A malpractice dispute can be resolved by agreement before a lawsuit is filed, but the same mediation rule does not apply to every case. A consumer dispute arising from private healthcare, a claim addressed to an insurer and a full remedy action against a public hospital are assessed separately. In a settlement, what matters is not only the amount to be paid, but also which harm is covered, how future harm is treated, when payment is made and which rights come to an end. [1] [2] [3] [4]
Settling while treatment is still ongoing may cover care or re-operation costs that are not yet known. Before signing, the medical situation, the claim items and the parties' authority to represent should be clarified.
Which malpractice disputes require mediation?
Consumer disputes concerning private hospitals and independent physicians
A dispute concerning private healthcare services that a patient obtained for non-commercial and non-professional purposes may, depending on the concrete relationship, be assessed as a consumer transaction. For disputes heard in consumer courts, the mediation condition precedent to litigation under Article 73/A of Law No. 6502 on Consumer Protection (Tüketicinin Korunması Hakkında Kanun) and its exceptions are examined. Which court has jurisdiction is not determined solely by looking at whether the defendant has the title of “doctor”. [1]
Disputes within the field of the Consumer Arbitration Committee are among the exceptions to this condition precedent. According to the Ministry of Trade's (Ticaret Bakanlığı) 2026 announcement, the arbitration committee limit applies to consumer disputes with a value below 186,000 TL. The figure just above or just below the limit matters in the same way, and so do the nature and scope of the claim and whether it falls within the committee's jurisdiction. The claim should not be artificially split to create a route of application. Limits for later years must also be checked separately. [1] [5]
Mediation as a condition precedent is not an obligation to settle. Having the required process carried out is different from accepting an offer. If no agreement is reached, a judicial application may be made together with the final minutes and the other conditions precedent to suit.
Distinction for public hospitals and insurance companies
A claim of service fault arising from public healthcare is, as a rule, taken up through an application to the administration and, within the framework of full remedy, in administrative courts. Private-law mediation under Law No. 6325 on Mediation in Civil Disputes (Hukuk Uyuşmazlıklarında Arabuluculuk Kanunu) does not apply automatically to disputes within administrative jurisdiction. The administrative pre-litigation settlement provisions under Article 13 of the Administrative Judicial Procedure Law No. 2577 (İYUK) and its scope are assessed separately. [2] [3]
A direct claim against a professional liability insurer raises questions of the policy, insurance law and jurisdiction. Where a monetary claim has the character of a commercial case, Article 5/A of the Turkish Commercial Code (TTK) is also considered. The fact that the hospital, the physician and the insurer take part in the same meeting does not show that all of them are liable on the same legal basis and without limit. The insurer's policy limit and coverage defences are examined separately. [4]
For an application to the insurance company, see malpractice insurance, coverage and compensation claim. For a route against a public hospital, see doctor error in a state hospital and full remedy action.
What file should be prepared for mediation?
For the settlement discussion to proceed properly, the treatment process, the alleged breach and the items of harm should be as concrete as possible. An amount set on an incomplete file may not cover the later treatment need. At the same time, waiting for all reports to be completed should not lead to missing application deadlines.
The preparatory file should contain the following documents:
- Treatment chronology, patient file and consent documents.
- Health records showing the current condition and the additional treatment foreseen.
- Expenses incurred, documents on income loss and care needs.
- Full identity of the parties, the company name and any policy information.
- Earlier offers, payments and signed documents.
- Known time limits and applications affecting the calculation of the time limit.
A mediator is neither a court-appointed expert (bilirkişi) nor a judge who decides the medical fault in a binding way. The parties may agree to obtain a joint expert assessment or an independent opinion to serve as the basis of the settlement. Who prepares this opinion, which questions it is meant to answer and who bears its cost should be clarified.
Which items should make up the amount to be paid?
