Legal and Ethical Issues in Health Care Chap 3

Legal and Ethical Issues in Health Care Chap 3

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Cards In This Set

Front Back
Purpose of liability insurance
Spread the risk of economic loss among members of a group who have a commonly shared risk.
Individual primary objective
Protect your assests
Independent contractors
Should obtain liability insurance
Employers liability policies
Protects entity against negligent acts of an employee or independent contractor
Claimant allegations against an entity
. employer failed its duty to ascertain the employee had the necessary qualifications and capability to render safe care

. employer failed to perform a background check

. employer failed to supervise the employee

. employer failed to provide proper training
Theory of vicarious liability
. acts and omissions of the employee are imputed to the employer - respondeat superior
Coverage under an employer policy
. policy spells out specifically those acts of employees that are covered and those that are not covered

. commonly employee is covered for a negligent act only if it is performed within the scope of the employees duties
Acts that are specifically excluded from an employer's liability policy:
. quasi-intentional torts of libel or slander
, intentional acts such as assault and battery

Self insurance
Employer must provide evidence of sufficient funds
Reasons for professional liability insurance
. employers policy does not provide coverage for certain acts of the employee
. limits of policy exceeded on employer's policy
. closure or meger of a facility may cause the employee to now be left without insurance
. conflict between employer and employee regarding an incident
. disagreement between the employer and employee over the settlement
. conflicts between multiple employees over an incident
. cost of professional liability insurance generally inexpensive
. disciplinary defense insurance - defends against disciplinary actions by a state board
. policies cover:
. legal fee reimbursement
. loss of wages
. reimbursement for travel food and lodging
. peace of mind
Applying for Professional liability insurance
. tell agent what services you provide
. types of clients you serve
. do you supervise others
. are you supervised and by whom
. are you in compliance with all licensing requirements in your state
. have you ever had a law suit filed against you
. any past incidents that could give rise to a future claim
. did the incident occur during the course and scope of employment

Types of policies
. Claims made - covers injuries/damages only if the injury occurs in the policy period and only if the claim is filed during the policy period or during the tail
, occurrence basis - will only covered if claim is filed during the period the policy is in place
. Tail coverage - uninterrupted extension of the insurance policy
. Umbrella coverage - coverage purchased in addition to the basic coverage, provides additional amounts or limits and or adds coverage to the basic policy.
Tail coverage
. special policy that extends the coverage provided in the original policy for an agree on period
Prior Acts Coverage
. coverage going back for a certain time
insurer requires:
, services that were provided
. whether the professional was employed or self employed
. details regarding any incident that the professional believes might possibly involve a claim
Occurrence Basis Policy
. provides coverage for an incident that occurs during the policy period regardless of when the claim was made.