Medical Professional Liability Insurance

Medical professional liability insurance, sometimes known as medical malpractice insurance, is one type of professional liability insurance. Professional liability refers to liability that arises from a failure to use due care and the standard of care expected from a person in a particular profession, in this case a doctor, dentist, nurse, hospital or other health-
related organization.

A medical professional liability insurance policy covers bodily injury or property damage as well as liability for personal injury such as mental anguish. The complexity involved in discovering negligence results in a higher percentage of premium dollars going toward defense and cost containment expenses. Medical liability insurers spend substantial funds investigating and defending claims where there is an adverse patient outcome not resulting from negligence.

Premiums for malpractice insurance vary with the provider’s degree of risk, but experience rating is not widely used. Insurers set premiums on a prospective basis based on:

1) Their expected payouts for providers in a particular risk group;
2) The uncertainty surrounding this estimate;
3) Their expected administrative expenses and future investment income; and
4) The profit rate they seek.

They use information on past losses and expenses, combined with other information, to help them set rates.

For hospitals, some degree of experience rating occurs, but usually no more than 25 percent of the hospital’s total premium is based on experience. Experience rating hospitals are more feasible than experience rating physicians because hospitals’ claims experience is more stable over time. Hospital premiums also vary with hospital location (e.g., urban versus rural) and the clinical services offered (e.g., level of trauma care).

It would be our intent to assist in the mitigation of these cost and occurrences by offering the following options as potential solutions:

directors & officers employers liability, motor (ambulances, employee, physician use of autos for medical purposes) & fiduciary liability insurance program underwritten by Lloyd’s syndicates specializing in professional liability including malpractice.

Exploration of additional insurance markets (Aon, Allied World, Ironshore, Ace, Arch, Allianz Global, HDI Gerling, Munich Re,Partner, Swiss Re etc) would be done. We propose for these insurers to work with a Barbadian insurance company, with all underwriting & claims management provided directly by the identified insurance markets.

Further the insurance program would be customized to reflect hospital contractual agreements with independent contractors (medical doctors) and employee protection (interns, nursing, ambulance & para – medical personnel, etc.) Nuclear (radioactive isotopes) medicine exposures would be protected under the program.

The insurance program will reflect risk management and cost effective medical incidents/claims controls, accident prevention & loss mitigation. The success of good risk management can be introduced through premium reduction by establishing a premium stabilization fund with the insurance market underwriting the insurance program for Queen Elizabeth Hospital. The premium stabilization program incorporates a premium credit annually for favorable underwriting results, retained by the hospital to mitigate future premium increases. Further a ‘triage system’ will be incorporated to record but distinguish incidents of possible loss from claims avoiding excessive claims reserving by the insurers of the insurance program. This can be done with automated software accessible by medical & administrative personnel 24 /7 directly to a claims management facility.

Additionally we will consider the following options to assist in addressing the needs:

• A dedicated 1 800# for easy access to 24 hour medical or legal advice.
•  Online access for queries as necessary with defined response times.
• An in-house Attorney as part of our local broker team to advise on legal matters as it relates to our local landscape and to liaise with international legal counsel asnecessary.
•  The creation of a guideline procedures document to assist with claims handling.

SHAWN HOPE INSURANCE BROKERS INC
 Many insurers write on a claims-made form basis where a policy in effect at the time a
 Ongoing training for medical practitioners as it relates to varying medical malpractice standards locally, regionally and internationally.
 Close attention will be paid to any exclusion listed in the policy to identify potential risk both short and long term and advise accordingly
 claim is reported responds for the loss, regardless of when the error was made. The policy that was more popular in earlier times is occurrence-made which covers a loss that occurred during the policy period, regardless of when the claim was made. We will seek to identify the best options based on overall risk exposure, current market conditions and cost to determine the most viable option. Additionally decisions would have to be made on how to cover any gaps in coverage by purchasing prior acts coverage or extended coverage.
 We will consider whether specific limits can be determined for certain types of claims to assist in reducing overall cost.
 It would be important to ensure the availability of closed claim data necessary for thorough analysis and understanding of issues associated with medical professional liability claims, in order to support the establishment and maintenance of sound public policy.