Purpose: To establish the procedure for issuance of Certificates of Malpractice Insurance Coverage

Transcription

1 University of Kentucky / UK HealthCare Policy and Procedure Policy A Title/Description: Malpractice Insurance Coverage and Certificates Purpose: To establish the procedure for issuance of Certificates of Malpractice Insurance Coverage Policy Issuing Authorities Colleges of Dentistry, Health Sciences, Nursing, Pharmacy and Public Health College of Medicine House Staff Research Activities Other Procedure Reporting Potential Claims Obtaining COIs Persons and Sites Affected Policies Replaced Effective Date Review/Revision Dates Policy Pursuant to the University of Kentucky Medical Center Malpractice Insurance Act, KRS , et seq, the University has established a self-insured medical malpractice program (the Program ). The Program covers the University of Kentucky and its faculty, house staff, hospital staff, nurses, nurse aides, employees and students involved in furnishing health care within the scope of their duties or courses of study in connection with the University of Kentucky. KRS (3). The Program covers claims or judgments for personal injury or death to patients resulting from any tort or breach of duty based on health care services rendered or which should have been rendered by the University or persons covered under the Program. KRS (1). No coverage is provided under the Program for private practice activities, including activities involving (i) direct payment to the health professional, (ii) activities outside the approved scope of practice, (iii) activities outside of approved facilities, or (iv) moonlighting. No coverage is provided under the Program for any liability which any entity other than the University is or will be obligated either by law or contract to pay and discharge. KRS (3). The University is solely responsible for the investigation and servicing of all claims made against it arising out of medical malpractice and all costs, expenses and fees incurred in the investigation, servicing and defense of all such claims shall be borne and paid by the A06-025, Malpractice Insurance Coverage and Certificates 1

2 University. KRS (7). Persons covered by the Program are required to report promptly all potential claims to the UK HealthCare Risk Management Office and to cooperate fully in the investigation, servicing and defense of all such claims. The UK HealthCare Risk Management Committee is authorized by the Board of Trustees to determine whether any practitioner and activity is covered under the Program. Coverage is provided under the Program through a Basic Compensation Fund which is funded by the University of Kentucky and an Excess Coverage Fund established by the Commonwealth of Kentucky. KRS Coverage is provided on an occurrence basis. Certificates of Insurance ( COIs ) will be issued by the Issuing Authorities identified in this policy pursuant to the procedures described in this policy at the request of a third party seeking assurance that the Program covers identified University faculty, staff, students and/or house staff performing approved clinical, educational or research activities either at the University or off-site within the scope of their duties and/or training. All off-site clinical activities that involve the use of space, equipment or personnel furnished by any third party or that will result in payment for clinical services from a source other than direct billing to a patient or the patient s health benefit plan require approved written contracts executed between the University and such third party. No COIs will be issued without verification of appropriate contracts. Issuing Authorities Colleges of Dentistry, Health Sciences, Nursing, Pharmacy and Public Health The Dean of each of the Colleges of Dentistry, Health Sciences, Nursing, Pharmacy and Public Health has exclusive authority to issue COIs for all educational activities of the students of such college, provided such educational activities are taught or supervised by faculty, including full time, part time and volunteer faculty of such college. The Dean shall also have authority to issue COIs for third party payers who enter into agreements with the University for payment for clinical services. The UK HealthCare Risk Management Office has exclusive authority to issue COIs for all clinical service activities of the faculty and staff of the Colleges of Dentistry, Health Sciences, Nursing, Pharmacy and Public Health. College of Medicine The Medical Staff Affairs Office has exclusive authority to issue COIs for all clinical service and educational activities of the faculty, staff and students of the College of Medicine. House Staff The Graduate Medical Education Office has exclusive authority to issue COIs for all clinical activities of house staff (interns, residents and fellows) in any of the Colleges of Dentistry, Medicine, Pharmacy and Public Health. The Graduate Medical Education Office will also issue COIs to provide proof of prior coverage for house staff who are completing or have already completed training and to provide proof of concurrent coverage for University of Kentucky training activities when house staff obtain separate coverage for moonlighting activities. Research Activities The UK HealthCare Risk Management Committee has exclusive authority to issue COIs for all non-indemnified research activities of persons covered by the Program. A06-025, Malpractice Insurance Coverage and Certificates 2

