From 1 July 2016 MIGA has increased the cover for legal expenses for doctors to $1,500,000. This is very important protection for you.
When doctors think of medical indemnity insurance their first thought is compensation claims and the large sums that can be awarded to patients.
However for many of our members their reliance on their insurance cover doesn’t just relate to compensation claims, it extends to the legal expenses cover needed to defend themselves in relation to a complaint or disciplinary action. This draws on the legal expenses cover provided under your policy.
Whilst this cover may not be your first thought in considering your insurance needs, our claims experience shows that it is becoming increasingly important for all of our members.
Complaints to Medical Boards, Healthcare Complaints entities, coronial investigations, Medicare audits and employment disputes have been on the rise. We have recent experience of two legal expense only matters where the legal costs have reached the current policy limit of $1,000,000. The legal and expert fees in both cases were astronomical and the circumstances of the cases may surprise and dismay you.
CASE 1 – snowballing legal proceedings
This case surrounded our representation of a doctor who was initially involved in a Coronial investigation. The Coronial Inquest was then followed by disciplinary action undertaken by the employer, and also an investigation by AHPRA. The defence and support of our member, who was under attack from all sides, was ultimately successful. The costs in this case reached the limit of the insurance cover. The progression of legal action in this case surprised even our experienced and battle-hardened solicitor.
CASE 2 – searching for a needle in a haystack
This case was a Medicare investigation into a practitioner’s management of 400 patients. The key issue was around billings and the justification of Medicare item claims. The investigation involved very detailed analysis of the 400 patient files – a laborious and time-consuming process which in itself incurred significant legal costs. Regrettably enquiry did not end there with the investigation escalating to a disciplinary matter questioning whether the practitioner was “practising to acceptable standards”. The disciplinary matter went to hearing and then appeal.
Both cases illustrate the unpredictable nature of investigation and legal action, what can initially seem a simple case can grow well beyond those initial expectations.
MIGA offering you the best protection
Our role as a specialist insurer for our doctor members is to use our knowledge, particularly in relation to claims outcomes to ensure that we provide the protection you need. We are increasing our policy limit this year because we know our members need it.
As always, if you are involved in an incident, or concerned that a matter may be brewing, please contact us for assistance as we can provide advice and assist you to manage it proactively. Proactive management can help to prevent matters escalating. You can call us 24/7 for urgent medico-legal assistance on 1800 839 280.
In the meantime you can rest assured that your insurance cover is evolving with the medical landscape to provide the protection you need.