Writing a single total figure does not always provide sufficient clarity. Past treatment costs, re-treatment, temporary loss of income, permanent loss of working capacity, care needs and non-pecuniary damages are different items. Refund of fees may also be separate from these. Earlier payments made for the same harm should be taken into account, and the item to which they are offset should be stated. [6]
| Subject of the settlement | Point to be clarified | Result of the uncertainty |
|---|---|---|
| Past expenses | Invoices up to which date? | Missing or double counting |
| Re-treatment | Scope of the procedure and price limit | New fee dispute |
| Future care | Duration, method and updating | Risk of insufficient payment |
| Non-pecuniary damages | Whose claim is it? | Confusion with the rights of relatives |
| Earlier payment | Offset against which item? | Dispute over the scope of the release |
Payment by the insurer does not automatically end every debt of the physician or the hospital that falls outside the settlement. It should be seen whether the release covers only a specific party or also other parties that are clearly identified in the text. Joint and several liability and recourse (rücu) relationships may change the consequences of the text.
For the calculation of the compensation items, see our article on how malpractice compensation is calculated.
How should harm that may arise in the future be arranged?
If the patient's recovery is still continuing, the harm may not yet be final. A new operation, prosthesis replacement, long-term care or a change in working capacity falls within this scope. A broad release that ignores these uncertainties may lead the parties into a dispute later.
The parties may consider, for example, settling only the expenses incurred up to a specific date and leaving the defined future items outside the agreement. In such a choice, the scope must be written concretely: a vague sentence such as “my rights are reserved” and, in another clause, a statement that “all claims have ended” create contradictory provisions.
Conversely, if a final resolution of the whole dispute is sought, the accepted uncertainty, the basis of the calculation and the claims covered must be clear. The later emergence of an unexpected situation does not by itself make every settlement invalid. Defects of intent, exploitation (Übervorteilung), breach of mandatory provisions or disputes over scope are assessed according to their specific circumstances. [6]
Are settlement, release and waiver of a lawsuit the same thing?
Release (ibra) aims at ending a specific debt in whole or in part. Settlement (sulh) is the resolution of an existing dispute by agreement; an in-court settlement has its own procedural consequences. Waiver of the claim (davadan feragat) is the plaintiff giving up the claim, and it produces effects similar to res judicata. These concepts should not be used interchangeably in a receipt. [6] [7]
A prior disclaimer of liability is different from a release given after the harm has occurred. The limits of Article 115 of the Turkish Code of Obligations (TBK) on advance exclusion of liability for future faults in medical services do not mean that every settlement made after an event is invalid. On the other hand, describing a payment as “help” or a “goodwill payment” does not make the extensive waiver provisions in the attached text insignificant.
The attorney must have the special authority required for a settlement, release or waiver. The participation of a relative in the meeting on behalf of the patient does not show that the relative can waive rights on their own. In cases of minors, persons under restriction and guardianship, representation and, where necessary, the permission of the authority are examined separately. [K7, Art. 74]
For the value of documents signed after a procedure, you may also read our article on whether a consent form releases the doctor from liability.
How does a settlement document become enforceable?
Article 18 of Law No. 6325 on Mediation contains special provisions on the agreement reached at the end of mediation and on its enforceability. Depending on the signature format and the type of dispute, the document may have the effect of a directly enforceable judgment, or an enforceability endorsement from a court may come into question. A signed mediation paper is not automatically treated as collectible merely because it is signed, even if its content is unclear. [2]
In a payment obligation, the amount, currency, due date, account, instalments and the consequence of default must be clear. In a commitment to further treatment, the provider, the procedure, the time frame, additional costs and how the patient's medical suitability will be assessed must be determined. The statement “the necessary treatment will be provided free of charge” may not resolve the discussion over which procedure is necessary.
The timing between payment and release is also important. An immediate and unconditional release given before the debt is paid may increase the collection risk for the patient. Conversely, making payment conditional on another party's arbitrary approval may create unpredictability for the debtor. The arrangement the parties choose should be clear and enforceable.
How are confidentiality and evidence protected?
