California attorney · CA Bar #279869

California MICRA pre-suit notice attorney

I'm Sergei Tokmakov, a California attorney. If you have a potential medical-malpractice claim in California, CCP § 364 requires a 90-day notice to the healthcare provider before filing, and the MICRA framework (Civ. Code § 3333.2 cap, CCP § 340.5 limitations) governs the case. I write the pre-suit memo and draft the § 364 notice. Active litigation gets referred out to MICRA-experienced contingency specialists with whom I have working relationships.

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Cal. Bus. & Prof. Code § 6146
Quick answer

California's Medical Injury Compensation Reform Act (MICRA) governs all medical-malpractice actions. The 90-day pre-suit notice under CCP § 364 must describe the legal basis, the type of loss, and the nature of injuries. Civ. Code § 3333.2 caps non-economic damages (AB 35 in 2022 replaced the 1975 $250,000 cap with a scheduled, indexed structure: $470,000 non-death / $650,000 wrongful death for 2026; the AB 35 schedule increases the cap each year through 2033 for non-death and 2034 for wrongful death, rising toward $750,000 and $1,000,000 respectively). CCP § 340.5 sets the statute of limitations at one year from discovery or three years from injury, whichever is sooner. I handle the pre-suit memo and § 364 notice; active litigation is referred to MICRA-experienced contingency litigators.

90-day notice
Required under CCP § 364
$470k cap
Non-economic non-death (2026, AB 35)
$650k cap
Wrongful death non-economic (2026, AB 35)
1-year SOL
From discovery under CCP § 340.5

What I do for medical-malpractice pre-suit work

1

Calendar the CCP § 364 90-day notice.

Notice must precede filing by 90 days under CCP § 364, or the case is dismissable. I confirm the notice date, the trigger event, and the form so the notice is unimpeachable.

CCP § 364
2

Map the case to current MICRA caps.

MICRA non-economic caps stepped up in 2023 and continue increasing. I map the matter to the cap that applies on the facts and to the wrongful-death versus non-death distinction.

Civ. § 3333.2 (MICRA)
3

Screen for the 1-year discovery clock.

CCP § 340.5 sets a 1-year-from-discovery / 3-year-outside SOL. I screen the discovery date and tolling so the file is filable when the contingency firm receives it.

CCP § 340.5
4

Hand off to a contingency firm.

The memo is the intake document for plaintiff-side medical-malpractice firms. They take it on contingency and run the case, the screening goes faster because the MICRA math and SOL analysis are already done.

Why this calls for an attorney memo before contingency intake

DIY / template

What a self-written letter misses

  • Misses the CCP § 364 90-day notice trigger
  • Cannot navigate the MICRA non-economic cap
  • Sends late notice or skips the arbitration clause
  • Lets the 1-year discovery clock run out
Attorney letter

What the attorney letter does

  • Sends the § 364 notice on time and in correct form
  • Maps the case to the current MICRA caps
  • Confirms arbitration posture before notice goes out
  • Calendars the SOL under CCP § 340.5

MICRA is a maze of caps, notice rules, and arbitration clauses, and missing any one of them can end the case before it starts.

The controlling law

Cal. Civ. Proc. Code § 364

This authority requires 90-day pre-suit written notice to the

This authority requires 90-day pre-suit written notice to the healthcare provider in any medical-malpractice action. The notice must describe the legal basis of the claim, the type of loss sustained, and the nature of the injuries. The notice tolls the statute of limitations for 90 days when served within 90 days of the limitations expiration. Failure to serve the notice is not jurisdictional (Woods v. Young, 53 Cal.3d 315 (1991)) but is best practice. Service is on each defendant healthcare provider individually.

Cal. Civ. Code § 3333.2 (MICRA Cap)

This authority caps non-economic damages (pain and suffering, loss

This authority caps non-economic damages (pain and suffering, loss of consortium, disfigurement) in medical-malpractice actions. AB 35 (signed by Governor Newsom in May 2022, effective January 1, 2023) replaced the 1975-era $250,000 cap with a scheduled, indexed structure. For non-death cases, the cap began at $350,000 (2023) and rises in $40,000 annual increments through 2033 toward $750,000; the 2026 cap is $470,000 (up from $430,000 in 2025). For wrongful-death cases, the cap began at $500,000 (2023) and rises in $50,000 annual increments through 2034 toward $1,000,000; the 2026 cap is $650,000 (up from $600,000 in 2025). The cap applies per defendant category under the AB 35 schedule. Cap calculations should be verified against the current year's increment at the time of filing.

Cal. Civ. Proc. Code § 340.5 (MICRA Limitations)

A one-year-from-discovery / three-year-outside-limit statute of

This authority sets a one-year-from-discovery / three-year-outside-limit statute of limitations for medical-malpractice actions. Limited exceptions for foreign-body cases, fraud or concealment, and minor plaintiffs (with their own age-based extensions). The discovery rule applies but the three-year outside window is harder to overcome.

