Alliance Insurance Company of Zimbabwe (Private) Limited

Transcription

1 Alliance Insurance Company of Zimbabwe (Private) Limited MEDICAL PROFESSIONAL INDEMNITY POLICY WHEREAS the Insured, as defined herein, has made to Insurers a written proposal or risk profile bearing the date stated in the Schedule which shall form the basis of the Policy and in consideration of the payment of the premium stated in the Schedule by or on behalf of the Insured. NOW WE, the Insurers, to the extent and in the manner hereinafter provided, hereby agree subject to the Terms, Conditions, Exclusions and Limitations of this Insurance, to pay on behalf of the Insured all sums which the Insured shall by law be held liable to pay for damages arising out of bodily injury or mental injury to or death of any patient caused by or alleged to have been caused by error, omission, negligence in the professional services rendered or which have been rendered (hereinafter referred to as Malpractice) PROVIDED ALWAYS THAT: A. Such Malpractice results in a claim first being made against the Insured during the Period of Insurance as stated in the Schedule and of which immediate notice has been given in accordance with Special Condition 2 hereof except that any claim subsequently arising out of the conduct or circumstances referred to in such notice shall for the purposes of this Insurance be deemed to have been made during the currency of this insurance. B. In respect of Malpractice committed by the Insured himself or any nurse technician employed by the Insured or any qualified assistant or locum tenens employed by the Insured to continue the Practice of the Insured in his absence. THIS INSURANCE SHALL APPLY ONLY in respect of those activities and, or duties and(or procedures carried out in the course of the Insured's profession, as declared in the Proposal Form (or Risk Profile) except that this insurance is extended to cover any claim or suit based on the Insured's alleged Malpractice committed whilst the Insured was in good faith rendering emergency medical care or treatment gratuitously at the scene of the accident or medical emergency even though such care or treatment involved a procedure not normally associated with the Insured's profession. C. There shall be no liability hereunder, for any claim made against the Insured for Malpractice committed or alleged to have been committed prior to the Retroactive Date specified in the Schedule. i. In respect of the cover afforded by this Insurance, the Insurers will defend any claim or suit in the name of and on behalf of the Insured and will pay the costs and expenses incurred in such defence. The cost of the defence and the total damages not to exceed the limit of liability. The Insurers will not settle any claims, without the consent of the Insured. If, however, the 05/2005 MPI Page 1 of 5

2 insured refuses to consent to any settlement recommended by the Insurers and shall elect to contest or continue any legal proceedings, then the liability of the insurers shall not exceed the amount for which the claim could have been settled, plus costs and expenses incurred with their consent up to the date of such refusal. II. Irrespective of the number of persons or entities named as insured in the Schedule or added by the endorsement, the liability of Insurers hereunder for damages, shall not exceed the Limit of Liability (which shall be deemed to include all costs and expenses incurred in the defense or settlement of any claim under this policy) set out in the Schedule in respect of all claims made against the Insured during the currency of this Insurance. 1. EXCLUSIONS: 1.1 No liability shall attach to the Insurers hereunder in respect of - a Any criminal act or any act committed while in violation of any law or ordinance. b. Services rendered while under the influence or intoxicants or narcotics. c. The performance by dentists and dental surgeons of i) General anaesthesia; or ii) Any procedure carried out under general anaesthesia, unless performed - In a hospital or Clinic suitable for such operations. Under the control of a Specialist Anaesthetist. d. This Insurance does not cover: i) loss or destruction of or damage to any property whatsoever resulting or arising therefrom or any consequential loss; ii) iii) Any claims arising from the conduct of the profession in the United States of America, Canada or Australia or from actions first instituted in those territories: any legal liability of whatsoever nature directly or indirectly caused by or contributed to or arising from atomic energy risks in operations employing the process of nuclear fission of handling radioactive material which operations include but are not limited to: the use of nuclear reactors such as atomic piles, particle accelerators or generators or similar devices; or the use, handling or transportation of radioactive materials; or the use, handling or transportation of any weapon of war or explosive device employing nuclear fission, handling or fusion 05/2005 MPI Page 2 of 5

