Kaiser Permanente is an integrated healthcare system that offers both health insurance plans and healthcare services delivered by its own medical professionals. The system emphasizes preventive care and is available in numerous states.
If you rely on Kaiser Permanente for your medical care, you have the right to expect services that meet the accepted standard of care. If a provider did not meet that expectation and you sustained injuries or losses, you may be entitled to file a claim for medical malpractice.
But what happens when you have a potential Kaiser malpractice case? It’s different from what you may expect.
Understanding Medical Malpractice Claims
Medical malpractice occurs when a patient suffers injuries as a result of a medical professional’s substandard care. Legal cases involving medical malpractice technically fall under personal injury law; however, there are significant differences between malpractice and personal injury cases (such as car accidents, slip and fall injuries, or dog bite injuries). What is common to both is that in order to win your case, you have to demonstrate that the defendant owed you a duty of care and that they breached it and thereby caused you injuries.
One element of malpractice cases that is not required in personal injury cases is especially complicated: You have to show that another professional in the same field would not have made the error that led to your injuries. In some states (but not California), you may be required to file an affidavit of merit to show that your claim is valid. Only a medical expert can provide this affidavit. Fortunately, that type of affidavit is not required in California.
Along the same lines, if you wish to file a Kaiser malpractice claim in California, there is no requirement for an affidavit of merit. But there are different hoops that you will need to jump through instead. That’s because the process for suing Kaiser Permanente does not begin with a lawsuit.
Filing a Complaint With Kaiser Permanente
After you’ve been harmed by a Kaiser Permanente provider in California, and if you are looking for your facility or health care provider to be investigated, but are NOT interested in getting compensation for your injuries, your first step may be to contact a state agency. The California Department of Public Health handles cases dealing with complaints against nursing homes, hospitals, and hospice providers. You can download a complaint form online or contact the department directly.
In instances where the complaint involves a nurse or physician, you can choose to go through the appropriate state licensing board.
Keep in mind that Kaiser Permanente is an HMO. This means that complaints about insurance coverage or billing practices have to go through the California Department of Managed Health Care.
Another alternative is to contact Kaiser Permanente directly to file your complaint. You can do so via the Support Center. You may speak to a Kaiser customer service representative by phone, ask a question by email, complete an online form, or send in a written complaint.
Kaiser Malpractice Complaints and How a Kaiser Member Can Submit an Urgent Complaint
If you are looking to recover compensation for your injuries and want to begin a medical malpractice claim against Kaiser Permanente, you must go through a binding arbitration process.
When you became a Kaiser member, you necessarily agreed to this process, which makes filing a malpractice lawsuit in court very difficult, if not impossible. However, the arbitration process is designed to be fair and to provide compensation to victims outside of the court system. Still, your chances of getting a positive outcome after going through the Kaiser arbitration process on your own are very small unless you have an attorney.
Arbitration involves the two sides working up their case, developing the evidence, and at the end, presenting their case before a neutral third party, called the “arbitrator.” If the matter cannot be settled before the final arbitration hearing, then it will be up to this person to decide the outcome and the amount of damages, if any, that the plaintiff (called a “claimant” in arbitration) receives.
Before you embark on the process of arbitration, your lawyer must make a demand for arbitration with Kaiser. This demand will describe the injuries you sustained, the compensation you’re seeking, and the names of all of the parties you think are responsible for your losses.
Just as in a lawsuit, there is a discovery phase, where both parties exchange information and evidence. Unlike a lawsuit, though, arbitration doesn’t involve a judge or jury. The rules and procedures are more relaxed as well.
If you decide to go down this pathway, the best option is to hire an attorney with specific experience in filing actions against Kaiser Permanente. Your attorney should know exactly the types of evidence that can make an impact on the case and help you obtain the outcome you’re looking for.
The lawyer you select should have specific experience with the Kaiser malpractice arbitration process. The outcomes of the process are binding, as per the contract you signed when you became a Kaiser member.
If the case cannot be settled and if the case proceeds all the way to the arbitration proceeding, and if the judgment is issued against you, it is highly unlikely that a court will overturn the arbitrator’s decision, so you may not have a chance to appeal. This means that you can’t risk attempting it alone.
Beginning a Claim Against Kaiser Permanente
If you suffered losses because of malpractice while receiving care from Kaiser Permanente, acting quickly is essential. At The Trial Law Offices of Bradley I. Kramer, M.D., Esq., our legal team can fight for your rights.
We have the medical knowledge and the proven legal skills required for success in Kaiser malpractice cases. Our experience and determination have led us to recover more than $100 million for our clients throughout the years.
Contact us at The Trial Law Offices of Bradley I. Kramer, M.D., Esq. to speak with a trusted attorney about beginning a claim.