Contents


Medical Malpractice Information 



All medical malpractice payments (including settlements, judgments, and arbitration awards) made within the past 5 years

  • Review any pre-printed information for factual accuracy.
  • Respond to the question regarding malpractice payments made on your behalf in the last 5 years by clicking Yes or No.
  • If the information is accurate and complete, you don't need to do anything further.
  • If any of the pre-printed malpractice events are under appeal, click on the box next to the pre-printed malpractice event. (Click on the box again to de-select).  
  • If the pre-printed information is not factually accurate, you can dispute the action by following the disputed steps.

        Disputed - The Default is NO. If you want to dispute this event, please choose YES
        Dispute Reason - Required when choosing YES to an action.
        
  • Your dispute will be directed to the New Jersey Board of Medical Examiners for review.


    Add  New Malpractice Item
  • If a medical malpractice payment made on your behalf in the past five years is not pre-printed, select the Click here to add a malpractice item link.
  • Enter data in the following fields:


         Date of Payment - Enter date (Ex. 03-24-2015)
         Dollar Amount - Enter amount (Round to nearest $)
         Type - Click on arrow, select from list
         Medical Malpractice Insurance Carrier - Click on arrow to select from list or enter the name of the insurance carrier directly in the space provided
         Under Appeal - Click on the box if this event is under appeal
         Dispute Yes/No - (if the data was entered or modified by the State of New Jersey)
         Dispute Reason - (if the data was entered or modified by the State of New Jersey)

  • Your dispute will be directed to the New Jersey Board of Medical Examiners for review.


    When finished, click one of the buttons at the bottom of the screen:
  • Save & go to previous page
  • Save & stop for now
  • Save & go to next page