Report a Medical Malpractice Claim/Suit

Please use this form to report any medical malpractice claims or suits.

It is important that you notify us of any lawsuits as soon as possible to ensure we meet the deadline to file an appearance on your behalf.

* = required field

Date *

Contact Name *

Contact Phone *

Contact Email *

Matter Type *

Incident Date *

Insured Group Name (if applicable)

Insured Provider Name(s) (if applicable)

Name of Patient (if known)

Patient Medical Record Number (if known)

Patient Date of Birth (if known)

Description of Incident *

Upload Optional Documents (i.e., letter of representation, photographs, medical records, incident report, etc.)

Optional Document

reCAPTCHA *

Contact HHCISL

Sharon Daust-Deleeuw
Marsh Senior Vice President, HealthCare Practice
Sharon.L.Daust-Deleeuw@marsh.com
248.945.5328

Mike Kane
HHC Director of Insurance & Risk Financing
Michael.Kane@hhchealth.org
Office: 860.545.4841
Mobile: 860.227.4052

Sharon Daust-Deleeuw
Marsh Senior Vice President, HealthCare Practice
Sharon.L.Daust-Deleeuw@marsh.com
248.945.5328

More Information

If you encounter any issues with the link, you may use the following email to report any claim or suit: NewClaimsReports-VAP@HHCHealth.org

Chris Maiello
Associate General Counsel
Christine.Maiello@hhchealth.org
Office: 860.545.3336
Mobile: 860.936.2053