Compensation for non-hospital doctors: Supreme Court

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New Delhi: The Supreme Court recently observed that if a hospital is not the beneficiary of insurance policies, which were obtained by doctors to cover the discharge of their own malpractice, joint and several liability could not be attached to it. insurer to cover claims made to a hospital.

Confirming the order of the NCDRC, the Apex tribunal composed of judges DY Chandrachud and AS Bopanna noted: “The hospital was not the beneficiary of the insurance policies which were obtained by the doctors to cover the execution. of their own professional obligations. a manifest error on the part of the District Forum as well as the State Commission. The NCDRC had a valid basis for exercising its review competence. “

“While it is true that the NCDRC interfered in the exercise of its review jurisdiction, it was justified to do so since joint and several liability could not have been established on the insurer by virtue of policies of insurance that has not been obtained by the hospital. the hospital’s assertion that it was the beneficiary of these insurance policies clearly has no basis, ”further noted the highest court in its judgment.

The appellant, a charity hospital registered under the Bombay Public Trust Act 1961, challenged the judgment of the National Consumer Disputes Redressal Commission dated February 26, 2014.

Between June 21 and 23, 2000, the appellant hospital organized an eye camp during which cataract operations were performed on 112 patients. Patients have complained of neglect in performing surgeries through the use of unsterilized devices, contaminated drugs and substandard lenses resulting in eye infections and loss of vision.

Also Read: Mens Rea As Unnecessary Intent In Medical Negligence Cases The Next Established Procedure Is: Supreme Court

As a result, the state government appointed a committee to investigate the causes that resulted in the situation where several patients lost their sight.

In the meantime, a consumer organization had filed twenty-four complaints and consumer complaints were filed against the hospital and the insurance company. However, the insurance policies were obtained by the doctors from the insurer to cover malpractice claims. In fact, in the consumer case proceedings before the District Consumer Court, doctors were not named parties even though they had filed affidavits.

On February 19, 2010, the District Forum granted an amount of Rs 1,70,000 as compensation to each of the twenty-four complainants as well as a reimbursement of registration fees (Rs 250), compensation for moral suffering (Rs 3,000), fees (Rs 1,500) and interest at the rate of 9% per annum.

In issuing the order, the District Consumer Court further rejected the insurer’s argument that it could not be held liable since the doctors (who had taken out the insurance policy) had no responsibility. not been made parties to the proceedings and, in any event, were not negligent.

The Forum considered that, according to the report of the Committee of Experts, the negligence of the doctors and staff of the requesting hospital had been established. Thus, the District Forum considered that the liability of the hospital and the insurer would be joint and several, but that the sentence would only be enforced against the insurer. The price was not contested by the hospital.

However, the insurer has filed appeals against the District Forum’s order with the National Consumer Disputes Appeals Board, Gujarat. By its judgment of November 30, 2012, the State Commission rejected the appeals.

As a result, the insurer filed a review with the NCDRC, and the Commission, in its order of February 26, 2014, quashed the consumer forum orders holding the insurer liable. However, the insurer had clarified that this would not affect the guidelines setting out the hospital’s liability. In reaching this conclusion, the NCDRC noted that the hospital’s liability was determined on the basis of six professional insurance policies obtained by the doctors, although their business addresses turned out to be the hospital concerned.

The NCDRC ruled that this fact alone could not engage the liability of the insurer, particularly in the absence of a specific allegation of negligence against one of the doctors. Attacking the NCDRC judgment, the hospital appealed to the Supreme Court.

Senior counsel representing the hospital argued that the hospital was entitled to file a claim against the insurer as the beneficiary of the insurance policies and, therefore, the NCDRC was not justified in reversing the findings of the District Forum and the State Review Commission. .

He maintained that the doctors having participated in the procedure by filing affidavits, it was open to the District Forum to engage the joint and several liability of the hospital as well as of the insurer.

On the other hand, the insurance company maintains that there is no contractual link between the insurer and the hospital and that the professional indemnity policies were obtained by the doctors. There was no insurance coverage for the hospital or the staff. Thus, the NCDRC was justified in considering the review and ordering that the insurer would not be required to compensate the hospital.

After examining the files, the supreme magistracy noted that the insurance policies had been obtained by the doctors. These were professional liability insurance policies that would cover a malpractice claim filed against doctors.

At this beginning, the bench of the higher court further noted,

“It is true that the finding of negligence, as it emerges from the order of the State Commission, is specifically against the hospital. The finding is that the hospital and its staff were negligent in the conduct of cataract operations. The specific observation is that the equipment used was not properly sterilized, the staff was not properly trained and the drugs administered were not of the required quality and were contaminated. , the question is whether the hospital could have claimed to be compensated by the insurer. The hospital was not the beneficiary of the insurance policies which were obtained by the doctors to cover the exercise of their own. Professional obligations There was a manifest error on the part of the District Forum as well as the State Commission The NCDRC had a valid basis for exercising its review competence.

“Against this background, and for the above reasons, no fault can be found in the NCDRC’s final conclusions. While it is true that the NCDRC interfered in the exercise of its review jurisdiction, it was justified to do so since joint and several liability could not have been imposed on the insurer under the policies insurance that has not been obtained by the hospital.

“Under the circumstances, we see no reason to hear the appeals. However, all that needs to be clarified is that the dismissal of the appeals should not prevent the appellant from asserting his or her rights or rights by adopting a procedure. appropriate against any other person, who they believe may also be negligent in the performance of their duties, upon whom this Court makes no observations or findings of fact whatsoever. withdrawn by the patients, it should also be clarified that this aspect must be confirmed during the review of appeals. If an amount has not been paid to the original claimants, it must be done quickly, “the order of the Supreme Court reads.

To read the higher court order, click on the link below.

https://medicaldialogues.in/pdf_upload/supreme-court-medical-negligence-insurance-166499.pdf

Also Read: Patient Critical After Sloppy Surgery at Private UP Hospital, Parent Alleges Medical Negligence


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