Medical malpractice insurance explained

Medical malpractice

Image courtesy: Sanderbusch

Medical malpractice is the legal term for negligence by providers of medical services including diagnostics, treatment, and care, which lead to serious injury, harm or even death. Medical malpractice covers the entire gamut of treatment cycle like diagnosis, medication, aftercare, kind and dose of medicine.

Medical negligence is measured by how a patient had to suffer due to sub-standard quality of service (diagnosis/ treatment / drug administration/ etc) offered by a medical professional / institution as compared to other standard treatment and quality of care offered by a more capable professionals (doctors / nurses / institutions). Drug errors, missed or wrong diagnosis and delayed treatment come under the gambit of medical malpractice.

Errors like leaving surgical equipment inside a patient’s body during surgery, operating a wrong part of the body, fatal infections caused due to non-adherence to good practices during operation, and/ or ulcers caused after the operation also come under the purview of medical malpractice cases.

Why is medical malpractice important?

Medico-legal cases are tough to prove and judge as in many cases of detected malpractice, the patient is deceased. However, as regulations get more stringent for healthcare delivery, such cases are becoming common.

As much as $38.8 billion were paid out as damages in wrong diagnosis resulting in claims between 1986 and 2010 in the US, according to Medical News Today. This is the common form of medical malpractice leading to claims. According to research by John Hopkins, American doctors are responsible for as many as 80,000 to 160,000 deaths annually.

It is not just doctors who are at the receiving end of this phenomenon. One in every three hospitalized patients in the US is victim to a hospital error.

Role of insurance

There are various kinds of insurance is available against medical malpractice. For healthcare professionals, there is

  • Medical Professional Liability Insurance
  • Property & General Liability: This is also sold by insurance carriers as two separate products: Property Insurance and General Liability Insurance (Slip-and-fall insurance).

These policies help counter false claims made against healthcare or diagnostics centers, doctors, or nurses. Adding to that, they are also insured against genuine mistakes which might have harmful effects. The policies cover legal fees, expert witness costs, and the payment if the case is lost. Insuring for legal fees is very important because a medical trial would need experts to testify and they come at a price. This is in addition to the fees paid to the law firm, paper work and other costs. The costs can dent a healthcare professional even if the case is won. Also, the legal system also does not allow the winner to recover costs, making insurance essential to professionals as well as corporations.

Apart from doctors and nurses, the policies for corporations also cover other healthcare staff like physician assistants, nurse practitioners and other aides at an additional premium. Any sort of legal cases arising due to illegal conduct, sexual misconduct are excluded from coverage in most insurance policies.


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