We have put together common questions to help you with certainty relating to your Professional Indemnity Coverage with us. As would ordinarily be the case standard policy terms and conditions will apply to any claim.

While these are extraordinary times, first principles still apply, and medical practitioners should continue to adhere to best practice in these challenging circumstances. If you have any specific concerns or queries, we are here to support you. We hope the following general comments may help answer some of your common questions.

Tego and Berkshire Hathaway Specialty Insurance have been working with the Medical Defence Organisations to ensure consistency across the insurers and to lobby government on behalf of the medical profession. It is critical the we work together on these important issues as the COVID-19 situation develops.

Yes, your Berkshire Hathaway Specialty Insurance Policy provides cover for claims, complaints and Medicare audits which arise from your provision of Healthcare Services. COVID-19 does not change your coverage and we have no plans to modify or restrict coverage. We will be here when you need us.

Yes, your Policy extends cover to claims arising from the provision of Healthcare Services, including Telehealth. Download the Minister for Health press release on Expansion of Telehealth Services as at 23 march 2020.

We are here to support our medical practitioners in times of difficulty which means reacting quickly and compassionately to the COVID-19 crisis, when they may be asked to practice outside of their regular scope of work, in non-surgical or emergency roles.
You are automatically covered where:
- Your training college considers the activity during the COVID-19 health crisis an appropriate clinical activity for your specialty.
- You have received training in the last five years to practice in an emergency or non-surgical role outside of your declared specialty.
- You are providing healthcare to public patients and have confirmation that you will be indemnified by the hospital, area health service, a government scheme, or another person for public patient care.

Yes, you do not need to update us if you are temporarily working from a different location in Australia.

Yes. Claims or complaints arising from cancellations or delays in elective surgery is covered by your Policy as a result of COVID-19.

Yes, you do not need to update us if you are temporarily working from a different location in Australia.

We are currently seeking clarification from the Commonwealth Government relating to the Run-Off Cover Scheme to see if waivers are available for medical practitioners temporarily ceasing retirement. In the short-term these practitioners will need to contact us to put cover in place.

We understand this is a difficult issue and there is concern that a doctor is not able to certify that a patient does not have COVID-19 as there is no readily available test yet available which provides immediate results for this. Moreover, a genuine negative test result might be superseded by a new COVID-19 infection in the several days it might take to receive the test result. We are not able to give clinical guidance, but suggest that doctors give consideration to the following:

- If you do not consider that you are able to provide a certificate in the circumstances, we encourage you to discuss this with the patient. You are not under an obligation to provide Fitness to Work certificates.
- You may wish to make a note on the certificate that you are not able to certify that the Patient does not have COVID-19.
- The Medical Board’s publication, ‘Good medical practice: a code of conduct for doctors in Australia’ provides guidance and sets out first principles when providing a certificates (Section 8)
-Remember that you have an obligation to be honest when providing certificates and you must ensure that it is accurate before signing.

We set out below several weblinks leading to a number of Government and other Authorities, with information specific to the Covid-19 situation.

The Commonwealth Government Department of Health has advised that medical practitioners may change the way your services operate to minimise the exposure of health care workers and other patients to people who have COVID‐19, and conserve resources, such as by:

- directing people with COVID‐19 to specialised clinics; and
- cancelling elective surgeries; and
- designating certain GP practices as specialising in COVID‐19

There are a number of resources that will help including training for your practice and yourself and templates and communication sheets to help with your communication to patients.

In particular RACGP and the Commonwealth Department of Health have training videos and other tools available for you and your team.

On 25th of March National Cabinet announced changes to elective surgery. Of note to medical practitioners in private hospitals, all non-urgent elective surgery will be temporarily suspended. Only Category 1 and some exceptional Category 2 surgery may continue until further notice.

- Category 1 and urgent Category 2 elective surgeries can continue
Semi-urgent Category 2 and Category 3 elective surgeries at private hospitals can continue until 11:59pm on 1 April 2020 – after that they cannot be performed until further notice by the Australian Government
-Non urgent Category 2 and Category 3 elective surgeries cannot be performed until further notice by the Australian Government.

National Cabinet has advised the following: Every patient waiting for elective surgery is assessed by their treating medical professional as Category 1, 2 or 3 per the following definitions:

- Category 1 – Needing treatment within 30 days. Has the potential to deteriorate quickly to the point where the patient’s situation may become an emergency
- Category 2 – Needing treatment within 90 days. Their condition causes pain, dysfunction or disability. Unlikely to deteriorate quickly and unlikely to become an emergency
Category 3 – Needing treatment at some point in the next year. Their condition causes pain, dysfunction or disability. Unlikely to deteriorate quickly.

Decisions on the category of patients are at the discretion of their treating medical professional. Australia’s health system will continue to ensure that any patient in need of urgent attention will receive treatment. Links to the categorisation of elective surgery can be found here.

The National Cabinet announcement can be found here.

On the 24th of March 2020, the Australian Government announced a number of measures to restrict the performance of deemed non-essential business activities and services. The restrictions to services also encompass “highly discretional services,” which include beauty therapy, tanning, waxing, nail salons, tattoo parlours, spas and massage parlours, and other services requiring close and prolonged personal contact between the service provider and client.

While the measures do not specifically refer to cosmetic/aesthetic medical services, the intent of the restrictions are clear. In the current circumstances, the ongoing provision of such services present an unjustifiable health risk to both the public and individuals providing them. There may be significant penalties for any business which continue to operate, to which these measures may apply. In addition, we do perceive that public and media sentiment would judge these businesses harshly, which would lead to reputational damage.

In response to the Australian Government measures, the Australasian College of Aesthetic Medicine made the following statement on the 25th of March 2020:

“After last night’s announcement of further restrictions to services, we now believe it would be wise for all our members to consider the possibility for closing their doors for all but essential medical services. Now is not the time to take unnecessary risks, for ourselves or our staff. As doctors, we may even be needed for front-line medical support in the near future. In the meantime, we need to keep ourselves, our families and our patients, and our staff and colleagues, safe from exposure and spread. Physical distancing is the best way to prevent the spread of COVID-19, and even with the best protection, our work involves close patient contact.”

The Australian Society of Plastic Surgeons has also advised “no cosmetic injectables, laser or “medispa” procedures should be provided.”

We are therefore of the view that it is no longer prudent to continue to offer cosmetic medical services.

This is a challenging time where information is rapidly evolving. No doubt you have been receiving information from the Departments of Health and your College. When you need more tailored assistance to manage coronavirus related issues in your practice please contact BHSI’s Medico-Legal Advisory Service on healthcareclaimsaustralia@bhspecialty.com or 1300 938 991.

For any insurance coverage questions please contact us on 1300 834 683.

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