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Healthcare Industry Insurance: Navigating Regulations and Liability Concerns for Medical Practices

Did you know that 31 percent of physicians practicing in the US had a claim filed against them throughout their careers? While most claims get dropped, dismissed, or withdrawn, they can have serious consequences for a medical practice.


Healthcare industry insurance offers reliable protection in those instances. Medical malpractice and errors occur, even when the most experienced professionals are involved. Anywhere between three and 15 percent of medical interventions are characterized by avoidable errors. Fatigue, an overwhelming workload, and other everyday factors are often to blame for such mistakes.


Choosing the right insurance product for your medical practice can prevent significant financial and reputation-based consequences in the future. To choose the right product, you need to understand the types of medical practice insurance available and the regulatory requirements about such coverage.


What Is Healthcare Industry Insurance

A hospital or healthcare organization needs insurance to protect the practice from various types of risks.


Accidents and unexpected situations happen in healthcare settings on a daily basis. Employees get hurt while doing their job. Doctors make mistakes that could prompt patients to file claims against the hospital or practice.


Healthcare industry insurance provides coverage for the financial losses stemming from such situations. It could also be used to protect the property and the expensive equipment that a medical practice uses.


Types of Insurance Medical Practices Need

The selection of an insurance type depends on the practice’s type, size, and its area of specialization. A few products, however, are recommended for all medical industry representatives:


·         Liability insurance: General liability insurance protects a medical practice against third-party claims for bodily injury or property damage. It’s a broad kind of coverage that can be used in numerous scenarios. If a patient slips and falls on the premises, sustaining an injury, the liability insurance will provide coverage in the event of a claim being filed.

·         Medical malpractice insurance: Also known as professional liability insurance, this product protects your assets whenever the medical practice faces negligence claims. This is the kind of insurance you need to address medical malpractice and errors. The insurance covers legal defense expenses, settlement costs, and other judgments arising from malpractice or negligence.

·         Property insurance: Most medical practices own expensive pieces of equipment. Business property insurance provides coverage in the event of damages or the loss of medical facilities because of theft, vandalism, or a natural disaster.  Whether a fire starts in the clinic or some equipment gets stolen, the property insurance will compensate you for the losses.

·         Workers’ compensation insurance:  Physicians and other professionals working in a hospital or a clinic could get injured while doing their jobs. Workers’ compensation insurance provides financial assistance in the event of injuries or permanent disabilities sustained while working at the health facility. The insurance covers treatment costs, as well as lost wages due to the traumatic event.

·         Cyber liability insurance: Medical practices process large volumes of patient data. As the volume of health records increases, so does the risk of cybercrime and data theft. Cyber liability insurance mitigates the financial losses stemming from a medical record leak. A cybersecurity breach can destroy the reputation of a clinic and contribute to significant financial losses. Cyber liability insurance covers the cost of forensic investigations, legal fees, regulatory fines, and eventual settlements.

·         Other options: Many other insurance products are tailored to the needs of medical practices. A few additional types of coverage you may want to consider include health insurance for employees, business interruption insurance, employment practices liability insurance (applicable in the event of harassment or discrimination claims), and excess liability insurance (to cover claims exceeding the limits of the primary liability policy).


An Overview of Regulatory Requirements

While there is no federal requirement to obtain medical practice insurance, many states have specific regulations for industry representatives.


Medical professionals in North and South Carolina aren’t legally obliged to obtain medical malpractice insurance. Hospitals and facilities, however, could have specific requirements for the doctors working there. Here’s a more comprehensive overview of medical malpractice law in the US and the insurance requirements that may or may not be linked to it.


Other regulations that will determine what kinds of insurance medical practices need include:


·         Affordable Care Act: The ACA states that employers must offer health insurance to their workers. The insurance should be affordable and also offering coverage to at least 95 percent of full-time employees. These requirements apply to all employers, including medical facilities.

·         OSHA: Compliance with the OSHA standards is mandated by federal law. In the event of workplace injuries or illnesses, coverage can be provided either via workers’ compensation or another kind of private insurance.


If you’re not confident about the legal requirements or the types of coverage your health industry business needs to have, a consultation with an experienced attorney or insurance professional will be essential.


Mitigating Medical Practice Liability Risks

The average medical malpractice injury settlement is slightly over 329,500 dollars. The largest payouts can exceed 200 million dollars, which is an obviously devastating amount for any medical practice.


You can do numerous things to mitigate medical practice liability risks. Making sure you have enough insurance is one of the keys to guaranteeing business stability in the long run.


A few other approaches that can help you mitigate common risks include:


·         Have standards for extensive and effective communication with patients

·         Create organization-wide safety and professional conduct guidelines, making sure all employees receive proper and ongoing training

·         Implement data security measures to reduce the risk of cybercrime

·         Thoroughly document interactions with patients

·         Supervise advanced practice providers

·         Have clear and well-established error reporting guidelines

·         Do ongoing risk assessments


Protecting your medical practice, your employees, and your patients necessitates a comprehensive and strategic approach. You have to be prepared for all risks, even the ones that seem far-fetched. Well-designed and easy-to-implement workplace protocols are your first line of defense. Comprehensive insurance is equally important.


Determining what type of insurance your practice needs and how to select adequate coverage isn’t always easy. Talking to someone who understands the industry will give you more clarity. Contact our team now and let us know more about your medical practice. We will recommend the insurance products that are best aligned with your goals and the potential liability risks your business will be exposed to.


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