Indemnity Notification: What, when and “Why me?”
Indemnity Insurance is a fact of life for all health professionals regardless of where they work and what level they practice. Your employer may reimburse your costs however this does not mean you can stop thinking about it. Although not a legal requirement in New Zealand to have indemnity insurance, the reality is that most of us cannot afford to defend ourselves should an indemnity case arise.
Despite most of us accepting the need for indemnity we frequently receive phone calls from health professionals who notify us of an indemnity case only to discover they have already spoken to the detective, sent a letter of apology to the family, responded to the Health and Disability Commissioner or reported to ACC. Or the message is:
“I got this complaint letter 4 weeks ago and I was going to send the reply today, but I just want to run it by you before I do.”
What do you need to notify us of?
Notify us of any issue that is potentially indemnity related.
Health and Disability Commissioner (HDC) and Accident Compensation Corporation (ACC) enquiries are the most common and because of the limited timeframe prescribed by law to respond, we like to be notified of these as early as possible.
Other potential indemnity cases include coroners enquiries, inquest reports, police investigations, internal enquiries, direct patient complaints, health and disability advocate requests, medical council reports or anything commonly known as an “adverse event”. Adverse events may include unexpected deaths following discharge or mistaken diagnoses (e.g. meningococcal disease).
Occasionally a patient consultation or patient contact just “doesn’t go well”, and despite your best intentions you get the feeling there is a good chance the family is going to complain. We encourage you to ring us about these so we can advise you accordingly.
Things we are likely to need include the patient details, date of the incident and where the enquiry is coming from. Most importantly we need a synopsis of the case from your point of view (written as close as possible to the incident date), and a draft response to the complaint or enquiry. Emailing the draft response through allows minor alterations to be made quickly to the draft.
We need copies of any correspondence to ensure the response addresses any issues raised. Finally we need a copy of the relevant patient notes. Often there will be information in the patient notes that is pertinent to the investigation, yet has not been included in the draft response. All information given to us is treated confidentially and stored under lock and alarm until destroyed.
The draft response should only be written from your point of view. Comments should not be made on events that happened prior to or following your involvement. Stick to the facts, although please mention any relevant mitigating circumstances (i.e. short staffing, overworked, poor communication) in your correspondence with us.
Why do you need to notify us early?
We cannot help you if you do not notify us of a potential indemnity claim. When you hear about a claim or potential claim, we need to be the first people you talk to, before your colleagues, the DHB or PHO and before the investigating body.
In all but the simplest of cases we need the details confirmed in writing and copies of the notes and correspondence this before we can offer advice. Even outwardly benign cases can have potentially serious indemnity issues beneath the surface. The sooner we are notified, the quicker we can act, thereby allowing a more rapid response to the patient or investigating body.
What do you do if an indemnity issue arises?
(1) DO NOT PANIC
(2) CALL US today
(3) LISTEN to what we say
Always follow our instructions, even if they seem unimportant. Most of the cases can be dealt with quickly, although this depends on notifying us in a timely manner and providing all the information we need to be able to give you advice.
When asked to respond to a complaint many health professionals feel affronted by the process, particularly as they feel they have done nothing wrong. It is a stressful process for most health professionals and we are here to smooth the path and support you through it.
Remember the majority of indemnity issues we deal with are resolved between the parties, following a letter of explanation, without further action being taken.
