EthiQal is the only South African insurer to offer occurrence-based and claims-made cover, the authorised financial services provider writes in the first of a series of columns, Getting to Know EthiQal.
What is the EthiQal Advantage?
We are the only South African insurer to offer occurrence-based and claims-made cover. Where practitioners are changing from other claims-made products, retroactive cover is also available.
As we are an authorised financial services provider, our clients are completely protected under SA laws.
What are the benefits of being covered by EthiQal?
Active protection of doctors
We firmly believe that our doctors are a national asset and must be protected. Our business model is underpinned by active risk management aimed at reducing medico-legal threats and stabilising professional indemnity premiums.
Easy access to medicolegal support
EthiQal’s in-house team of highly experienced lawyers and doctors is easily accessible. They provide day-to-day medico-legal advice and oversee the claim adjudication and resolution process with the support of reputable law firms, all of whom have established track records of excellence in the medico-legal field.
Policyholder protection
EthiQal is a division of Constantia Insurance Company Limited, a licensed non-life insurer and an authorised Financial Services Provider(FSP 31111), and so our policies, including limits of insurance, scope of cover, exclusions and requirements for cover are clearly defined and binding. Policyholders are fully protected in terms of South African laws and regulations which include the insurance principle of Treating Customers Fairly (TCF) and easy access to the industry ombudsman in the unlikely event of a dispute between the insured and the insurer.
This contrasts with indemnity cover provided by mutuals that may not be licensed as a Financial Services Provider (FSP) in South Africa and that offer cover on a discretionary basis according to their Memorandum and Articles of Association. Where the mutual is offshore, only a foreign country’s courts or arbitration panel could potentially adjudicate and rule on any dispute between the doctor and the indemnifier.
What types of cover are available?
Occurrence-based cover
Occurrence-based cover is the most popular form of indemnity cover amongst doctors. It provides protection for claims that result from any incident that occurs whilst being a policyholder. This is irrespective of when the claim is made and it includes the time after a policy has been cancelled.
Contrary to claims-made cover, it does not expose doctors to potential gaps in cover as a result of policy migration between financial service providers, contracted scope of practice, unexpected inability to purchase run-off cover or forfeiting of extended reporting periods.
Claims-made cover
With this cover, you are only protected for incidents that both occur and are reported during the policy period, regardless of when a claim is received. Depending on the cover purchased, this may include a retroactive date which makes provision for cover of claims that emanate from a period prior to taking out the new policy, for adverse events that you could not have reasonably anticipated at the time and which you would thus not have notified to your previous insurer.
Run-off cover/extended reporting period is available on application and refers to a period after termination of the policy, within which incidents that occur during the insurance period can still be reported for purposes of qualifying for cover.
Retroactive cover
If you are switching insurance from another claims-made product, it is important that you do not expose yourself to gaps in cover. Careful attention must be paid in such transition to your current retro date, as well as your scope of practice during your professional career. Retroactive cover, both on an occurrence-based and claims-made basis, is available via EthiQal.
Meet the EthiQal team:
Chief Executive Officer
Executive: EthiQal & Group Health Actuary
Client Service & Business Development Manager
Legal & Claims Manager
Clinical Risk Management
Risk Management & Technical Underwriting Manager
Contact us via info@ethiqal.co.za or visit www.ethiqal.co.za and let us give you a comparative quote.