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How does medical professional indemnity operate?

“The Consumer Disputes Redressal Forum holds a doctor guilty of medical negligence and asks them to pay a compensation amount to the family and relatives of the patient.” 

The above statement is something we all have read somewhere or the other. After all, doctors have always been blamed for the death of any patient. However, there’s something known as a Professional Indemnity Insurance Cover that can help the doctors out of this pickle of a situation. And that’s precisely what we’ll be discussing in the article that follows.

A CONSTANT FEAR

Doctors are constantly under the stress of getting caught in medical negligence cases, which, in turn, leads to inane charges from patients and their relatives. Many a times, the relatives can turn quite aggressive and even beat up the doctor or vandalize the hospital/clinic.

According to a 2016 survey, India recorded a total of 5.2 million medico-legal cases a year. These ranged from incorrect prescriptions, wrong time, wrong surgery, wrong medicine, to even wrong dosages.

Lawsuits filed by patients and their relatives are only jamming up the courtrooms throughout the nation. As per a study conducted by NABH, 98,000 deaths occurred in India just because of medical injuries. Because of the same reasons, more and more people are coming forward and taking the legal route to challenge the doctor’s expertise. Such medical cases are only increasing in number.

Because of public awareness, these claims and litigation are increasing at an unprecedented rate. This not only leads to a lot of monetary loss for the doctors, but can also put their career at stake. Their names flashing across newspapers, television, social media – this is exactly the kind of ‘publicity’ any doctor dreads.

 

IS THE PATIENT ALWAYS RIGHT?

To be very honest – no.

It is not that the doctor is always at fault. Just like there are good doctors and bad doctors, there are good patients and bad patients. In many cases, such bad patients are filing cases of medical negligence just to wave off their fees. In all such cases, it’s the doctors that face legal action – whether or not they’re at fault.  

The fear of litigation is so high, that today, many corporate hospitals have made it a compulsion for doctors to buy professional indemnity insurance in order to work as consultants. Even the topmost surgeons, obstetricians, anesthetists, etc. are not spared off these charges and legal actions.

WHAT’S THE WAY OUT THEN?

Professional Indemnity

It is always recommended to have professional indemnity insurance solely because of the number of litigation. Many a times, frivolous charges are foisted which leaves physicians by themselves to fend in the court. It is exactly here that professional indemnity acts like a boon.

The policy covers costs like lawyer fees, compensation to be paid by the doctors, and other costs incurred in the investigation. Everything from bodily injury or death of a patient due to error, omission, or negligence in the professional service of the doctor is covered under this. The policy gets triggered as soon as a legal notice is served to the doctor.

Professional Indemnity Insurance covers claims against an individual for a breach of a professional duty but, depending on the policy, cover can extend to:

  • Misleading and deceptive conduct
  • Defamation
  • Breach of intellectual property rights
  • Damages arising from fraud
  • Defense costs associated with claims

 

HOW DOES IT OPERATE?

The scope of cover varies with each profession. For instance, registered medical practitioners like physicians, cardiologists, surgeons, and pathologists, as well as medical establishments are covered against legal liability claims made by any of the patients. These can be based on bodily injuries and/or death. The policy is responsible for paying for the defense cost incurred while defending in the court. Further, they can insure not only themselves but also other partners or consulting doctors as well as assistants, if any. Unqualified staff of the clinic, like sweepers and peons working in the clinic can also be protected for omissions, errors, and negligence on their part – if any.

However, these indemnity insurance do not cover liabilities that arise out of criminal acts. Or, any act committed that violates the law or ordinance – besides services rendered while under the influence of intoxicants. Similarly, fines, penalties, punitive damages etc. are also not covered under these policies. Nor is any third party public liability or loss arising out of war or other perils. Breach of confidentiality or prior anticipation or knowledge of the claim will only lead to the rebuttal of a claim. In fact, every insurer has a different list of exclusions which must be taken into consideration before opting for any cover.

 

CONSIDERABLE POINTS

The insurer will only respond to the claims while the policy is in action. What that means is that you must be insured both at the time when the liability arose and during the time of the claim. This can be a significant issue if problems arise long after the advice was given. This means you need to consider insurance during your retirement as well, and if you wish to change insurers, you need to ensure that they accept historic liability.

 

CONCLUSION

It’s always better to be safe than sorry, and a professional indemnity insurance helps you with just that. You wouldn’t want to wake up severely alleged one day, with no one that has your back.

Now that you’re aware of medical professional indemnity and how it works, you’re all set to make the necessary decisions for yourself!

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