Tailored for the needs
A solution for all your professional needs
At EthiQal, we pride ourselves in having revolutionised professional medical indemnity cover in South Africa, by offering affordable, professional indemnity solutions tailored to the requirements of our doctors. Our commitment is to provide peace of mind to doctors and their patients, while bringing stability to the medico-legal landscape.
What is professional medical indemnity?
Professional indemnity, also called Errors and Omissions Insurance or Malpractice Insurance, is designed to protect you against legal costs and claims for personal injury damages where you are accused of medical negligence. It can include the claimant’s costs and the medical practitioner’s defence costs which may arise out of an act, omission or alleged breach of professional duty during treatment of your patients.
What types of cover are available?
We are the only South African insurer to offer occurrence-based and claims-made cover. Where practitioners are changing from other claims-made products, retroactive cover is also available.
This popular type of cover provides protection for claims that result from any incident that occurs whilst being a policyholder, irrespective of when the claim is made. This includes the time after a policy has been cancelled.
Our premiums are designed to create business stability for individual practitioners.
• Base rates are generally much cheaper than for other occurrence-based cover available in South Africa
• Most practitioners qualify for locked-in prices for the first three years from joining, subject to their risk profile remaining unchanged
By means of example, the following graph shows the typical premiums, excluding VAT, for an average doctor in one of the surgical disciplines who moved to EthiQal occurrence-based cover in 2017.
Given the easy-to-understand nature of occurrence-based cover and the peace of mind it provides, most doctors prefer this option when given the choice.
Claims made cover
With this cover, you are only protected for incidents that both occur and are reported during the policy period, regardless of when a claim is received. Depending on the cover purchased, this may include a retroactive date which makes provision for cover of claims that emanate from a period prior to taking out the new policy, for adverse events that you could not have reasonably anticipated at the time and which you would thus not have notified to your previous insurer.
Run-off cover/extended reporting period is available on application and refers to a period after termination of the policy within which incidents that occur during the insurance period can still be reported for purposes of qualifying for cover.
* Unless you reported the incident whilst your insurance was active, or you purchased run-off cover / qualified for an extended reporting period and you report the incident during such period and the claim is not rejected for reasons of late notification.
Premiums are increased on an annual basis, subject to the discretion of the insurer.
If you are switching insurance from another claims-made product, it is important that you do not expose yourself to gaps in cover. Careful attention must be paid in such transition to your current retro date, as well as your scope of practice during your professional career. Retroactive cover, both on an occurrence-based and claims-made basis, is available via EthiQal.
To protect yourself and your practice, speak to EthiQal about finding the right professional indemnity cover for your needs and at the best price.
What are the benefits of being covered by EthiQal?
EthiQal is a division of Constantia, a registered Financial Services Provider, and so our policies, including limits of insurance, scope of cover, exclusions and requirements for cover are clearly defined and binding. Policyholders are fully protected in terms of South African laws and regulations which includes the insurance principle of Treating Customers Fairly (TCF) and easy access to the industry Ombudsman in the unlikely event of a dispute between the insured and the insurer.
This contrasts with indemnity cover provided by mutuals who may not be licensed as a Financial Services Provider (FSP) in South Africa and who offer cover on a discretionary basis according to their Memorandum and Articles of Association. Where the mutual is offshore, only a foreign country’s courts or arbitration panel could potentially adjudicate and rule on any dispute between the doctor and the indemnifier.
As a division of Constantia, EthiQal operates in a highly regulated market and submits regular reports to the Prudential Authority to demonstrate that our reserves suffice for the defence and settlement of future claims. This is similar to the medical aid industry where the Council for Medical Schemes monitors the reserves of medical aid schemes and implements corrective actions in the event of a scheme’s solvency being threatened. Such oversight which provides peace of mind to consumers does not apply to indemnifiers who are not licensed FSPs.
Our medico-legal services are not limited to the legal defence of claims where monetary demands are made. Our in-house medico-legal team is available to advise on, and defend you, where necessary, in any of the following circumstances that may arise from your professional practice:
- HPCSA-related complaints relating to patient care
- Relevant disciplinary matters
- Criminal investigations emanating from your clinical practice
- Complaints in relation to your professional conduct and services
- Defamation, including on social media and other media platforms
Support is also offered where you experience ethical dilemmas in terms of patient care or where you have specific medico-legal concerns relating to aspects of your practice management. For example, you may be concerned that your informed consent process may be inadequate in terms of legal requirements, or you are worried about your or your practices liability in terms of employees.
Experiencing an adverse patient outcome or receiving a summons can have a devastating impact on a practitioner’s well-being. Counselling by qualified experts is available for practitioners who are suffering stress as a result of such events.
Practice management support
Few doctors have any form of training in running a private practice. Managing a business can thus be challenging and expose the practitioner to unknown medico-legal risks. This is particularly relevant where a doctor enters private practice for the first time.
To assist our practitioners manage a successful business where patients can be cared for safely, we have partnered with Vizibiliti, a company providing business management solutions for healthcare professionals. Vizibiliti has an eight-year track record of assisting independent healthcare business owners run compliant, profitable and sustainable practices. The organisation provides a structured framework with which to evaluate a doctor’s practice, allowing for a clear and focussed approach to managing risk.
Similarly, Vizibiliti offers guidance where practitioners retire or sell their practices. This is important for future peace of mind, both in terms of finances, as well as medico-legal risks.
Should you be interested in a practice review by Vizibiliti and to find out whether you qualify for a complimentary consultation through EthiQal, please contact Vizibiliti on the details listed below:
B.Com, MBA (UCT)
T +27 (0)21 762 2207
C +27 (0)82 712 4980