Health care professional liability insurance
The fundamental tenets of insurance law and their application to the typical liability insurance policy are pertinent to the provisions of health care professional liability insurance as applied to individuals and institutions. Health care professional liability insurance policies vary in the broadness, the exclusions from coverage, and the interpretations a company places on the language of the contract.
There are three health care professional liability insurance classes :
- Individuals, including physicians, surgeons, dentists, nurses, osteopaths, chiropractors, opticians, physiotherapists, optometrists, and different types of health care technicians. This category includes health care or medical laboratories and blood banks.
- Health care institutions, such as hospitals, extended care facilities, homes for the aged, institutions for the mentally ill, and other health care facilities where bed and board are provided for patients or residents.
- Outpatient facilities and clinics where there are no regular bed or board facilities. These institutions may be related to industrial or commercial enterprise;however, they are to be distinguished from facilities operated by dentists or physicians, which usually are covered under individual professional liability contracts.
The insuring clause usually will provide for payment on behalf of the insured if an injury arises from either of the following :
- Malpractice, error, or mistake in rendering or failing to render health care professional insurance services in the practice of the insureds profession during the policy period.
- Acts or omissions on the part of the insured during the policy period as a member of a formal accreditation or similar professional board or committee of a health care facility or a professional society.
- Although injury is not limited to bodily injury or property damage, it must result from malpractice, error, mistake, or failure to perform acts that should have been performed.
The most common risks covered by health care professional liability insurance are :
- Negligence
- Assault and battery as a result of failing to obtain consent to a health care, medical or surgical procedure.
- Invasion of privacy for betrayal of professional confidences.
Coverage may vary from company to company, but standards of policy coverage generally are followed. Rates will differ for individuals be profession and specialty and by type of health care professional liability insurance facility.
The difficulty that health care organizations and physicians had in obtaining malpractice insurance in many states resulted in the formation of health care malpractice insurance associations. The purpose of these associations is to provide a market for institutions or physicians who are made to obtain health care malpractice insurance in the open market at a reasonable price. Legislation was introduced requiring all insurance carriers engaged in writing personal liability insurance within a particular state to provide malpractice coverage through these associations.
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