Top 7 Insurance & Legal Questions for Resuming Medical Practice During COVID-19
by Todd Zeiter, Vice President of Underwriting, The Doctors Company
We’ve heard from physicians that they are concerned about the risks involved in reopening their practices and resuming elective procedures. In response to these concerns, the following are answers to the top questions from our members and doctors across the country:
Q: Am I covered for employee claims involving COVID-19?
A: If an employee of yours makes the claim that you failed to provide a safe work environment that claim would fall outside of your medical professional liability coverage.
Q: Am I covered if a patient alleges they contracted COVID-19 in my office?
A: If you are covered by The Doctors Company, the short answer is yes. The longer answer involves separating what the physician can’t control from what they can. Perform daily reviews of any new CDC guidelines, train your staff, and maintain infection control standards—and document that you are doing those things.
Q: Can I continue my practice contrary to state recommendations?
A: We will rely on your professional judgment relative to your practice and your patients’ best interests. We encourage you to follow all state mandates, laws, bulletins, and orders.
Q: If I cannot yet resume my usual level of patient interaction, can I adjust my coverage to reduce my premium?
A: The Doctors Company offers two types of coverage adjustment: reduction in time and/or reduction in the nature of procedures performed. Either or both would reduce premium.
Q: Am I covered if I provide services outside the scope of my specialty?
A: If you're being requested to provide services outside of the scope of your specialty your coverage with The Doctors Company will not be impacted. We will rely upon your professional judgment.
Q: Assuming elective surgeries or procedures are allowed, what special considerations apply during COVID-19?
A: The return to offering procedures will be a gradual process. Use your best judgment to determine whether you have the capability to safely perform the procedure. Additionally, no one knows what things will look like in a year or two, so documenting clinical reasoning based on conditions right now is critical.
Q: What if I have documented my best clinical judgment, but the insurer disagrees? Will I still be defended in case of a suit?
A: If you are a member of The Doctors Company, you can count on aggressive, effective defense of your claim. We do not cast doubt on our members’ clinical judgment. However, we strongly recommend that you document your clinical reasoning in case of a suit.
The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each healthcare provider considering the circumstances of the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.
If you have questions about this information
or OSMA’s services to physicians:
Call 800-766-6762 or email OSMA.