Cal. Bus. & Prof. Code § 6146 (MICRA Fee Schedule)

This authority caps contingency fees in medical-malpractice actions on

This authority caps contingency fees in medical-malpractice actions on a sliding scale: 40% of the first $50,000, 33% of the next $50,000, 25% of the next $500,000, and 15% of any amount above $600,000. This is part of what shapes the economics of contingency-fee medical-malpractice litigation in California.

Welf. & Inst. Code § 15600 et seq. (Elder Abuse Act)

A parallel framework when the harm

This authority is a parallel framework when the harm involves elders or dependent adults. Heightened remedies under § 15657 include attorney fees, costs, and treble damages in some cases. An elder-abuse claim that does not arise from professional medical negligence is not capped by MICRA. The pre-suit memo flags which framework applies.

The MICRA-cap math in 2026. A surgical-error case with $250,000 in past medical bills, $400,000 in projected future medical care, $300,000 in lost earnings, and severe ongoing pain. Economic damages (uncapped): $950,000. Non-economic damages (capped at $470,000 under the AB 35 schedule for 2026 non-death cases; the cap rises each year through 2033): $470,000. Total case value: approximately $1,420,000 before contingency fees and expert costs. The MICRA fee schedule applies on the recovery; the case economics are workable for the right contingency litigator with the right expert team. The memo confirms whether your case math supports referral.

What clients send me

The pre-suit memo is built from medical records and a structured intake. Before drafting, I ask for:

  • Complete medical records for the treatment at issue (hospital records, imaging, lab results, operative notes, discharge summaries, follow-up visits)
  • The names and specialties of every healthcare provider involved (treating physicians, consultants, hospital, surgicenter, anesthesiologist, nursing staff)
  • A written timeline of events: when symptoms appeared, when you sought care, what was done, when injury or worsening was discovered
  • The injury or harm you sustained, with current medical status and prognosis if available
  • A list of follow-up treatment received because of the injury
  • Medical bills for the disputed treatment and follow-up care
  • Lost-earnings documentation (pay stubs, W-2s, employer letter on missed work)
  • Any informed-consent documents signed before the procedure
  • Any communications with the healthcare provider about the outcome or any acknowledgment of fault
  • Any complaints filed with the Medical Board of California or hospital incident reports

If records are incomplete, send what you have. I tell you what's needed and whether the gaps affect the memo's reach before quoting.

What I send back

How the engagement runs

1
Send facts

Email a paragraph + key documents.

2
Identify theory

I map the facts to the CA statute.

3
Draft letter

Attorney letter on letterhead.

4
You approve

Two revision rounds included.

5
Send certified

USPS certified + email delivery.

6
Negotiate

Three negotiation responses included.

Choose your path

Start here if

Case memo

$349
  • You want a written legal evaluation first
  • You may refer to a contingency firm later
  • Statute or evidence questions are unsettled
Accept memo - $349
Start here if

Demand + draft lawsuit

$1,200
  • Counterparty needs to see the lawsuit is real
  • Multiple claims or institutional defendant
  • You may file pro se after the demand
Accept package - $1,200

Pricing

Note on litigation: Active medical-malpractice litigation runs on contingency-fee economics governed by Bus. & Prof. Code § 6146. The MICRA-experienced firms I refer to handle the filing, depositions, expert work, and trial. The handoff includes the memo, the medical records, and the served § 364 notice.

