Which of the following should prompt a risk manager to give notice to a malpractice carrier?
A.
written medical record request from an attorney
B.
demand letter from a patient
C.
internal incident report
D.
disclosure to a patient
The Answer Is:
B
This question includes an explanation.
Explanation:
Under Health Care Risk Management principles established by ASHRM and the American Hospital Association Certification Center, timely notice to a malpractice carrier is a critical obligation, particularly under claims-made policies. A demand letter from a patient constitutes a clear assertion of liability and a request for compensation, which typically meets the definition of a claim under most malpractice insurance policies. Failure to notify the carrier promptly may jeopardize coverage.
A written medical record request from an attorney may signal potential litigation, but it does not necessarily constitute a claim unless accompanied by an allegation of wrongdoing or a demand for damages. An internal incident report is a risk management tool used for quality and safety improvement and does not itself trigger insurance notification requirements. Similarly, disclosure to a patient regarding an adverse event aligns with transparency practices but does not automatically represent a formal claim.
Risk management objectives emphasize understanding policy language, particularly definitions of claim and reporting requirements. Because a demand letter explicitly alleges harm and seeks compensation, it most clearly triggers the duty to notify the malpractice carrier to preserve coverage and initiate appropriate claims handling procedures.
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