Which medical indemnity to get as an intern?

Discussion in 'Australasia and Oceania' started by Ezekiel20, Dec 8, 2008.

  1. Ezekiel20

    Ezekiel20 Resident
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    I know there aren't too many medical graduates on this forum, but I was wondering if someone could help me decide which medical indemnity insurance to get when I start work in January as an intern.

    As a student I signed up to Avant and MDA (or was it MIPS?) as a free member in order to score freebies, but it is my understanding that I must renew membership as a paying policy holder as a doctor.


    My questions are as follows:

    1. Is there much difference between different organisations, in terms of policy and amount covered etc? (I got the impression they were all pretty similar..?)

    2. Is there much difference in policy premiums? I mean, do you have to 'shop around' like you do for car insurance and greenslips?

    3. Which organisation are you with, and would you recommend it?



    Thanks in advance,
     
  2. driedcaribou

    driedcaribou Senior Member
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    They all are pretty similar and to be honest, at our level, as long as you have one, you should be good.

    There are a list of questions you can look at here:

    http://www.asa.org.au/Page.aspx?A=7552

    But honestly, don't look too hard.
    MDA National charges you $20 and it will take you all of your intern year and half of your PGY-2 year which is a good marketing strategy.

    I would just join them all as the rest are free during internship.

    You are covered by your employing hospital but the insurance they give you is VERY limited. The medical defense organizations provide you with medico-legal advice 24/7 (at least MDA did for me as I had to do police statements for coroner's cases) whereas the blanket hospital coverage provides no services.

    Don't stress too much about it. If you have time, by all means sift through the policies but I do not think you will save too much.

    I think at the consultant level when you pay over $10k in medical indemnity then it becomes an issue. But this should all be tax-deductible anyways.


    MDA and MIPS do cover locum work and overseas work.

    Though I hear NSW does not allow you to locum until PGY-3?
    B.S. I say.

    "

    Medical Defence as a Trainee
    As trainees, we are likely to be employer-indemnified. This means that our practice within the public hospital system is covered by the hospital's insurance policy. Unfortunately, employer indemnity does have some significant limitations, and the indemnity provided varies markedly across Australia, and even between hospitals in each state. Some important questions to ask regarding your employer indemnity include:
    • Is the indemnity contractual (i.e. must be provided) or discretionary (i.e. the hospital can choose whether to cover you in relation to a claim)?
    • Is the indemnity specified in your contract of employment?
    • Are there any areas or aspects of training where this indemnity will not apply (eg. private patients in a public hospital)?
    • Does this indemnity extend to legal costs and representation for Coronial inquiries, Medical Board inquiries and disciplinary hearings? Generally not!
    • What happens if the hospital's legal team finds against you, or you have a professional dispute with your employing hospital?
    • Am I covered for Good Samaritan acts in the community ? Generally not!
    • Am I covered for locum shifts at other hospitals or work outside of my employed position, eg. surgical assisting or working as a team doctor at a local sporting club ? Generally not!
    • Am I covered for volunteer work in Australia or overseas ? Generally not!
    • With the prospect of more anaesthesia training being conducted in the private sector, it is especially important for trainees to be clear about what they are indemnified for by their employer.

    Due to these limitations of employer-indemnified cover, many trainees will have chosen to take out additional medical indemnity insurance with a medical defence organisation (MDO). The most commonly used MDOs in
    Australia are as follows:

    1. Avant – formed in 2007 through the merger of MDAV and United Medical Protection

    2. MDA National (expanded from MDA WA)

    3. Medical Indemnity Protection Society (MIPS)

    4. MIGA (formerly MDA SA)

    5. Invivo – a new provider now in its third year of practice, and backed by QBE

    Previously, insurance companies were predominantly state-based, but now all of the above companies are expanding Australia-wide. With increased choice comes increased potential for confusion. The most important areas to consider include:
    • What categories of cover are available for trainee doctors? Often you can choose between very basic cover to supplement employer-indemnified cover (eg. legal cover and expenses) or more expansive policies that include Good Samaritan acts, volunteer work, and small amounts of private practice (at an additional premium)
    • Is there a category that is suitable for my current and future insurance needs?
    • What is covered by the insurance policy? What are the restrictions and limitations?
    • Is Good Samaritan work covered? Is gratuitous advice covered?
    • Is volunteer work covered?
    • Am I covered for private practice which forms part of my training program?
    • Am I covered for private practice outside of my training program, e.g. locum work?
    • Does it include retroactive cover? Retroactive cover is insurance for claims first made against you during the policy period, but which relate to events which occurred prior to the policy commencing. This is extremely important if taking out insurance for the first time, or if switching MDO. The amount of retroactive cover will affect the price of the premium, although for trainees the cost increase is small as they have generally been employer-indemnified.
    • Does the company have offices in my state, and understand the hospital system in my city?
    • Is there a 24 hour medicolegal helpline?
    • Are claims handled by the MDO itself, or outsourced to external insurance companies?
    • What is the financial position of the company? Do they have a history of making "calls" to members for additional funds?
    • What other member benefits do I have access to (eg. access to risk management
    • education, educational publications, handbooks etc)?
    • Do my colleagues have any experience (good or bad) with this company?
    • How much does the insurance policy cost?
    • What is the excess associated with making a claim?

    As each insurance company offers a range of different products, and calculates premiums on a case-by-case basis, it is unfortunately not possible to offer generalised advice to choose between them. However, the above companies have detailed websites, and offer the option of online quotes, allowing easier comparison between them. As a guide, the majority of companies offer policies for registrars in training of approximately $600-$800 per year.

    "
     
  3. Ezekiel20

    Ezekiel20 Resident
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    Oh I didn't know that coverage as an intern was also free or as cheap as $20..


    Thanks for the useful info.
     
  4. driedcaribou

    driedcaribou Senior Member
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    Avant gives you coverage during PGY-2 for free as well.

    They don't expect you to use their services much and you are a low liability since we are supposed to be supervised.

    The hospital gives you very limited coverage.
    The advantage of signing up for a MDO is that you can call their lawyers for advice anytime. You can fax them police statements for them to check before you submit them officially too.
     

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