New policy sparks a new approach to medical malpractice cover

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To counter the exponential rise in medical malpractice claims in recent years, Genoa Underwriting Managers and KwaZulu-Natal-based Safire Insurance Company have launched a specialised medical malpractice insurance product that will completely change the way local doctors and specialists manage risk.

Michael-John Damant, a director of Genoa, said that a new offering, which took 14 months to formulate, will factor in the many challenges faced by today’s doctors. In addition, the new policy would give the South African medical fraternity access to a locally grown product where doctors and specialist will have improved protection and recourse to either the Financial Advisory and Intermediary Services Act or the South African Ombudsman of Short-Term Insurance (OSTI).

It is underwritten by South African based Safire Insurance Company and reinsured by Munich Re, one of the world’s largest and leading reinsurers.

“We are pleased to be the first Med-Mal insurer in South Africa to have received their support in respect of this innovative claims made product,” says Pierre Bekker, CEO of Safire Insurance Company.

Claims increases coupled with the volatility of the rand have led to punitive premium increases each year which have contributed towards the massive increase in costs associated with running a medical practice.

“We are aware that amendments to legislation governing the Road Accident Fund (RAF) make damage claims from injuries sustained in motor vehicle accidents less profitable for personal injury litigators. This has spurred many to turn to more lucrative options such as medical malpractice claims. As a result, many doctors risk becoming the targets of vexatious litigation. As we are committed to making a positive contribution to the long-term sustainability of the medical sector in South Africa, we are happy to be able to not only offer a claims made insurance policy with stable, sustainable premiums but one that offers active support to medical practitioners,” Bekker explains.

Available to select medical practitioners registered with the HPCSA (Health Professions Council of South Africa), Genoa offers a claims made policy which, subject to the retroactive date contained in the policy, provides cover that is triggered when a claim is made against the insured during the policy period regardless of when the wrongful act that gave rise to the claim took place.

This new product now offers individual risk rated premiums based on each practitioner’s individual risk profile, avoiding cross subsidisation of premiums for higher risk practitioners by lower risk practitioners.

When coupled with low allocations to operating costs and cost-effective litigation, this enables Genoa to focus on what’s most important – offering full protection and support to its select clients at cost effective rates,” he adds.

According to Mark Lynn, a director of Shackleton Risk Management, one of a broad national network of brokerages that will be marketing this policy, the high standard of personalised service on which all partners have focused during their dealings with other product offerings, including professional indemnity insurance for the legal, insolvency, business rescue and fiduciary sector, will play a prominent part in the roll out of this product.

He says that assisting doctors having to deal with significant personal distress and massive potential reputational damage resulting from a medical malpractice claim must be top of mind.

Thus, there will be no call centres and all interactions will be face-to-face both before and during the full life of the policy.

In the event of a claim, a doctor will receive personal coaching by a highly qualified medico-legal team on how to best deal with it and manage the associated trauma.

“From the get go, as soon as a practitioner is notified of a potential claim by the HPCSA, we will ensure that the process is handled correctly. We will assist with responses and even attend the HPCSA hearings with the practitioner,” Damant says.

Bekker explains that the policy focuses on mediation and other alternative dispute resolution techniques to reduce claim costs so that practitioners are not faced with a situation where their Limit of Indemnity has been eroded by unnecessary litigation or defence costs.

“The quick and efficient resolution of valid claims and the rigorous defence of vexatious claims is backed firstly by an in-house legal team and then by a team of medical and legal professionals from the top firms (MacRobert Attorneys, Clyde & Co, Weber Wentzel, Malatji Kanyane and Garlicke and Bousfield) in this field across the country,” he says.

Another value add comes with a partnership with medical practice consulting (MPC) to offer CPD training to select practitioners. In addition, policy holders have access to relevant and innovative patient relationship management tips garnered from sound international research and supplemented with insights received from practitioners’ interactions through their daily dealings with their patients.

Genoa encourages medical practitioners to utilise proactive technological back up to mitigate potential claims. “This includes the use of electronic note taking and cloud computing, and we are happy to assist and advise practitioners of such available technologies,” says Damant.

The new policy offering also includes a number of extensions such as free fidelity cover of R25,000 for theft by employees, a good Samaritan extension and a premium holiday of up to three months to cover maternity leave or time taken for additional studies.

The policy automatically includes an extended reporting period (ERP) of up to 60 months and, subject to certain conditions, doctors also have the option to extend cover beyond the initial period stipulated.

“Based on their associated risk profiles, we will be providing practitioners with different limits of indemnity from which to choose. This enables them to balance the costs of insurance against the cover that best suits their needs and ultimately places the choice back into the hands of the medical practitioner,” he noted.

This news release was provided by Genoa Underwriting Managers


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