An insurance policy that provides coverage to healthcare entities and professionals for bodily injury caused to patients resulting from their alleged negligent professional acts errors or omissions.
Any provider of healthcare services that supplies direct or indirect patient care may need medical malpractice insurance; traditionally, this includes both individuals (e.g. allied staff, medical and dental practitioners) and entities (e.g. labs, hospitals, clinics and offices).
The full scope of healthcare services covered within a traditional medical malpractice policy are addressed within the ‘professional healthcare services’ definition which typically captures those services that are performed to care for patients, often including:
New digital health technologies are transforming operational models and redefining what ‘healthcare services’ are, how they are delivered and by whom.
Some insurance professionals may argue that traditional medical malpractice policies with the standard definitions provide adequate coverage for bodily injury harms (even those that may arise within a digital health context).
Yet, it is unclear how these emerging models and healthcare technologies are:
“The increasingly digital topography in healthcare demands a re-examination of traditional approaches to medical malpractice insurance coverage.”
Tracy Grant | Healthcare Industry Leader - Australasia
The increasingly digital topography in healthcare demands a re-examination of traditional approaches to medical malpractice insurance coverage.
Given the substantial changes to the healthcare landscape it is appropriate to consider whether long-standing definitions of ‘professional healthcare services’ need to be updated to include emerging areas such as:
The convergence of healthcare and technology is also resulting in an increasingly wide array of entities that provide healthcare services.
The variation in entity type and service delivery models is likely to result in complex claims with overlapping harms – the coverage for which may be found in multiple different policy forms.
Thus, clients with digital health exposures are grappling with events that involve product liability, medical malpractice, technology liability and/or privacy issues.
In such complex claim situations, a multi-disciplinary coverage approach is critical to avoid inevitable finger pointing and the quagmire of coverage disputes and ‘other insurance’ clauses.
Consequently, complex digital health exposures demand a multi-line approach to underwriting that breaks down traditional barriers between insurance products. There is a clear need for integrated coverage solutions that approach the underwriting of medical malpractice with consideration to the blurring of lines between services, entities and coverages.
“There is a clear need for integrated coverage solutions that approach the underwriting of medical malpractice with consideration to the blurring of lines between services, entities and coverages.”
Tracy Grant | Healthcare Industry Leader - Australasia
Dealing with closely related coverages is a challenge that the healthcare liability market has addressed in the past, as evidenced by the combination of general liability (GL) and professional indemnity (PI) coverages within the same policy form.
However, a truly integrated approach will require insurance carriers to break down individual product line silos – a solution that has historically proven difficult for many carriers.
Currently, in this region, there is only one insurer that provides a flexible structured digital health specific product that combine multiple coverage lines, including medical malpractice, into one policy.
As such, most clients must address their coverage needs through multiple insurance policies – a potentially expensive approach that can result in a ‘patchwork quilt of insurance coverage’ that is prone to gaps.
Therefore, until integrated solutions are more widespread the medical malpractice marketplace may be pushed to consider updating coverage and key definitions to address emerging digital health exposures.
New paradigms in healthcare require a different kind of underwriting, new coverage combinations and multi-disciplinary underwriting models.
The insurance industry must recognise that product line profit and loss (P&Ls) boundaries create imaginary lines between coverages that are increasingly irrelevant to our clients.
This presents a challenge for healthcare insurers that requires ‘out of your product silo’ thinking and creative, client-centric solutions – starting with a re-imagining of what constitutes ‘professional health services’ within the context of an increasingly digital health landscape.
1 O’Neill, P. H. Ransomware did not kill a German hospital patient. MIT Technology Review https://www.technologyreview.com/2020/11/12/1012015/ransomware-did-not-kill-a-german-hospital-patient/ (2020).
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