SPECIALIST MEDICAL INSURANCE BROKERS
FAQ’s
Medical Malpractice Insurance arises when there has been an act of professional negligence or breach of duty of care as a result of result of treatment and/or advice provided.
A Medical Malpractice insurance policy is triggered when the medical professional healthcare service delivered is alleged to be substandard and it is claimed that there has been a physical injury, mental harm or misdiagnosis to a patient.
Medical Malpractice Insurance can often be referred to as Medical Indemnity or Medical Negligence Insurance.
For those engaged in private healthcare, the responsibility for securing medical indemnity insurance falls on individual practitioners.
It is a common misconception that corporate entities do not need to purchase Medical Malpractice insurance however companies providing services in the healthcare industry may face potential legal action from dissatisfied patients, whether due to treatment complications or allegations of malpractice.
In this highly regulated sector, it is crucial for medical professionals and organisations to have comprehensive insurance coverage in place to address any unforeseen issues and safeguard against claims brought by patients.
Traditionally, cover provided by a Medical Defence Organisation is not a contractual policy and cover is discretionary only. This means that there is no guarantee that a claim will be accepted and there is no legal redress if it is not. If a notification is declined coverage, an individual can find themselves personally exposed to claims costs.
Mediguard will only provide contractual insurance policies with A rated insurers regulated by the Financial Conduct Authority. A contractual policy will set out the terms, conditions and exclusions of the policy and the maximum amount of cover provided. Contractual policies will often be on a Claims Made basis.
Claims based indemnity only provides cover for notifications and ‘claims made’ during your policy period, for work that you did after the retroactive date of the policy (subject to policy terms and conditions).
No cover will be provided under a Claims Made insurance policy for claims made in respect of work that was done prior to the retroactive date of the policy or for any matters that were previously known by you, your prior insurer, or a Medical Defence Organisation.
Once the policy has lapsed, no cover will be offered in respect of any new notifications which were not reported during the policy period.
To protect yourself from potential incoming claims, you have the option to choose run-off cover, ensuring ongoing protection even after the conclusion of the policy period.
Typically, a claim should be filed within three years from the date of the incident or from the date you become aware of the negligence.
Regarding the treatment of a child, the three-year period extends from the child’s eighteenth birthday.
However, there are some exceptions to the three-year limitation period – usually in medical negligence cases where the potential claimant is not an adult of sound mind.
It is imperative that you understand your policy details and clarify with your broker on anything not fully understood. In the event that you receive a notification of claim, you will then be aware of what the policy covers you for and any action you must take.
It is the responsibility of the consultant or clinic to make ‘Fair Presentation’ of their practice to insurers. All facts material to the proposed insurance policy must be declared fully and truthfully and to the best of your knowledge. A material fact would be one that would affect insurers determining whether to provide insurance cover and if so, the terms and conditions of the policy.
The insuring clauses of the policy will specify the scope of coverage being offered and any exclusions will limit this if necessary. Please ensure that you are aware of any exclusions contained under your policy.
If you do have a circumstance, please make yourself familiar with any claim reporting procedures in your policy and notify your insurance broker as soon as possible.
We often find that individuals and clinics are tied to schemes. Whilst being part of a scheme may provide certain benefits, we often find that the limited parameters of a scheme may mean that the policy is not suited to your needs and does not adequately protect all your activities.
Mediguard deal with over 20 markets and whilst they may not all be the right insurer for you, we will discuss available options with you and find the right indemnity provider.
