Stresses and Strains!

I am seeing more and more claims where the word STRESS is used on med certs under Locum Insurance policies and so I decided to look up the definition in the Oxford Dictionary.  The first definition that I came across was” tension exerted by a material object” – this did not fit the bill.  The next definition was more interesting “a state of mental or emotional strain or tension resulting from adverse or demanding circumstances”.

I now wanted to apply this definition to the Stress Claims that have been made under Locum Insurance policies that we design and arrange for the healthcare professions.  Very rarely was a reason given for being unable to perform normal duties apart from the word Stress.  Could it be work related, personal problems or financial strains? Whichever one it is, the sooner a plan of action/treatment is started the quicker the recovery time for that person. It sounds so simple.

Most medical practices have a Locum Insurance policy to cover the practice partners/staff in the event of sickness accident and absence.  However, there is usually an initial 4 week period in the policy (to tie in with the practice agreement) where the practice cover the costs incurred for partner/employees – this is referred to as the deferred period.  It is quite common for a claim to be notified just before or just after the deferred period.  Here lies the problem when the claim being made is for stress.

The person making the stress claim has already had 4 weeks off from their normal duties and relies on the medical certificate issued by their GP.  Enter the MIC Early Intervention Scheme that can provide counselling after 3 days and if the problem is skeletal, physiotherapy is also available after 3 days.  It makes sense that if the problem is tackled right from the start it is easier to manage.

The MIC Early Intervention Scheme is not designed to replace procedures that are currently in place, it is designed to assist the practice and individual in their recovery and rehabilitation.  This is in everybody’s interest.  The practice manager does not have to continually look for a Locum, patients can see their normal doctor and it also complies with the Management of Health & Safety at Work Regulations (1999), where employers must assess the nature and scale of health risks at work and must take measures to control them.

Here are a few examples of genuine claims for stress:

  • Full time GP – £1000 per week benefit – Total claim £48,000 – Time off 48 weeks
  • Full time GP – £1375 per week benefit – Total claim £31,625 – Time off 27 weeks
  • Part Time GP – £687 per week benefit – Total claim £26,793 – Time off 42 weeks
  • Part Time GP – £950 per week benefit – Total claim £20,900 – Time off 26 weeks.

Total amount paid for these claims £127,318. Total time off 143 weeks.

Insurers are now becoming more concerned and looking for more ways of controlling stress claims.  The MIC Early intervention Scheme is the start.