A recent article by Chris Rauber of San Francisco Business Times highlights how some insurance giants handle medical malpractice claims in California.
The article goes on to describe a case where a teen was stabbed at a San Diego trolley stop in 2011, ended up in care of Kaiser Zion hospital and sustained serious brain injury after a breathing tube was dislodged during care.
A rare arbitration disclosure to the public (arbitration awards are typically confidential) shows an arbitrator’s binding ruling in favor of the brain injury victim in the amount of $4.9 million.
As part of the total award, a mere $250,000 is for non-economic damages (pain and suffering, loss of companionship, emotional distress), $587,904 for loss of earning capacity, $570,000 for future care costs at a rehab center and $3.52 million for lifetime care costs.
Looking at those numbers, what might catch the eye is the $250,000 figure. How can pain and suffering be limited to a quarter million dollars for the remainder of an individual’s life? Well, most people don’t realize California has a law in place that limits medical injury compensation to this amount. The California Medical Injury Compensation Reform Act (MIRCA) of 1975 limits general damages for malpractice claimants.
Another aspect of medical malpractice claims that people don’t realize is that they are handled in most cases by 3rd party arbitrators instead of court rooms and juries. Before medical care is administered, patients typically waive the right to a jury trial by signing agreements that spell out the course of action should a malpractice claim arise. That course of action is arbitration. Arbitration clauses are also typical in many health insurance plans, such as Kaiser Permanente’s policies. In arbitration, cases are handled privately, outside the court room and don’t involve juries. Final rulings are typically binding, meaning the outcome is final and there is no venue to appeal the case to.
As part of the arbitration process, claimants and defendants can support their arguments through expert testimony. In this case, the arbitrator found the claimant’s expert testimony to be more convincing than the defendant’s (Kaiser).
The article concludes with plaintiff attorney’s statements about the unfairness of MIRCA limit, citing that the compensation collected could have been much higher (and more fair) had the brain injury stemmed from an automobile accident rather than a malpractice claim.
A few questions for you: Were you aware of the $250,000 MIRCA limit for non-economic damages? Did you know that if you waive your right to a jury trial, you may have to live with whatever outcome decided by an arbitrator?