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Coverage About Individual Doctors
  Salient Features:
This insurance covers legal liability arising from errors and omissions on the part of Registered Medical Practitioners while rendering professional service.		  
 

Scope of Cover:
The policy indemnifies any act committed by the insured, who shall be a Registered Medical practitioner, giving rise to any legal liability to Third Parties. The insured includes the policy holder and his qualified assistants of employees as named in the proposal from. It applies to claims arising out of bodily injury and/or death of any patient caused by or alleged to have been caused by error, omission or negligence in professional services rendered or which should been rendered by the insured or qualified assistants name in the schedule or any nurse or technician employed by the insured.

1. Legal liability as fixed by court in India to pay compensation.

2. Defense costs and expenses. This means all costs, fees and expenses incurred with the prior consent of the insure in the investigation, defense or settlement of any claim made against the insured, provided the claim with in the ambit of the policy.
The amount of payment under (a) and (b) will not exceed he amount insured for in he policy under the limit of Any One Accident (AOA) in respect of any or all claims made against the insured arising out of Any one Accident.

  
 

Exclusions:

  1. Third party public liability.
  2. Fines, penalties, punitive or exemplary damages.
  3. Any loss of financial nature like loss of goodwill, loss of market etc.
  4. Liability, if any assumed by agreement and which would not have attached if not for the agreement.
  
 

Special Benefits:

1. Retro Active Benefit:
This means that the insured will be covered for any professional act or omission occurring during the period of insurance, which means the first date of the first policy, provided that the policy is renewed with out interruption and is in force when the claim arising out of the act or omission is made in writing against the insured during the policy period. Policy period means the period incepting from the date and hour mentioned in the policy schedule and terminating at midnight on the expiry date indicated in the policy schedule.		  
  2. Notification Extension Clause:
If the insured notifies during the policy period any specific event o circumstance which the insurer accepts may give rise to a claim, then the acceptance of such notification means that the insurer will deal with the claim as if it has been made during the policy period.		  
  3. Extended Claim Reporting Clause:
In the event of non-renewal or cancellation of the policy, In Insurer will allow time limit upto 90 days, provided another policy does not exists, for notification of claims for accidents which had taken place during he period of insurance.		  
  Meaning Of AOA: AOY
AOA means Any One Accident, which include one or more, or a series of claims arising out of the same cause or error or omission  relating to professional service. AOY means Any One Year. The Insured Can choose an indemnity limit which can be in the ratio 1:1:2, 1:3, 1:4 of AOA: AOY and the premium will be charged in AOY limit.		  
  Main Exclusions:
  1. Liability arising from any criminal act or act in violation of any law or ordinance.
  2. Services rendered under the influence of intoxicants or narcotics.
  3. Dental treatment under general anaesthesia except in a hospital.
  4. The use of drugs for weight reduction.
  5. Plastic surgery except for repair of scar being the result of previous surgery, or in connection with burns or other traumatic injury.
  6. AIDS related conditions.
  7. Due to intentional non-compliance of statutory provisions.
  8. Personal injuries such as libel ,false arrest, defamation, mental injury, shock etc.
  9. Genetic injuries caused by x-ray and radioactive substances.
  10. Liability to employees/apprentices/contractors/general third party public.
  
  Important Conditions:
  1. Early Written notice of any claim to the insurer. Sending of any claim, writ, summons or process and all documents to the Insure.
  2. No admission offer promise or payment to be made with out the consent of the Insurer.
  3. The Insurer has the right to take over and conduct in the name of the Insured, the defense/settlement of the claim.
  4. The Insured shall give all such information and assistance as the company may reasonably require.
  5. No short period policy is permitted i.e. all policies will be for 12 months.
  
  Indicative Premium Rate
Varies between 0.30 per thousand rupees and 3.00 pe thousand rupees depending upon(a) Category of Doctor and (b) AOA:AOY ratio chosen.		  
     
Coverage About Hospital
  1. What is Errors & Omissions Insurance Coverage?
It is an insurance policy under which may register viz., Hospitals/Nursing. Home any where in India can be for Professional errors & Omissions. The Policy will indemnity the insured in respect of any act commited by the professionals or qualified assistants named in the proposals engaged in the medical establishments which rise at any Third Party legal liablity. Such activities will be part of the declared medical activities of the establishment.		  
 

2. Who are the eligible Medical Establishment?
1. Hospitals 2. Nursing /convalescent Homes 3. Medical Homes 4. Homes for physically disabled.

 
 

3. What are the minimum criteria applicable for the above coverage?

  1. There should be at least 10 inpatient beds.
  2. A Fully equipped operation theatre of is own.
  3. Fully qualified / unqualified Nursing staff.
  4. Fully qualified Doctor / Doctors should be in -charge round the clock.
  5. Shoul be registered with competent authority as per the local regulations.
 
 

4. Is the Doctors of the Medical Establishments are covered under the above policy?

This policy iindemnifies the Errors or neglisgence committed by the qualified Doctors of the above establishments with in the hospitals but not individually. Due to the error of any Doctor or Nurse shall be covered under the abbove policy. provided that the complaint is filed against the insured i.e. the Medical Establishment. 		 
 

5. What are the Premium Rates?
As the premium amount consist of:

  1. The rate of Basic premium for proof. I nd is @Rs3 /-per thousand.
  2. Rate of premium applicable for inpatient is @Rs5 /-per inpatient.
  3. Rate of premium applicable for outpaient is @Rs1 /-per patient.
  4. Rate of premium applicable for the coverage of unqualified staff is 7.5% on the Amount of basic premium.
  5. Govt. Tax applicable is on the total amount of premium as applicable.
 
     
     
 
 
  Medico Legal Insurance Consultants Pvt. Ltd..
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