What Is Medical Malpractice Insurance

Medical malpractice is defined as professional negligence on the part of a healthcare provider. In these situations the treatment provided is below expectations or even incorrect leading to injuries to the patient and sometimes even death. In United States most of the health care providers are required to have medical malpractice insurance. Doctors employed by the government do not avail this as in case of filing of a case, it is done against the State and not the doctor.

Medical malpractice originates when a medical practitioner treats a patient in a neglectful way. There are certain examples of medical malfunction which are:-

  • Failure in providing suitable treatment for a medicinal condition
  • Failure in diagnosis a medicinal condition or disease
  • Failure due to neglectfulness in hospital facility maintenance, defective equipments and/or non-conformance to real medical standards
  • Unreasonable holdup for carrying out the process of diagnosis and/or treatment     

Most of the doctors, nurses, other medical aficionados and hospitals fall under the high risk zone of medical malpractice.
In case of malpractice, the patient or its family files a lawsuit demanding compensation of injuries or health damage caused to the patient. For proving the medical malpractice claim, patient needs to prove that medical practitioner did not maintain acceptable standards and it caused harm to the patient. Claim and its related compensation can be proved by four basic elements which are:-

  • One has to show that medical practitioner owed a duty after taking the patient in the hospital.
  • One has to show the incorrect performance and obvious errors in it.
  • One has to prove that this negligence in duty caused injury which should be compensated by the medical practitioner or hospital. 

These claims can run into large amounts and can completely destabilize the financial condition of a healthcare practitioner. This is where Medical malpractice insurance comes into picture by providing coverage to the medical practitioner if one comes across any of such claims made by the patient.


Benefits of Medical Malpractice Insurance

Medical malpractice insurance provides extensive coverage to the insurance holder. Medical malpractice can really shake up the financial stability of the medical practitioner. Therefore, medical malpractice insurance comes up with following benefits:-

Protection against the Foreign Articles Left in the Treated Bodies : If medical practitioners forget their medical paraphernalia in their patients’ bodies or forget to make them unconscious during the operation, they have to pay to the patients. Medical malpractice insurance takes care of this rare but horrific ignorance by their specific coverage.  

Overdoses, Misdiagnosis and Drug Medical Malpractice Coverage : There is specific coverage against the aforementioned mishaps under any circumstances. All of them should be unintentional and infrequent. 

Patient Doctor Confidentiality : A doctor has to know all the health related issues, some of them may be secrets. There exists a bond of understanding where doctor is never supposed to break the bond of confidentiality. If patient feels any breach in the confidentiality, then one may claim for the costs associated in the defense. Medical malpractice insurance takes care of this aspect by carrying out the repayment procedure.

Loss of electronic data of the patient : Today, most of the patient information, however sensitive is also stored electronically. This electronically stored data is vulnerable to theft, loss, or accidental transmission (of electronic patient information). A patient in such cases file lawsuit against the medical practitioner.

Elderly Abuse or Nursing Home Negligence : Along with medicinal practice, all the doctors are trained to deal respectfully with disabled, elderly or other special patients. Sometimes, there can be some problems where medical practitioners may misbehave with the patients. Medical malpractice insurance covers them and hospitals from the claims made by the troubled patients.

Types of Medical Malpractice Insurance

In March 2008, American academy of Actuaries Medical Malpractice Insurance Subcommittee issued a catalogue regarding Informational Fact Sheets for specific usage by subsequent actuaries and people. They categorized medical malpractice insurance into three broad classifications which are:-

Occurrence Policies

Occurrence policies cover all the incidents happening during the specific time period of insurance policy. Insurance companies do not consider the time duration passed before the claim is notified to them. It is most extended form out of all the three insurance policies. At the same time, it is the costliest and riskiest of other two policies. These policies are not suitable for medical malpractice insurance because it takes years before actual clarification of the claim and most of the occurrence policies get expired before that.

Claim-made Policies

Medical Malpractice Insurance

Claim-made policies come into existence when malpractice occurs during or after the retroactive date of particular insurance policy. There is variation in the policy costs depending upon the retroactive date. If incident happens in the beginning the policy, it gets expensive. Premium amounts keep on increasing until policy attains its maturity. Matured policy is often five to eight years old and premium amount become fixed when policy become matured. Claim-made policies are widely used in the medical malpractice insurance industry today.

Before the policy expiration, insurance holders should clear all the medical malpractice claims. This is required to fill in the gap between occurrence and claims-made coverage. At the same time, insurer can purchase ERP (Extended Reporting Period) coverage which can cover him/her if policy terminates due to disability, qualified retirement or death.

Modified Occurrence Policies

These policies represent a combination of above two policies. There is already included ERP coverage on the basis of claim-made policy. ERP coverage can buy some important time to insurer after the policy expiration. After ERP expiration, insurance company provides another alternative of unlimited ERP coverage to the insurer.  

Major Medical Malpractice Insurance Companies  

As per the reports from American Medical Association, medical malpractice insurance is highly prioritized apprehension for medical practitioners.  There are various medical malpractice insurance providers and some of them are as follows:-

The Doctors Company 
The Doctors Company is acclaimed as USA’s largest medical malpractice insurance company. It emerged 35 years ago when medical malpractice crises were leading the doctors and physicians to retort. The Doctors Company is known for defending, protecting and rewarding the good medicinal practices with local influence and national resources. They are already protecting 71, 000 medical practitioners with their three plans namely MediGuard, CyberGuard and the Tribute Plan. MediGuard protects insurers from administrative actions whereas CyberGuard protect them from accidental loss or theft of patient information. It covers all the costs realted to data recovery.

Founded in 1976 by Pennsylvania Medical Society,  is highly committed to the medical practitioners. In previous five years, 89% of their trials were successfully defended in the favor of their policyholders. They offer their plans in three different categories namely:-

  • Quality and service in coverage – under this policy, PMSLIC provides claims-made coverage with user-friendly rates.
  • Quality and coverage in claims – this policy is managed for defending good medicine. There would be no settlement before proper consent of their policy holder.
  • Quality and service in risk management – under this policy, PMSLIC manages risk management topics, newsletter, presentations, sample forms and litigation stress content.