Thursday 15 March 2012

FAQ: Professional Indemnity


Frequently Asked Questions

Q: What is Professional Indemnity Insurance?
A: Professional Indemnity Insurance provides insurance cover to professional
people against their legal liability to pay damages arising out of negligence in the
performance of their professional duties.
It is a product of National Insurance Company Ltd. [gov. of India undertaking] and
is promoted by Secure Insurance Services and Indian Dental Association.

Q: What are the scopes of cover?
A: The policy indemnifies any act committed by the insured, who shall be a
Registered Medical Practitioner, giving rise to any legal liability to Third Parties.
a) Legal liability as fixed by courts in India to pay compensation.
b) Defense costs and expenses. This means all costs, fees and expenses
incurred with the prior consent of the insurer in the investigation, defense or
settlement of any claim made against the insured, provided the claim falls within
the ambit of the policy.
The amount of payment under (a) and (b) will not exceed the amount insured for
in the policy under the limit of Any One Accident (AOA) in respect of any or all
claims made against the insured arising out of Any One Accident.

Q: What are the exclusions?
A: 1. Third party public liability.
2. Fines, penalties, punitive or exemplary damages.
3. Any loss of financial nature like loss of goodwill, loss of market etc.
4. Liability, if any, assumed by agreement and which would not have attached if
not for the agreement.
Liability arising from any criminal act or act in violation of any law or ordinance.
5. Services rendered under the influence of intoxicants or narcotics.
6. Dental treatment under general anesthesia except in a hospital.
7. The use of drugs for weight reduction.
8. Plastic surgery except for repair of scar being the result of previous surgery, or
in connection with burns or other traumatic injury.
9. AIDS related conditions.
10. Due to intentional non-compliance of statutory provisions.
11. Personal injuries such as libel, false arrest, defamation, mental injury, shock
etc.
12. Genetic injuries caused by x-ray and radioactive substances.
13. Caused by intentional disregard of technical or administrative management of
the need to take ail care to prevent claims.
14. Liability to employees/apprentices/contractors/general third party public.

Q: Who can take the insurance cover?
A: All registered dentists practicing in India.

Q: Is it a life time cover?
A: No. Policy has to be renewed every year before the expiry date mentioned on
the Policy Document.

Q: How much is the Premium?
A: Premium for Dental Surgeon for unrestricted AOA:AOY is Rs.2 per thousand
plus Service Tax as applicable.
It is recommended to take Indemnity Cover of min. Rs.3L for General Dentist and
for dentist practicing in metro cities, Indemnity Cover of Rs.5L is recommended.
For Oral & Maxillo-Facial Surgeons, Implantologist, Dentist doing high end Dental
Treatment or seeing more than 10 patients per day it is recommended to opt for
even higher Indemnity Cover.

For any one year limit
Rs.
300000
400000
500000
For any one Act.
Rs.
300000
400000
500000
Premium @ Rs.2 per 1000
Rs.
600
800
1000
10.30% Service Tax
Rs.
61.8
82.4
103
Total Premium
Rs.
662
882
1103



Q: What is AOA:AOY?
A: AOA means Any One Accident, which may include one or more, or a series of
claims arising out of the same cause or error or omission relating to professional
service. AOY means Any One Year. The Insured can choose an indemnity limit
which can be in the ratio 1 ;1, 1:2, 1:3, 1:4 of AOA : AOY and the premium will be
charged on AOY limit
For simplification, unrestricted AOA:AOY can be explained as “n” number of
incidences(claims) to be accepted consisting of “n’ sum of amount in a year, total
of which would not exceed the Indemnity Limit opted.


Q: Whom to contact if there us some case been filled against the dentist?
A: Policy holder should contact the policy issuing office mentioned on the Policy
Document.


Q: How to take the Indemnity Policy?
A: Send the filled-up Proposal Form and Premium amount to IDA-HO. Insurance
document will be sent at the address mentioned in the Proposal Form once it is
received and accepted at the Insurance Office.


Q: Whom to contact for more details?
A: Dr.Tanmay Haldar:
Phone: 9970157952
e-mail: secure.insurance@rediffmail.com
or
Indian Dental Association-Head Office:
e-mail: insurance@ida.org.in
Phone: 022-43434545

Wednesday 1 February 2012

Professional Indemnity Insurance for Dentist..... Launched at 65th IDC, Mumbai

Professional Indemnity Insurance for Dentist
Professional Indemnity Insurance provides insurance cover to professional people against their legal liability to pay damages arising out of negligence in the performance of their professional duties.

It is a product of National Insurance Company Ltd. [gov. of India undertaking] and is promoted by Secure Insurance Services and Indian Dental Association.

Dentist’ Biggest Nightmare:

Ø    What if something wrong happen to patient unknowingly?
Ø   What if something wrong happen to patient and I don’t disclose that to him and patient comes to know latter on from some other dentist?
Ø    What if some notorious patient tries to take undue advantage of Consumer Protection Act [CPA] ?

Types Of Dental Negligence:
As with all other areas of healthcare, dentistry is a complex area, which inevitably means there are a number of things that can, and sometimes do, go wrong.  Below are some examples of the different types of dental negligence:
Ø      Dental negligence through misdiagnosis
Ø      Dental negligence through careless work
Ø      Dental negligence through inadequate treatment

Dental negligence through misdiagnosis:
Ø   This is when a dentist misdiagnoses a patient’s dental problem, which then results in a failure to provide the appropriate treatment.  If this misdiagnosis causes more suffering and pain to the patient, the patient may have a potential compensation claim for dental negligence.

