How to Report a Claim

How to Report a Medical Incident

Your policy requires you to notify Advocate, D.O. as soon as possible after you become aware of a "Medical Incident." A "Medical Incident" is defined in your policy as, "professional services, acts, or omissions arising out of treatment to a patient which could or did result in bodily injury, sickness, disease, disability, or death to any person for which damages may reasonably be expected or should have known to be sought against the Insured."

Accordingly, you should notify Advocate, D.O. immediately if you receive any of the following:

1. Notice of Claim: A Notice of Claim letter that refers to Texas Civil Practice & Remedies Code Section 74. Upon receipt of a Chapter 74 letter, you and Advocate, D.O. have 60 days to investigate and evaluate the claim. Any letter from a patient which indicates an intent to pursue a claim or lawsuit against you.
2. Lawsuit: A lawsuit can be served upon you either in person or by mail. You and Advocate, D.O. have a limited time within which to engage counsel and file an Answer on your behalf. Thus, you are requested to forward a copy of the lawsuit to Advocate, D.O. within 24 hours of receipt of service.
3. Subpoena for testimony: A subpoena is defined as a verbal request from an attorney representing your patient in a lawsuit involving a third party. If you receive a subpoena or a verbal request from an attorney requesting your deposition (testimony under oath), please contact Advocate, D.O. immediately. Advocate, D.O. will review the subpoena and make an inquiry as to the basis of the request. If it appears that there is a potential for a claim to be pursued against you, Advocate, D.O. may engage counsel to represent you at the deposition.

Advocate, MD Insurance of the Southwest
Attn: Claims Department
Advocate, MD Insurance
811 Barton Springs Road
Austin, TX 78704

How to Report a Claim

1. Lawsuits must be reported within 24 hours from date of service by contacting Advocate, D.O. at (800)686-2734.
2. Report a Notice of claim, or subpoena immediately by calling (800)686-2734.
3. Submit a Notice of Claim Form via fax (512)275-1840 or overnight mail to Advocate, D.O..
4. Please copy your agent with Notice of claim.

What to Do After Reporting a Claim:

1. Locate and copy all medical records (including hospital records and charts) relating to the patient. Please include a copy of the records for any prior or subsequent services rendered to the patient.
2. Mail (via overnight mail) a copy of all medical records to Advocate, D.O. as soon as possible.

DO NOT Take the Following Actions:

1. Do Not admit any liability, make any voluntary payments or assume any obligation without consulting Advocate, D.O..
2. Do Not make references to any claim related information in the patient’s medical records. Maintain all correspondence to and from Advocate, D.O. and your attorney in a separate file.
3. Do Not release medical records or information relating to your patient without a proper medical authorization.
4. Do Not discuss any material about the case with anyone other than a representative of Advocate, D.O. or the attorney assigned to represent you.

Remember:

You can contact Advocate, D.O. at any time to discuss your claim: (800)686-2734 or Claims department contact form.