“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.”
As we are a member-based organization, the HSG Claim Management Team philosophy is to vigorously represent and protect your interests with respect to liability claims. We manage all details of each claim and are actively involved in aggressively defending our insured member/owners.
The HSG Claim Management Team has over 110 years of combined experience handling medical professional and general liability claims. Our Claim Management Team includes three attorneys who have many years of trial experience defending medical professional and general liability claims.
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:
Mail: P.O. Box 1498, Jefferson City, MO 65102
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 hours, call our regular telephone number and our automated telephone system will provide instructions on how to activate the Claims Urgent Response System. Callers will be asked to provide a brief description of the event, their name and telephone number. A member of our Claims Management staff will return your call as soon as possible.
DEDICATED, INDIVIDUALIZED SERVICE
Our attorneys are available to consult with insureds 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.
Our claim representatives can assist our insureds in responding to subpoenas and other requests for the production of medical records or other documents. When appropriate, we will retain outside counsel as well to represent the insured’s interests.
When an insured client or any of its employees are subpoenaed or requested to give a deposition regarding medical care (even if a formal claim has not been presented), we will assign an attorney to represent and defend the individual at the deposition. Our claim representative may also attend 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 will assist throughout the process and will retain an attorney to represent the insured.
HSG strives to provide individualized claim service for our insured clients. We provide each insured with the dedicated service of one claim representative. That claim representative will handle all claims that may arise.
The HSG Claim Management Team has frequent face-to-face interaction with the HSG Risk Management Staff. This communication 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
The HSG Claim Management Team partners with independent investigators and defense attorneys on claims and lawsuits. These investigators and attorneys are knowledgeable and experienced because they specialize in healthcare-related claims and litigation. Moreover, each has experience in the geographic area where the claim is pending. This engagement 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
A monthly claim summary documenting each claim, status of each claim and current reserve is provided.
PERSONALIZED CLAIM REVIEW
In addition to periodic claim reviews, our Claim Management Team
is available to speak about pending matters at any time. Moreover, at the appropriate time, we will discuss each claim with you to determine if we should attempt to settle the claim or if the claim should be pursued through trial.
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.