Comparing Interpretation – Locum Insurance: “Normal Terms” – part 2

‘Normal Terms’ – these two words can cost your practice a lot of money. It seems ridiculous to make such a statement but it is true.

Here is an example:

You are changing your Locum Insurance cover to another provider as they have quoted a premium that is lower than what you have been paying.

You have been told that you will receive “normal terms”. To the uninitiated this suggests that everybody is fully covered. What it really means is that everybody is covered as per the policy conditions and exclusions and there can be some nasty little clauses in the policy that changes everything.

It goes like this – The Practice Manager gets a cheaper Locum Insurance quote and is told by that potential new provider that even though the practice had made a recent claim the condition that was claimed for would be covered and would be given “normal terms”. When challenged on this point (the practice manager has been alerted to a particular policy exclusion) the potential new provider admitted that as the policy had a “pre-existing condition exclusion” there would be a period before the condition that was previously claimed on could be covered. This situation did happen and the Practice Manager made the right call and kept the cover they had.

Remember – The policy conditions and exclusions determine what locum insurance cover you have. If it seems too good to be true it probably is.

Medical Insurance Consultants

Completing A Medical Confirmation Form on Behalf of Partners/Staff

Here is the classic case through the eyes of a Practice Manager:

Just filled out the form for our Locum Insurance and as far as I am aware none of the individuals that are being insured have had any anything wrong with them in the period requested. Insurance now in place – On to the next job.

Some months later – One of the partners has been off sick with a stress related condition for the last 3 weeks and it looks as though he will be off for another 8 weeks at least. Contacted our insurance broker/company and requested a claim form. The claim form has been completed and has been sent to the insurance broker/company. I am now waiting to be paid as we are already employing a locum.

To my amazement I have received an email/letter from the insurance broker/company saying that they will not be paying the claim due to non-disclosure. I now find out that the partner who is off sick had suffered from a stress related condition in the preceding x months. Not a happy bunny at the moment to say the least!

The partners reason for not disclosing this to me  – He/She did not think that the previous condition warranted a mention.

Make sure you stress the implications of not fully disclosing medical condition.

Comparing Interpretations – Locum Insurance

Have you ever noticed that when companies compare their product against a competitors theirs always appears miles better.

What is the comparions based on?  INTERPRETATION is the word.

I recently saw a Locum Insurance comparison which stated that their comparison was “based upon their interpretation” – basically this is a “get out of jail” phrase that enables them to write more or less what they want to compare, as well as extracting selective wording from the Locum Insurance policy.  A good example of this relates to claiming for a mental illness – according to the comparison the person claiming “will have to see a psychiatrist” whereas the policy wording actually says “will have to see a psychiatrist when requested by the insurer”.  Two totally different meanings.  This also doesn’t mention that the insurer has the general right within the policy to request the insured to provide all information required for the claim and co-operate with insurers request in order to administer the claim (i.e. attend a medical examination).

Beware of comparisons!!

Always ask the specific questions you want answered.

An interpretation of an interpretation made on Wednesday 21st May 2014!!!!

Medical Insurance Consultants

MIC Surgery Insurance awarded 5 Star rating

We are proud to announce that the MIC Surgery Insurance policy has been awarded a 5 Star rating by Defaqto, the independent financial rating company.  This rating confirms to our clients that the cover we offer is at the top of the pile, backed up with excellent customer support and advice.

We will not stop there however, as we are constantly looking at ways in improving the cover we can provide without costing our clients more in premium.  If you don’t have a Medical Insurance Consultants Surgery Insurance policy why not contact us on 0800 163870, email us on [email protected] or visit our website www.m-i-c.co.uk to receive your quote.

Claiming and Changing – Locum Insurance

A practice claims £55,000 for an illness to an insured GP on the practice Locum Insurance policy and they have just returned to work. The practice then decides to place their Locum Insurance with another provider who offered a lower premium. Not only is the premium cheaper but the new insurer says that they will cover the GP without exclusions or conditions for the illness that was just claimed for. I just hope that the illness doesn’t return!  The devil as always is in the detail and the level of transparency your insurance provider gives you.  Seeing the policy wording does not necessarily mean you understand what it is saying and I would always recommend asking for an explanation to points you are concerned about.

Cost should not always be the main driver behind selecting your policy, as a history of having your claims paid is by far the best indicator of a good policy.  After all that is the reason you took the policy out in the first place, not just to show that you have got a policy for less than last year!

Locum & Absence Insurance Marketing – Getting It So Wrong!

How can you compare the merits of one policy over the other? The only way is if you have the most up to date information on both products.

Unfortunately there have been several very recent occasions when out of date information has been used to undermine the MIC Locum/Absence Insurance cover. Obviously this gives a very false picture of MIC but makes our competitor’s products seem that much better. Has this been done as a deliberate marketing tool or is just done in error? If it were just one or two points being incorrect then I would say that it was an error. In fact there were in excess of 15 points raised in one comparison that were inaccurate or bore no relation to the policy in question, which makes me think that it was a deliberate marketing tool. As the old phrase goes “A little knowledge is dangerous”

As MIC has been arranging insurance for some 16 years we take all of this in our stride but it does make you wonder how these companies “get away with it”. Practice Managers and GPs are being given inaccurate information to make their decision upon. This is very worrying when you consider the costs that could fall on the practice if their Locum Insurance failed to perform the way they thought it would. If any Practice Manager has had a comparison including MIC products I would be delighted to hear from them.

