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Early case assessment for malpractice claims: an interactive checklist

By Ahmed Jemaa, Co-Founder and CEO of Medrecords AI. Updated 2026-11-14.

Answer in brief: early case assessment is the first structured look at a malpractice claim: what the chart shows, what is missing, how strong the care and causation questions look, and which path to take. AI speeds up the record items on this list (timeline, missing records, damages documents). Notice, preservation, the expert opinion, disclosure and the reserve stay with people.

Limits: We read each vendor's own web pages and the cited studies on 2026-11-14 and did not upload records to any tool, ours included. Nothing here is legal, actuarial or clinical advice; privilege and reserving rules vary by state and by program.

What an early case assessment has to answer

An early case assessment, or ECA, turns a notice into a plan. A demand letter, a records request from plaintiff counsel, a presuit notice or a served complaint each starts it. Whatever your program calls it, it answers 5 questions, usually in a short memo for the claims committee:

What happened, in order, according to the chart?
Do we have every record we need, and are they preserved?
What does a qualified reviewer think of the care and of causation?
What are the likely damages, and what documents support them?
Which path: disclose and offer, defend, or investigate further, and when do we look again?

Questions 1, 2 and the document half of 4 are reading jobs. That is where AI earns its place. Questions 3, 5 and the value half of 4 are judgment. The checklist marks each item so you can see the split.

Early case assessment checklist: 28 items

Tick items as you go. AI can help marks items a record review tool can draft or speed up; someone still checks the output. Must do marks items we'd expect before an ECA memo goes to committee. Nothing you tick leaves your browser, and the list resets when you reload.

1. Notice and clocks Date and type of notice logged: demand, records request, presuit notice or complaintMust do Carrier, captive or excess insurer notified as the policy requiresMust do Limitations date and any presuit notice deadline calendared by counselMust do Litigation hold issued: EHR, audit trail, monitor and pump data, emails, textsMust do

2. Records Full chart for the episode pulled: orders, MAR, flowsheets, notes, resultsAI can help EHR audit trail exported for the notes that matter Device and monitor data secured: pump logs, telemetry, fetal strips, imagingMust do Prior and later providers listed, with records requestedAI can help Duplicate pages removed and the unique page count recordedAI can help Records the chart refers to but the file lacks, listed by dateAI can help

3. Facts Page-cited timeline of the episode builtAI can helpMust do Every timeline line the memo relies on checked against its cited pageMust do Late entries and amended notes flagged, with care time and entry timeAI can help Status and storage of the incident report and internal review confirmed with counselMust do Involved clinicians listed with roles; employment and coverage status confirmedAI can help

4. Care questions for the reviewer Questions for the reviewer written from the timeline, as questions, not conclusionsAI can help Reviewer in the matching specialty chosen, internal or externalMust do Reviewer's view on the standard of care receivedMust do

5. Causation and damages Baseline health and prior conditions documented from earlier recordsAI can help Current condition and course documented from later recordsAI can help Billed and paid medical expenses gathered, with lien informationAI can help Wage loss and other economic loss documents requested Reviewer's view on causation received

6. Resolution path Disclosure conversation with the patient or family documented, if your program has oneMust do Venue, jurisdiction and damages caps noted by counsel Initial case reserve set, with a written rationaleMust do Recommendation recorded: disclose and offer, defend, or investigate, plus a next review dateMust do Patient safety follow-up assigned separately from the claim

0 of 28 done.

Open items, ready to paste into your ECA memo:

How we built this list: from the 5 questions above, the record-preservation duties that follow a notice, and the clocks cited on the home page. It is a starting point, not a standard. Add your program's own items, such as reporting to a state agency or a captive's notice form.

Which items AI speeds up, and how much to trust it

11 of the 28 items carry the AI tag. All are reading or sorting jobs, and all have an output you can check against a page:

Item	What the tool gives you	How to check it in minutes
Timeline	Every entry in time order with its page	Open the cited page for each line the memo uses
Missing records	Records referred to but absent, by date	Search the file for 2 of them yourself
Late entries	Notes whose entry time is well after the care time	Compare with the audit trail for the key note
Duplicates	Unique page count; repeats removed	Spot-check 5 removed pages against their kept twin
Prior and later care	Baseline and current condition with pages	Read the 2 or 3 entries that define baseline
Medical expenses	Billed and paid amounts pulled from bills and EOBs	Total them yourself from the cited pages
Reviewer questions	Neutral questions tied to timeline entries	Remove any question that assumes the answer

The other 17 items are notices, holds, coverage, privilege, the expert and the decision. A tool can remind you of them. It can't do them.

A 1-page ECA memo template

Copy this into your own format. The bracketed parts come from the checklist. Keep conclusions in the reviewer's and counsel's words.

EARLY CASE ASSESSMENT, [claim number], [date]
Prepared by [name, role], at the direction of [counsel], [privilege label per counsel]

1. Notice: [type], received [date]. Carrier notified [date]. Hold issued [date].
2. Episode: [admission or visit dates, unit, service]. [1 to 3 sentences, cited pages].
3. Key timeline: [5 to 10 lines, each with date, time, source and page].
4. Records: [unique page count]. Missing: [list]. Requested: [dates].
5. Care questions sent to reviewer: [list]. Reviewer view: [summary in reviewer's words].
6. Causation view: [reviewer's words, or pending].
7. Damages documents: [medical expenses billed and paid, wage records, liens].
8. Disclosure status: [conversation date and who attended, or not applicable].
9. Reserve: [amount] set [date] by [name]. Rationale: [2 to 4 sentences].
10. Recommendation: [disclose and offer / defend / investigate]. Next review: [date].

Why the early look pays off

The studies on the home page point the same way. In 1,452 closed claims, 37% involved no error, and most of those were never paid; administrative costs ran 54 cents per dollar of compensation (Studdert et al., 2006). After the University of Michigan Health System adopted disclosure with offers, the median time from claim to resolution fell from 1.36 to 0.95 years (Kachalia et al., 2010; the authors caution the design can't prove cause). An ECA that sorts error from no-error early is the step those results depend on.

Questions about early case assessment

When should an early case assessment start?

At the first notice that a claim is likely: a demand letter, a records request from plaintiff counsel, a presuit notice or a served complaint. Many programs also open one after a serious event before any notice arrives, inside their communication and resolution program.

Who should do the early case assessment?

The claims or risk lead runs it, with defense counsel, a reviewer in the matching specialty and, for the reserve, whoever has reserve authority. AI tools support the record work; they don't sign off on any part.

Can we run the checklist on a closed claim?

Yes, and it's a good test of a tool. Run the 11 AI-assisted items on a closed file and compare with what your team found at the time.