As an allied health assistant, you may face an incident or a complaint from a patient at some point during your career. While having insurance cover is an important step in helping you protect yourself, your response to an incident, complaint, and/or claim can be equally important. This includes the timing of making a notification to your insurer.
In this article, BMS, AHANA's dedicated insurance partner, explains the importance of making a notification, and how to respond in the event an incident, complaint or claim arises.
Do:
Immediately report any potential complaint or claim to your insurer or broker
Formally document the incident, including details of those involved
Submit any formal statement to your insurer
Report any regulatory investigations or notice of complaint immediately
Gather any noted and supporting documentation
Don’t:
Speak with any third parties about the claim
Assume any legal fees before reporting a claim
Offer compensation to independently settle a claim
Amend or change any previous medical records once a statement of claim has been received.
A common misconception is that you only need to make a notification if a claim is made against you, but it's important to notify your insurer as soon as you become aware of an incident or any situation that could give rise to a claim. Why?
This is because a claim could arise months or years after an incident takes place, and ‘claims made’ insurance policies like professional indemnity and public & products liability insurance require notifications to be made within a specified notification period.
Under the AHANA Member Insurance program, the Professional Indemnity Insurance policy with BMS is a ‘claims made’ policy. ‘Claims made’ means that the policy in effect at the time a complaint or claim is made against you (regardless of when the alleged incident occurred), is the policy that responds. Therefore, waiting too long to report an incident may lead to a breach of your policy conditions and potentially without cover.
Notifying your insurer means they have all the information at hand and are ready to efficiently handle a claim should an incident escalate.
When deciding whether or not to make a notification to your insurer, consider asking yourself:
Could this situation potentially lead to a claim?
Do you have concerns about the incident?
If you’re part of the AHANA Member Insurance program, the BMS team is available to assist you in reporting an incident or responding to a claim, and guiding you through the claims process.
If while working within your scope of practice a claim is made against you relating to:
acting in a negligent manner;
making a mistake;
excluding something you shouldn’t have; or
not working to an expected level of professionalism
Your Professional Indemnity (PI) insurance cover could assist you in managing the allegation or claim made against you. PI cover can also assist with costs of patient damages or legal defence costs.
As an AHANA member, you have exclusive access to the AHANA Member Insurance program with BMS. This includes professional indemnity insurance. For more information visit the insurance page or speak to a BMS broker on ahana@bmsgroup.com
Eligible members can apply for insurance using a secure link via a members-only webpage, after being granted a practising membership. Please note it is a requirement of the insurance policy that you hold an active practising membership with AHANA, are an Australian resident and over 18 years of age. If your membership ceases you will not be offered renewal when your policy expires. In arranging this insurance for our members AHANA is acting as a distributor of BMS Risk Solutions Pty Ltd (BMS) AFSL 461594, ABN 45161187980. This insurance policy is issued by BMS under a binder with Certain Underwriters at Lloyd’s. When acting under a binder BMS is acting as agent for the insurer and not as your agent. This is general advice only and BMS has not considered whether it was suitable for your particular objectives, needs or financial situation. Please read the Policy Wording and the BMS Terms of Engagement which contains the Financial Services Guide before making a decision about purchasing this policy. AHANA may receive a percentage of the commission paid to BMS by the insurer and/or a fee per policy.