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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 Association

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 Association

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.