What to do when you receive a letter of complaint and/or summons?

Receiving a formal complaint, letter of demand or summons can leave even the most experienced professional feeling anxious. It is natural to want to respond immediately, explain what happened and defend your reputation. Before you do, pause.

What you say and do next could affect your legal position and your professional indemnity insurance cover. A rushed email, an informal promise or an attempt to settle the matter privately may seem helpful at the time, but it could make the situation more difficult to manage later.

Receiving a complaint doesn’t automatically mean that you were negligent or that you will be held liable. It means that the matter needs to be handled carefully, promptly and through the correct channels. This guide explains what to do, what to avoid and when to contact your broker or insurer.

First, understand what you have received

A letter of complaint, a letter of demand and a summons are not the same thing. Each one may require a different response, so your first task is to identify the document in front of you.

A letter of complaint

A complaint is usually an expression of dissatisfaction with your conduct, service, advice or treatment. It may come directly from a client, patient, family member, employer, professional body, regulator or ombud.

Sometimes the person simply wants an explanation or an apology. In other cases, they may be asking for a refund, corrective action, compensation or a formal investigation.

A complaint does not always develop into a claim, but it may be the first sign of a situation that could lead to one. For that reason, it should not be dismissed as an emotional response from an unhappy client or patient.

Before responding, refer the complaint to Shackleton Risk or your insurer. The insurer can help you prepare an appropriate response and begin building the strongest possible defence from the outset. Responding without guidance, admitting fault, offering compensation or making promises could prejudice the insurer’s rights or make the matter more difficult to defend later.

Even if the complaint appears minor or unfounded, notify your broker promptly and wait for guidance before sending a substantive response.

A letter of demand

A letter of demand is generally more formal. It sets out what the sender believes went wrong and what they expect you to do about it. The letter might demand compensation, repayment, access to records or a response within a specified period.

It may come from the person directly or from an attorney acting on their behalf. A letter of demand is not a court order, but it is often a clear indication that legal proceedings are being considered. It should be referred to your broker or insurer immediately.

A summons

A summons is a formal court document that starts legal proceedings against you. It generally identifies the parties, explains the claim and states how and when you must respond. A summons should never be placed in a drawer or left until you have time to deal with it. If you fail to respond within the required period, the claimant may be able to apply for default judgment. This means a court could grant judgment against you without first hearing your full defence.

Under the South African Uniform Rules of Court, an ordinary High Court summons will generally allow at least 10 days after service for the defendant to deliver a notice of intention to defend. However, not every legal document follows the same timetable. Urgent applications, regulatory notices and other proceedings may have much shorter deadlines. Don’t try to calculate the deadline from memory. Check the document itself and obtain legal assistance immediately.

What should you do when you receive a complaint?

The safest response is a calm and methodical one. These steps will help you protect your position while your broker assesses the matter.

1. Record exactly when the document was received

Start by creating a clear record of how the complaint, demand or summons reached you. Write down:

• The date and time it was received
• How it was delivered
• The name of the person who accepted it
• The name of the sender or person who served it
• Any deadline stated in the document
• Every attachment that accompanied it

If the document was served by a sheriff, retain the envelope, service details and every accompanying page. This information matters because legal response periods are often calculated from the date of service. If there is later any uncertainty about when the document arrived, a clear record made at the time can be extremely useful.

Scan the complete document and store it securely. Check that no pages are missing and that all stamps, handwritten notes and service details are visible.

2. Read it carefully, but resist the urge to answer

Read the document slowly enough to understand who is making the allegation, what they say happened and what they want from you.

Pay particular attention to the incident or service being questioned, the dates mentioned, the amount being claimed and any response deadline. Also check whether the matter involves a court, professional council, regulator or ombud.

At this stage, you are gathering information. You are not accepting the allegations and you do not need to prepare your defence alone.

Even if the complaint contains obvious mistakes, resist the temptation to send a quick correction. A response written while you are shocked, angry or embarrassed is rarely the response you would choose after receiving proper advice.

3. Notify your broker immediately

Send the complete document to your broker as soon as possible. Don’t wait until you have collected every record or written a detailed account of what happened. You can provide additional information once the initial notification has been made. Your first message should identify you, include your policy number if it is available, explain when and how the document was received and highlight the response deadline. Attach a complete copy of everything you received.

Ask for written confirmation that your notification has been received. You should also ask who will be managing the matter and whether any immediate action is required. Prompt notification is particularly important with professional indemnity policies. Many of these policies are written on a claims-made basis, which means the timing of the claim and its notification may determine whether the policy responds.

