• Reporting a Claim
• 
  

Sally E. Anderson
Vice President - Claims

Brian C. Anderson
Claims Counsel

Joyce R.H. Neumaier
Claims Assistant

Reporting a Claim

What should I report?
When should I report a claim?
How do I report a claim?
What will happen after I report a claim?
What happens when a claim becomes a lawsuit?
What should I avoid doing when I have a claim?
Is there anything else I should know?

If a malpractice claim has been made against you or you believe that a situation may develop into a malpractice claim, relax and remember that you're not in this alone. Our goal at Wisconsin Lawyers Mutual Insurance Company is to work with you to resolve your claim with the least amount of financial and emotional expense possible.

In order to trigger your insurance coverage, you need to report a claim or claim incident to us in writing as soon as you become aware of it. A claim is defined as your receipt of a demand for money or services, naming you and alleging a wrongful act. A claim incident is any act, error or omission by you in rendering professional services which a reasonably prudent lawyer might expect to be the basis of a claim. This means you need to report negligence that might become a claim against you, regardless of the client's knowledge or action in the matter and regardless of whether or not you believe the claim has merit.

We encourage you to report a claim or claim incident as early as possible for two reasons:

Under a claims made policy, coverage is provided under the policy that is in effect at the time a claim is first made against you or you first discover a wrongful act (any act, error or omission that is negligent or is alleged to be negligent). Failure to report a claim or claim incident during the policy period may result in lack of coverage. Remember, the claim must be made and reported to effect coverage.

A claim or claim incident that is reported early frequently can be "repaired." Our claims staff will work with you to find ways to reduce damages or mitigate a claim before it develops into a lawsuit.

Remember, there is no premium surcharge for simply reporting a claim or claim incident. Most incidents and many alleged claims are resolved without paying indemnity.

Many lawyers call us about a claim or potential claim, then follow up with a letter. Our claims staff may ask for additional information after reviewing your letter.

When reporting a claim or claim incident, please include:

• the name and address of the person making the claim
• dates of retainer
• a chronological summary of the representation
• the act, error or omission alleged to have occurred, including the date
• how and when you became aware of the act, error or omission
• the injury or damage that has resulted or may result, including your estimate of value
• any recommendations you have for repairing the claim or reducing the damages
• copies of all related documents
• the name and address of the claimant's attorney, if an attorney has been retained

After reviewing your report, our claims staff will work with you to determine a course of action to resolve the claim or claim incident. Your knowledge of the client, the circumstances surrounding your representation, and the substantive area of law will help us find a responsible solution.

Depending on the circumstances, the next step may be to:

• collect more information
• hire an expert to review the claim
• attempt to repair the claim
• settle the claim
• select a defense attorney
• wait for further developments

We will not settle a claim without your consent. (If you refuse to consent to a settlement that we consider appropriate, some other conditions apply. Please see your policy.) Likewise, you will have the opportunity to review any letters sent to the client denying the claim. You will be involved in all major decisions related to your claim.

Only a small percentage of the claims or claim incidents reported to us develop into lawsuits. If your claim does become a lawsuit, we will invite you to help select your defense attorney. Your defense attorney will send regular reports to our claims staff and will work closely with you and us. Please call your defense attorney or our claims staff any time you have questions about your claim.

In the interest of resolving your claim and protecting your coverage, we ask that you talk with us before:

• admitting negligence
• discussing your claim or corresponding with anyone other than our staff or your defense attorney
• attempting to settle the claim on your own

You purchased professional liability insurance to give you peace of mind and to protect your financial security in the event of a malpractice claim. With WILMIC, you receive insurance coverage plus the services of a claims staff devoted to giving prompt and personal attention to your concerns. Please call us any time you have a question about an actual or potential claim. Remember, we're on your team.

This information was developed as a reference for you. Wisconsin Lawyers Mutual Insurance Company does not imply through this information that coverage will be provided for a specific situation or activity. Please refer to your policy or call our office if you have questions about coverage provided under your WILMIC policy.