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Insurance Claims professional presents articles and videos on insurance, insurance Claims and insurance law for insurance Claims adjusters, insurance professionals and insurance lawyers who wish to improve their skills and knowledge. Presented by an internationally recognized expert and author.
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May 02, 2025
Pre-Suit Notice to Hospital Required

Failure to Comply with Tort Claims Act Defeats Suit

Post 5064

Read the full article at https://www.linkedin.com/pulse/pre-suit-notice-hospital-required-barry-zalma-esq-cfe-is3hc, see the full video at https://rumble.com/v6stk1f-pre-suit-notice-to-hospital-required.html and at https://youtu.be/EYCmc8GLcIo, and at https://zalma.com/blog plus more than 5050 posts.

In April Holifield And Jeffery Holifield v. Highland Community Hospital, No. 2023-CA-01342-COA, Court of Appeals of Mississippi (April 15, 2025) the Court of Appeals highlighted the issues surrounding proper notice under the Mississippi Tort Claims Act (MTCA) and the relationship between HCH and Forrest General Hospital (FGH).

FACTUAL BACKGROUND

Filing of Complaint

The Holifields filed a medical-negligence complaint against HCH on April 5, 2023, for injuries sustained during a procedure on November 5, 2021. Prior communication with HCH’s insurer was initiated by their attorney in January 2022.

Notice of Claim Issues

A notice-of-claim letter was sent to HCH on October 5, 2022, but there was uncertainty regarding its receipt. After discovering a change in administration, a new letter was delivered to the current administrator on October 28, 2022.

HCH’s Defense

HCH moved to dismiss the case on May 24, 2023, claiming it is not a separate entity from FGH and thus not capable of being sued under the MTCA.

Plaintiffs’ Motion to Amend

The plaintiffs sought to amend their complaint to substitute FGH for HCH, asserting that both entities received proper notice. HCH countered that FGH had not received any notice, and the statute of limitations had expired.

Trial Court’s Ruling

The circuit court denied the motion to amend on October 30, 2023, stating that HCH is a division of FGH and that the plaintiffs failed to serve proper notice to FGH’s chief executive officer before the statute of limitations expired.

DISCUSSION

Both of the trial court’s rulings at issue on appeal require a determination whether the Holifields properly served presuit notice on FGH in accordance with the MTCA.

One does not have to be a lawyer to sense that the organization, funding and operation of Memorial Hospital at Gulfport are matters capable of accurate and ready determination by resort to sources whose accuracy cannot reasonably be questioned.

In the context of an MTCA case, pre-suit notice either does or does not occur prior to the filing of a complaint. There is little that can be pleaded in an amended complaint that can cure the failure to give proper pre-suit notice of an MTCA claim. The Holifields did not provide the statutorily required notice to FGH under the MTCA. The Court of Appeals concluded that trial court did not err in denying the motion to amend the complaint.

APPEAL OUTCOME

The Court of Appeals affirmed the dismissal, emphasizing that the failure to provide notice under the MTCA warranted dismissal of the case with prejudice.

The circuit court granted HCH’s motion to dismiss or for summary judgment and entered a final judgment of dismissal with prejudice on October 31, 2023. The circuit court also addressed the Mississippi Supreme Court’s recent holding in University of Mississippi Medical Center v. Aycock, 369 So.3d 534 (Miss. 2023), that although the plaintiffs there had “never filed the statutorily required notice with the hospital’s chief executive officer,” the case should be remanded to allow plaintiffs an opportunity to “establish equitable estoppel or waiver based on the medical center’s conduct by competent evidence.” The trial court concluded that Aycock was “distinguishable” because the Holifields “had no communication with FGH (only with a claims representative working on behalf of FGH),” and “HCH committed no acts or made no communicat[ions] which could have given Plaintiffs occasion to say they ‘relied’ upon such acts or communications in good faith or to their detriment.”

ZALMA OPINION

States, like Mississippi enacted statutes limiting suits against doctors and hospitals unless the plaintiff first gives written notice to the Defendant(s) of the intent to sue and providing an opportunity to create an opportunity for an early settlement. The plaintiffs failed to give notice to the correct parties before filling suit, a statutory condition precedent to maintaining a suit against the hospitals.

(c) 2025 Barry Zalma & ClaimSchool, Inc.

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00:06:59
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Post 5163

Read the full article at https://lnkd.in/dNpKKcYx, see the full video at https://lnkd.in/dNgwRP8q and at https://lnkd.in/dA9dvd-D, and at https://zalma.com/blog plus more than 5150 posts.

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After Menchaca retained counsel HAIC advised that, under the terms of the policy, Menchaca was required to first invoke the appraisal process prior to filing suit, and that HAIC reserved the right to request that Menchaca and any adjuster hired on his behalf submit to an Examination Under Oath (“EUO”).

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August 07, 2025
Amount of Loss Set by Appraisal Award

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Post 5163

Read the full article at https://lnkd.in/dNpKKcYx, see the full video at https://lnkd.in/dNgwRP8q and at https://lnkd.in/dA9dvd-D, and at https://zalma.com/blog plus more than 5150 posts.

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In Homeowners Of America Insurance Company v. Emilio Menchaca, No. 01-23-00633-CV, Court of Appeals of Texas, First District (July 31, 2025) after a hurricane Homeowners of America Insurance Company (“HAIC”) estimated that the cost of covered repair to Menchaca’s house was $3,688.54, which was less than his deductible, and therefore no payment would be made.

FACTS

After Menchaca retained counsel HAIC advised that, under the terms of the policy, Menchaca was required to first invoke the appraisal process prior to filing suit, and that HAIC reserved the right to request that Menchaca and any adjuster hired on his behalf submit to an Examination Under Oath (“EUO”).

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There is no Tort of Negligent Claims handling in Alaska

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Read the full article at https://lnkd.in/gwJKZnCP and at https://zalma/blog plus more than 5100 posts.

CASE OVERVIEW

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May 15, 2025
Zalma's Insurance Fraud Letter - May 15, 2025

ZIFL Volume 29, Issue 10
The Source for the Insurance Fraud Professional

See the full video at https://lnkd.in/gK_P4-BK and at https://lnkd.in/g2Q7BHBu, and at https://zalma.com/blog and at https://lnkd.in/gjyMWHff.

Zalma’s Insurance Fraud Letter (ZIFL) continues its 29th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is published 24 times a year by ClaimSchool and is written by Barry Zalma. It is provided FREE to anyone who visits the site at http://zalma.com/zalmas-insurance-fraud-letter-2/ You can read the full issue of the May 15, 2025 issue at http://zalma.com/blog/wp-content/uploads/2025/05/ZIFL-05-15-2025.pdf
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Health Care Fraud Trial Results in Murder for Hire of Witness

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In United States of America v. Louis Age, Jr.; Stanton Guillory; Louis Age, III; Ronald Wilson, Jr., No. 22-30656, United States Court of Appeals, Fifth Circuit (April 25, 2025) the Fifth Circuit dealt with the ...

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Professional Health Care Services Exclusion Effective

Post 5073

See the full video at https://lnkd.in/g-f6Tjm5 and at https://lnkd.in/gx3agRzi, and at https://zalma.com/blog plus more than 5050 posts.

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