Claims Management

What should I report to the EPIX Claims Department?

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Effective claims management relies on timely notification of an incident or claim. You should notify EPIX as soon as reasonably possible if you receive any of the following:

• Letter of intent or correspondence serving as notice of a claim or lawsuit from a patient or attorney
• Notice from a hospital or other healthcare provider indicating that a lawsuit has been filed
• A written demand for compensation from or on behalf of a patient, due to an alleged error in medical treatment or an adverse outcome
• Notice of complaint from a state licensing board or other consumer complaint board
• Notice from a patient's healthcare insurer of patient dissatisfaction or complaint
• Request for deposition or meeting to discuss the medical care and treatment of a patient

In addition to the above, you may want to notify us of any unexpected result, untoward complication, or adverse outcome which has occurred that may precipitate a claim. EPIX can offer advice that may prevent the situation from evolving into a future claim or provide support behind the scenes if needed.

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How do I report to the EPIX Claims Department?

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If you have a claim or potential claim to report to EPIX:

• Complete EPIX's First Report Form ( Word or PDF)
• Gather a complete and unaltered copy of the patient’s medical records
• Send the First Report Form and the medical records to us by email at claims@epixrrg.com or by fax to (530) 653-2153.

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I have reported a claim. What happens next?

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Once a claim is reported, it is assigned to a claims specialist and coverage is verified. A letter is sent to the insured physician and policyholder, acknowledging the report and verifying the applicable coverage under the EPIX policy. If a notice of claim or demand for compensation has been received, a response letter is sent to the patient or patient’s attorney, requesting specific allegations, damage information, and pertinent medical records. If a lawsuit has been filed, we assign a defense attorney to answer the lawsuit and defend the insured physician/policyholder. A letter advising of the attorney assignment will be sent. The claims specialist assigned to your case will keep you fully informed as the case proceeds, both directly and through your assigned attorney. If you have questions, do not hesitate to call your claims specialist.

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