Dental negligence through careless work:

Ø   If the patient suffers from a personal injury which is caused by the careless work of a dentist, patient may be entitled to compensation by making a dental negligence claim. This may include failing to carrying out dental procedures in the correct manner.

Dental negligence through inadequate treatment:

Ø   If a dentist provides inadequate treatment which causes further pain and suffering, which could have been avoided, the patient may have sufficient grounds to make a dental negligence compensation claim. Patient may have a valid negligence claim whether the inadequate treatment occurred on one occasion or over a long period, provided it can be shown that a reasonable and competent member of the dental professional would not have made the same error.

Medico-Legal Cases In India: (few names are withheld to prevent privacy)

Ø      [***** v. Sriman D. Veerendra Heggade & Ors, 1999 (3) CPR 72 ( Ker. SCDRC)] …. Detachment of needle from syringe and slipping into throat- Efforts to take it out failing-Needle further slips to stomach- Taking it out from intestine by surgery and ultimate malady to patient-Negligence held-Compensation of Rs. 1,00,200/- and costs Rs. 3,000/- awarded



Ø      [Dr.**** v. Moratkal Kalarikkal Janardhanan, 1999 (2) CPR 14 (Ker. SCDRC)] … The complainant alleged Defective artificial tooth of denture after about 10 years-Denture made by first surgeon …No deficiency in service

Ø      Paramjit Singh S/o S. Davinder Singh r/o 216-I, Bhai Randhir Singh Nagar, Ludhiana…...Complainant.
      Versus
Dr. *****, Ludhiana.….Opposite party.
COMPLAINT UNDER SECTION 12 OF THE CONSUMER PROTECTION ACT, 1986.
Complainant sought compensation of Rs.50,000/- for negligence…claimed not entitled for any compensation or damages.

Ø      In case ******** vs. Mohd. Ishfaq reported in 1 (2009) CPJ 32 (SC) ….. Finding no merits in the complaint, the same stands dismissed.

Ø      Dentist-Defective dentures-Refund ordered- The State Commission upheld the order of the District Forum to refund Rs.1,500/- charged for making a denture set by the dentist as the said denture was not fitting properly. [Dr. ****** vs. Smt. Urmila Mathur, Appeal No. 1334/Cs of 1992, decided on 11.11.1994 (UP SCDRC) (unreported).] 

Ø      The National Commission upheld the finding of the State Commission and dismissed the appeal. [S.B. Tiwari vs. Dr.******, 1996 (1) CPJ 301 (NCDRC).] …. The complainant alleged that the dentist extracted his tooth without taking BP and other precautions, due to which he had suffered Over-bleeding and headache following tooth extraction.

Ø      [Dr. ***** vs. Sahib ChandShanna, 2003 (6) CLD 26: 2003 (3) CPR 509: 2003 (3) CPJ 622 (Del. SCDRC)] …Denture prepared by appellant becoming loose and coming out not only while eating but also while talking-Despite several requests appellant failing to rectify the defect-Complainant getting a new denture prepared from another dentist-Negligence held-Direction of District Forum to refund cost of denture together with Rs.2,000/- as compensation upheld by State Commission

Medico-Legal Insurance Cover Available In India:
Ø      Register and pay the prescribed fee and premium amount.
Ø      Inform the insurance company if any Medico-Legal case arises.
Ø      Such companies have their own panel of Advocates, Insure has no liberty to choose advocate of his own choice.
Ø      Advocate fee and clam amount, if any, is paid by company.
Ø      Premium is very high and coverage is annulled once Medico-Legal case arises.
    E.g. AICL (Apex Insurance Consultant Limited) charges Rs.7124 for a cover of Rs.5L. This premium is very high and hardly any clam arises though premium has to be paid. Dentist feels it wastage of money for the claim free year.


Most Simple and Economical Solution....
Professional Indemnity Insurance of National Insurace Company.

 
Salient Feature:
This insurance covers legal liability arising from errors and/or omissions on the part of Registered Dental Practitioners while rendering professional service.

Scope Of Cover:
The policy indemnifies any act committed by the insured, who shall be a Registered Dental Practitioner, giving rise to any legal liability to Third Parties. The insured includes the policyholder and his qualified assistants or employees as named in the proposal form.

It applies to claims arising out of bodily injury and/or death of any patient caused by or alleged to have been caused by error, omission or negligence in professional service rendered or which should have been rendered by the insured or qualified assistants named in the schedule or any nurse or technician employed by the insured.
a) Legal liability as fixed by courts in India to pay compensation.
b) Defense costs and expenses.

Exclusions:
a. Third party public liability.
b. Fines, penalties, punitive or exemplary damages.
c. Any loss of financial nature like loss of goodwill, loss of market etc.
d. Liability, if any, assumed by agreement and which would not have attached if not for the agreement.

Premium:
Rs.2 per thousand + Service Tax (as applicable)

Proposal:
A) For General Dentist:
Dentist Immunity Scheme A: Professional Indemnity Insurance of Rs.3 Lakh, Premium Rs.600+S.T

B) For Specialist Dentist (Doing Implant, Major Surgeries, high-end dental treatment etc.):
Dentist Immunity Scheme B: Professional Indemnity Insurance of Rs.4 Lakh. Premium Rs.800+S.T
Dentist Immunity Scheme C: Professional Indemnity Insurance of Rs.5 Lakh. Premium Rs.1000+S.T

can see full details here:
http://www.nationalinsuranceindia.com/nicWeb/nic/PolicyServlet?id=9999&name=4625.html


[for more details and Insurance Proposal Form contact: secure.insurance@rediffmail.com]

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