Medical malpractice insurance

Medical malpractice insurance provides indemnity for professional negligence by act or omission by a healthcare provider in which the treatment provided falls below the accepted standard of practice in the medical community and causes injury or death to the patient, with most cases involving medical error.

With rapid advances in pharmaceutical efficacy, combined with increasingly sophisticated and complicated medical procedures professional healthcare providers are under increasing pressure to meet not only the minimum standards of their industry but also the expectations of their patients.

Medical malpractice insurance is available to both individual consultant’s doctors and surgeons and the business entity.

In 2013 it became a legal requirement for Doctors to have medical indemnity insurance. In many cases this cover is provided via the GMC or MDU but sometimes Doctors need to look outside of these organisations to obtain indemnity cover. We can help you to find a solution.

It’s not only Doctors that require medical malpractice insurance but also for anyone that providing clinical or medical care medical malpractice insurance is essential. Claims are frequent and settlements significant.

Business entities also require medical malpractice insurance. Increasingly claims are made against both the individual consultant/surgeon and the company that employs him or her. These claims are costly to defend even if they prove ultimately unsuccessful.

Medical malpractice insurance is crucial as it provides some critical areas of protection: –
  • Negligence
  • Breach of confidence
  • Misuse of information which is either confidential or subject to statutory restrictions;
  • invasion, infringement or interference with the right to privacy;
  • Libel or slander, arising out of the provision of medical and clinical professional services; and good Samaritan acts
Breach of professional duty in undertaking or providing any service on a formal review board or committee while performing the following functions:
  • Evaluating professional qualifications or clinical performance of any member of the healthcare profession(s); or
  • Promoting and maintaining the quality of medical and clinical professional services being provided;
  • Legal costs, fees and expenses incurred in investigating and defending claims covered by the policy a
  • Claims made after the period of insurance if the insured dies or retires during the period of insurance

The insurance market for medical malpractice is not large. Understanding and underwriting such business is time consuming. The level of research required and the need to keep abreast of problems and progress in these fields is essential. Industry developments, happening at an ever-increasing rate, can mean huge changes in exposure for different segments of the profession. Therefore, only specialist insurers are able to underwrite confidently and effectively in this market.

ADF Insurance work extensively with these insurers to deliver medical malpractice insurance for a wide range of professional healthcare providers including but not limited to;
  • Physiotherapists
  • Dentists
  • Surgeons
  • Cardiologists
  • General practitioners
  • Pharmacists
  • Orthopaedic practitioners

At ADF insurance we pride ourselves on being able to cater for the needs of most healthcare professionals ensuring that they are provided with the highest standards of service and insurance. We will aim to help all healthcare professionals so as they are able to continue helping others.

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  • Claims

    Implied term of contract – reasonable care and skill

    A claimant underwent surgery which was performed by a Plastic Surgeon who was engaged by the Clinic as an independent practitioner. He had practising privileges and was not employed by the clinic. He had his own cover in place. There was an issue about the type of product used during the surgery, which caused the claimant to suffer physical injuries. It was the surgeon’s decision to use that particular product, but the correct solution was not in stock. This was the clinic’s responsibility. A claim was brought against the clinic as well as the surgeon. It was argued that the clinic had breached an implied term of the Supply of Goods and Services Act 1982. It was said that there was an agreement in place between the clinic and the claimant, which constituted a supply of service, and that it was an implied term that the surgery would be carried out with reasonable care and skill. Given the nature of the events in question, those allegations carried weight and the legal firm advised that the claim against the clinic was likely to succeed, although lawyers were able to persuade the surgeon and his insurers to accept responsibility in full for dealing with the claim.

    The claimant had permanent physical injuries and also alleged that she suffered psychological injuries which disrupted her education and employment. Lawyers estimated that the value of the claim could have been in the region of £50,000.

     

    Operating haphazard and unsafe system

     A claimant underwent a gastric banding procedure which was performed by a surgeon who was engaged by the clinic as an independent practitioner. The clinic was therefore not vicariously liable for the surgeon’s acts and omissions. The surgeon had his own cover in place. A claim was brought against the surgeon and the clinic. The allegations against the surgeon focused on consent and the performance of the procedure, but it was alleged that the clinic allowed the surgeon to operate in a haphazard and unsafe system and failed to ensure continuity of care. Lawyers were able to persuade the claimant to discontinue her claim against the clinic, but defence costs were incurred as a result.

    The damages the Claimant sought for physical injuries were limited, but she also alleged psychiatric injuries arising from the negligence. Such injuries can lead to significant claims for loss of earnings, depending on the extent and nature of the psychiatric condition. Lawyers valued the claim in the region of £20,000.

    In addition to the claim, the claimant complained to the General Medical Council, who commenced an investigation. The clinic was required to cooperate with this and defence costs were incurred as a result in lawyers advising and assisting them with the investigation.

     

    DENTAL NEGLIGENCE CLAIMS

    The types of circumstances we can envisage where claims are brought against dental clinics are:

    • Infection control – It could be alleged that a clinic did not have appropriate infection control policies and/or procedures in place to ensure clean and sterile equipment is available, resulting in patients suffering infections and unnecessary pain. Patients could require remedial treatment and/or time off work. Patients may also suffer psychiatric injuries (e.g. anxiety and/or an adjustment disorder). Patients could seek damages for pain, suffering and loss of amenity in addition to loss of earnings and the costs of future treatment (dental and psychiatric).

     

    • Anaesthetic – It could be alleged that a clinic did not have appropriate procedures in place for the provision of anaesthesia. For example, there could be equipment malfunctions and it could be alleged that the claimant failed to follow the manufacturer’s guidelines on maintenance and/or having the equipment serviced. Another example could be allegations that the clinic failed to properly train or inform staff.

     

    • Delayed referral – It could be alleged that there was a delayed or failed referral by the clinic when a patient is diagnosed with a serious condition. Again, this could relate to the clinic’s procedures. A patient could suffer an exacerbation of his/her symptoms, causing unnecessary pain. More extensive treatment could also be required as a result. Legal firms envisage high value claims arising from these types of circumstances in a case, for example, where a patient had suspected oral cancer and there was a failure or a delay in referral.

     

    DENTAL REGULATORY ISSUES

     As already indicated above, the dental clinics could be involved in an investigation by the GDC. Such investigations could relate to their policies and procedures or, for example, in relation to them allowing nurses to practise without registration with GDC. If such an investigation is commenced, cover for this would depend on the policy wording.