The importance of making sure your indemnity cover adequately protects you.

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Ms Emily Borhan

For many, the days of having a rolling renewal with a defence organisation have passed. The market has followed the trend of the other professions, with numerous products on the market and a variety of competitive prices. The application and renewal forms have become longer and more detailed, and the responsibility on you to ensure that cover is in place has tightened. 

For many, the days of having a rolling renewal with a defence organisation have passed. The market has followed the trend of the other professions, with numerous products on the market and a variety of competitive prices. The application and renewal forms have become longer and more detailed, and the responsibility on you to ensure that cover is in place has tightened.

But what happens if you get it wrong? How does that put your practice at risk? 

Firstly, and most importantly, ensuring that you have continuity of cover in place is essential. Your retro-active date needs to be when you first took out insurance cover on a claims made basis and should never change. You need to make sure that the policy you have chosen covers for treatment in the past, to ensure that it protects you in case a claim or complaint arises from treatment you have previously carried out. The best way to do this is by providing accurate details to the OTSIS office, including dates of previous cover and who your previous insurers were. 

By way of example, I assisted an OTSIS member who had been a member for a couple of years, he received legal correspondence in connection to a patient that he had treated for an arthroscopy some years previous. He had not heard from the patient for some time, but in short, the patient had been having continual pain, further investigations, with ongoing infections, and eventually needed to have a knee replacement. The investigation of the claim was traced back to the original treatment that the OTSIS member had carried out, and he called to notify it as a circumstance under his policy. Unfortunately, during the application process, there had been some confusion with the dates and providers of his previous cover, and it transpired that there was a two-year gap in cover which this claim happened to fall under. The OTSIS member had to cover the costs himself. 

Another important area is that of outsourced NHS work and whether this is covered under the NHS or whether you need cover for it under your private policy. With the current length of waiting times on the NHS, more and more work is being outsourced to private hospitals. It is important to make sure that you have an agreement in place, or you have confirmation in writing, that these procedures are being covered by the NHS. Your OTSIS policy can cover for the work if it is not covered by the NHS, and if it has been declared on your form at renewal, but your OTSIS policy will not cover for treatment that you suspected was covered under the NHS and therefore did not include as part of your renewal process. 

I have previously assisted an OTSIS member who had received legal correspondence from an NHS patient who he had treated in a private hospital. Assuming that this treatment was covered under the NHS work, it had not been formally declared under his OTSIS policy. Unfortunately, when he notified it to the hospital, they informed him that this particular work was not part of the NHS cover, and because it had not been declared under his OTSIS policy, he was left with no cover in place. 

In summary, your indemnity is probably the most important thing that you will buy throughout the year. It provides the protection and security that you need in order to carry out your work. But your cover will only protect you if it has been set up correctly, and accurately. Please make sure that you have written confirmation from hospitals when you are relying on them providing cover, and most importantly, ensure that all details of current procedures, and previous cover, are provided to the OTSIS office so that we can assist you with making sure the correct cover is in place.