Professional liability insurance – reliable protection of specialists against errors in work, insurance nuances
Regardless of occupation, each person can make mistakes in their work. Sometimes such errors and omissions lead to the obligation to pay damages to other people.
Compensation can be quite large, but professional liability insurance allows you to protect the specialist in such cases. The presence of the policy ensures that the insurer will pay the money instead of the policyholder’s mistake in his work.
What does professional liability insurance mean?
The policy guarantees the protection of the responsibility of a representative of a particular profession to the people to whom he caused damage in his workplace.
Most often, professional liability insurance is chosen by doctors, lawyers, architects, representatives of other specialties who are not insured by the enterprise within its civil liability. The insured person can be an individual or an entire organization.
Insured persons must be professionals in their field, have the necessary knowledge and skills, proper qualifications, confirmed by a certificate, diploma, or other official document. In addition, they must conscientiously fulfill their duties and have no complaints about the work.
Types of activities are different, so the risks of professional liability insurance also differ from each other.
Insurers allocate 4 main groups:
- physical: health workers, pharmacists, drivers of various vehicles and many others are capable of harming life / health;
- material: such damage can be obtained from the workers of repair services, construction companies, design bureaus, designers, etc .;
- financial: the risk of losing capital arises when interacting with bank employees, stock brokers, auditors, etc .;
- moral: damage can be obtained from representatives of various professions that are in close contact for working with people.
Compulsory professional liability insurance is implemented taking into account both the main risks and the goals of a representative of a particular profession.
For example, a doctor or lawyer provides the services people need, and a designer or architect seeks to get the end result – a constructed building or other structure.
Types of insurance
Today, the following types of professional liability insurance arepracticed :
In many foreign countries, private doctors, lawyers, notaries can insure their liability on a voluntary basis. Those who are legally charged with compulsory professional liability insurance can, at their own request, increase the insurance amount standard for their specialization for an additional fee.
The Russian legislation provides for the obligation to insure their professional liability for notaries, who must provide the insurer with a valid license, and for appraisers.
Features of doctors liability insurance
The profession of a medical worker is associated with high risks, and the mistakes made by him in his work may have a variety of reasons.
Such a cause may be negligence, failure to exercise due caution during various procedures and operations, and even incompetence of a specialist who was unable to produce effective treatment for the patient.
When insuring the professional liability of doctors, the main criterion is negligence. This formulation implies that the doctor, who has the necessary qualifications and always conscientiously performs his work, incorrectly used his knowledge and skills in the specific case for the diagnosis and treatment of the patient.
In assessing this fact, the insurer uses the basic list of requirements that are standard for a representative of this profession. The expert analyzes and concludes whether a mistake was made by negligence.
When insuring the professional liability of physicians, the insured is protected against the patients to whom he has caused harm while providing them with medical services.
The insured event is the fact that the doctor caused harm to the patient, as a result of which the patient suffered injury, lost work ability or passed away.
If there is a proven fact of the insured event, the obligation to pay compensation for the damage caused to the injured person automatically passes from the insured to the issuing policy.
In the event that the insurer causes harm to the patient’s life or health, the insurance company will be obliged to pay damages to the injured person. The amount of compensation is calculated within the amount specified in the policy and provided for by the Russian legislation.
In addition, the insurer will reimburse all legal costs if a claim is filed by the injured person regarding the payment and the amount of compensation.
Health care insurance has one distinguishing feature. Responsibility for such a policy applies not only to the period of validity specified in the policy, but also for the next six months after its termination.
If the patient’s health deteriorates or dies within six months after the insurance period expires, compensation will still be paid to the injured party.
Refusal to pay compensation
The company that issued the policy has the right to refuse to pay compensation in the following circumstances:
- if the doctor has caused harm to the patient intentionally or knowingly, while understanding the high probability of occurrence of the insured risk;
- if the doctor carried out activities requiring special qualifications without having supporting documents (diploma, license, certificate, etc.);
- if the insured event occurred during the period of hostilities, a state of emergency in the country, sabotage, etc., without specifying such circumstances in the contract;
- if the mistake was made by a doctor in conditions that could significantly increase the degree of risk, and the insurance company was not notified of them in advance;
- if the doctor acted in violation of the law, instructions or other normative acts, which he should have been guided by during his work.
The insurance company assumes responsibility for the payment of compensation, starting with the court deciding whether the insured person is guilty of harming or harming other people.
The insurance company may also refuse to indemnify the damage caused if the following factors are the cause:
- alcohol / drug intoxication of the doctor during the provision of medical services to patients;
- violation of instructions for the storage and use of medicines;
- the spread of AIDS, venereal or other diseases due to hygiene, sanitary or anti-epidemic prescriptions;
- infection of the patient during the blood transfusion procedure;
- the doctor performs the manipulations that are not included in the list of his duties, not related to the areas of activity, confirmed by his personal license, not corresponding to his qualifications;
- the provision of medical services by a doctor to third parties outside his place of work;
- conducting activities during military and civil unrest, thermonuclear explosion, lack of electricity, water, heating, and under other extreme circumstances;
- a documented waiver of the injured person from medical care;
- the presence of requirements, regulations, instructions of the authorities, specific competent authorities regarding the performance by the insured of his professional duties.
Conclusion of an insurance contract
Having chosen a suitable company, the client has the right to issue a professional liability insurance contract indicating any period: from several months to several years.
The application for insurance shall indicate the data on the policyholder. If it is an organization, then information is attached for each employee: age, length of service, education, qualifications, academic degree, and the position he occupies.
Also in the application it is necessary to indicate the facts of insured persons’ legal claims of civil liability, if any, in the past 5 years.
The insurance amount specified in the policy can be set in any size and is agreed upon by both parties when entering into the contract. This is the limit within which the insurer will pay compensation for claims during the entire insurance period.
The same amount includes legal costs if this condition is separately stated in the insurance contract.
The policy will indicate the limits of liability. They can be set as follows:
- on one claim,
- for one insured event
- on one kind of risk:
- compensation for damage caused by harm to life / health,
- reimbursement of the costs of litigation for the insured event.