, and witness statements. They use their findings to build a comprehensive case that clearly establishes negligence.
Some of the other strategies they use to support your case include:
- Conduct comparative case analysis. Attorneys examine other similar medical malpractice cases that resulted in substantial settlements or favorable trial outcomes. They use that information to establish precedent for the value of your claim.
- Engage medical experts. Medical malpractice lawyers know the value of seeking out opinions from medical experts familiar with the kinds of injuries you suffered. They can establish whether a standard of care was breached and how negligence caused the injuries. Expert testimony adds weight to your case and strengthens negotiation positions.
- Practice strategic timing. Timing their negotiation efforts after building a strong case and gathering compelling evidence to support your claim can lead to a more successful outcome.
How long does the negotiation process take?
The short answer to this question is it depends. The duration of medical malpractice negotiations varies significantly based on the complexity of your case, the willingness of both parties to negotiate, and the strength of the evidence.
On average, the negotiation process can take several months to a year or more. Here’s a breakdown of some of the other factors that influence the timeline.
- Insurance company’s approach. Some insurance companies are more motivated to settle than others. If the supporting evidence provided in the demand letter is strong, it may prompt the insurance company to avoid the expense and hassle of a trial it knows it likely will lose.
- Mediation or alternative dispute resolution. If both parties choose to engage in mediation or an alternative dispute resolution (ADR) process, it might expedite the negotiation process. A third party facilities the discussions between parties, which may speed things up.
- Legal deadlines. Statutes of limitations and other legal deadlines can affect negotiation timelines. Parties might expedite the process if deadlines are fast approaching to avoid potential legal complications.
If negotiations aren’t successful, your attorney then asks if you wish to pursue the claim in court.
What should you look for in a medical malpractice lawyer?
When choosing a medical malpractice lawyer, it’s important to find someone with experience and expertise. Make sure your lawyer specializes in medical malpractice cases and has a proven track record of handling such cases successfully.
It’s OK to favor an attorney with strong negotiation skills and a penchant for settling medical malpractice cases outside the courtroom. Just be sure your attorney also has trial experience in case you end up before a judge and jury.
Another critical factor is a positive reputation in the legal community and with past clients. Read reviews and testimonials. Ask for references to gauge their professionalism and the quality of their services.
Verify your attorney is a member in good standing with the State Bar New Mexico. You can use the public tools on the bar’s website to check whether your lawyer is a member and if they’ve had any complaints or disciplinary action taken against them.
Lastly, make sure they have a transparent fees structure. You can discuss this during the initial consultation. Ensure you’re comfortable with whatever method the attorney uses before signing a contract for services.
Have additional questions? Our team is always happy to assist. Give us a call today to schedule your complimentary consultation with one of our medical malpractice legal experts.