Medical Malpractice Insurance Claims Examples

Why you need Medical Malpractice Insurance 

As healthcare businesses evolve they face new and unexpected challenges, so it is essential that they have  adequate insurance to cover them for the wide variety of claims which can arise from previously unforeseen circumstances. Often practices expect that their doctors’ own indemnity insurance policies will cover them in  the event of a claim, but there are many scenarios where this is not the case.  

Seemingly innocent errors of administrative staff can have devastating effects and expose medical practices to  litigation, complaints and investigations. Medical receptionists, practice managers, nurses, and administrative staff play a crucial role in any practice, as they are often the first points of contact for patients and are often the intermediaries through whom patient follow up is organised. These staff often undertake important unsupervised activities that may  place the practice itself at risk. Practice protocols or system failures, such as triaging and recalling of patients, can also  create or contribute to adverse patient outcomes which may expose medical practice entities to claims.  

As a specialist healthcare indemnity insurer, we are frequently assisting practices with these claims and complaints. 

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Two real case studies

1. A practice staff’s failure to keep up to date contact details, compromising timely follow up

The patient was incorrectly advised by a GP that she did not carry the HIV virus when the test result was equivocal and required further investigations. The patient did not receive a recall request actioned by another GP at the practice who had originally ordered the test because her contact details were not up to date on the practice management software. The patient then had unprotected sexual intercourse with her partner. While not a patient of the practice, the patient’s partner contracted the HIV virus and brought proceedings against the relevant GP’s who settled his claim for $745,000 plus legal costs. The GP’s’ insurer sought contribution against the medical practice entity and recovered 40% on the basis that practice staff had failed to maintain up to date contact information for the patient which meant she was unable to be recalled before she infected her partner. 

2. Incorrect information was provided by a receptionist

The patient presented with a head injury and advised a receptionist he felt he was about to collapse. The receptionist advised he would have to wait hours to be seen by a doctor despite policy requiring that head injury patients were to be seen much sooner. Due to the receptionist providing inaccurate information about waiting times the patient went home and later sustained an extradural haematoma. The court determined that a receptionist is expected to take reasonable care not to provide misleading advice about the availability of medical assistance, and that the standard required is that of an averagely competent and well-informed person performing the function of a receptionist. Whilst a UK case involving a hospital, a similar approach applies in Australia.

Tego insurance – Our Strength. Your Security.

We are Australian medical indemnity insurance providers and cover your practice with medical indemnity insurance, medical malpractice insurance, doctors indemnity insurance, gp medical indemnity insurance,, medical practice insurance, and more. If you are a health practitioner with Tego, we offer 24/7 medico-legal advice and support in regards to what you need to know about how to prevent medical malpractice claims. 

This publication is general in nature and is not comprehensive or constitutes legal or medical advice. You should seek legal, medical or other professional advice before relying on any content, and practice proper clinical decision making with regard to individual circumstances. Persons implementing any recommendations contained in this publication must exercise their own independent skill or judgment or seek appropriate professional advice relevant to their own particular practice. Compliance with any recommendations will not in any way guarantee discharge of the duty of care owed to patients and others coming into contact with the health professional or practice. Tego Insurance Pty Ltd is not responsible to you or anyone else for any loss suffered in connection with the use of this information. All content on this page has been written in a generic way, and has not been presented with any knowledge of your personal objectives or financial needs.

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