A tertiary level of protection against outcome of litigation would be to go for Insurance cover. PROFESSIONAL INDEMNITY INSURANCE cover became available for Doctors and Medical establishments only recently, i.e. from December, 1991.
Insurance companies such as Allianz provide insurance coverage and policies to provide this kind of protection.
The term " indemnity " means reimbursement, to compensate.The principle of indemnity is strictly observed in liability insurances. These insurances ( e.g., Professional Indemnity Insurance ) are designed to provide the insured person protection against the financial consequences of legal liability.If the insured is legally liable to pay damages to others, the policy will indemnify him subject to the terms, conditions and limitations of the contract. Indemnity is also available in respect of legal costs awarded against the insured as well as legal costs and expenses incurred by the insured with the written consent of the insurers in the defence of settlement of claims. PROFESSIONAL INDEMNITY INSURANCE
General Rules and Regulations :
Voluntary Excess (percentage) of limit of Indemnity per any one Accident | Discount (%) |
1 | 2.5 |
2 | 5.0 |
4 | 7.5 |
6 | 10.0 |
8 | 12.5 |
10 | 15.0 |
The Voluntary Excess shall be in addition to the Compulsory Excess and shall be applicable to both property damage claims and / or death / bodily injury claims inclusive of defence costs arising out of any one accident.
Period | Rate |
Not exceeding one month | 1/4th of the annual premium |
Not exceeding two months | 3/8th of the annual premium |
Not exceeding three months | 1/2th of the annual premium |
Not exceeding four months | 5/8th of the annual premium |
Not exceeding six months | 3/4th of the annual premium |
Exceeding six months | Full annual premium |
For annual policies cancelled during the currency at the request of the insured,premium should be adjusted at the Short Period Scales for the actual period of cover subject to no claims.No refund is permissible in case of any claim under the policy.
The short period premium is subject to the minimum premium in the Rating Schedule.
DOCTORS AND MEDICAL PRACTITIONERS (GUIDELINES)
The policy will indemnify any act committed by the insured, who shall be a Registered Medical Practitioner, giving rise to any legal liability to Third Parties. The Insured includes the policy holder and his qualified assistants or employees named in the proposal.
The act has to be committed during the period of insurance commencing from the retroactive date.
In the normal course all claims for compensation have to be legally established in a court of law. However, insurers may arrive at compromised settlement if prima-facie liability exists under the policy.
Jurisdiction applicable will be Indian Courts.
The limit of indemnity granted under the policy for any one accident or any one year (per accident per policy year ) will be identical.
No short period policies are permitted. However, in case of cancellation of the policy by the Insured short period scale rates as provided for will be applicable.
Registered Medical Practitioners shall be classified as :-
(1) Physicians (2) Pathologists (3) Oncologists (4) Cardiologists (5) Psychiatrists (6) Radiologists or Roentgenologists (7) General Surgeons (8) Plastic Surgeons (8) Orthopaedic Surgeons (10) Urologists (11) Abdominal Surgeons (12) Thoracic Surgeons (13) Neuro-Surgeons (14) Cardio-Vascular Surgeons (15) Otorhinolaryngologists (16) Protologists (17) Ophthalmologic Surgeon (18) Ophthalmologic Physician (19) Obstetrician & Gynaecologist (Excluding Surgery) (20) Physician & non-specialist (21) Other Practitioner-describe Surgeon. fully.
Insurance Rating for Doctors and Medical Practitioners
[To be charged on Any One Year (AOY) limit]
1. (a) Physicians without dispensing and other facilities General Pathologist/Radiologist (b) General Physicians with facilities like dispensing /pathological/ radiological etc | Rs. 0.5 per 1000 on AOY limit. 7.5% additional premium for each facility subject to maximum of 20%. |
2. (a) Specialists/Consulting Physician (Non-surgical) (b) For other facilities (Specify) such as E.C.G.,X-ray,Scanning, Sonography etc. | Rs. 1.0 per 1000 on AOY limit 7.5% extra for each facility subject to facility subject to maximum of 20%. |
3. (a) Surgeons excluding specialists in Plastic Surgery,Lithotripsy Dentists & similar extra corporeal methods of treatment would fall within this category. (b) For other facilities (specify) such as E.C.G.,X-Ray,Scanning,Sonography etc. | Rs. 2.0 per 1000 on AOY limit 7.5% extra for each facility subject to a maximum of 20%. |
4. (a) Diagnostic Centres (b) For other facilities (specify) such as E.C.G.,X-Ray,Scanning,Sonography etc | Rs. 1.0 per 1000 on AOY limit. 7.5% extra for each facility subject to a maximum of 20%. |
5. (a) Surgeons (Plastic Surgery) Anesthetics. (b) For other facilities (specify) such as E.C.G.,X-Ray,Scanning,Sonography etc. | Rs. 3 per 1000 on AOY limit 7.5% extra for each facility subject to a maximum of 20%. |
Minimum Premium Rs. 100.
No Compulsory or Voluntary Deductibles are applicable.
Insurance Rating for Medical Establishments
Rs. 3 per 1000 on AOY limits plus
Rs. 5 per each in patient plus
Rs. 1 per out-patient.
(Number of patients to be as per previous year’s record or the anticipated number of patients during the year whichever is higher.)
Radioactive treatment Additional premium of 15% (other than X-ray) on total premium.
The indemnity in respect of any one person would be limited to 25% of the Any One Year (AOY) limit under the policy.
Minimum Premium under one policy : Rs. 1000.
Compulsory Excess and Voluntary Excess are applicable.
Exclusions:
It may be noted that the amount paid as premium for obtaining a Professional Indemnity Insurance Policy qualifies as deductible expense under Sec. 36 of the Income Tax Act.
The doctors /hospitals may contact the Insurance Companies or their Agents for obtaining more information on the subject.
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