The Surat District Consumer Disputes Redressal Forum recently held a doctor guilty of medical negligence. The panel asked the doctor to pay Rs 4.8 lakh with a compound interest of 9%, and Rs 1.5 lakh to the patient’s relatives.
So, what’s new in this information? It is common to hear about alleged doctor’s negligence causing a patient’s death.
However, in this case, the doctor is covered under the doctor’s professional indemnity insurance policy from a leading insurance company.
An alarming situation
Many doctors have bought this insurance policy out of the fear of lawsuits and accusations of medical negligence.
There have been incidents of relatives of patients assaulting doctors and vandalizing hospitals or clinics. In a 2013 survey, Dr Ashish Jha of Harvard School of Public Health, India, says 5.2 million medico-legal cases have been recorded in a year. These are incidents occurring due to the doctor issuing an incorrect prescription, wrong timing of treatment, botched-up surgery or wrong medication.
Lawsuits against doctors are jamming up courtrooms throughout the nation. As per National Accreditation Board for Hospitals & Healthcare Providers (NABH) study, until a few years ago India witnessed 98,000 deaths from medical injuries annually.
According to Supreme Court advocate Mahendrakumar Bajpai, an increasing number of patients are suing doctors for alleged negligence and questioning their expertise. These cases have doubled since 2014, he noted. Doctors dread the negative media coverage associated with such cases.
There have been several instances of patients and relatives challenging the prescribed treatment on the basis of information available on the internet. This is also leading to an increase in claims and litigations.
Dr Girish Tyagi, Registrar of Delhi Medical Council, an authority that deals with such cases, says the number of medico-legal cases has increased from nearly 15 complaints to 40 in a month. In most cases, doctors fight accusations of overcharging and performing needless medical procedures.
Doctors are not always at fault. In some cases, patients want their expenses waived and falsely accuse medical professionals of negligence.
Thus, they get caught in legal action, irrespective of whether they are at fault or not.
Many corporate hospitals now ask doctors to buy professional indemnity insurance cover. This is also compulsory for any doctor’s appointment as a consultant. Moreover, almost all top surgeons, anaesthetists and obstetricians have taken cover against medical negligence.
The way out
How professional indemnity insurance protects doctors against legal liabilities?
Professional indemnity insurance acts as a boon against litigation costs and compensation. Physicians have to bear legal costs to fight frivolous charges. The policy also covers other expenses incurred during the investigation.
Insurance companies offer cover for disabilities, injuries or death due to a doctor’s acts of omission, error or negligence. The insurer starts the process to pay the damages as soon as the insured informs them about the litigation notice.
Additional Read: When does a claim occur under DPI and how to raise a claim?
A quick look at the benefits of DPI
The policy covers numerous kinds of risks and losses that a doctor faces. It also provides for legal expenses.
The policy doesn’t involve documentation. The insured can also seek a mid-term increase or decrease in the sum insured.
How to choose the sum insured?
In this policy, the sum insured is as per the limit of indemnity.
It is fixed as per the AOA:AOY ratio. This ratio between Any One Accident (AOA) and Any One Year (AOY) can be 1:1, 1:2, 1:3 and 1:4.
The AOA limit, which is the maximum amount to be paid for each accident, should be based on factors like the nature of the accident and the doctor’s specialty. Mostly, you should keep to a 1:1 ratio.
How to fix the premium?
This policy’s premium depends on factors like the doctor’s speciality, seniority, type of practice and equipment used.
For example, for a surgeon, the policy can cost between Rs 8,000 and Rs 10,000 for a Rs 1 crore sum assured. It is cheaper for physicians (Rs 2,000 to 4,000) and other categories of doctors. A majority of these policies offer annual coverage. The policy is renewed every year.
The Doctor’s Professional Indemnity insurance doesn’t cover damages for a criminal act or related penalties. The other exclusions are liabilities on account of the use of drugs for hair transplants, weight reduction, cosmetic plastic surgery and similar procedures. There is no coverage for AIDS-related liabilities.
The Hippocrates Oath captures the essence of the medical profession which is to “do no harm.”
In India, doctors are accused of negligence although the medical profession is considered noble. Therefore, doctors must go in for professional indemnity insurance to secure their profession against all complaints.