Kaiser Permanente is one of the largest nonprofit healthcare plans in the United States with more than 12 million active members. Kaiser Permanente is actually three distinct entities that operate in tandem: the Kaiser Foundation Health Plan, Inc., Kaiser Foundation Hospitals, and the Permanente Medical Groups. Kaiser Permanente currently operates nearly 40 hospitals and more than 700 medical offices in eight states, forming the largest managed care organization in the US.
Just like any other medical care provider, Kaiser Permanente can and does make mistakes in the treatment of patients. However, due to the nature of the Kaiser Permanente HMO agreement, many patients who suffer injuries from malpractice feel trapped by their contracts and unable to obtain fair compensation. If you have experienced any type of medical malpractice from Kaiser Permanente in the San Diego area, you need to know your legal options.
Why You Need Legal Representation for a Medical Malpractice Claim Against Kaiser Permanente
The legal team of Kenneth M. Sigelman & Associates has successfully handled many cases for injured patients of the Kaiser Permanente healthcare system in California. We know patient agreements stipulate all claims of medical malpractice must go through Kaiser’s arbitration process, but this process is usually one-sided and does not hold patients’ best interests above the interests of Kaiser Permanente.
Our legal team can assess your situation and determine whether it’s possible to challenge or break your patient agreement and pursue compensation from Kaiser Permanente for the damages you sustained from medical malpractice.
Common Issues with the Kaiser Arbitration System
If you have healthcare coverage under Kaiser Permanente, you probably signed a contract that stipulates you must defer to the Kaiser Permanente arbitration system if you have any claim of medical malpractice or medical negligence against a Kaiser Permanente facility, doctor, or other employee. These arbitration clauses are common in employee-employer contracts, but many Kaiser Permanente HMO members are not aware of the unique legal system Kaiser Permanente has developed and used over the years.
In 1978, Kaiser Permanente implemented a private arbitration clause in all contracts with patients, requiring the use of private arbitration procedures for product liability, prescription medication claims, negligence, and medical malpractice claims against all Kaiser employees or doctors from the Permanente Medical Groups. Kaiser Permanente pays the Office of the Independent Administrator to handle the private court system for all claims filed against Kaiser employees or Permanente Medical Groups doctors.
The Office of the Independent Administrator upholds strict rules for claims filed through the Office, such as an 18-month resolution timetable beginning on the date a claim is filed with the Office. Kaiser Permanente’s Office of the Independent Administrator also upholds complex and unique rules for timing, procedures, and disposition of claims against Kaiser Permanente entities and employees.
Breaking and Challenging Your Patient Contract with Kaiser Permanente
If you are covered under the Kaiser Foundation Health Plan, your patient agreement included a waiver of your right to a jury trial. The legal team of Kenneth M. Sigelman & Associates can determine if there is room in your case to challenge or break this contract and confront the one-sided Kaiser Permanente arbitration system. In some cases, we can provide the opportunity to seek legal remedy outside of this private arbitration system. In others, we can provide the legal counsel you need to navigate the Kaiser Permanente arbitration system successfully.
Kaiser Permanente arbitrators often attempt to handle their arbitrations on an “informal” basis but having an attorney on your side helps to keep the proceedings of your claim consistent with the California Evidence Code and the California Code of Civil Procedure. An experienced Kaiser Permanente medical malpractice attorney will recognize that the arbitration is the client’s “day in court” and provide a well-rounded explanation of the client’s claim and right to recovery.
Elements of a Successful Medical Malpractice Claim Against Kaiser Permanente
During Kaiser Permanente arbitration for medical malpractice, the plaintiff’s attorney must establish the basic elements of medical malpractice and bear in mind that the arbitration hearing may be as close to a jury trial that the client may get. The plaintiff’s attorney should make a compelling opening statement, offer a robust trial presentation of the evidence, and refer to all available testimony the same way they would in a jury trial.
Witness examinations may also take place, and the plaintiff’s attorney must conduct these interviews as if they were questioning witnesses in front of an actual jury in a courtroom. It falls to the plaintiff’s attorney to remind the arbitrator of their duty to conduct a fair and impartial arbitration process and to carefully weigh all available evidence in the same vein as it would be considered in court.
It is essential for any patient injured by medical malpractice to hire an attorney who has an in-depth knowledge of Kaiser Permanente’s electronic records system and the various ways medical malpractice might be hidden or covered up within this system. There is no indication that Kaiser Permanente has any intention of altering their usage of their arbitration system anytime soon, so Kaiser Permanente patients who suffer damages from medical malpractice must hire attorneys who know the Kaiser Permanente arbitration system inside and out.
Potential Damages and Recovery from Your Successful Claim
The damages recoverable from a Kaiser Permanente medical malpractice claim mirror those of a standard medical malpractice claim carried through the typical court system. An injured patient can potentially recover any and all damages resulting from the medical malpractice or negligence in question, and the Kaiser Permanente arbitrator may agree to an arbitrated verdict or settlement that covers the full extent of the patient’s damages, including wrongful death damages awarded to family members of a deceased patient who died due to medical malpractice.
The legal team of Kenneth M. Sigelman & Associates understands how daunting it can be to pursue a medical malpractice claim against a massive company like Kaiser Permanente, but we do not back down from intense litigation. Attorney Sigelman’s experience as both an attorney and a doctor provides clients with an unmatched level of representation, even in difficult Kaiser Permanente arbitration hearings. If you believe you have grounds for a medical malpractice claim against Kaiser Permanente, contact Kenneth M. Sigelman & Associates today to schedule your free consultation.