The confidentiality of mediation, and the rule that certain statements made during the meetings cannot be used as evidence, are addressed within Articles 4–5 of Law No. 6325. Pre-existing medical records or invoices do not automatically become inadmissible evidence merely because they were presented in mediation. The settlement offer and the independent evidence of the incident should be kept separate. [2]
A confidentiality clause must not unlawfully prevent notifications that must be made to competent authorities, legal obligations, or the sharing of information needed for necessary health care. Conditions on whether the patient may post on social media require concrete assessment in terms of personality rights, freedom of expression and mandatory provisions. Protection of health data in the file continues separately.
For the general framework of the subject, you may consult our medical malpractice and physician error lawsuits page.
Do time limits continue to run while negotiations are ongoing?
Conducting ordinary negotiations with the hospital or the insurer does not automatically suspend the statute of limitations. In mandatory mediation as a condition precedent to litigation, there is a specific rule that the period between the application to the mediation bureau and the final minutes is not taken into account. In voluntary mediation, the start of the process and its effect on time limits are determined under different conditions set out in the law. For this reason, the start and end dates must be documented. [K2, Art. 16 and 18/A]
Time limits for administrative proceedings concerning a public hospital cannot be subject to the same rule. A bargaining process conducted with the wrong person, or a request for a fee refund left unanswered, may not replace an application to the correct administration and in the correct procedure. The existence of a possibility of settlement is not sufficient reason to postpone the monitoring of time limits.
For the general framework of time limits, you may consult our article on limitation periods and filing deadlines in malpractice lawsuits.
Conclusion
A good malpractice settlement is not merely agreement on an amount. It clarifies the parties to the dispute, the harms covered, the future uncertainties and how the payment will be carried out. The distinctions between consent, release, settlement and waiver should be preserved; whether mediation is required and its effect on time limits should be determined according to the concrete legal relationship.
Frequently Asked Questions
Does applying to mediation mean accepting the hospital's offer?
No. Taking part in the process and the settlement are separate matters. If the offer is not accepted, the relevant conditions precedent to suit can be completed and the matter can be taken to court.
Is mandatory consumer mediation also required for a public hospital?
A dispute based on a service fault within administrative jurisdiction is not automatically subject to consumer mediation. The prior application and the litigation route under the Administrative Judicial Procedure Law (İYUK) are assessed.
Does receiving a payment from the insurer end all my rights?
It depends on the scope of the payment and the text signed. It should be determined for which items and which persons a release has been given.
Can a lawsuit be filed on the same matter after a mediation agreement?
The law limits the filing of a new lawsuit on matters agreed upon. Specific disputes about the validity and scope of the agreement are assessed separately.
Is it important to sign a document stating “I have no remaining claims” before payment is made?
Yes. This wording may have consequences for collection and release. The payment due date and the condition under which rights end must be clearly set out.
Sources and legal bases
- Law No. 6502 on Consumer Protection (Tüketicinin Korunması Hakkında Kanun), Articles 68, 73, 73/A. Official legislation.
- Law No. 6325 on Mediation in Civil Disputes (Hukuk Uyuşmazlıklarında Arabuluculuk Kanunu), Articles 1, 4–5, 16, 18, 18/A. Ministry of Justice legislation record.
- Administrative Judicial Procedure Law No. 2577 (İdari Yargılama Usulü Kanunu), Article 13. Ministry of Justice legislation record.
- Turkish Commercial Code No. 6102 (Türk Ticaret Kanunu), Articles 5/A, 1478. Official legislation.
- Ministry of Trade (Ticaret Bakanlığı), announcement dated December 29, 2025 on the 2026 monetary limits for consumer arbitration committees. Official announcement.
- Turkish Code of Obligations No. 6098 (Türk Borçlar Kanunu), Articles 28, 30–39, 53–56, 115, 132. Official legislation.
- Code of Civil Procedure No. 6100 (Hukuk Muhakemeleri Kanunu), Articles 74, 307–315. Ministry of Justice legislation record.