Medical Malpractice Insurance Basics

John Fisher
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Stopping Medical Injustice

We all know what insurance is; it protects people from the costs associated with an accident.  Car insurance comes to mind and most people understand how it works.  But what about other types of insurance?  Since we all visit doctors and hospitals from time to time, what type of insurance coverage do doctors and hospitals have so that they are covered when a patient is negligently injured by a medical professional?

The experienced Kingston medical malpractice attorney knows that medical professionals will carry medical malpractice insurance.  The coverage can be a group policy under which medical staff is covered; the clinic or hospital where the doctor works might provide for the policy.  Medical professionals may have personal coverage instead or in addition to a group policy.  

When will medical malpractice insurance coverage cover a claim against a doctor?  It will depend on the language of the policy and whether the policy is claims-made or occurrence-made.  Of course, the policy must be in effect as well.  

If a doctor commits malpractice when the medical malpractice insurance policy was in effect, the claim can be covered even after the policy expired if the coverage is occurrence based.  For example, a surgeon messes up during surgery and negligently harms a patient.  The policy is in effect at the time.  The claim is not reported until two months later and the surgeon’s insurance policy expired a week earlier.  Since the policy was occurrence based, insurance can cover the patient’s losses.  

Claims made policies are a bit different, and the difference is important.  Under these medical malpractice insurance policies, both the occurrence and the claim must be made within the time frame that the policy is in effect.  Absent nose and tail coverage, any negligence that which occurs and claimed outside of that time frame will not be covered by insurance.  

These are important things to understand because medical malpractice claims can cost a lot of money.  Injured victims deserve proper compensation.  Without proper insurance coverage, a doctor might not be able to pay for the victim’s losses.  But also, coverage can be limited in respect to what will be paid to a victim.  For example, the policy can be capped at a million dollars.  Patients might find it easier to receive compensation within policy limits, but then have to fight harder to get more compensation rightly deserved from the defendant himself.  

Moreover, not all acts will be covered by the insurance policy.  Criminal acts committed by the medical professional will most likely not be covered by the insurance policy, nor will sexual misconduct be covered.  Any misrepresentations made by the medical professional to the insurance company when the policy was established may also void the policy.  

But what do you think?  I would love to hear from you!  Leave a comment or I also welcome your phone call on my toll-free cell at 1-866-889-6882 or you can drop me an e-mail at [email protected]  You are always welcome to request my FREE book, The Seven Deadly Mistakes of Malpractice Victims, at the home page of my website at www.protectingpatientrights.com

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