What should I do if I receive a patient complaint or a threat of legal action?
Do not respond directly to the complaint or communicate with the patient or their attorney without first notifying your malpractice carrier and contacting us. The way a potential claim is handled in the first 24 to 72 hours significantly affects outcomes. Your policy includes a duty-to-defend obligation, which means your carrier provides legal defense — but that protection only activates after proper notice. We guide you through the notification process and coordinate with your carrier's claims team from the first call.
- Category
- Billing & Claims
- Audience
- All audiences
- Topic
- General
Related FAQs
Claims-made vs. occurrence — what's the difference?
A coverage trigger distinction. **Occurrence policies** cover claims arising from incidents that *happened* during the policy period, no matter when the claim is later filed. Once you've held an occurrence policy for a year, that year is permanently covered — no tail coverage needed. **Claims-made policies** cover claims that are *first reported* during the policy period (subject to the retroactive date), regardless of when the underlying incident happened. Claims-made starts cheaper but rises in price each year for 5–7 years,…
Read answerHow do brokers get paid?
Three common compensation structures: - **Commission**: a percentage of the policy premium, paid by the carrier (not by you on top of the premium). Standard commercial rates run **5–15%** of premium depending on line and carrier; most fall in the **2–8%** range. Commission is built into the premium the carrier charges, not added separately. - **Fee-based**: the carrier writes the policy "net of commission" (no broker commission), and the client pays the broker a separate annual fee for services. Common…
Read answerHow do I file a claim?
Contact us directly as your first step — before calling the carrier. We help you assess whether a formal claim is the right course of action, which policy applies, what documentation you need to gather, and how to present the claim most effectively. For urgent situations involving active liability, bodily injury, or potential litigation, contact us immediately. For non-urgent property or other claims, a same-business-day response is standard. We stay involved throughout the process, not just at intake.
Read answerHow do I file an insurance claim?
General process across most lines: 1. **Report immediately** — to the carrier or to us. Don't wait to determine "how serious" the claim is; late reporting can become a coverage dispute. 2. **Document the incident** — photos, witness names and contact info, police report (if applicable), incident report (workers' comp), and a written narrative while details are fresh. 3. **Don't admit fault, sign anything from claimants, or settle directly** — let the carrier's claims team and assigned defense counsel handle…
Read answerHow do I prepare for a premium audit?
Three categories of records: - **Payroll records** — by class code, summarized monthly or quarterly. If you use a payroll provider (ADP, Paychex, Gusto), they typically supply audit-ready reports. - **Subcontractor records** — payments to 1099 contractors plus their certificates of insurance proving they carried their own coverage. Subs without COIs may get added to your payroll for audit purposes, materially increasing premium. - **Sales/revenue figures** — by class for general liability, by location, by operation type. Common audit surprises:…
Read answer
STILL HAVE QUESTIONS?
We answer the same business day.
If yours isn't covered here, schedule a consultation and we'll get you a clear answer.