When does a claim fall under a Doctor’s PI policy?
A Doctor’s Professional Indemnity insurance policy covers instances of death, physical injury or disability due to medical negligence or unintentional errors. The policy covers legal costs in case of lawsuits. It also bears settlements associated with such cases.
The DPI claims are of the type known as legal liability. This policy covers only civil liability claims. The claim will not be payable if there is criminal liability involved.
A civil liability claim will fall under this policy when the patient or the family provides prima facie evidence of the doctor’s negligence that resulted in injury or death.
Besides, the negligence should have occurred while the doctor was on duty to care of the patient. The claim also covers negligence causing death or suffering to the patient.
How to raise a claim under a Doctor’s PI Policy?
In case of liability, the insurance company should be immediately notified. The insured must submit all notices and summons received.
The doctor can either hire legal defence or ask the insurance company to do so. However, the policy should cover the same.
The incident should take place during the policy period of the retroactive period. The latter is the period since when the doctor has had continuous coverage.
The insured should make the first claim in writing for documentary proof. The AOA (Any One Accident) limit determines the claim amount.
The claim amount is then taken out of the AOY (Any One Year) limit. This is termed AOA:AOY under the policy.
The insurance company will accept multiple claims provided the aggregate amount does not cross the policyholder’s AOY limit.
The policyholder should also be aware of the exclusions in this policy and avoid making claims for them. Moreover, the insurer rejects such claims.
A Doctor’s Professional Indemnity insurance policy covers a medical practitioner’s personal financial liability. This policy is available for various types of medical establishments and consultants like General Physicians, and specialists such as Radiologists, Pediatricians, Cardiologists and various types of Surgeons and Dentists.
However, policyholders should acquaint themselves with instances that lead to a successful claim under the policy and the relevant process. This will help in settling a claim successfully.