“Supporting the mission of HSG by performing the functions of claim management in a fair, professional manner with emphasis on fiscal responsibility, including prompt, frequent and open communications with our insureds, defense counsel and investigators.”
The HSG Claim Management Team‘s philosophy is to vigorously represent and protect our members’/insureds’ interests with respect to liability claims. We manage all details of each claim and are actively involved in aggressively defending our members/insureds. Our Claim Management Team has over 50 years of combined experience handling medical professional and general liability claims, including three attorneys who have many years of trial experience defending medical professional and general liability claims. We provide the following value-added services and resources to our clients as part of your professional liability package, at no additional cost:
WE PROVIDE FREE LEGAL SERVICES BEYOND CLAIMS:
REPORT A CLAIM
24/7 CLAIM HOTLINE
To report a claim or lawsuit, contact your claim representative by phone or submit pertinent information, lien letter, or petition by mail, fax or email to:
Phone: (573) 893-5300
Mail: 4700 Country Club Drive, Jefferson City, MO 65109
Email: email@example.com or one of the HSG Claim Management Team members directly.
Step by Step Claim Management
- Notice of claim or lawsuit received by phone, email or fax
- Communication with insured client regarding details involved in the claim
- Assignment to Investigator or Defense Counsel
- Claim: Assigned to Investigator to analyze records
- Lawsuit: Assigned to defense counsel to defend case and work through legal process with the insured. As the case progresses, our claim representative and defense counsel will discuss findings and strategies with the insured. With the insured client’s agreement, we will either attempt settlement or continue to defend the case through trial.
- Settlement or continued defense through trial and appeal
- Close claim
ASSISTANCE WITH LEGAL MATTERS / LEGAL CONSULTATION
Our claim managers are available 24/7 to address your claim concerns or questions.
During normal business hours (8a-4:30p), simply call our home office and request our Claim Management staff. After normal business hours, please call the number below to activate the 24/7 Claims Hotline. If you do not reach someone immediately, please leave your name, affiliation, phone number and a brief description of the event and a member of our Claim staff will call you back as soon as possible.
|To activate the 24/7 Claim Hotline:
DEDICATED, INDIVIDUALIZED SERVICE
Our attorneys are available to consult with clients concerning legal matters, even if a formal claim has not been made. Such matters may include advice on HIPAA compliance, responding to complaints or requests by patients or family members, and other legal matters, such as:
Our claim representatives assist our clients in response to subpoenas and other requests to produce medical records or documents. When appropriate, we retain outside counsel to represent the client’s interests, at no additional cost.
When an insured client or any of its employees is subpoenaed or requested to give a deposition regarding medical care (even if a formal claim has not been presented), we assign an attorney to represent and defend the individual at the deposition.
When a licensing board or other governmental agency requires an insured client or any of its employees to provide records, create a written summary, or appear in front of the board or agency, our claim representatives assist throughout the process and retain an attorney to represent the insured.
We provide individualized claim service for each insured client, including the dedicated service of one claim representative.
TEAM APPROACH TO CLAIM MANAGEMENT
The HSG Claim Management team has frequent face-to-face interaction which allows us to address issues facing you to improve patient care, minimize recurrent problems, and decrease the frequency and severity of claims.
KNOWLEDGEABLE, EXPERIENCED PARTNERS
We partner with independent, knowledgeable and experienced investigators and defense attorneys who specialize in healthcare-related claims and litigation. Each has experience in the geographic area where the claim is pending, which provides a familiarity with the judges, types of juries and local environment. HSG has had a long-standing relationship with these preferred partners because they provide priority service to our insured clients and have shown consistently successful results.
MONTHLY LOSS REPORT
Each insured receives a monthly claim summary documenting each claim, status of each claim, and current reserve.
PERSONALIZED CLAIM REVIEW
We review pending claims periodically with insured clients to address the status of the claim and the future course of action. In addition, the claim representative, when appropriate, will meet with each insured client annually. We will discuss the status of each claim, the issues that have arisen, potential defense strategies, and the plans for future handling.
ACCESSIBLE CLAIM MANAGEMENT TEAM
In addition to periodic claim reviews, our Claim Management Team is available to discuss pending matters at any time. Moreover, at the appropriate time, we discuss each claim with you to determine if we should attempt to settle the claim or if the claim should be pursued to trial.