Frequently Asked Questions
WHICH CATEGORY INSURANCE SHOULD BE TAKEN ?
All insurers offer insurance in 4 categories with different rate slabs ie 1) General Physician ,2) Consultant Physician ,3) Surgeon and 4) Plastic surgeon / Anesthetist. Ideally anyone who does minor suturing, Incision and drainage, nail removal, endoscopy, delivery should take insurance in category meant for surgeons plus 7.5% for unqualified attendants in ratio of 1:1 ie Rs 1900 per 10 lacs irrespective of fact that he or she is only MBBS and not a qualified surgeon. Only resident doctors, non interventional radiologists and laboratory incharge doctors should opt for category of General Physicians without dispensing. Doctors who are pure consultants not doing any minor surgical procedural work only should take policy in the 2nd category meant for consultant physicians. Plastic surgeons and anesthetists fall in the highest category but for cosmetic surgery (which is normally excluded by most insurers) cover MLAG Indemnity offers coverage on additional premium.
HOW MUCH INSURANCE SHOULD BE TAKEN?
With 4 judgments awarding 1 crore plus compensation so far and individual doctors already being saddled with 70 lacs compensation and hospitals upto 11 crore our conservative recommendation is
General Physician 20 lacs
Specialist Physician 20 lacs
Surgeon 30 lacs
Anesthetist 30 lacs
Plastic Surgeon 50 lacs
Hospital Errors & Omission 50 lacs
ALREADY HAVE INSURANCE SHOULD I WAIT ?
Partial redemption of Insurance is possible but expensive. Since MLAG indemnity is so cheap, it is better to start MLAG Indemnity now and discontinue previous insurance once the renewal time comes.
CAN INSURANCE FROM 2 COMPANIES BE TAKEN?
Yes insurance from 2 companies can be taken. But we advise that if 2 insurances have to be taken they should be taken from same company. The reason is that in court when you declare that you have insurance for Rs 20 lac from X company and do not inform the court that you also have 10 lac insurance from Y company then later if it is found you also have insurance cover from Y company, X company will claim reduced / shared liability. The courts award of amount even less than your insurance cover will not be fully paid as company x will claim that the risk was shared.
IS IT BETTER TO HAVE ONE LARGE INSURANCE OR TWO SMALLER INSURANCES FROM ONE SAME COMPANY?
The sole advantage of 2 insurances is that court does not become liberal in awarding compensation knowing that doctor has insurance cover of 40 lacs. For them if cover declared is for 20 lacs they feel they have been fair in awarding 20 lacs compensation. Advantage of same company is you can mention only one company and one policy number in court. Later if the award is more than what was covered by that policy one can always claim the remainder from the same company by including the other policy.
IF I TAKE INSURANCE FROM MLAG INDEMNITY AND A CASE FROM MY PREVIOUS INSURANCE TIME ARISES WILL MLAG INDEMNITY COVER IT
The date when cause of action occurs decides which insurer will cover your liability. If the incidence has occured at a time when you were covered by previous insurers then even if today you are covered through MLAG Indemnity, the previous insurers are duty bound to cover your liability and provide all services as promised under their policy then.
INSURANCE SHOULD BE TAKEN IN WHICH RATIO 1:1, 1:2, 1:3 OR 1:4?
The courts are usually not concerned whether the insurance cover is in 1:1 or 1;4. If they are informed that doctor has insurance cover for 20 lacs and they award 20 lac compensation, the company will pay only 5 lac out of this if insurance is in ratio of 1:4. It does not make sense to take any other insurance other than 1;1.For a 20 lac 1;2 cover MLAG indemnity offers rate of 3040 which is cheaper than 2 policies of 10 lac each which would cost 3800 with MLAG Indemnity. However we still would recommend 2 policies of 10 lac each be taken because of advantage in court where you have presented only a policy of 10 lacs which makes the courts think twice before awarding a higher compensation.
WHY IS PREMIUM OF LARGER INSURANCES RELATIVELY CHEAPER FOR HOSPITALS / ESTABLISHMENTS?
A major cost of the premium which is due to number of OPD patients seen in previous year or due to number of Inpatients in last year remains the same whether insurance is taken for 20 lac or 20 crore. For a very large Govt hospital in Delhi we have quoted rates of 1793611 for a 20 crore Error and Omission policy vs Rs 1316522 for the same hospital for a 20 lac policy.
DO RESIDENT DOCTORS/TRAINEES NEED INDEMNITY INSURANCE?
Yes, for this refer to following cases:
1) Amit Sarkar vs PGI on 1st April, 2013.
2) Mrs. Suman vs Government Multi Speciality.... on 1 March, 2012
3) Sichendra Kumar vs Dr. Kiran Kathpalia on 14 February, 2013
DO DOCTORS IN GOVERNMENT SERVICE NEED INDEMNITY INSURANCE?
Yes, for this refer to following cases:
1) Jagjeevan pal vs PGIMER
2) Dr. Anil Jain Medical Officer c/o civil surgeon Ambala vs Devender Kumar NCDRC 10/10/2012
3) Master Akash vs Govt. of India, Kalawati Saran Children Hospital & ors
4) Sh. Rajender Prasad vs AIIMS State Commission Delhi 16/3/2010