Doctors are obliged to take out malpractice insurance

Medical malpractice suspected: you need to know that

If medical professionals make mistakes and this results in harm to their patients, you may be entitled to damages and compensation for pain and suffering. To do this, you must first prove a medical malpractice and prove that you have suffered damage as a result of this mistake. To do this, as a first step, the complete medical records must be requested and checked by all attending physicians. You have the right to view your patient file at any time.

In order for you to be able to prove the malpractice, a medical expert opinion must usually be obtained.
Your health insurance company and the expert commissions or arbitration boards of the state medical associations can help you with this

Step 1: Contact your health insurance company

In the first interview, first describe your case and your complaints in detail. During this initial consultation, the responsible employee will inform you about your patient rights, the specific support from the health insurance company and the further course of the consultation. It is helpful to make a written memory log of the course of treatment.

Step 2: Assessment of the previous course of the disease

The health insurance company can check the information you have provided to ensure that it is complete and plausible. In addition, the health insurance companies have the option of drawing on further data on the care situation, which can already provide important indications of a treatment error - for example if you have been transferred to a special hospital after a routine operation. In addition, the health insurance companies can request treatment documents as well as examination results, x-rays or other images from doctors and hospitals for an assessment. To do this, you have to sign a confidentiality release declaration from your health insurance company.

This procedure can relieve you as a person seeking advice, as you then no longer have to worry about inspecting files at doctors and hospitals yourself.

Step 3: Report from the Medical Service of Health Insurance (MDK)

If there is justified suspicion of a malpractice, the health insurance company can commission the Medical Service (MDK) to provide an expert opinion. The report is free of charge. The MDK assesses whether the health insured has suffered damage to their health and whether a treatment error is the possible cause. The expert opinion then serves as a technical basis for further judicial or extrajudicial clarification.

Step 4: Final statement from the cash register

At the end of the analysis, the health insurance company should finally evaluate all available documents. Even if the health insurance company does not have the MDK prepare an opinion, you should insist on a written statement on your concern.

In the letter, the fund should explain clearly which facts it has, which conclusions can be drawn from them and which further steps follow. If the expert opinion comes to the conclusion that there is no medical error, it should be explained why there was no medical error or why a continuation of the matter is not advised.

The best way to clarify any unanswered questions is in a final discussion with the supervising employee. However, if a health insurance company finds a treatment error after a thorough examination of the facts, you should then consult a specialist lawyer for medical law to enforce your claims for damages at the latest.

Important to know: In any case, please note the limitation period!

Claims based on treatment errors become statute-barred after three years. The period begins at the end of the year in which the claim arose. Basically, it is crucial when you became aware of the error and its cause.

Arbitration proceedings of the state dental associations

If you suspect a medical malpractice, contact the arbitration boards of the dental associations. We have summarized for you when and where you can contact an arbitration board, what costs you will incur and how the procedure works.

This content was created by the consumer centers North Rhine-Westphalia and Rhineland-Palatinate for the network of consumer centers in Germany.