Insurer sees good results from disclosure, apologies

One prominent insurer is seeing substantial improvements in how malpractice claims are handled by promoting a full-disclosure policy for physicians.

The program promotes disclosure, apologies when appropriate, and open communication between physicians and patients, says George Dikeou, JD, recently retired from his position as executive vice president and general counsel for Copic, a prominent medical malpractice insurer in Denver. The insurer started actively promoting full disclosure and apologies in 2001 but met considerable resistance from physicians who had been counseled to never admit anything, he says. When Colorado passed "I'm Sorry" legislation in 2003 that gave physicians some protection from having their apologies used against them in court, the doctors started coming around to the idea.

Since that legislation was passed, Copic has seen positive results. Dikeou says 2,050 physicians — a bit more than a third of all the company's insured doctors — participate in Copic's disclosure program, which encourages them to call Copic whenever they have an unhappy patient. A Copic representative then helps them determine how to proceed. An immediate payment of up to $30,000 can be authorized to resolve the claim.

Since 2003, there have been 1,505 physician/ patient meetings, and 1,702 cases were resolved without any payment at all. Another 403 were closed with some payment, ranging from $54 to $30,000. The average payment was $5,683.

The remaining 30 claims were sent to the Copic claims department for routine handling, usually because the case required more than $30,000 to resolve or the patient was still unhappy. Of those 30 cases, 12 were closed without payment, and three were closed with payments ranging from $1,600 to $300,000. The remaining 15 cases are still open.

Less money spent; no attorneys involved

Dikeou notes that all of the claims resolved before going to the claims department did not involve a patient's attorney. Most of the payments made under this program do not require the claimant to sign a release, so theoretically the patient could still sue even after the case was resolved. That has not happened yet, he says. For the cases that go to the claims department, the patient is required to sign a release form.

"It would appear that everything we've learned about how patients want full disclosure so they can know what happened is true, and these numbers bear that out," he says. "The physicians like the program also because they can resolve cases more amicably and faster."

Editor's note: In next month's issue, Healthcare Risk Management will explore how the "I'm Sorry" laws in some states promote more full disclosure and apologies, and whether they truly offer as much protection from litigation as proponents claim.