Insurance for the occupational health (OH) profession can be a complex arrangement, and if that arrangement is incorrect, the costs can be very high.
Historically, there has been a lack of understanding among brokers and insurers dealing with what OH professionals provide. As a result, OH providers have found insurance a minefield.
For OH health nurses and practitioners fully employed by the NHS or contracted on an employed basis, it is relatively simple. Membership of the Royal College of Nursing (RCN) or other professional bodies automatically includes personal professional indemnity and malpractice, subject to certain limitations, and provided that you do not allow membership to lapse, this will provide you with the protection you need.
But if you also provide a freelance service (even on a part-time basis) in addition to your employment, then your personal membership may not fully protect you. In this situation, it is possible that you could be deemed a commercial OH provider, and would need to take out further cover to ensure that you are adequately protected.
Insufficient cover
For commercial OH providers, it is common to find that policies can be arranged incorrectly and with either too much or too little protection, leaving both the OH professional and the companies they serve providing OH services vulnerable to extra costs or unnecessary risk. For example, many brokers have advised their clients that a simple office policy is sufficient, sometimes in conjunction with a professional indemnity policy. Yet the office policy provided by these brokers is a simple package designed to give cover to small businesses providing a purely clerical service to their clients, with an occasional visit to their client’s premises. Such policies are designed for, and ideally suited to, solicitors and accountants. They also cover surgeries where most patients visit the premises. The policy accepts that doctors will make house calls, meaning one doctor visiting a patient in their own private house.
However, OH companies operate differently. The essence of OH means that the nurse or doctor will spend most of their time at the client site, which could be anything from an office to an oil refinery. And there is a much greater risk of them suffering an injury, or causing damage to an employee or visitor to the company at that site compared with a doctor making a house call.
This is not what the basic office policy and surgery policies were designed for, which means the cover is not adequate to fully protect the liabilities of the OH provider.
Extreme
At the other extreme, some brokers have advised their clients that a full medical malpractice and professional indemnity policy is necessary, resulting in unnecessarily excessive premiums.
Brokers and insurers assume that, as OH falls within the medical profession, it is a high-risk category for malpractice and professional negligence and, in many cases, expensive combined malpractice and professional indemnity policies are provided on the assumption that the OH provider will be conducting medical procedures. But this is not generally the case, as much of the work is of a preventative or consultative nature and rarely involves any form of treatment.
Nonetheless, the OH provider can certainly be exposed to malpractice and professional negligence claims, the ‘contract’ being between the provider and the client (usually a limited company). Therefore, any allegation of negligence in the treatment of the client’s staff could lead to an initial action against the OH provider, making it essential that the correct cover is in place to respond to the action and provide cover for defence costs.
As the claim progresses, it may become apparent that it is the actions of the individual nurse or doctor that has caused the claim, or it may be decided that the OH provider is only partially at fault, leaving a claim for contributory negligence.
So while having malpractice and professional negligence cover provides access to skilled legal advice, and covers defence costs and any awards made against the provider, ensure that the premium reflects the risks faced, and is not based on false assumptions of risks the company faces.
Key points
Avoid over-insurance from uninformed brokers. Remind them that you are not conducting medical procedures.
Avoid under-insurance from unconcerned brokers. Whether you are a freelance professional or running an OH company, professional indemnity and office policies alone are unlikely to be enough.
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See next month’s issue for a report on insurance and OH
Tracy Keep is a Fellow of the Chartered Insurance Institute and is responsible for the medical professions department at Brett & Randall. For information on her bespoke insurance package for OH providers, developed with the Commercial Occupational Health Providers Association (COHPA), contact COHPA on 01933 303 007 (e-mail [email protected]), or contact Tracy directly on 0116 2228242 (e-mail tkeep@brettandrandall).co.uk
