What constitutes a claim that should be reported?

A claim can be first made under several different scenarios: 

1. Receipt of a letter or verbal statement making a monetary demand 
2. Receipt of a Notice of Claim or Representation letter directed to the Insured 
3. Receipt of a summons, citation & petition or any other process from a court of law 
4. When an injury occurs, which appears likely to involve the insured in a claim or suit for damages

How do I report a claim?

A claim can be reported by phone, fax, e-mail, overnight mail, or regular service of mail. It should be reported to the JUA immediately, no later than 7 business days. Upon receipt of a claim, the JUA should be provided a complete copy of the documentation received, along with the patient’s name, the date of loss, time and place of the incident, and circumstances surrounding the injury itself. Once your claim has been reported and coverage has been confirmed, a claim number will be assigned and the JUA Claims Manager will walk you through the process and answer any questions.

How is the defense attorney chosen?

If a lawsuit is filed, or it is determined that a file in claim status requires consulting with an attorney, the JUA will retain counsel, under the policy, on behalf of the insured physician or facility. The JUA maintains a panel of approved defense firms throughout the State of Texas. The approved firms/attorneys must meet the criteria set forth in the JUA Claims Management Guidelines.

What type of information can be provided to the policyholders?

The JUA can provide information on a policyholder's credentials and loss history to authorized individuals only.