How a Medical Negligence Claim Works, Step by Step
A medical negligence claim usually follows five steps: a first conversation, records and independent expert opinion on whether the care fell short and caused the injury, assessing what the injury has cost, putting the claim to the other side, and mediation and settlement. Most claims settle without a trial. Rosemary’s practice aims to complete claims within 18 to 24 months, although claims for children can take longer. This guide walks through each step and what you will be asked to do.
Most people picture a courtroom when they think about “suing a doctor”. For many, that picture alone is enough to stop them asking whether they have a claim at all.
The reality is quieter and slower than that. Most of a claim happens on paper, between lawyers, experts and insurers. You do not usually have to face the doctor. And most claims are resolved at a negotiated settlement, not a trial. Knowing what is ahead can make the decision to ask far less daunting.
The five steps of a claim
Every claim is different, and steps sometimes overlap. But this is the path most claims follow.
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The first weeks
A first conversation
You explain what happened, at your own pace. Your lawyer will ask about the care you received, what has changed since, and when you first realised something was wrong. You should come away with an honest early view, including if there does not appear to be a claim, and an explanation of your options. This conversation is free. Find out about a free case review.
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Usually three to nine months
Records and independent expert opinion
With your permission, your lawyer requests the medical records from every hospital, clinic and practitioner involved, and builds a detailed timeline of your care. Independent specialists in the relevant field, who had no involvement in your care, then review it and answer two questions: was the care below the standard the law expects, and did that cause your injury? Both answers need to be yes for a claim to go ahead.
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Ongoing
Understanding your losses
Further reports look at your condition now, what the future holds, and how the injury affects your work, care needs and daily life. You may be asked to see a specialist for an assessment, and the other side may ask you to see doctors of their choosing. This evidence is what compensation is based on. Read what compensation can cover.
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Once the evidence supports a claim
Putting the claim to the other side
The doctor, hospital or health service, and usually their insurer, receive the details of the claim and the evidence behind it. From here, the claim is mostly handled between lawyers and insurers, not with the doctor.
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Often 12 to 24 months in
Mediation and settlement
Most claims settle at mediation, a confidential meeting where both sides try to reach an agreement with the help of a neutral mediator. You can attend, your lawyer will prepare you beforehand, and you never have to accept an offer you are unhappy with. Settlements for children must be approved by a court. Only a small number of claims go to a full hearing before a judge.
Strict time limits apply to medical negligence claims, and they do not always run from the day of treatment. If you are unsure, it is important to get advice early. Read about time limits, or whether you can still sue a doctor years after surgery and what a recent case means for late claims.
How long does a claim take?
At Peter Evans & Associates, Rosemary’s practice aims to complete claims within 18 to 24 months of the first conversation. Some take longer, and the timeframe depends on a few things outside anyone’s control:
- Experts need time. Good specialists are in demand, and their reports need to be thorough.
- Your condition needs to settle. Future losses can only be assessed properly once doctors can say what the long-term picture looks like.
- Children’s claims take longer. The full effect of an injury to a baby or child may not be clear until they are older.
Throughout, your lawyer should keep you informed about what is happening and what is coming next.
Who does what
Your part
- Explain what happened, in your own words
- Sign forms so your records can be requested
- Attend some medical assessments
- Keep receipts and note how the injury affects you
- Make decisions at key points, such as offers
Your lawyer’s part
- Get and review your records
- Find and brief the right experts
- Deal with the other side and their insurer
- Prepare the evidence of your losses
- Explain your options plainly at every step
What it costs
The first conversation is free. Before any further work starts, how costs work should be explained to you in writing, in plain language, so you know where you stand from the beginning.
In my practice
The people I talk to rarely start by asking about compensation. They ask whether what happened to them was normal, whether anyone will listen, and whether they are overreacting. A claim is one of the few ways to have independent experts look closely at your care and answer those questions properly.
Asking about a claim is not the same as committing to one. Plenty of people come to me simply to understand what happened. Whatever you decide, you deserve a clear explanation.
With care,
Rosemary
Frequently asked questions
Will I have to go to court?
Probably not. Most medical negligence claims settle, usually at or after mediation. Only a small number go to a full hearing before a judge.
Will I have to face the doctor?
Usually not. Once a claim is made, it is generally handled by the other side’s lawyers and insurer. If you attend a mediation, the doctor is rarely there.
Who is the claim against?
It depends on where you were treated. A claim may be against a private doctor, a private hospital, or the health service responsible for a public hospital. In most cases, an insurer manages the claim on their behalf.
How long does a medical negligence claim take?
Rosemary’s practice aims to complete claims within 18 to 24 months. Some take longer, particularly claims for children, because the full effect of the injury may not be clear until the child is older.
What do I need to start?
Nothing, except your account of what happened. Dates, letters or test results help if you have them, but your lawyer can request your records for you.
Can I make a complaint and a claim?
Yes. A complaint and a claim do different things. A complaint can bring answers, an apology or changes in care. A claim is about compensation for the harm. Many people do both.
Wondering whether you have a claim?
A short, confidential conversation can help you understand what happened and what your options are. There is no cost to find out where you stand.
- Free claim checker: is it worth a closer look?
- Time limits: how long do I have?
- Compensation: what can I claim for?
- How a claim works, step by step (you are here)
- Free case review
Written by Dr Rosemary Listing, PhD (Law). Rosemary is a medical negligence lawyer and Of Counsel at Peter Evans & Associates. She has practised since 2013 and worked on many hundreds of claims. Her doctoral research examined patterns of failure in medical negligence, and she is a Sessional Lecturer in Health Law at the University of Newcastle. She is responsible for all content published under her name.
Legal information reflects the law as at the review date. Timeframes are typical ranges, not guarantees, and every claim is different.
Last updated 27 October 2026. First published 27 October 2026. Next review April 2027.
This article is general information only. It is not legal advice about your situation, and reading it does not create a lawyer and client relationship. If you are worried about your health, please see your doctor. If you are in crisis, call 000 or Lifeline on 13 11 14. Legal services are provided by Peter Evans & Associates.