Saga Professional Liability Insurance
Saga Professional Liability Insurance, The legal obligation of professional liability insurance charged to all health professionals, since March 4, 2002, was used to test the ambition of Insurers and once again punish the practitioners. The professional liability insurers (SPC) have for the most part, terminated their contracts with practitioners whose work represented a security risk too heavy. To avoid the certain death of the surgical activity in France, the Legislature must yield to the advances of lobbying insurers. The law of 30 December 2002 made it possible for practitioners who have suffered two refusals insurance liability insurance. A coinsurance has been established at the behest of insurers: the birth of a temporary grouping of medical insurance (GTAM).
Of course, this assurance “last chance” was not created without abuse by providers of security. Indeed, the excessive premiums imposed obstetricians have led them to express their discontent by a strike at the beginning of January 2003.
The GTAM has been established for a specified period, the time that insurers participating in this group, returning to the market for professional liability. The duration of the subscription period is from GTAM 01/01/2003 to 31/12/2003. Insurance companies that participate in GTAM in proportion to their commitment to medical malpractice in the French market, have found a tool to measure. This entity allows insurers to be held jointly in the event of failure of a group of companies. In addition, insurers can observe the evolution GTAM risk of medical activity without being in the forefront.
Currently, the GTAM is not renewed. It is therefore up to each physician who suffered a termination of his contract GTAM CPR, to solicit a new insurer. Annual premiums may however be maintained at high prices of up to € 15,000 for a surgical activity.
Conversely, if insurers often balk treaty to take out an insurance policy for surgical activity, it is not the same for the purchase of an insurance consulting business. The risk posed by a consulting firm ophthalmology, for example, is still statistically reasonable for insurers to SPC. But it depends on the willingness of insurers to the activity of this type of study potentially uninsurable. The day the risk of prescription glasses will be too sharp decline in turnover for insurance companies, we can expect that is opposed to most ophthalmologists France exorbitant premiums or denial of insurance.
The regulatory role of the Central Pricing
We will remind all practical purposes, a practitioner who had two insurance refusal can operate the Central Bureau of pricing (BCT). The CPS was created by the Act of March 4, 2002. Article L 252-1 of the Insurance Code and Decree No. 2003-168, 28/02/2003 we put in place well after the crisis of late 2002. This office is the same as for automobile insurance. Indeed, the CPA’s role is to require an insurer to take over the guarantee of a risk for a defined amount of premium. But the insurance premium is much higher than the bonuses paid on the insurance market. We can not force an insurer to promise without adequate security. The premium of the insured physician thus ends up reaching peaks despite the device supposed to protect! If the drunk driver, a surcharge may seem natural for the surgeon or doctor conscientious and careful, mere victims of legalization of medical practice, it seems unreasonable, unfair and commercially questionable! We note also that the time between the decision of the CPA, requiring an insurer to accept the guarantee of medical RCP, and the effective coverage of the activity of the practitioner may reach 2-3 months. Is it reasonable to stop working until the end of February 2004 for the sole purpose of being in compliance with the law?
Moreover, Article L 1142-25 of the Code of Public Health, and Article 5 of Decree No. 2003-168, 28/02/2003 provide for any breach of statutory duty insurance penalty a fine of € 45,000, which may be accompanied by an additional penalty of disqualification.
To overcome this problem, insurance companies will offer practitioners eligible for access to the CPA, to ensure that while implementing the standard rates established by the “jurisprudence” of the BCT. Faced with a CPS invaded requests practitioners victims of commercial practices mentioned above, these same insurers will by force of circumstances recover their role while having increased premiums.
Faced with this situation, some practitioners may be tempted by attractive incentives offered by companies based abroad. The guarantees in the event of litigation seem to offer very little security, leaving many insurance experts, lawyers and officials skeptical.
The saga of the professional liability insurance is far from complete and appropriate for each physician to exercise the utmost vigilance on his contract and the evolution of his bonus. Insurance is also know to be cautious!
