Medical responsibility: European insurance alternatives for doctors

Recent statistics have shown a significant increase in the number of claims against doctors for medical malpractice. The Italian Corte di Cassazione has, in fact, registered a 200% increase in the claims presented during the last 10 years. Such numbers represent a spectacular increase if considering that during the previous 50 years the volume of claims remained at a stable level. The greater amount of information at disposal and the concern of patients, as well as the many alternatives for damage compensation, have made it so that today more than ever, doctors be under close inspection from patients, hospitals and authorities.

The most common motives for medical malpractice lawsuits are delayed diagnosis of illnesses, especially in the fields of oncology and gynaecology. Mistaken or nonexistent diagnosis is the following of the reasons that cases against doctors raise at the court, right before errors in anaesthesia dosage, blood transfusions and surgical interventions.

The various modalities of patient coverage vary from country to country, as do the alternatives for the insurance of medical professionals, who are subject to the state's health legislation and system, the structure in which they practice (public or private) and the existence of individual insurance coverage.

In the case of Scandinavian countries, for example, both hospitals and doctors are protected against medical errors and malpractice in a different way than the professionals of the United States or other European countries. Hospitals, under this regime, hire an insurance on behalf of their patients, which means that should a medical malpractice take place, both hospital and patient turn to the insurance company for the compensation of damages. This system has the advantage of working as a two-way coverage alternative but has a significantly high cost that may not be sustainable for all health structures and that might be difficult to implement in countries with divergent health systems.

The vast majority of European health systems, medical institutions like health institutes and hospitals, have contracted an insurance policy that is however far from covering all eventualities of risk. At disposal of every single doctor are, therefore, several coverage options that vary depending on the timing of both the claim and the wrongful practice.

The first type of insurance, called claim-based, covers the medical events that have taken place during the period contemplated in the insurance contract if the claim falls also into this time frame. This means that both the error (surgery, diagnosis or negligence) and the claim from the patient have to take place during the operating time frame of the insurance policy. Another version of this type of protection is called "tail coverage", which covers doctors even after the insurance has expired for all the events that fall into the period where the coverage was operating. This service is to be considered when, for example, a doctor changes from a medical structure to another with a different insurance company. The "tail coverage" has, however, a very high cost.

The second type of insurance policy contemplates an approach similar to this last one at a slightly lower quote. Such policy guarantees life-long coverage for all events occurred during the operating period of the insurance policy. This means that even if a doctor is forced to change insurance company, or just decides it is better to trust another one, if he/she had subscribed this kind of coverage, the company is forever tied to him for the actions that took place during the period in which the insurance was valid.

Alternatives for doctors are numerous and change depending also on the medical field of practice. The knowledge of the health system, as well as the study of current insurance within the structure the doctor is working in is crucial for determining whether or not an individual coverage is necessary.