A

Allegation: the plaintiff’s assertion of what led to the patient’s injury.

Alternative Dispute Resolution: use of a neutral third party to resolve a case without a trial.

Answer: the written response to the initial complaint of the plaintiff, setting forth the grounds of the defense.

Assert year: the year in which a malpractice claim or suit is filed.

B

Binding Arbitration: a form of alternative dispute resolution in which both parties agree to have a case heard by a neutral party instead of judge and jury and in which they will accept the arbitrator’s decision as final.

C

Case: a malpractice claim or lawsuit.

Causation: the relationship, if any, between the alleged act of negligence and the alleged damages.

Claim: a written or oral demand for compensation for damages caused by an alleged act of negligence.

Claimant: the person filing the claim.

Claim Representative: the CRICO employee who investigates and evaluates case, provides support to insureds, and coordinates the activities of the defense team.

Complaint: written material filed with the court to institute a civil action (suit).

CRICO: Controlled Risk Insurance Company

D

Damages: both the injury to a patient and the monetary compensation for those injuries.

Defendants: individuals (e.g., physician, nurse) in malpractice cases who are named by the plaintiff in a lawsuit.

Defense Attorney: legal counsel assigned by CRICO to represent your interest in a malpractice lawsuit.

Deposition: method of discovery in which the lawyer for one side asks questions of a party or witness on the other side.

Discovery: variety of legal mechanisms used by both sides in a case to obtain information from the other party.

Duty: obligation to the patient who was (allegedly) harmed.

I

Indemnity: monetary payment made to a claimant for damages under an agreement of insurance.

Interrogatories: a series of written questions from one party in the case to the other side to be answered under oath.

L

Lawsuit: a claim that has formally entered the civil litigation system.

Liability: responsibility for conduct falling below the standard of care.

M

Medical Expert: a qualified individual providing evidence based on inference after reviewing available medical information, not personal knowledge of the situation being considered.

Medical Malpractice: liability based on acts or omissions in the provision of health care or professional services.

Mediation: a voluntary non-binding form of alternative dispute resolution in which a neutral third party assists both sides in reconciling differences or negotiating a resolution of the matter in dispute.

N

National Practitioner Data Bank: federally established repository of information regarding malpractice payments and disciplinary actions against health care providers.

Negligence: a legal theory based on the duty of an individual to act and use such care as a reasonably prudent person would do in the same or similar circumstances.

Notice of Intent Letter: most patients and their attorneys are legally required to state in writing the basis for their medical negligence claims. Allegations made in the notice of intent letter are investigated and evaluated in much the same way as a lawsuit.

P

Peer Review: Privileged and confidential discussions of a patient’s care and treatment conducted by duly authorized peer reviewed committees pursuant to M.G.L. c 111, Section 204.

Plaintiff: one or more individuals, or someone authorized to act on their behalf, who files a lawsuit seeking monetary damages or other relief.

R

Risk Manager: the person within a health care institution responsible for coordinating the institutional risk management program.

S

Settlement: the resolution of a formal claim or lawsuit by the parties involved, without judicial intervention or proceedings.

Standard of Care: the level and type of care provided by the average qualified member of the profession practicing a given specialty, taking into account advances in the profession. Expert testimony is required in order to establish the relevant standard.

Statute of Limitations: the time period in which a lawsuit alleging malpractice must be brought.

Subpoena: an official order requiring a person to appear at a certain place and time to give testimony on a particular matter or to present certain documents in his/her possession.

Suit: see Lawsuit

Summons and Complaint: notification that an action against the recipient has been filed in court.

T

Tribunal: a screening mechanism in Massachusetts for lawsuits alleging medical malpractice.