Admission of liability • Conduct or statements that indicate that you are responsible for damage or harm could be an admission of liability. This is excluded unless prior consent from insurers is received.
Aggregate limit of indemnity • All of your claims in one period must fall within the indemnity limit. The aggregate limit is the total of all those claims and cannot exceed the overall indemnity limit.
Broker • An intermediary who helps get the policy in place and is the middleman between insurer and insured. The broker is the first port of call on all questions relating to the policy and coverage offered.
Claims-made policy • A claims-made policy refers to an insurance policy that provides coverage when a claim is made against it, regardless of when the claim event occurred. However, the policy only covers claims made while the policy is active/in force.
Damage • Loss, Harm or Injury to a person or property
Damages • Monetary claim for compensation for loss or injury
Deductible • The first amount that you must contribute towards any claim made under your policy. It is also called an ‘excess’.
Defence costs • The legal costs, fees and expenses incurred in defending a claim that is covered under the policy.
Excess • The first amount that you must contribute towards any claim made under your policy. It is also called a ‘deductible’.
Exclusions • Events, liabilities or risks that are not insured.
Extended reporting period • It allows you (or Executor acting on his/her behalf) to report any claims or notifications in the event that you retire, cease to practice as a Practitioner, becomes permanently disabled, or dies.
Extensions • Optional extra cover for specific additional risks. Additional premiums may be applicable.
Fine or penalty • A monetary sum that can be imposed by a regulatory body on a healthcare practitioner that has been found guilty of unprofessional conduct.
Good faith • It implies that the relationship between the insurer and insured is based on trust and proper disclosures.
Health Care Provider • A person who provides healthcare services in terms of any law.
Informed consent • Informed consent is permission granted in full knowledge of the possible consequences. Informed consent is given by a patient to a doctor for treatment with knowledge of the possible risks and benefits.
Liability • A legal responsibility for a loss, debt or damage.
Medical Malpractice • A negligent act or omission by a healthcare practitioner in the course and scope of their practice that causes harm to the patient.
Policyholder • The person covered under the policy.
Prescription • A person who has suffered damage or loss usually has three years from the date of the loss or damage arising to initiate court proceedings, usually by way of a summons in order to get compensation. If the deadline is missed, the claim “prescribes” and they are out of time to successfully launch a court case.
There are exceptions to the three-year rule, for example, formally admitting liability interrupts the running of prescription, as does minority, or mental incapacity.
Professional Indemnity Insurance • Provides cover for a professional in respect of any allegation made against him/her for professional negligence in the practice of their profession. This normally arises as the result of any actual or alleged negligent acts, errors or omissions.
Public Liability Insurance • Relates to 3rd parties who suffer loss, bodily injury or damage to property while they are on the policyholder’s premises.
Retroactive date • The date that you first took up a claims- made policy and have maintained continuous cover since that date. Losses or claims occurring before this date are not covered under the policy.
Statutory defense costs • Defense costs related to the breach of a statute in the course of rendering healthcare services, only if the breach was unintentional.
Vicarious liability • An employer may be liable for the harmful conduct of their employees, depending on whether the harmful conduct occurred while in the course and scope of employment.