Medical Indemnity Insurance – Are You Covered?

Medical Indemnity Insurance – Are You Covered?

The frequency and size of compensation related to medical negligence claims has significantly increased globally over the last decade. In South Africa, The Gauteng Department of Health alone saw an increase in claims from R573-million in the 2009/2010 to R1.28-billion in the 2012/2013 financial year.1 As a result of this, the cost of medical indemnity for doctors has spiraled. In the eight years between 2005 and 2013, the cost of indemnity insurance for private specialists in obstetrics had increased by 382%.2 Obviously, this is one of the higher paying specialties, as an injury incurred during childbirth can have lifelong implications and costs. The actual amount that some obstetricians are paying on an annual basis can be up to R850, 000. There are a number of hypothesis to explain this increasing trend. Firstly, that overall standard of practice has declined over the years and that doctors are not as competent as previously; secondly, patients have more rights and are better informed of their rights and ability to lay claims and lastly that litigating lawyers have taken an increased interest in medical claims and are advertising their services to a greater extent. For each of these hypotheses, one could argue for and against their validity, however regardless of the reasons, the outcome is negatively impacting the way doctors are practicing and their decisions to practice. Unsurprisingly, clinical practice is shifting to a “defensive” strategy rather than an appropriate patient centered approach.

What exactly is medical indemnity insurance?

It is a type of insurance cover for any “actual or alleged” medical negligence by a healthcare professional, including complaints lodged with the professions Councils. The cover indemnifies you against your legal liabilities for damages for any bodily injury, mental injury, mental anguish or shock, illness, disease or death of any patient caused by your alleged negligence, including legal costs and expenses.

Who should have medical indemnity insurance?

Anyone who is practicing or offering traditional or non-traditional medical healthcare.

Do I need insurance if I work for the state?

The state has its own indemnity which will protect doctors from any negligence claims whilst under their employment. However, this does not include assistance for internal disciplinary committees or HPCSA investigations. Thus as a result the majority of doctors have insurance with a third party provider e.g. MPS.

Which insurance provider should I use?

There are a number of insurance providers including the 2 biggest and most popular providers, Medical Protection Society (MPS) and newer player Aon, as well as smaller private insurance providers. It is important to note that MPS is not an insurance provider but rather a not-for-profit professional organisation, owned and accountable to its members. They have been offering services in South Africa for 50 years and has 31,000 members in the country. In order to claim from MPS however, you need to be a current member at the time of the event. This means that post retirement if a claim is laid against you, you will not be covered. One can purchase an additional five years of post-retirement protection at a special rate however beyond this, doctors are open to civil action. There have been claims up to 40 years after the event in some circumstances.3 Thus for peace of mind one should consider Aon who does offer tail cover, or coverage for future suits against incidents that occurred while the doctor was insured, even after he has retired or left for private practice. When it comes to pricing, this can greatly vary depending on your position level and specialty, therefore for each provider you would need to request a personalised quote.

Conclusion

As with any form of insurance, it is expensive when you don’t need it, but very cheap if you ever do. In the current landscape of increasing medical negligence claims, it is an indispensable part of practicing healthcare and you shouldn’t be caught without it.

Reference:

  1. PIENAAR, Letitia.Investigating the reasons behind the increase in medical negligence claims. PER [online]. 2016, vol.19, n.1 [cited  2018-03-26], pp.1-22. Available from: <http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S1727-37812016000100005&lng=en&nrm=iso>. ISSN 1727-3781.  http://dx.doi.org/10.17159/1727-3781/2016/v19i0a1101.
  2. https://www.fin24.com/Economy/r1m-bill-no-one-left-to-deliver-our-babies-20170406
  3. https://www.themdu.com/guidance-and-advice/journals/mdu-journal-november-2013/indemnity-for-claims-many-years-after-an-incident