Sabrina Gordon and Gareth Manning Sunday Gleaner Reporters

codling

LOCAL INSURANCE companies are shying away from providing indemnity for negligence by medical professionals in Jamaica because of the high probability of errors in delivering health care, and the potentially large payout.

Approximately one in 25, or four in every 100, patients seen in hospital will be the victim of a medical error, local insurers claim.The Journal of American Medical Association reports that one in 10,000 admitted to hospital in the Unites States would have lived for three months or more had optimal care been provided. A subsequent Harvard study concluded that at least 44,000 people died each year as a result of medical errors, and over one million injured.

professional negligence

The last local insurance company - AIG - to offer coverage for professional negligence in the health sector ceased doing so in 2001 when it was met with a high volume of claims that caused it to pay out $29.2 million between 1997 and the year 2000.

According to AIG's Earl Codling, his company received reports of 38 incidents over the four-year period that it insured the University Hospital of the West Indies. The highest number of claim - 15 - were received in 1998, and cost the company $20.7 million.

"Insurers are reluctant to provide coverage for this type of exposure due to the risks involved. There is a possibility of substantial awards being made against doctors, et al, for errors and omissions," says Codling. "The problems are associated with outdated medical equipment and lack of proper maintenance in some areas," he adds.

He notes that while there is a monetary limit on each insurance policy, many claims can be made for any one period.

States Codling: "Professionals make mistakes constantly in their business. The medical world has more than its fair share, whether it be wrong prescription, wrong medicine or omitting to do something while the patient is on the operating table. Human errors have proven to be extremely costly within the context of insurance exposures."

The high cost of reinsurance premiums poses another challenge for local insurance companies, Codling points out. The reinsurance premium costs approximately US$100,000 ($7.1 billion) for a coverage of US$200,000 ($14.2 billion) for any one incident but U$400,000 ($28.4 billion) during the policy period.

Additionally, the lack of experienced underwriting professionals poses a problem for insurers.

Resulting from the absence of insurance coverage locally, some doctors have established their own fund to indemnify themselves, or seek coverage in the overseas market.

nine claims

The Medical Association of Jamaica offers insurance coverage for its members through a pool of funds it established some time ago. Dr Albert Lockhart, who is in charge of the fund, has been reluctant to disclose how many claims have been made since it (the fund) was established. He, however, discloses that nine claims have been made between 2002 and 2007, including those made to the Medical Protective Society - a local body that also offers coverage - as well as the attorney general.

gareth.manning@gleanerjm.com