3 These Exclusions shall not apply to insurance of occupational risks arising from radioisotopes or radium compounds when used away from the place where such are made or produced and when used exclusively incidental to ordinary medical research pursuits or medical educational pursuits. 1.2 This Insurance does not cover any liability which is insured by or would, but for the existence of this Insurance, be insured by any other existing Insurance (s) except in respect of any excess beyond the amount which could have been payable under such Insurance (s) had this Insurance not been effected. 1.3 The insurance shall not apply to any claim or circumstance which has been or should have been notified under any other Policy or Certificate of Insurance attaching prior to the inception of this policy. 2. SPECIAL CONDITIONS: It is a condition precedent to the right of the insured to be defended or indemnified under this Insurance that: 2.1 The statements and particulars contained in this Proposal (or Risk Profile) are true and correct; 2.2 During the currency of this insurance the Insured shall give to the person named for this purpose in the schedule immediate notice in writing of: a) any claim for Malpractice made against the Insured; or b) any receipt of notice from any person of an intention to hold the Insured responsible for any Malpractice; or c) any conduct or circumstances which may give rise to a claim for Malpractise being made against the Insured. 2.3 The insured shall not admit liability for or settle any claims or incur any costs or expenses in connection therewith, without the written consent of Insurers, who shall be entitled at any time to take over and conduct in the name of the Insured or said Firm, as the case may be, the defence or settlement of any claim. Nor shall the Insured in connection with any claim or claim's circumstance, disclose the Nature and Terms of this Insurance, without the written consent of Insurers. 2.4 The Insured shall at all times: a) maintain accurate, descriptive records of all professional services, which records shall be available for inspection and use by the Insurers or their duly appointed representatives insofar as they pertain to any claim hereunder; b) give to the Insurers or their duly appointed representatives such information, assistance and signed statements as the Insurers may require; and c) assist in the defence of any claim without charge to the Insurers. 05/2005 MPI Page 3 of 5

4 2.5 Should circumstances arise which would entitle insurers to avoid liability under this Policy by reason of any misrepresentation, misstatement or non-disclosure contained in the Proposal Form, the Underwriters in their sole discretion, as an alternative to avoiding this Policy, shall give notice in writing to the Insured that they regard the cover afforded hereunder as continuing in full force and effect, save that there shall be excluded from the indemnity afforded hereunder any claim which has arisen or which may arise and which is related to circumstances involving such misstatement, misrepresentation or non - disclosure, whereon this Policy shall continue in full force and effect but shall be deemed to exclude as if the same had been specifically endorsed the particular or possible claim referred to in such written notice. 3. GENERAL CONDITIONS: 3.1 If the Insurers become liable for any payment under this Insurance in respect of loss, the Insurers shall be subrogated to the extent of such payment to all the rights and remedies of the Insured against any party in respect of such loss and shall be entitled to sue in the name of the Insured. The Insured shall give to the Insurers all such assistance in his power as the Insurers may require to secure their rights and remedies and at the Insurers' request shall execute all documents necessary to enable the Insurers to effectively bring suit in the name of the Insured. 3.2 If the Insured shall make any claim knowing the same to be false or fraudulent, as regards amount or otherwise, this Insurance shall become void and all claims hereunder shall be forfeited. 3.3 If the limit of indemnity is increased during the Period of Insurance, then the lower limit of Indemnity shall apply to all claims made or circumstances notified or required to have been notified to the Insurers prior to such increase in the Limit of Indemnity. Unless otherwise stated, the Retroactive Date for the new Limit of Indemnity shall be effective date thereof. 3.4 Insurers shall be entitled to cancel this policy at any time, provided they give the Insured 90 days notice of their intention to do so, when notice shall be sent by registered mail to the address shown in the schedule to the Policy. The Insured shall be entitled to the same Cancellation Terms. 3.5 In the event of cancellation under Condition (3.4), the Insured shall be entitled to a pro rata return of premium for the un-expired Period of the Policy. 3.6 Any claims notified prior to termination of the cover under the Policy, will be regarded as falling within the Period of Insurance, subject to all other Policy Terms, Conditions and Exclusions. 05/2005 MPI Page 4 of 5

5 CLAIMS S PROCEDURES 1. Notify Unique Insurance Brokers immediately. Contact: Address: 88 Rezende Street, 2 nd Floor, Engineering Hse Telephone: /3, Facsimile: Cell: unibrok@comone.co.zw 2. Do not comment or enter into any correspondence or discussion with Claimants or Lawyers, unless directed by insurers to do so (or lawyers appointed by insurers). 3. You may contact Alliance Insurance Company who are the Underwriters of this product: Contact Address: Suite 1, Westgate House, West, Westgate, Harare P.O. Box WGT 196, Westgate, Harare queries@aic.co.zw Tel / Fax: /8 05/2005 MPI Page 5 of 5