What I’ve Learned: Sean Gelsey

What I’ve Learned About Litigation, Insurance, and Claims Management
Sean Gelsey—Chief Claims Officer

Sean Gelsey, MBA, Copic’s Chief Claims Officer, brings more than 30 years of experience in litigation, insurance, and claims management, helping physicians, healthcare facilities and healthcare professionals navigate one of the most difficult experiences of their careers: a medical liability claim or lawsuit. From that vantage point, he has seen how fear, uncertainty, communication, preparation, and trust can shape not only the legal outcome, but also the personal experience of the clinician involved. Before joining Copic, he retired from the United States Air Force and worked as a senior claims professional specializing in complex medical claims.

If a patient issue comes up, contact Copic right away—it’s one of the best ways to protect yourself. One common misconception is that a matter only needs to be reported once a lawsuit is filed or papers are served. In reality, early reporting gives Copic and the defense team the best opportunity to understand what happened, preserve the medical record, evaluate the facts, and provide guidance before the situation escalates. Waiting can make an already stressful situation harder to manage and difficult to recall facts around care provided.

A claim can make you feel isolated and overwhelmed, but physicians are not alone in the process. Being named in a lawsuit can feel deeply personal, and many physicians assume they are carrying the burden by themselves. The defense attorney is there to advocate for that clinician, and Copic’s role is to stand with the insured throughout the process. Our goal is to help shoulder the weight of the matter and develop the strongest path forward as a team.

Talking medicine with other physicians is one thing. Explaining it to people outside medicine is another. Physicians are experts in clinical care, but depositions and trials call for a different style of communication. Acronyms, shorthand, and assumptions that work among colleagues may not resonate with attorneys, jurors, or patients. My advice is to slow down, speak in plain language, and confirm understanding. The goal is not to dilute the medicine, but to explain it in a way that is clear, credible, and accessible to people who are not immersed in clinical practice every day.

Preparation changes the way a physician shows up. Preparing for a deposition or trial should be approached much like preparing for an exam. Physicians need to understand the care they provided, the reasons behind their decisions, what the record reflects, and how to answer only the question asked. Clear, credible testimony is essential, as is the confidence to say, “I don’t know,” when that is the truthful answer. Preparation helps clinicians avoid speculation, unnecessary elaboration filling silence, and preventable complications.

The applicable standard of care depends on the medical setting’s geography and characteristics. A recurring lesson is that cases should not all be judged against the resources of a large metropolitan medical center. Rural communities and urban hospitals may operate with very different capabilities, and that context matters. Defense teams help clinicians understand how the standard of care is evaluated in light of the clinician’s specialty, the facts, location, available resources, and circumstances surrounding the care.

Trust and candor with the defense team are essential. Successful defense depends on timely, accurate, and complete information. Physicians may hesitate to share everything, especially when they are anxious or worried about how information will be used. But the defense team needs the full picture to help. Surprises during a deposition or trial can be damaging. Open communication helps the team evaluate the matter, prepare the physician, and avoid preventable missteps.

Documentation should be timely, accurate, and left intact. Strong documentation can be one of the most important tools in defending a claim or lawsuit. Document according to established protocols and never try to add to or alter the record after a claim or lawsuit arises. Good documentation helps explain what happened; late or incomplete documentation can create new challenges.

What gives me hope in this field is legislative progress and rising talent. I’m encouraged by courts upholding damage caps and by states pushing back against third-party litigation funding, both of which are important to protecting the practice of medicine. At the same time, as many experienced professionals move closer to the later stages of their careers, there is a meaningful opportunity to mentor younger attorneys and claims professionals. Sharing lessons learned and strengthening collaboration across defense teams is one of the most rewarding parts of my work and an important investment in the future.

"This work is ultimately about helping clinicians understand that they are not alone, that preparation matters, and that Copic is here to protect and support them through one of the hardest professional experiences they may face."

Article originally published in Copic’s Copiscope 3Q26 newsletter.