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December 2006
Dear Doctor
MEDICAL MALPRACTICE INDEMNITY COVER - OPHTHALMOLOGY
Glenrand MIB Professional Services (a Division of Glenrand MIB Ltd) was founded more that 20 years ago to
provide specialist expertise in the field of Professional Indemnity Insurance. Today they are the provider
of professional indemnity and medical malpractice insurance to several major healthcare associations.
The Glenrand M.I.B Medical Malpractice Practitioners Scheme in association with HealthMan offers you:
- Medical malpractice and professional indemnity insurance at highly competitive premiums in which the
VAT portion of the premium is reclaimable from the Receiver of Revenue.
- Secure legal contracts
- Retro-active cover (conditions apply).
- 3 years free run-off cover.(after termination of your Glenrand cover)
- Medico-legal advice on a toll-free helpline.
- Leading law firms to assist with litigation.
- Cover for employees within the professional’s employment.
- Contractually guaranteed limits of Indemnity offered depending on your personalized risk.
- An option is available to pay premiums in monthly installments.
- Handling of complaints/provision of legal representation at HPCSA inquiries.
- Continuing cover with no further premium being payable when you cease to practice or retire.
- There is no excess or deductible payable under the policy.
- Cover for claims for defamation (which must have been committed by the client in good faith in the
course and scope of professional activities) and cover for liability arising out of employee dishonesty.
Please note that:
- Cover runs in 12 month cycles (from entry date) and can not be terminated during a cycle.
- Glenrand employs a claims made policy (Important: See attached document for further explanation).
If you had no previous cover you can buy the retro-active cover.
The 2007 premiums in respect of OPHTHALMOLOGISTS are as follows
(LOADINGS OF 20% APPLY IN CASE OF WORK DONE OVERSEAS OR WHERE CERTAIN COSMETIC PROCEDURES ARE INVOLVED.)
| | | |
| | Annual premiums | Monthly premiums
| | Surgery | R20,0 million cover | R22 195 | R2 035
| | R10,0 million cover | R17 160 | R1 630
| | R 5,0 million cover |
R14 210 | R1 305
| | |
| No Surgery | R20,0 million cover | R 6250 | R 575
| | R10,0 million cover | R 5000 | R 460
| | R 5,0 million cover | R4000 | R 370 |
Prosper Financial Services (a subsidiary of HealthMan) will assist in lodging your applications, claims and
any enquiries to Glenrand M.I.B.
Kindly contact the persons mentioned below should you wish to apply.
All applications must be forwarded to the HealthMan office.
Yours sincerely
IMPORTANT NOTICE
EXPLANATION OF CLAIMS-MADE AND RUN-OFF COVER:
Our current policy is a "claims-made" policy. We are pleased to advise that we have recently negotiated with the Admiral,
the underwriters, to include 3 year’s free run-off cover. Please note that this does not affect the free continuing cover
which you will enjoy should you retire.
WHAT DOES THIS MEAN?
- A "claims-made" policy means that the policy which you have in place at the time that a claim is made, is
the policy which is expected to respond to provide cover for that claim, hence the term, "claims-made".
Claims-made cover is the standard type of cover obtainable in the professional indemnity insurance market and applies
across the whole spectrum of professionals.
- We have provided below an example of how your claims-made policy would respond to claims and how the cover
you enjoy has now been broadened by the addition of 3 years free run-off cover.
EXAMPLE OF HOW "CLAIMS-MADE" COVER OPERATES:
- You perform an operation in the year 2000;
- 2 years later, i.e. in 2002, your patient has a summons issued and served on you,
alleging harm as a result of your negligence and claiming damages in the amount of R100 000.00
With ordinary claims-made cover there would be a number of questions to be asked at this stage:
Did you have your cover with us in 2000 when the incident giving rise to the claim occurred?
A) No: then the claim would need to be referred to your previous professional indemnity
provider for them to handle;
A) Yes: then, were you aware in 2000 that the patient was dissatisfied with the operation and that there was
therefore the potential of a claim against you arising at some future date? If you were aware that there was the potential
that a claim might arise, in order to comply with the provisions of your policy wording, you would have had to report a
potential claim to us, your brokers, so that we could notify your underwriters of the potential claim and obtain a "claim" number.
If you did report the potential claim to us in 2000 and the summons is only served on you in 2002, then, whether or not you
have renewed your policy with us in 2001 or 2002, your policy will respond to cover the claim which only arises in 2002,
because the claim will be deemed to have been made in 2000, when you had your policy with us and when you reported the incident to us.
If you had cover with us in 2000, 2001 and 2002 when the claim arises then you will obviously enjoy cover on the condition
that you reported the potential claim to us in 2000, if you had any suspicion that there was potentially going to be a claim
against you.
If you have cover with us in 2000, 2001 and 2002, and you do not report a potential claim to us when it can be shown that
you should have been aware that the patient was dissatisfied and the circumstances could potentially have led to a claim,
underwriters will be entitled to repudiate liability on the basis that you did not timeously notify them of the potential
claim and they have been prejudiced by your late notification.
Not notifying your underwriters of a potential claim when you have any awareness that one may arise, effectively constitutes
a breach of your contract with the underwriters. In this regard we request that you read the relevant provisions of
your policy wording and contact us if you have any queries.
Obviously, your underwriters do not expect you to report a potential claim, if you are completely unaware that your patient
was dissatisfied or that the circumstances involved could potentially lead to a claim being made against you.
NB: ORDINARILY, IF YOU HAVE CLAIMS MADE COVER AND:
- you performed the operation in 2000;
- you had cover with us in 2000;
- you were unaware that the patient was dissatisfied and that the circumstances would result in a
claim being made against you;
- you e.g. renewed your cover in 2001 but not in 2002 when the summons is served on you;
THEN
YOU WOULD NOT ENJOY COVER AND YOUR POLICY WOULD NOT RESPOND BECAUSE YOU
DON’T HAVE A POLICY WITH US AT THE TIME THAT THE CLAIM IS MADE.
To reiterate what was said earlier; a claims-made policy means that the policy which you have in place
at the time that a claim is made, is the policy which is expected to respond to cover that claim.
In the above example, there is no policy in place with us and therefore, no cover in place.
HOWEVER;
We are pleased to advise that with the addition of 3 years free run-off cover, you now enjoy far wider
cover than that described above.
Using the above example, you would now be able to report the claim to us, so long as you had no previous
knowledge of a potential claim against you, your policy will respond and you will enjoy cover.
HOW DOES RUN-OFF COVER WORK?
- You now have 3 years free run-off cover from the date of your last expired policy.
- This allows you a period of 3 years from the date of the expiry of your policy with us to
report any claims that may arise out of the period when you enjoyed cover with us.
- Please note that run-off cover only provides cover for claims arising from past activities,
while you were covered with us, and does not provide cover for claims arising out of ongoing activities
once your policy has expired.
- The 3 years free run-off cover does not affect the free continuing cover you are entitled to
upon retirement, if you have had your policy with us immediately prior to retiring.
- The extension of 3 years run-off cover is dependent on your last annual premium having been
fully paid whether or not you have elected to pay the annual premium by monthly debit order.
Previously, 3 years’ run-off cover could be purchased at 105% of your last paid premium. This cover is
now being provided free of charge. We look forward to continuing our search to find ways such as this,
to improve the product which we can offer you and give you, our valued client, value for your money.
Please do not hesitate to contact us should you have any queries with regard to the above.
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