Your obligation may also begin before a formal claim is made. As Aon South Africa explains in its guidance on liability claims, liability policies commonly require an insured to report not only an actual claim but also a circumstance that could potentially lead to one. This is where professionals sometimes get caught out. They decide not to report an incident because they do not believe they were at fault. 

The duty to notify is not necessarily based on your personal view of whether you are liable. The question is whether the situation could reasonably develop into a claim. Early notification gives the insurer an opportunity to investigate while records are available and memories are still fresh. A delay may prejudice that investigation and, depending on the policy wording and circumstances, could affect your cover. If you are unsure whether something needs to be reported, speak to your broker. It is usually far better to ask the question early than to explain a late notification after the matter has escalated.

4. Do not admit liability

One of the most important things you can do is avoid making any statement that accepts legal responsibility. This does not mean that you need to be defensive or unsympathetic. It simply means that you should not reach a legal conclusion before the facts have been investigated.

A statement such as “I am sorry that this has been such a distressing experience” expresses empathy. A statement such as “I am sorry that my negligence caused this” could be understood as an admission of liability. The difference is significant.

You should also avoid promising to pay compensation, refunding fees, offering free corrective services or agreeing to settle the matter privately without approval. Professional indemnity policies commonly restrict an insured from admitting liability, negotiating a settlement, making a payment or incurring defence costs without the insurer’s prior consent. 

Similar guidance is provided by the Legal Practitioners Indemnity Insurance Fund, which warns insured practitioners not to admit, deny, negotiate or settle a claim without approval. The principle applies more widely across professional indemnity insurance. The insurer must be given an opportunity to assess the allegations and determine the most appropriate response.

5. Acknowledge the complaint only if necessary

Sometimes a complainant expects an immediate acknowledgement, or a professional body requires confirmation that its correspondence has been received. If an acknowledgement cannot wait, keep it brief and neutral. You might say:

“Thank you for your correspondence. We acknowledge receipt and are referring the matter through the appropriate review process. We will respond once the matter has been considered.”

Do not include a detailed explanation, challenge the complainant’s version or make promises about the outcome. Whenever possible, ask your broker to approve the wording before it is sent. A short, courteous acknowledgement can reassure the complainant that the matter has not been ignored. It should not become an improvised defence.

6. Preserve every relevant record

Once you become aware of a complaint or potential claim, take immediate steps to preserve the available evidence. Depending on your profession and the nature of the allegations, relevant records may include:

• Client or patient files
• Clinical or consultation notes
• Consent forms
• Contracts and engagement letters
• Appointment and diary records
• Emails and messaging-app conversations
• Invoices and payment records
• Photographs, scans and test results
• Internal reports and incident records
• Telephone notes or recordings
• Staff rosters and training records
• Policies and operating procedures
• CCTV footage
• Electronic audit trails and metadata

Do not delete a message because it looks unhelpful. Do not ask a staff member to clean up a file or replace an original document with a more polished version. Most importantly, never alter a clinical or professional record retrospectively. An unexplained change can damage the credibility of records that may otherwise have supported your position.

There may be circumstances where a legitimate supplementary note is appropriate. If so, it should be clearly identified as a later entry, accurately dated and made only after you have obtained suitable advice. It should never be presented as though it formed part of the original record.

Preserving evidence does not mean sharing confidential information without restriction. Records must still be stored and handled securely in accordance with the Protection of Personal Information Act, your professional duties and any applicable record-retention requirements.

7. Write down what you remember

While the events are still fresh in your mind, prepare a factual chronology for your insurer and legal team. Start with the first relevant interaction and work forward in date order. Explain what service, advice or treatment was provided, what information was available at the time, who was present and what follow-up took place. Include when you first became aware that the client or patient was dissatisfied.

Be clear about the difference between what you personally remember and what you learned later from a file or another person. If you cannot remember something, say so. Do not fill gaps with assumptions. A straightforward account is far more valuable than a defensive one. Your attorney needs the facts as they are, including anything that may be uncomfortable or unhelpful. Surprises are much easier to manage when they are disclosed early and privately.

Label the chronology as confidential and prepare it for the purpose of obtaining legal and insurance advice. Do not circulate it among colleagues unless your appointed adviser tells you to do so.

8. Identify everyone involved

A complaint may involve more than one person or business. Tell your broker if the matter concerns an employee, partner, locum, assistant, subcontractor, supplier, healthcare facility or another professional. This allows the insurer to consider whether another party needs to be notified and whether any conflict of interest could arise.

You may ask employees to preserve their records and prepare an independent account of what they remember. However, do not hold a group discussion in which everyone tries to agree on a single version of events. That can unintentionally influence recollections and create problems later. Each person should give an honest account in their own words.

