Medical and Professional Covers - Terminology

Below we explain some of the covers normally found in our packages.  Some quotes we provide may be restricted to Malpractice only in certain circumstances, or where another policy may be covering the additional insurance for example, Public Liability ...

Malpractice

Malpractice is where a practitioner has not performed with a reasonable degree of skill and care, resulting in possible injury or loss to the client.

Professional indemnity

Indemnifies (i.e. protects) the practitioner against any allegations of loss arising from the conduct of his/her occupation, whether treating or not. This can cover financial loss due to inadequate or incorrect advice, consultancy work etc., and applies where injury has not been caused. Includes breaches of Duty of Care which come under the Law of Negligence or “Tort”.

Claims Made

Most professionals have this type of policy. It covers ‘the therapist’ when an incident is discovered, not when it is alleged to have taken place. This is the type we mainly offer other than a few other schemes.

When retiring or ceasing a policy, ‘the therapist’ needs to ensure that any new carrier will pick up the previous period insured, or that ‘the therapist’ purchases at a premium some “run-off” cover (see below).

Cover can be updated and improved each renewal. Any claim made after the update will be dealt with under the wider cover, even though the event may have taken place in a previous year. The statute of limitation (normally 3-6 years from date of discovery of a problem, not from the date of giving the treatment) means that ‘the therapist’ does not need run-off cover indefinitely. The statute regarding children is 3 yrs from date of discovery of the problem after they reach majority, and Courts may overturn this statute in respect of children. In practice, there is no limitation period regarding mentally disabled patients. For this reason we recommend patient notes are never destroyed, or at least are kept for significant periods of time if therapist have treated children or the disabled.

Claims Occuring Policy

A type of policy (usually Public or Civil Liability wording) where a claim is agreed to be triggered by the date the incident was alleged to have taken place. There is no need to keep a policy going when discontinuing cover, after retirement or when changing to another policy. This can be less confusing to the therapist. However, the therapist is locked into that type of wording, and any claim will be based on the cover and amount which was in force at the time of the incident which is alleged to have occurred, however long ago that may be. Retroactive cover is not usually automatically included but some insurers will allow clients to buy it at usually quite high cost. Gaps between missed periods are not normally picked up by this type of cover. See also Table below under heading “Run Off Cover”.

Multi Therapy Cover

We cover as many therapies as requested, provided that suitable qualifications are supplied. The cost of the policy is dependant upon the therapy in the highest risk category.

Retroactive cover

Cover for period of work prior to the current policy term.

Run-Off Cover

Lapsing claims made policies need to be advised to have run-off cover in order to answer any claims made relating to work previously carried out.

N.B. The limit of indemnity can be increased or decreased on claims made policies in run-off

Public liability**

This covers liability at law for causing injury to other people (not necessarily clients/clients) for damage to them or their property, provided that no treatment or advice was the reason for the incident.

Products liability**

This covers you for any defect in goods (e.g. medicines, cosmetics, beauty aids, or health aids) sold, supplied or demonstrated to your clients, which may cause injury or damage. Even if you did not manufacture the item concerned and innocently passed it on, under EU directive, the Consumer Protections Act etc., you will still be initially held liable.

Employers liability**

This covers you for injuries sustained by any employees or work experience assistants while working for you or on your premises, and is legally required. The certificate needs to be displayed. (Your must also follow the national laws on Health and Safety in the workplace.) This cover is available now under the package policy.

Indemnity limit

The maximum amount payable by the insurance company for any damages awarded against you by a court, or as an out of court settlement figure. (Any amount greater than this is payable by you.)

Legal & defence costs

The amount available in the policy to pay for the legal advice and support throughout the process. This can be a large amount and this policy includes this over and above the Indemnity Limit.

Excess

The amount you are liable to pay yourself in the event of a claim. It varies according to the type of treatment.

** Whose Liability?

The word "Liability" conjures up all sorts of negative images, and in our experience there are still many health professionals who get confused about whose policy covers what when other Health Professionals, organisations, or Landlords/ Room Providers are involved. What follows may help to sort out the different applications of Liability insurance (as opposed to Medical Malpractice).

Property Owners Liability is Public Liability but with a significant difference! It applies if a Health Professional actually owns a property, rather than uses someone else’s For example an owner could be held legally liable for not maintaining the property properly, or if a tree fell down on neighbours land, or a tile fell off roof and injured a passer-by. This sort of thing usually comes with or can be added to, a buildings insurance.

In addition, Practitioners should check that any landlord renting them space has a public liability cover in place in case patient slips on a staircase due to faulty maintenance or other reasons where blame could be attached to the owner. Most Balen Schemes covers PL where it is your legal liability but clearly not if it is someone else’s.