3 Other Notwithstanding the designation of exclusive authority above, the UK HealthCare Risk Management Office has authority to issue COIs for any clinical activities or educational activities of the faculty, staff, house staff and students of any of the Colleges of Dentistry, Health Sciences, Medicine, Nursing, Pharmacy and Public Health. Procedure Reporting Potential Claims To report a potential claim under the Program, any person with information concerning such claim must call the UK HealthCare Risk Management Office at (859) promptly upon obtaining such information. Obtaining COIs The following procedure must be followed to obtain a COI: 1. A written application must be submitted to the Issuing Authority. The application must include, at a minimum, the following information: (a) The name and address of the requesting person/entity ( Requestor ); (b) The name of the University faculty, staff, student or house staff for whom a COI is being requested; (c) The faculty/staff/student/house staff s College, Department and Division (if any); (d) The name and address of the facility where the clinical, educational or research activity is performed (if applicable); (e) A specific description of the clinical, educational, or research (must include a copy of the research protocol and consent form as approved by the Institutional Review Board) activity for which the COI is being requested; (f) The date the clinical, educational or research activity was approved by the University and the name and title of the approving authority; (g) A description of the contract (e.g., clinical services, lease services, medical director, clinical trial agreement, clinical education, resident rotation, etc.), if any, covering the clinical, educational or research activity, including the date of execution and the inclusive dates of the contract s term. 2. Upon receipt of the COI application, the Issuing Authority will obtain documentation that the clinical, educational or research activity has been approved by the authorized University official and any additional documentation and information that the Issuing Authority may require to determine whether the activity is within the scope of the duties or course of study of the faculty/staff/student/house staff in connection with the University of Kentucky. Any issue of whether an activity is appropriately covered by the Program will be resolved by the UK HealthCare Risk Management Committee. 3. If appropriate, the Issuing Authority will issue a copy of the COI to the Requestor certifying that the Program covers the subject faculty/staff/student/house staff for the subject activity. A copy of the COI will be forwarded to the office of the approving authority. A06-025, Malpractice Insurance Coverage and Certificates 3

4 4. The Issuing Authority will maintain a file for each University faculty, staff, student and/or house officer for whom a COI is issued including the original COI, the COI application and all other documentation considered by the Issuing Authority in issuing the COI. The COI will be valid by its terms for certification of coverage by the Program of the faculty, staff, student or house staff for the specific clinical, educational or research activity approved to be performed at the specific University/offsite facility identified in the COI. A sample of the application for a COI is attached for reference. Persons and Sites Affected Enterprise Chandler Good Samaritan Kentucky Children s Ambulatory Colleges: Dentistry, Health Sciences, Medicine, Nursing, Pharmacy and Public Health Policies Replaced Chandler HP Good Samaritan Kentucky Children s CH Ambulatory KC Other Effective Date: 7/1/2009 Review/Revision Dates: Approval by and date: Margaret Pisacano, Director UK HealthCare Risk Management, Review Team Leader Barbara W. Jones, General Counsel and Chair, UK HealthCare Risk Management Committee Richard P. Lofgren, Chief Clinical Officer A06-025, Malpractice Insurance Coverage and Certificates 4

5 University of Kentucky Certificate of Insurance Application Applicant s Information Name Position: Faculty Staff Student House Staff College: Dentistry Health Sciences Medicine Nursing Pharmacy Public Health Department: UK Address: Division: Administrator/Supervisor/Clinical Rotation Coordinator/Other Contact: Telephone Number: Fax Number: Off-Site Facility s Information Facility s Name: Street Address: City, State, Zip: Contact Name: Telephone Number: Fax Number: Description of clinical, research or educational activity for which certificate of insurance is requested: Activity Approved: Yes No If yes, date approved Contract Number: Name & Title of approving authority: KMSF Lease Agreement: Yes No Name of Principal Investigator: Title of Study: Approval: IRB: Yes No IACUC: Yes No Protocol Number Sponsor: Research Information A06-025, Malpractice Insurance Coverage and Certificates 5

6 Contact: Address: Telephone Number: Fax Number: Attachments Copy of Contract Copy of Research Protocol Copy of Consent Form as approved by IRB Send completed form to: Student of College of Dentistry, Health Sciences, Nursing, Pharmacy or Public Health: Dean of College or designee Faculty/Staff of College of Dentistry, Health Sciences, Nursing, Pharmacy or Public Health: UK HealthCare Risk Management: or Fax (859) Faculty/Staff/Student of College of Medicine: Medical Staff Affairs Coordinator: or Fax(859) House Staff: Graduate Medical Education Office: or Fax (859) Research: UK HealthCare Risk Management: or Fax (859) A06-025, Malpractice Insurance Coverage and Certificates 6