Physicians aren’t the only ones worrying about medical malpractice. As I shared in my last post, nursing homes, assisted living environments, and other private healthcare facilities are prime targets for lawsuits that can wreak havoc on their bottom line.
If you own or operate these facilities, then you know how time-consuming and complicated a single lawsuit can be — and how costly a wrong move can prove. How can you avoid or manage this risk? Often, the solution is a third-party administrator, one who can manage litigation for your facilities and remove the drain on your time so you can focus on other priorities. Yet third-party administrators can vary greatly, and you don’t want to turn over a core part of your business to the wrong partner.
What do you need to look for in a claim administration and litigation management partner? How can you find the right fit? Here are the essential services to look for in a litigation manager, along with some pointers on making the right selection.
Carefully Selects Defense Counsel
Just as third-party administrators (TPAs) vary greatly in the expertise they offer, lawyers, too, differ immensely in their experience and knowledge of elder care suits. A TPA with proven litigation management practices can be key in assisting you with a strategic choice for the right counsel in a lawsuit. Make sure the litigation manager on your TPA’s team is familiar with local defense firms and attorneys, and will take the time to make a strategic choice based on your case and the attorney’s history and expertise.
Understands Healthcare and Your State Laws
A strong litigation manager knows that medical malpractice laws and deadlines differ across states, and can decipher the nuances and intervene as needed. Your litigation manager should step in and guide the process if he or she notices that state-specific deadlines have been missed by the plaintiffs, or if there is an opportunity for dismissal.
Healthcare is complex, and just as attorneys can miss details, third-party administrators can, too. Look for a TPA team with a litigation manager who not only knows your state laws but also has solid experience handling medical malpractice claims in long-term care facilities.
Serves as a Liaison
Once you retain counsel, a good litigation manager coordinates the release of all documentation and records from your facility to the defense law firm. This eases the burden on you and your facilities and prevents common mistakes that can happen, for instance, when healthcare personnel at the facility hand over the wrong medical or business records, unintentionally damaging your case.
Effective litigation managers vet all documents before delivering them to attorneys, a simple step that prevents costly oversights. If a defense attorney contacts a facility requesting the policies and procedures on wound care, for example, many facilities will release what they have on hand without giving it a second thought. This might seem minor, but it can cause real problems if, for instance, the claim is two years old, but the staff is handing over the facility’s policies and procedures on wound care that have since been updated, rather than providing the appropriate policies and procedures in effect when the claim occurred.
Giving out the wrong information, whether deliberately or not, can be damaging and expensive. So find a partner who knows the discovery process and is experienced with the release of appropriate documentation.
Monitors Your Legal Expenses
Legal expenses can add up. You want to make sure you get the services you’re paying for — and steer clear of unreasonable or inflated legal fees. Most third-party administrators don’t get involved in this level of detail, but good litigation managers review all legal billing and ensure that it’s timely, reasonable, and correct. When it’s not, they work with the defense firm to make any necessary corrections or changes to the bill.
Litigation managers can handle the administrative side of legal billing, too, by approving bills and requesting payment. With this level of oversight, you get a complete and accurate account of all expenses and can focus on your business.
Anticipates Claims Payments
Healthcare companies and elder care facilities don’t typically have huge reserves of cash that they can pay out unexpectedly. Planning is essential, and effective litigation managers anticipate what you will pay per claim.
It is important for your business that indemnity and expense reserves are closely monitored, and that all facts are considered when reserving funds for each individual case. At PSA, for instance, we provide monthly updates on all payments and reserves, and take into account all recent activity in the claim and litigation processes.These added steps enable us to develop a strong reserve strategy for our clients and make sure they are as accurate as possible. When choosing a litigation management partner, inquire about the kind of updates and reserve strategy you will receive.
Involves You in the Process
Most third-party administrators have authority, within certain limits, to make litigation decisions on their own, without consulting the client. I’ve seen time and again how disadvantageous this approach can be for healthcare facilities, which unknowingly pay more than needed for claims.
Look for a litigation manager who treats you like a true partner and updates you regularly on the process. You may not have time to review it all in detail, but you do want to keep tabs on how each claim is being handled and be aware of any expenses coming your way. Since professional liability claims are a direct reflection on the quality of your services, your reputation is at risk when claims are paid without your input.
Many companies, for instance, want to play a role in developing the resolution strategy for their cases. Make sure your TPA arranges for and participates actively in discussions with you and the defense attorney about the strategy and resolution of cases, so that you’re all working as a team.
Need help managing litigation for your healthcare facility or lowering your overall risk? PSA’s Healthcare Risk Solutions team can partner with you to put the right policies and practices in place. To learn more about our approach and services, reach out to me at FGiachini@psafinancial.com.