If you would like to see what our policies actually cover, visit our website www.m-i-c.co.uk or call us on 0800 163 870.

MIC Charity Golf Day 16 May 2013

Over 80 golfers made the MIC sponsored Golf Day at the Salisbury and West Wilts Golf Club and helped to raise over £3000.

The money raised went to supporting the Weldmar Hospicecare Trust and Julia’s House Childrens Hospice.

Although the weather was terrible – wet, windy and cold all participants completed their round of golf and a good day was had by all!

If you are a client of MIC for Locum Insurance, Surgery Insurance or any of our Medical Liability products and would like to take part in next years event please get in touch and we can put your name down.

The MDU change their mind again!

Some of you may have heard recently about the Medical Defence Union switching the way in which they provide indemnity cover to its members again. You may have also not even realised that the MDU have been providing indemnity to its members since 2000 via an insurance policy.

Why have they done this? Well this is not too clear from their press release or the ‘we want you back letter’ they are sending out to ex-members and those thinking of moving to another insurance provider from the MDU. Their reasons for switching in 2000 and their press release in 2010 heavily contradict the reasoning behind switching back to discretionary cover as of the 1st April 2013. They say that discretionary is now the best way to offer this cover to their members, yet in another breath, as shown in their December 2010 press release, ‘if there is no legal entitlement to indemnity, as is the case with discretionary indemnity, then there is a risk that deserving patients may go uncompensated.’ They then go on to add, ‘You are not allowed to insure your house or home with discretionary indemnity and it is unthinkable that discretionary indemnity remains acceptable for clinical negligence.’

Well I am not sure about you, but this has confused me. Which method is the right one to use to indemnify medical and dental professionals? The answer is that both have their merits, it just depends on which merits you hold as being the most important to you. Discretionary cover holds itself up as being flexible in the manner it can support someone, which is true, but then look at the word discretionary. There is no legal obligation to provide support and I have heard many people say, ‘of course they will provide support’. Unfortunately, this way of thinking of it is not actually true. There have been many occasions where support has not been provided, and the MDU mention some of these in their 2010 press release. Why haven’t they provided support? Well they don’t have to tell you, is the answer to that.

Here lies the flaw in the discretionary indemnity model. Accountability and transparency is almost non-existent within the mutual discretionary model. Members have no recourse options if they feel hard done by and no regulatory body to impose sanctions or fines. The majority of other EU and Non-EU countries realise this fact and have pushed through the requirement to hold an insurance policy, rather than relying upon descretionary cover. Another point that comes from this is how do you know if the MDO you are paying your subscriptions to is financially secure? They are not regulated, they don’t have to publish their results and they are not accountable to any authority.

A recent client of ours incepted their indemnity cover with us on the 1st March 2013 and all was fine. They then received the letter, referred to earlier, from the MDU which raised points about the cover they were going to and how bad it was. Again, forgetting that they themselves had been providing such a policy for he last 13 years, and making assertions that ‘claims made’ policies ‘lock you in until retirement’, ‘one year’s cover for one years premium’ and ‘claims made subscriptions start low but will eventually rise’. All of these sound bad to the client, but are they accurate in reality? Simple answer is NO!. One years cover for one years premium is inaccurate, as claims made policies have a retroactive date that provides cover for claims notified during the period of insurance that may have occurred after the retoractive date. This is exactly what happens when someone moves from the MDU, as the new claims made policy will have a retroactive date back to the year 2000, when the MDU changed to a claims made policy. Claims made policies lock you in until retirement. Do they? NO! Clients who move from us or the MDU to the MPS or MDDUS have to simply ask the new indemnity provider to cover the previous period of cover. This is not a difficult question and it something claims made policies do all the time.If the new provider will not cover them then you may have to purchase run-off cover for this period. But if they want you back then they have to work to your needs, not theirs. Simple market forces. Claims made subscriptions start low but will eventually rise. Do they all? NO! It is a simple matter of rating and underwriting. Insurers don’t walk blindly into insuring areas, they gather information to understand the market, the trends and future activity. Insurers also know what competition means, an example is the current Consultants indemnity scheme we use for our clients hasn’t seen a rate rise in 4 years. I would like to see an MDO’s subscription rates over the last 4 years, as I am sure there would be significant rises in subscriptions. The MDU here are relying upon their experience solely, which raises the question, is the way they do it the best way for individuals. Clearly not, as a lack of individual assessment means a higher charge back to that individual.

Take a look at how Medical Insurance Consultants can help you cover your indemnity on a legally binding insurance contract. View our summary page here.

Consultants Private Practice Medical Indemnity Insurance Savings!

MIC recently released their new Medical Indemnity Insurance product to Consultants with a great reception. The product covers all indemnity needs for private practice and gives medico-legal helpline if you need it. We don’t blanket rate specialities, like most MDO’s, we look at you as an individual and quote you a price based upon your roles, income and history. Indemnity limits are available to suit your needs or the limits set down by the private hospital you may work for, be it £1 million, £3 million, £5 million or £10 million.

Current savings being achieved are at least 25% off your existing membership rates/premium.

To see what you could be saving just give us a call on 0800 163870 or email [email protected] .

Remember that MIC is not a one trick pony and can assist you in all your business insurance needs as well as many personal ones.

Welcome to the MIC blog

Welcome to the MIC blog where we will be talking about all things relevant to the insurance needs of healthcare professionals, including:

We will also be looking at issues raised by our clients, regulatory bodies and the insurance industry to give a better understanding to all.