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Common exclusions for medical malpractice insurance

March 24, 2017

Physicians save lives and assist people with the treatment they provide. However, patients who feel they are victims of medical mistakes and errors or low quality care sometimes file lawsuits against physicians, who therefore need to be covered by medical malpractice insurance. Medical malpractice insurance policies do not cover all types of medical mistakes and errors that a physician makes and often exclude some of the following.

Reckless and Intentional Acts Are Typically Excluded From Coverage

Medical malpractice insurance policies cover many acts of medical negligence committed by the covered party. Negligence typically describes an erroneous act or omission that doesn’t rise to the level of recklessness. Erroneous conduct by the medical care provider must not rise to the level of willful or wanton disregard for the patient’s safety to be covered by most medical insurance policies. Thus, a physician’s personal assets and finances may be liable if the erroneous acts are reckless or negligent.

Illegal Acts Are Generally Excluded From Coverage

Most medical malpractice insurance policies exclude acts that are illegal or criminal in nature. Covered physicians are not permitted to break the law, even in emergency situations or to satisfy a patient’s wishes. This issue often presents itself in instances of assisted suicide. In these cases, a patient’s family sues the medical establishment where their loved one received care or the physician who treated the patient. Medical malpractice insurance often fails to cover damage awards in this circumstance in states which deem assisted suicide illegal. Errors resulting from criminal acts are likewise not covered.

Misrepresentations on a Medical Care Provider’s Application for Insurance

If a medical care provider makes misrepresentations or omissions on applications for medical malpractice insurance, the insurance typically does not cover certain acts committed by the medical care provider. In fact, misrepresentations appearing on the medical malpractice insurance application can render the entire policy void in some instances. Therefore, physicians and those seeking coverage should be honest and forthright on their applications to ensure coverage is valid should a malpractice suit occur. Misstated qualifications and omissions of past medical malpractice lawsuits are typical misrepresentations on medical malpractice insurance applications.

Sexual Misconduct

Medical malpractice insurance typically does not cover acts of sexual misconduct. Policies generally exclude all acts of sexual misconduct whether consensual or otherwise, because such behavior has no place in the medical industry.

Hospital Administration Errors

Some policies set by hospitals may lead to medical errors, causing patients to file lawsuits. The hospital is often deemed liable for these acts, which medical malpractice insurance typically does not cover. In many cases, the hospital is in a financial position to cover the lawsuit, and it often changes its policies to prevent future medical errors.

Medical malpractice insurance covers physicians and protects their personal finances and assets in the event that they are sued. Without this type of insurance, many physicians might choose to go into other professions. Medical malpractice insurance, however, does not cover all types of medical errors that occur. Common exclusions include reckless or intentional conduct, illegal acts, misrepresentation on the application, sexual misconduct, and errors on the part of hospital administration.

Filed Under: Uncategorized Tagged With: errors, exclusions, illegal, intentional, misconduct, reckless

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