How To Choose The Right Doctor Indemnity Insurance Policy For Your Practice?

Introduction

A Doctor Indemnity policy is an insurance offered to cover the medico-legal case expenses of doctors when they face any medical negligence or error in treatment cases. Being a doctor is always a respectable profession, but it is also associated with many risks. 

The major risk is the problems that a doctor can face due to unintentional errors, loops and negligence that lead to a loss for the patient in physical and mental terms. The patient is also a customer and has many relevant rights. If they are not satisfied with the treatment or an error occurs during a treatment that leads to harm for the patient, they may issue a sue in a court of Law and such cases when found true may lead to a heavy Indemnity sum charged to the doctors who treat the patient or health care workers.

Hospitals are responsible and answerable to any of such problems and should face the consequences in such scenarios. One such case may lead to the ruin of goodwill in the market and heavy monetary loss. 

Such a situation is inevitable in the present society. According to a survey conducted by National Law University, Medical negligence cases increased at an alarming rate and the genuine cases where doctors are real culprits are very less, most of the cases aimed at the goodwill or reputation of expert doctors. 

Most cases will be ruled in favor of the patient and the doctor or hospital will be liable to pay a huge amount. The Indemnity Insurance policy covers you from all these expenses and safeguards your business.

Irrespective of whether doctors win or lose cases, they have to hire lawyers to defend themselves in court which can be time-consuming and expensive. Selection of an apt insurance policy is based on your experience of you as a doctor, practice type, treatment etc.

Table of Contents

1. Factors affecting Indemnity insurance
2. Other factors affecting Indemnity insurance
3. Types of Policy
4. Exclusions from policy
5. Frequently Asked Questions

Factors Affecting Indemnity Insurance

1. The Provider must have adequate experience in the field. The ability and credibility of the company must be considered.
2. The premium for a Doctor’ Professional Indemnity policy depends on the following factors:

• Sum Insured Required
• Past Claims History
• Area of Specialisation for the Doctor.
• Estimated Annual Revenue for the doctor.
• Type of Medico-legal case.
• Past History of Doctor legal cases.

Other Factors Affecting Indemnity Insurance

Apart from the above-mentioned factors the other policy-related considerations are as follows:-

• Coverage offered
• Premium of policy
• Legal documentation
• The credibility of the insurance firm
• AOA & AYA ratio of policy
• Experience of firm in such cases

The doctors should choose a policy based on the above-mentioned factors mainly their experience, expertise and specialisation. An expert surgeon or other practitioners should pay around 10-15% of their annual income towards the policy to get insurance coverage.

Types of Policy:

If the Indemnity charged by the court exceeds the insurance sum, the doctor or hospital must pay the difference at their own risk. The sum guaranteed is the limit of Indemnity. This limit is set per accident and policy term and is referred to as

Any One Accident (AOA) limit: The insurance will only cover one mishap.

Any One Year (AOY) limit: The service will be annual.

When purchasing insurance, the AOA/AOY ratio should be determined. This decides the payout and varies according to the insurance companies.

Insurance coverage under the Professional Indemnity policy is applicable in the following cases.

• If the complications or patient loss is due to non-willful neglect.
• Unintentional omission or errors.
• Cost includes court charges
• It covers all employers in the hospital.

Group Policies: These are policies provided for a professional group or hospital. Hospitals are liable for any negligence on the part of doctors, nurses, or other healthcare staff; this is called “vicarious liability.” According to the legal rule of vicarious liability, any employer (including hospitals) is liable for its employee’s negligence.

Exclusions from policy

• Willful neglect of patient by the doctor
• Treatments like plastic surgery, cosmetic surgery, and Bariatric( weight loss)surgery.
• Using Drugs or Alcohol by the doctor while the treatment.
• Criminal acts, penalties, intentional neglect in treatment

These acts of criminal negligence and those against professional ethics will not be covered by insurance.

It is the responsibility of the consultant to ensure that they have adequate insurance to cover cases of indemnity and also provide compensation for patients in the case of any unfortunate incident. It is therefore very important for consultants to understand the policy details and to clarify the exact meaning of any clauses that they do not fully understand. Then, if a claim is received, they know what they are covered for and what action is required. Indemnity insurance for doctors is necessary for providing safety to the medical practitioners and is also essential to safeguard the hospital against any Indemnity.

Frequently Asked Questions

Q1. What factors should I consider when choosing a doctor’s indemnity insurance policy?

Ans: Factors you should consider while choosing a doctor’s indemnity insurance policy are:

• Check for coverage, 
• Do a cost analysis, 
• The study claims to handle, inspect flexibility, and 
• Select based on experience and specialisation.

Q2. How do I compare the different coverage options available in doctor indemnity insurance policies?

Ans: The policies can be compared by considering the premium amount, insurance sum, specialization and expertise of the doctor, and AOA and AOY ratios.

Q3. How do I determine the right amount of coverage I need for my practice?

Ans: The thumb rule is that one needs to have insurance coverage equivalent to 7–10 times their annual income.  Typically, a premium of 10-15% of annual income is paid.

Q4. How do I evaluate the financial stability of different doctor indemnity insurance providers?

Ans: Select an insurance firm based on expertise and experience in the field, credibility, etc., and select based on customer reviews and rating agency reports.

Q5. What steps can I take to ensure my doctor’s indemnity insurance policy is adequate for my needs?

Ans: Here are some pointers to choose the best cover –

• Select an appropriate sum insured.
• Ensure the coverage benefits are suitable.
• Set an appropriate AOA: AOY ratio.
• Ask for evidence of a claim settlement.