As soon as the insured gets a legal notice or learns about a medical negligence, error or omission, the insured musts start preparing to file for a claim settlement. In case any legal notice or summons is received, it should be sent to the insurance company. The company has the option of arranging the defense of the case.
The event giving rise to the claim should have occurred during the period of insurance or retroactive period and the claim first made in writing against the insured during the policy period. The maximum amount payable including defense cost will be the AOA limit selected. The Any One Year limit will get reduced by the amount of claim or indemnity paid for any one accident. Any number of such claims made during the policy period will be covered subject to the total indemnity not exceeding the Any One Year limit.
Provide the completed claim form, legal notices, court and other correspondence on the matter, estimate of legal fees, letter of subrogation. Prescription copies or medical records are also helpful. Do not admit liability without informing the insurer.
Since there can often be a long delay between an event and a subsequent claim, one needs to be covered both at the time of the event and when the claim is made. It is important to maintain continuity in the policy.