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Professional Indemnity Policy for Doctors and Medical

Professional Indemnity Policy for Doctors and Medical

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Published by Manali Jain

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Published by: Manali Jain on Mar 16, 2011
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Case StudyPublic Liability Insurance policy for Doctorsand Medical Professionals (Non IndustrialRisk).
This policy is meant for professionals to cover liability falling on them as aresult of errors and omissions committed by them whilst renderingprofessional service.
Highlights
This policy is meant for professionals to cover liability falling on them as aresult of errors and omissions committed by them whilst renderingprofessional service.The policy offers a benefit of Retroactive period on continuous renewal of policy whereby claims reported in subsequent renewal but pertaining toearlier period after first inception of the policy, also become payable. Grouppolicies can also be issued covering members of one profession. Groupdiscount in premium is available depending upon the number of memberscovered.
Scope
The policy covers all sums which the insured professional becomes legallyliable to pay as damages to third party in respect of any error and/oromission on his/her part committed whilst rendering professional service.Legal cost and expenses incurred in defense of the case, with the priorconsent of the insurance company, are also payable, subject to the overalllimit of indemnity selected. Only civil liability claims are covered. Any liabilityarising out of any criminal act or act committed in violation of any law orordinance is not covered.
Who can take the policy?
The policy is meant for professionals. We issue 'Professional Indemnity'policies to the following group of professionals:‐i. Doctors and medical practitioners ‐ which covers registered medicalpractitioners likephysicians, surgeons, cardiologists, pathologists etc.ii. Medical establishments ‐ which covers legal liability falling on the medicalestablishment such as hospitals and nursing homes, as a result of error oromission committed by any named professional or qualified assistantsengaged by the medical establishment.iii. Engineers, architects and interior decorators.iv. Lawyers, advocates, solicitors and counsels.v. Chartered accountants, financial accountants, management consultants
How to select the sum insured
In Professional Indemnity Policy, the sum insured is referred to as Limit of Indemnity. This limit is fixed per accident and per policy period which iscalled Any One Accident (AOA) limit and Any One Year (AOY) limitrespectively. The ratio of AOA limit to AOY limit can be chosen from thefollowing:
 
a. 1:1b. 1:2c. 1:3d. 1:4The AOA limit, which is the maximum amount payable for each accident,should be fixed taking into account the nature of activity of the insured andthe maximum number of people who could be affected and maximumproperty damage that could occur, in the worst possible accident. In the caseof Professional Indemnity policy issued to engineers, architects, interiordecorators, lawyers, advocates, solicitors, counsels, chartered accountants,financial accountants and management consultants, the Any One Accident(AOA) limit is restricted to 25% of the Any One Year (AOY) limit.
How to claim
The term "liability" means responsibility and "legal liability" meansresponsibilities which can be enforced by law. Legal Liability may beclassified into Criminal Liability and Civil Liability. Only Civil Liability claimsare payable. Civil Liability claims will arise if there is prima facie evidence of negligence by the insured resulting in injury or death to any third party orresulting in damage to property belonging to a person other than insured.Negligence will be proved only when following conditions are satisfied:a. Existence of duty of careb. Breach of this dutyc. Injury suffered by a person or property damaged as a result of that breach.In case of any event likely to give rise to a liability claim as describedabove, insurance company should be informed immediately. In case any legalnotice or summons is received, it should be sent to the insurance company.The company has the option of arranging the defense of the case. The eventgiving rise to the claim should have occurred during the period of insuranceor retroactive period and the claim first made in writing against the insuredduring the policy period. The maximum amount payable including defensecost will be the AOA limit selected. The Any One Year limit will get reduced bythe amount of claim or indemnity paid for any one accident. Any number of such claims made during the policy period will be covered subject to the totalindemnity not exceeding the Any One Year limit .The policy will not pay forclaims arising out of contractual liability, intentional non‐compliance of anystatutory provision, loss of goodwill, slander, fines, penalties, libel, falsearrest, defamation, mental injury etc.
 
Public Liability Policy – Industrial Risk 
This policy covers the amount which the insured becomes legally liable to payas damages to third parties as a result of accidental death, bodily injury, lossor damage to the property belonging to a third party.
Highlights
This policy covers the amount which the insured becomes legally liable to payas damages to third parties as a result of accidental death, bodily injury, lossor damage to the property belonging to a third party. The legal cost andexpenses incurred in defending the case with prior consent of the insurancecompany are also payable subject to certain terms and conditions. One caninsure more than one unit situated in different locations under a single policy.The policy offers a benefit of Retroactive period on continuous renewal of policy whereby claims reported in subsequent renewal but pertaining toearlier period after first inception of thepolicy, also become payable
Scope
We issue three types of Public Liability Policies.a. Public Liability Non Industrial Risk ‐ For offices, hotels, cinemas houses,hospitals , schools etc.b. Public Liability Industrial Risk ‐ For godowns, warehouses and factories.c. Public Liability Insurance Act 1991 ‐ This is a mandatory policy to be takenby owners,users or transporters of hazardous substance as defined under Environment(Protection) Act 1986 in excess of the minimum quantity specified under thePublicLiability Insurance Act 1991.
Add on covers
The Public Liability Policy can be extended to cover the following risks onpayment of anadditional premium.a. Natural calamities like flood, earthquake etc.b. Pollution Risk subject to NOC from Pollution Control Boardc. Transportation Risk
How to select the sum insured
In Public Liability Policy, the sum insured is referred to as Limit of Indemnity.This limit is fixed per accident and per policy period which is called Any OneAccident (AOA) limit and Any One Year (AOY) limit respectively. The ratio of AOA limit to AOY limit can be chosen from the following:a.1:1b.1:2c.1:3

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