9. Keep the matter confidential

It is normal to want to talk to someone when you receive upsetting correspondence, but a complaint or legal claim should only be discussed with people who genuinely need to know.

That will usually include your broker, insurer, appointed attorney and authorised decision-makers within your organisation.

Do not discuss the allegations on social media, in informal professional groups or with colleagues who are not involved. Do not share a patient or client’s records simply because someone has offered an opinion or informal assistance.

If the complaint concerns a patient, your duty of confidentiality does not disappear because the patient has made an allegation against you. Personal information must still be handled carefully and lawfully.

Public comments can also create new difficulties. Even a vague social media post about a “difficult client” may be identifiable from the surrounding circumstances and could be used to question your professionalism.

Prepare before a complaint arrives

The best time to establish a complaints procedure is before you need one. Every professional practice should have:

• A written process for receiving and escalating complaints
• A designated person responsible for notifying the broker
• Easy access to current policy and contact details
• Secure record-keeping and document-retention procedures
• Staff training on admissions, compensation and confidentiality
• A process for reporting incidents and near misses
• A plan for preserving electronic and physical evidence

Staff should understand that a complaint does not need to use words such as “claim”, “negligence” or “compensation” before it is escalated. An unexpected outcome, serious allegation or breakdown in a professional relationship may already constitute a reportable circumstance.

Your professional indemnity cover should also be reviewed regularly with Shackleton Risk. Check that the insured names, professional activities, indemnity limits and retroactive arrangements remain appropriate for your practice. A policy that suited your business several years ago may no longer reflect the work you perform today.

A calm response protects your position

Receiving a complaint or summons is stressful, but you do not need to manage it alone.

Start with the basics. Record when the document arrived, note the deadline, notify your broker or insurer and preserve the relevant information. Avoid admissions, private negotiations and emotional replies until you have received advice.

A complaint is an allegation, not a finding. A summons is the start of a legal process, not proof that you are liable. Acting early gives your insurer and legal team the best opportunity to understand the facts and protect your interests.

If you have received a complaint, letter of demand, regulatory notification or summons, contact your Shackleton Risk broker as soon as possible. You should also speak to us if you are aware of an incident that could reasonably lead to a claim, even if no formal complaint has been made yet. The earlier we know about the matter, the sooner we can help you take the right next step.

FAQs

What happens after you notify the matter?

Once the notification has been received, your broker will assess it against the wording of the policy. They may ask for supporting documents, a chronology and further information about the people involved. If the matter requires a formal response, the insurer may appoint an attorney, investigator or relevant specialist. That team will assess the allegations, consider the available evidence and advise on whether the claim should be defended, resolved or investigated further.

Professional indemnity insurance is not only there to pay compensation when an insured is legally liable. Subject to the terms of the policy, it may also cover the legal costs of defending a claim. Those defence costs can be substantial, even where the allegations are ultimately shown to be unfounded. This is another reason not to appoint your own attorney or incur significant costs without speaking to the insurer first. The policy may require prior approval, and the insurer may have a panel of suitably experienced attorneys.

What if you have already replied?

If you responded before contacting your broker, do not panic. More importantly, do not send another message in an attempt to fix the first one. Provide your broker or insurer with the complete correspondence, including your reply and any later conversations. 

Tell them about any apology, refund, payment or offer you have already made. Honesty is essential. Your claims team can only give sound advice if it understands the full position. Concealing an earlier response is likely to create a larger problem than the response itself.

Can you apologise?

Many professionals worry that contacting their insurer will prevent them from treating the complainant with compassion. It should not. There is a place for empathy, especially where someone is distressed, disappointed or has experienced a poor outcome. The risk lies in confusing empathy with a legal admission.

An appropriately worded apology may acknowledge the person’s experience without accepting negligence. Since the wording and surrounding circumstances matter, discuss the proposed response with your insurer or attorney first. A thoughtful response can still sound human. It simply needs to be informed by the facts and the legal position.

What happens if you ignore a summons?

Ignoring a summons does not make the claim disappear. If you fail to deliver the required notice or response, the claimant may seek default judgment. A judgment can have serious financial and practical consequences. Depending on the nature of the order, enforcement steps may follow. You may then need to apply for rescission of the judgment, which involves further legal work, cost and uncertainty.

If a summons has already been sitting unanswered, contact your broker and obtain legal assistance immediately. Do not assume that it is too late to act, but do not lose another day.

This article provides general information and should not be treated as legal advice. Every complaint, insurance policy and legal proceeding is different. Obtain advice from your broker based on your particular circumstances and consult the wording of your policy.