Medical Malpractice & Professional Indemnity
Insurance
Cover;
Malpractice/Indemnity Insurance cover you for
claims made by
a patient for bodily injury, damages and losses, normally as a result
of
negligence by yourself.
Extensions/Clauses included in the Medical
Malpractice,
Professional Indemnity cover above:
• Council Hearings
• Criminal Defence Costs Sub-limited to R2.5
million
• Liability Following Employee Dishonesty
• Defamation
• Breach of Confidentiality
• Public Liability
• Products Liability & Defective Workmanship
(Legal
Defence Costs) sub limited to R2.5million in theaggregate
Notes on Quotes
We provide herewith general notes on the various
covers
listed above. These notes are merely a brief summary and do not in any
way
replace the
formal policy documentation.
1. Retro-active date inception or subject to proof
of
continuous ‘claims-made’ insurance (i.e. date on or after which any
claim
against you will be
indemnified in terms of the policy. There is thus
no cover
in place for claims arising out of work performed prior to the
retroactivedate.
2. No known claims/circumstances.
3. Premiums quoted include VAT at 15% and can be
recovered
from the Receiver of Revenue should you be a VATVendor.
4. Combined Single Limits of Indemnity for
Professional
Indemnity/Malpractice (i.e. (the maximum amount the Insurer will pay
for
oneloss).
5. All limits of indemnity quoted, include costs
and
expenses are aggregated (i.e. maximum amount the Insurer will pay in
any
oneyear).
6. All limits of indemnity offer 1 reinstatement
(i.e.
increased aggregate limit of Indemnity after one loss).
7. Limits of indemnity/excess quotes are exclusive
of VAT
8. The deductibles quoted are in respect of each
and every
claim (This is the amount that you would pay towards any claim that
might be
paid by
the Insurer. The excess/ deductible is paid in
respect of
each and every claim and paid by you only on settlement of a claim and
only
when an
award for damages is granted to the patient. Costs
and
expenses are not included in the excess/deductible.
9. 3 years free Run-off cover “additional
reporting period”
Allows you to report any claims that first come to your attention only
after
your policy has
ceased and these claims’ notifications will be
dealt with as
if you still had a policy in place. This is in respect of (i) Death,
(ii)
Retirement, (iii) Serious
illness, (iv)Ceasing to practice and (v.)
Cancellation on
notification and subject to underwriting criteria.
10. Professional Indemnity policies are issued on
a “claims
made basis”
This means that it is the policy that is in force
at the
time a claim is made against you that will respond to the claim and NOT
the
policy that was in
force at the time the work was done. Therefore,
should the
policy be lapsed or not renewed there will be NO COVER in force to
respond to
any
claims, unless you inform us of cancellation as
mentioned in
point 9 above.
11. In terms of the policy you are obliged to
maintain
accurate descriptive records of professional servicesrendered.
12. It is a condition precedent to liability that
you are
fully qualified and registered with the relevant Industry Body /
Association in
terms of
legislation as applicable.
13. Penalties and fines will not be covered under
this
policy.
14. No cover for nurses involved in midwifery
activities.
15. State employment endorsement applicable for
nurses
working in state.
The benefits provided by the insurance contract
e.g.
Representation in respect of Council enquiries, Legal costs and a
guaranteed
amount of money in the event of
a claim for damages arising out of medical
malpractice,
Damages arising out of defamatory statements made in good faith (i.e.
not
intentional defamationsomething said purely with the intention of
damaging
another’s reputation), Legal Risk Management Services e.g. billing,
consent,
practice structures, access to
information, medical scheme queries etc.
ADDENDUM: IMPORTANT NOTICE
NB Claims/Complaints’ Procedure
Itis essential that you notify us of any potential
claim or
complaint against you that you become aware of orsuspectmay bemade
against you
priorto yourrenewal.
If you do not do so, underwriters could reject any
such
claim/complaint which subsequently arises post renewal, if they can
prove that
you would reasonably have
known about such claim/complaint prior to your
renewal and
yet failed to disclose it. It is also important that you notify us as
soon as
possible of any new potential
claims/complaints after your policy has been
renewed.
We set out below some examples of possible
“claims” which
need to be reported to us as soon as you become aware of them:
1. Should you feel that there was a complication
during a
procedure even if the patient seemsfine;
2. Any notification from a patient whether verbal
or written
indicating that they are unhappy with treatment received byyourself;
3. Receipt of correspondence from attorneys
requesting
copies of your treatment records in respect of any of yourpatients;
4. Indications from any medical aid that they are
investigating your accounts;
5. Complaint that is lodged against you at your
Council.
Please do not submit your response, prior to consulting with us as you
may
unwittingly prejudice your
defense.
6. Please notify Aon of any incidents, claims,
potential
claims or Council complaints. For further complaint procedures please
refer to
the policy wording
once cover bound.
Aon Medical Malpractice Consultant: Carol-Lee
Axford,
Telephone: 011 944 7457, Email: carol-lee axford@aon.co.za
