Professional Liability Closed Claims Industry Statements
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Statement by affected HMOs
Not all claims against HMOs are included on this site. For example, five of the
seven largest HMOs in Florida do not appear in this listing as having claims. The
fact that an HMO has no or few claims may be due to the absence of professional
liability insurance. Likewise, claims against HMOs in amounts below their liability
policy deductible may not be reported.
Further, HMOs that employ doctors (staff-model HMOs) are subject to lawsuit for
the alleged acts of their doctors. HMOs that contract with outside doctors (group-
or IPA-model HMOs) aren't as likely to be sued even when its doctors are. As
a result, there may be fewer claims involving HMOs that contract with doctors.
In some instances, although a service provider or institution believes it isn't
liable, it may nevertheless choose to settle disputed claims quickly rather than
incur sizable legal costs in lengthy litigation.
Inappropriate use of such malpractice information or closed claims reports may violate
various provisions of law, including Section 641.3903(9), F.S., which prohibits:
"Knowingly making any misleading representations or incomplete or fraudulent
comparisons of any health maintenance contracts or health maintenance organizations
or of any insurance policies or insurers for the purpose of inducing, or intending
to induce, any person to lapse, forfeit, surrender, terminate, retain, pledge, assign,
borrow on, or convert any insurance policy or health maintenance contract or to
take out a health maintenance contract or policy of insurance in another health
maintenance organization or insurer."
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Statement by the Florida Medical
The Florida Medical Association cautions that the settlement of malpractice claims
occurs for a variety of reasons, which do not necessarily reflect negatively on
the professional competence or conduct of the individual provider or institution.
Payment of a claim should not be a presumption that malpractice has occurred. Physicians
often have little control over whether the insurance company pays an award. An insurance
company may pay a claim on behalf of the insured physician, even when there is no
liability, if the cost of defending the claim might exceed a potential settlement.
A large payment in a malpractice case does not necessarily indicate the provider
or institution made a serious error. It could indicate, instead, that the patient
suffered significant economic damages as a result of alleged malpractice.
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Statement by the Florida Hospital
The Florida Hospital Association strongly supports providing meaningful data to
consumers. However, liability claims information can be misleading. Insurance companies
may settle claims for business reasons without consideration of fault and certain
physicians are more prone to lawsuits because of the specialty in which they practice.
These issues are complex. Medical incidents, like medical malpractice suits, are
often not clear cut. Experts disagree on medical practice and whether a result could
have been prevented or was within the range of expected outcomes. Not all patients
react the same to identical treatment.
Hospitals have checks and balances in place to reduce the potential for human error.
Hospitals have policies, procedures and training to help prevent mistakes. They
have teams of physicians, nurses and licensed risk managers who examine, identify
and correct problems. The liability claims on this site should not be used as a
measure of quality care.
DISCLAIMER and IMPORTANT CONSUMER NOTICE
Consumers are urged to read this notice prior to searching the closed claims database.
1. Florida's professional liability reporting statute (Chapter
627.912, F.S.) doesn't cover all licensed professionals or institutions.
The law requires only that three entities -- insurance companies, self-insurance
funds and joint underwriting associations -- file reports of alleged error, omission
or negligence by insured doctors, dentists, hospitals, health maintenance
organizations (HMOs), abortion clinics, ambulatory surgical centers, crisis stabilization
units and lawyers.
2. The reports on this site stem from patient or client allegations and are public
record. The site contains a listing of only those claims in which an insurer made
a payment to a claimant to satisfy a judgment or reach a settlement, which companies
sometimes do because it's less costly than fighting the matter in court. Consumers
should also note that:
(a) Some providers and institutions covered by the closed claims law will not appear
in this listing for various other reasons. For example, some may not carry professional
liability insurance; and, others may be self-insured.
(b) Some of the closed claims -- because they date back many years -- involve professionals
who have moved, retired or passed away. Likewise, some institutions may no longer
exist; or, they may have changed names.
(c) Over the years, the claims reporting forms have changed. Prior to March 1988,
for example, insurers could only report the name of a law firm instead of the name
of the individual lawyer deemed responsible for the claim. In any event, neither
the number nor amount of any claim is necessarily an indicator of professional competence
3. Additional information from the Florida Medical Association, the Florida Hospital
Association and certain HMOs can be viewed by clicking here.
4. Neither the Department of Insurance nor the State of Florida accepts legal liability
or responsibility for the accuracy, completeness or usefulness of this information
on closed claim reports filed by insurers.
5. Inappropriate use of any closed claims information to make incomplete or misleading
comparisons of professional providers or institutions may violate the law.
For closed liability claims on:
Doctors / Dentists / Hospitals / HMO's / Abortion Clinics
Ambulatory Surgical Centers / Crisis Stabilization Units / Lawyers.
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