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The promise of a no-fault program which covers injured babies when no one is at fault is often an illusion.  While it is true a family does not have to actually prove someone was negligent during labor or delivery to get NICA benefits, almost all injuries that will fit under the program are by definition injuries that were actually caused by negligence at the time of the delivery.  Why do we say that? 

First, for NICA to apply the baby must be born in a hospital, so anything like a true no-fault accidental delivery in a taxicab or at home will not be covered. 

The baby must weigh at least 2500 grams (2000 grams for multiple gestation) so true no-fault injuries resulting just from  being a tiny premature baby are not covered. 

The injury by definition must be caused by oxygen deprivation or mechanical injury during the labor, or during the delivery, or during the immediate post delivery resuscitation period in the hospital. So true no-fault injuries from congenital deformities like spina bifida, downs syndrome, or similar no-fault birth defects are not covered. 

So what you are left with is that the only deliveries covered are those babies who start out full term and otherwise healthy but then during the birthing process are severely physically and cognitively injured by asphyxiation (suffocation) or mechanical trauma while they are in the hospital and under the direct care of the obstetrician and other hospital personnel. 

Most people knowledgeable about hospital based deliveries will tell you that these types of catastrophic suffocation and mechanical injuries rarely occur to otherwise healthy term newborns who are delivered in a monitored hospital setting unless there was actual negligence by those managing the delivery or resuscitation.   So in reality it is only these serious at-fault malpractice cases that are included in the NICA plan definitions and most of the real no-fault injuries are not covered by NICA at all.    


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This site contains only general background information and is not intended to constitute specific legal advice or establish an attorney/client relationship.  Malpractice laws vary from state to state and are constantly changing.   If you think you may have a malpractice case you should promptly contact a lawyer in your state with experience in handling malpractice cases.

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