Frequently asked questions

You
What is the CCP § 364 90-day notice?
S
California Code of Civil Procedure § 364 requires a plaintiff in a medical malpractice action to give 90 days' written notice to the defendant healthcare provider before filing the complaint. The notice must describe the legal basis of the claim, the type of loss sustained, and the nature of the injuries. The notice tolls the statute of limitations under CCP § 340.5 for 90 days when served within 90 days of the limitations expiration. Failure to comply with the notice can extend the limitations period and is not itself a jurisdictional bar (Woods v. Young, 53 Cal.3d 315 (1991)), but it is best practice to serve the notice and use the negotiation window.
You
What is the MICRA non-economic damages cap?
S
Cal. Civ. Code § 3333.2 caps non-economic damages (pain and suffering, loss of consortium, disfigurement) in medical-malpractice actions. AB 35, signed in May 2022 and effective January 1, 2023, replaced the 1975-era $250,000 cap with a scheduled, indexed structure. For non-death cases, the cap began at $350,000 (2023) and rises in $40,000 annual increments through 2033 toward $750,000; the 2026 cap is $470,000 (up from $430,000 in 2025). For wrongful-death cases, the cap began at $500,000 and rises in $50,000 annual increments through 2034 toward $1,000,000; the 2026 cap is $650,000 (up from $600,000 in 2025). Economic damages (medical bills, lost wages, future care) are not capped. The cap applies per defendant category under the AB 35 schedule.
You
What is the statute of limitations on California medical malpractice?
S
CCP § 340.5 sets the limitations period at one year from discovery of the injury OR three years from the date of injury, whichever is sooner. There are limited exceptions for foreign-body cases (where the foreign object is left in the body) and fraud or concealment. Minors have additional time depending on age at injury. CCP § 364's 90-day notice tolls the limitations period for 90 days when served within the last 90 days of the limitations window. Missing the limitations clock kills the case, so the pre-suit memo runs the date math carefully before anything else.
You
Why doesn't Sergei handle the litigation himself?
S
Medical malpractice litigation in California is structured around contingency fees governed by Bus. & Prof. Code § 6146 (the MICRA fee schedule). Litigating these cases requires expert witnesses (medical, life-care planner, vocational, economist), depositions, day-in-the-life production, and trial preparation that runs 18-36 months. The economics are contingency-based and the litigators who do this work have the medical-expert relationships and trial infrastructure that make it viable. I handle the front end (intake, MICRA analysis, statute-of-limitations preservation, CCP § 364 notice) and refer out to plaintiff-side medical-malpractice firms when the case warrants litigation. The pre-suit memo includes the referral recommendation.
You
What's in the $349 pre-suit memo?
S
A written legal memo covering: (1) the statute-of-limitations analysis under CCP § 340.5 with the calendared filing window, (2) the MICRA non-economic damages cap analysis under Civ. Code § 3333.2 with the applicable cap amount for the year of filing, (3) a drafted CCP § 364 90-day notice ready to serve on the defendant healthcare provider, (4) an outline of the standard-of-care theory based on the medical records and your description of the events, (5) a damages framework (economic vs. non-economic with the cap applied), and (6) a referral recommendation to a MICRA-experienced contingency litigator with whom I have a working relationship.
You
Does the 90-day notice have to be served before filing?
S
Yes, in the sense that the statute requires it. The California Supreme Court in Woods v. Young, 53 Cal.3d 315 (1991), held that the notice is not strictly jurisdictional and a filing without notice can sometimes survive, but it is best practice to comply and the notice tolls the limitations period when served in the last 90 days of the window. Most experienced MICRA practitioners serve the notice at intake and use the 90 days to negotiate before filing.
You
What does the 90-day window typically produce?
S
It varies. Hospitals and large medical groups have risk-management teams that evaluate the notice, often request medical records, and sometimes make settlement offers within the 90-day window. Solo or small-group physicians usually route the notice to their malpractice insurer (typically MICRA-aware carriers like NORCAL, The Doctors Company, or Cooperative of American Physicians), which evaluates the claim and may engage. In other cases, the window simply runs out and the matter proceeds to filing. The litigator who takes the case post-referral handles the filing decision based on what the 90 days produced.
You
Do you handle nursing-home and elder-abuse cases?
S
Elder abuse claims under the Elder Abuse and Dependent Adult Civil Protection Act (Welf. & Inst. Code § 15600 et seq.) are a separate framework from MICRA and have different damages rules (heightened remedies under § 15657 including attorney fees, treble damages in some cases, no MICRA cap on a pure elder-abuse claim that does not arise from professional medical negligence). The line between elder abuse and medical malpractice is fact-specific and the pre-suit memo flags which framework applies. For cases that are pure elder abuse, I refer to elder-law specialists. For cases that overlap, the memo addresses both tracks.
You
What if the harm happened in a hospital ER?
S
Emergency room cases are MICRA cases. The standard of care is the level of care provided by reasonably competent emergency physicians in similar circumstances. Hospital corporate liability (negligent credentialing, failure to supervise) is a parallel theory. ER cases often have complications around informed consent, abandonment, and EMTALA (the federal Emergency Medical Treatment and Active Labor Act), which add layers but stay within the MICRA framework on the state-law claims. The memo addresses each theory and the applicable statute of limitations for each.
You
How long does the pre-suit memo take?
S
Seven to ten business days from receipt of medical records and a written description of events. The memo is delivered as a PDF report covering the limitations analysis, the cap analysis, the standard-of-care theory, the damages framework, and the referral recommendation. The drafted CCP § 364 notice is delivered as an editable Word document ready to sign and serve. Cases with extensive medical records or multiple-provider fact patterns take longer; the quote covers the standard scope and additional work is scoped separately.

Medical-malpractice case? Let me write the memo.

Email me a short paragraph about the provider, the treatment, and when you discovered the injury. I'll respond same day with a scoped flat-fee quote.

Email owner@terms.law