Should insurers prepare for an influx of professional liability claims?

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More than 43,000 initial specialist assessments and follow-up appointments have been canceled across the country due to COVID-19, as well as 6,550 planned inpatient procedures in New Zealand hospitals. Other procedures affected included diagnostic x-ray examinations such as CT scans, MRIs and ultrasounds, as well as endoscopies.

Academic surgeon Dr Sarah Rennie said an increase in the number of COVID-19 cases requiring hospital care would further delay these procedures and could put patients on the wait list at greater risk.

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“Patients’ condition may deteriorate in the meantime, and they may suffer more pain and disability as a result of their condition, and this may have a negative impact on their quality of life,” said Rennie.

“I’m concerned that we have the capacity to deal with the backlog, and I’m also concerned that it will get worse before things get better.”

Commenting on the impact of COVID-19 on the healthcare system, insurer Medicus said it already occupies significant capacity – and as the end of the lockdown approaches, intensive care capacity will be particularly monitored.

Medicus president Dr Richard Stubbs said we may start to see more complaints over the next few years about potential treatment delays, and at the moment it’s difficult to predict how those cases might resolve.

“We have started to see a bit of the impact of COVID on our health care system now, and we have started talking about the number of canceled procedures at Auckland hospitals as they divert energy to managing patients. COVID patients. Said Stubbs.

“If we have 80 hospital patients with COVID in Auckland – that’s a significant proportion of beds that were never needed for this condition before, and we didn’t have enough beds to keep up with everything else to get started. Suddenly, we removed 80 beds, and the problem is that they are not taken for one or two days on average. They are often removed for an average period of several weeks, and sometimes longer. It’s a big problem.

“The coverage we provide is professional indemnity, and the only thing I think we can unfortunately expect is that when there are significant delays in people’s health care, people can end up blaming doctors and hospitals, ”he said.

“So it is not impossible that we may see more complaints against doctors, professionals and the health service because of the delays that occur.”

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Dr Stubbs noted that even now, the majority of professional compensation claims relate to complaints about processing delays. With the healthcare system under pressure and a significant number of diagnostic procedures already delayed, it seems likely that number will increase – and when it comes to damage, he said the type of IP coverage professionals have will become very important. .

“It is difficult to know how easily these kinds of complaints can be dismissed. Some will likely be concluded fairly easily, but others may well lead to the establishment of a significant legal defense, ”Stubbs said.

“A fairly large portion of complaints made to the Health and Disability Commissioner are already about a late diagnosis, and every physician who receives a complaint about a late diagnosis will need the help of a professional indemnity provider.” . So there are implications for insurers there, as well as for those who provide compensation, in-house advice and legal assistance. “

“Traditionally, mutuals that provide professional compensation will provide assistance without giving any assurance as to compensation or the award of damages,” he added.

“This is one of the points of difference compared to the product that we offer, where if there is any damage it is covered by the policy and it is not a discretionary payment. This is one of the reasons why many professionals in this country do not have professional liability insurance coverage as good as they think.


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