Medical Malpractice Insurance Overview

Over the past several decades, medicine has become a highly litigious and risky area of business. Physicians and surgeons are practicing defensive medicine in an effort to reduce their risk of having to utilize their medical malpractice insurance to defend a claim. It is critically important for doctors to understand how their insurance policy works. In fact, many doctors who are sued have not made a mistake that constitutes medical malpractice, however in these instances, like those where there has been medical malpractice, they will need to depend on their physician malpractice insurance carrier to vigorously defend them when a claim comes in. This exploration will help the reader understand the intricacies of medical malpractice insurance from both the physician the insurance carrier’s view.

The Risk of Medical Malpractice
In the legal environment that has evolved in UAE, doctors must always be protected from potential claims. The reality is that every specialty and practice is susceptible to some amount of risk of a lawsuit. Many variables affect the potential of a lawsuit. They include; location, specialty, types of procedures, loss history, time spent working per week, length of time spent in practice, certifications, management of exposures, and limits of liability in the state of the medical practice.
The sum of these variables is called “risk.” That risk is transferred in the form of insurance policies to medical malpractice insurance companies who spread their risk over numerous physician specialties and generally over a large territory. For some medical liability insurance companies, a large territory means covering physicians throughout just one emirate, while others cover physicians and surgeons throughout the entire nation. Typically, the wider the spread of risk, the lower the risk is to the physician malpractice insurance company. The difference in risk between provinces within emirate can be quite large. This is evident by looking at the difference in premiums between different provinces for the same specialty.

The Four Elements of a Medical Malpractice Lawsuit
1. Obligation or duty on the part of the medical provider to the patient
2. Breach of duty on the part of the medical provider
3. There must be an injury as a result of the breach
4. Proximate Cause must be established.

Medical Malpractice Insurance Policy determining factors:
The medical malpractice insurance application process starts with a quote or an estimate of a doctor, surgeon or medical professional’s potential premium. Generally, the basic information needed includes:
•The doctor’s specialty (Does the doctor perform surgery?)
•The emirate in which the doctor practices
•The type of insurance sought (claims made/occurrence)
•Retroactive Date (claims made) -or- Effective Date (occurrence)
•Is the doctor board certified?
•Limits of Liability Desired •Claims History
The above list constitutes the general information needed by a medical malpractice insurance company to generate an accurate indication.

Most medical malpractice insurance applications generally ask the same questions, which essentially are seeking more details about the original questions a broker asked. Each application will ask for:
•The medical professional’s name and practice information
•The doctor’s license and professional information (American board certification, education)
•Specialty information (specialty, procedures, number of patients, etc.)
•Practice information (ancillary personnel, entity coverage, part time/full-time, location)
•Loss History and Insurance History
•Previous Policy Information (retroactive dates, limits of liability, policy coverage dates)
•New Policy information (limits)
•Hospital Admitting Privilege information

A medical malpractice insurance application should be treated as a legal contract. Many doctors have lost their coverage due to inaccuracies, omissions, or understatements in an application.
These imprecise answers range anywhere from simply forgetting some inconsequential information to a flagrant exclusion of prior claims or lawsuits. In EVERY medical malpractice application and policy, language is present that nullifies the contract in the event of a doctor intentionally misleading the insurance company. Therefore, if there are intentional inaccuracies that could have swayed an underwriter’s decision, the medical professional is essentially paying a premium for medical malpractice insurance coverage that legally has no obligation to cover his or her practice. Keep in mind that your medical malpractice insurance broker is your advocate to the insurance companies.
If the broker has all of the information up front about a physician, he or she can position the physician in a more positive light in to an insurance company underwriter than if negative information is made known for the first time, for example, in the loss history reports much further into the underwriting process.

Medical malpractice insurance is an extremely complex form of liability coverage that in no way can be completely explained in one article. There are innumerable caveats and exceptions to every rule and guideline in this market. However following basic outline will protect a doctor’s medical practice from lawsuits.
Additionally, every doctor’s situation is different and there are no “one size fits all” answers in the medical malpractice field. A medical professional should consult an educated and experienced professional regarding any specific questions or needs he or she might have with regards to medical malpractice insurance.
Finally, please keep in mind that a physician’s single greatest assets while navigating their medical malpractice insurance coverage from year to year is a basic knowledge of the coverage that protects their practice combine with a trusted relationship with a professional confidant in the medical malpractice field. A doctor’s needs medical malpractice insurance needs will change over time and the medical malpractice insurance market will change over time, but the one constant in the world of medical malpractice insurance is the need to have access to the most up-to date information, allowing the doctor to make the best decisions to adequately protect his or her practice.

Attorney / Mohamed Al Marzooqi
Mohamed Al Marzooqi advocates & Consultancy
Lawyer in Abu Dhabi, Dubai – UAE

The Reasons Malpractice Victims Receive Nothing Medical malpractice cases are among the most difficult a lawyer will ever handle. A medical malpractice case WhatsApp: +971555570005