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A Guide to Medical Malpractice Insurance Law

Medical practitioners, such as doctors, are covered by medical malpractice insurance. Medical malpractice insurance is designed to protect medical practitioners from liabilities that stem from the harm or death of a patient. 

Most doctors will be involved in a medical negligence claim at some point in their careers. Interestingly, most jurisdictions require that practising doctors obtain medical malpractice insurance in order to practice.

It should be noted that medical malpractice insurance products will vary depending on the insurer that you decide to go with. There are also different levels of coverage, premium levels and types of products to consider.

Given the number of options available, you need to perform the necessary due diligence in order to determine which policy and coverage is best for you and your medical practice.

Here, our focus will be on medical malpractice insurance law and what it entails so that you will be better prepared to navigate the rather confusing and complicated medical system.

What is medical malpractice insurance?

Medical malpractice insurance is also known as medical professional liability insurance. It is designed to protect licensed healthcare professionals such as nurses, dentists and doctors from liabilities resulting from property damage, medical costs and/or physical harm.

In addition, medical malpractice insurance protects licensed healthcare professionals from the costs involved in challenging such claims in the court of law. It should also be noted that the average doctor will pay roughly $7,500 per year in malpractice insurance premiums.

The amount that you will need to pay will be determined by several factors that affect coverage pricing.

Types of Malpractice Insurance

Claims-made coverage: Most insurance companies will write on a claims-made basis. In other words, a policy in force at the time a claim is made will respond to the loss.

If a doctor is covered between 2014 and 2024, and a claim is filed in 2017 related to an issue that transpired in 2016, then the doctor in this scenario will be covered. However, any claims or incidents that are made outside of this designated policy period will not be covered. 

You may need to consider supplemental insurance protection in such a case.

Occurrence-made coverage: Occurrence-made coverage was very popular in the past. It is designed to cover a loss that takes place within a designated insurance period. When the policy is cancelled or when the claim is actually filed is irrelevant.

If a claim is made after the insurance has ended then the doctor in question will still be protected provided that the incident occured when the insurance policy was still in place.

Tail coverage: Tail coverage will protect you when you are transitioning from one job to another. It will also protect you when you are between positions or when you are on the cusp of retirement.

Claims-paid coverage: In order for the claim to be acknowledged the claim will either need to be closed or the indemnity will need to be paid out. However, this will not be an issue if you do not have any claims. You will also have the option to swap if this is the case.

What is covered by medical malpractice insurance?

Medical malpractice insurance will protect you if you are a healthcare worker who is accused of blatant negligence due to an omission or a grievous error. You may be excluded from liability for criminal or intentional activities, which may include sexual misconduct.

If you are sued for medical negligence then your insurance company will cover the expenses needed to hire a lawyer to defend you. In fact, many malpractice insurance firms will offer supplementary services as well, including, but not limited to, risk management training.

Medical malpractice coverage is designed for legal claims that stem from medical malpractice or negligence allegations. Settlement costs, expert witness costs, defence and legal fees will usually be covered in their entirety.

Moreover, most insurance policies will also cover work as a doctor and may even cover your labour on panels that have been peer-reviewed as well. Other types of medical professionals will also usually be protected.

If a decision results in a full-blown lawsuit then your medical malpractice insurance coverage will provide adequate protection up to your policy limit.

Medical malpractice insurance: who needs it?

When you interact with people on a regular basis, you, your practice and your workers become vulnerable to professional liability. 

Anyone that provides direct or indirect patient care or is a provider of general healthcare services, should have medical malpractice insurance without exception. 

Examples include fellows, medical students, doctors, residents, allied staff, nurses, nurse practitioners, physician assistants, advanced practitioners and even their affiliated entities.

Most states and provinces require physicians to have malpractice insurance in order to practice. Most hospitals will also require malpractice insurance in order to enjoy certain facility-based privileges.

Most healthcare insurance plans will require every physician who is a part of their program to obtain medical malpractice insurance. Basically, even if medical malpractice insurance is not required it is strongly recommended in order to protect your best interests.

If you practise long enough you will have to deal with a malpractice claim at some point in your career, so it’s best to be prepared for such an eventuality.

Being Proactive

There are many fine points in your policy that you need to fully understand. Most malpractice insurance policies will cover compensatory damages, punitive damages, medical losses, court costs, arbitration costs, attorney fees and settlement expenditures.

To ensure that you obtain all of the protection that you need and deserve you need to know exactly what your policy does not cover as well as what your policy does cover.

You also need to be aware of how much coverage you have for each incident. Several claims may be made against you at some point in your career. Think of medical malpractice insurance as a contingency plan for a possible worst-case scenario down the road.

Jessica Coates
Jessica Coates is a blogger in Toronto. She graduated with honors from the University of British Columbia with a dual degree in Business Administration and Creative Writing. Jessica Coates is a community manager for small businesses across Canada. When not working, she leisurely studies economics, history, law and business solutions.
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