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Are You a Victim of HMO and Clinic Liability? Five Instances That May Entitle You to Compensation Under the Law

Did you know that you may be able to hold HMOs and clinics liable for injuries affecting patients?

Many patients have opted into HMO programs to support their medical care. Unfortunately, however, not all HMOs are created equal, meaning that patients can become the victim of preventable injuries. In these cases, a Florida HMO and clinic liability law firm can help you fight to recover compensation when you or a loved one suffers serious injury due to HMO and clinic liability.

Understanding the Elements of Medical Malpractice

In a medical malpractice lawsuit, a victim or a Florida HMO malpractice lawyer will need to prove that the doctor made an error or was negligent and that these actions led to injury or harm. A victim must prove the following elements in a general medical malpractice case:

  • There was a doctor-patient relationship.
  • The doctor owed a duty to the patient and breached that duty.
  • That breach of duty led to injury or harm.
  • The harm or injury resulted in the worsening of the illness or damages.

There are five different kinds of cases that can lead to a lawsuit against an HMO:

  1. Situations in which a primary care physician working at a clinic did not complete a referral to a specialist that might have helped the patient recover from a condition or get necessary care to stop the condition altogether.
  2. The second type of case includes a patient’s condition worsening after being denied care. A denial like this can delay a patient’s ability to bounce back and may even require them to miss work or significantly alter their daily life and quality of life.
  3. The third type of case refers to situations in which a certain kind of medication was denied when there was clear evidence that this kind of medicine could have helped the patient.
  4. The fourth type of situation is when a physician orders a medical test that the HMO denied. Imagine, for example, that a physician ordered a CT test to rule out whether or not a child’s seizures were serious or life-threatening. If the HMO rejected the request and the patient continues to suffer more advanced problems, such as a tumor later, this could form the basis of an HMO clinic liability lawsuit.
  5. The fifth type of case refers to those situations in which a clinic physician did not run all of the necessary tests to begin with, meaning that they did not obtain a proper diagnosis.

Challenges of Filing a Lawsuit Against an HMO

Any medical malpractice suit comes with challenges and rules that must be followed to recover damages. Filing a lawsuit against an HMO also carries additional challenges because of the base claim against the medical professional that might also exist and the difficulty of collecting evidence to show that the HMO played a role in the negligence. An HMO who merely contracts with a physician may not be liable for that physician’s negligence unless there is active negligence on the part of the HMO.

Medical malpractice lawsuits in FL against HMOs are less common than suits against individual providers, which means there is not as much legal precedent in place. Furthermore, because of the complexities of filing a case like this, we cannot overstate the importance of hiring a fully experienced attorney in this field.

Remember that you cannot file a medical malpractice lawsuit if the statute of limitations has passed. All states have rules about the time limits in which the victim or their surviving family members must file a suit to prevent cases from decades or years past from coming forward.

In Florida, HMO medical malpractice cases should be filed no later than two years after the date on which the victim became aware of the negligence in question.

There are two exceptions to this filing deadline, however. Florida has what is known as a statute of repose in place, meaning that unless there is concealment, fraud, or misrepresentation at play, an individual cannot sue a healthcare provider in any circumstances if it has been more than four years after the date of the actual incident. The second exception has to do with the statute of repose and children. The four-year deadline cannot cut off a child’s right to a medical malpractice claim if it would do so before the child turns eight years old. Bear in mind, however, that the two-year overall deadline might still apply if any legal guardians knew about the malpractice.

Unfortunately, there are far too many situations in which HMOs focus on the bottom line at patients’ expense. If you believe that you or your loved one has suffered the consequences of an HMO’s liability, you need to retain an experienced Florida medical malpractice law firm to proceed with your next steps. Our professional team of medical malpractice attorneys at Menendez Trial Attorneys cares about your rights. Contact us today at (305) 445-6500 to schedule a free consultation to discuss your case. We serve clients throughout Miami-Dade and South Florida.


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Disclaimer: The information in this blog post (“post”) is provided for general informational purposes only, and may not reflect the current law in your jurisdiction. No information contained in this post should be construed as legal advice from the individual author or the law firm, nor is it intended to be a substitute for legal counsel on any subject matter. No reader of this post should act or refrain from acting on the basis of any information included in, or accessible through, this post without seeking the appropriate legal or other professional advice on the particular facts and circumstances at issue from a lawyer licensed in the recipient’s state, country or other appropriate licensing jurisdiction.

Menendez Trial Attorneys
113 Almeria Avenue
Coral Gables, FL 33134