How do I report a malpractice claim to my insurance carrier?

Timely claim reporting is one of the most critical obligations under a claims-made malpractice policy. Most policies require you to notify the insurer as soon as practicable after you become aware of a claim or potential claim. Failure to report promptly can jeopardize your coverage, as late notice is one of the most common grounds carriers use to deny or limit coverage.

When you receive a demand letter, lawsuit, grievance, or even a strongly worded complaint from a client suggesting potential legal action, contact your carrier's dedicated claims hotline or email address listed on your policy declarations page. Provide the claimant's name, the matter involved, a timeline of your representation, the nature of the alleged error, and copies of all correspondence related to the claim.

Many policies also allow you to report circumstances that you reasonably believe may result in a future claim, even before a formal demand is made. This is known as a circumstance or incident report. Filing a circumstance report locks in coverage under the current policy period, which is especially valuable if your policy is approaching renewal or if you are considering switching carriers. Once a circumstance is properly reported, any resulting claim is treated as having been made during the policy period in which the report was filed.

After reporting, the carrier will assign a claims attorney or adjuster who will guide you through the process. Do not admit liability, attempt to settle, or communicate with the claimant about the merits of the claim without first consulting your assigned claims professional. Most policies contain a cooperation clause requiring you to assist the carrier in the defense, and a provision prohibiting voluntary payments or admissions without the carrier's consent.