So, You re Patient s Hearing Aid Was Thrown Away

Transcription

1 So, You re Patient s Hearing Aid Was Thrown Away OR Coverys Risk Management All materials are subject to copyright. Reproduction without prior permission is prohibited. This information is intended to provide general guidelines for risk management. It is not intended and should not be construed as legal advice.

2 Navigating the Maze of Insurance Brad Leeser Senior Claim Representative MHA Insurance Company Coverys Risk Management All materials are subject to copyright. Reproduction without prior permission is prohibited. This information is intended to provide general guidelines for risk management. It is not intended and should not be construed as legal advice.

3 HERE S THE EXPECTED DISCLAIMER: This presentation is not legal or insurance advice. Rather this is designed as a bird s eye view of the various types of insurance. See your agent for more information on coverage that you might need, its cost, deductibles, exclusions and other options. I not a licensed insurance agent nor am I an attorney. Nothing in this presentation should be considered advice on purchasing insurance or legal advise.

4 Do you see insurance like this???

5 Or do you see insurance like this..

6 Types of Coverages Professional Physician Professional Facility General Liability Liability Coverage Medical Payments Coverage

7 Coverage (con t) Directors and Officers Property Work Comp Auto Bonds Marine Aircraft (Property and Liability)

8 Coverage (con t) Health Life Legal Dental Disability Pet Other (Employee Benefits, EPL, etc) (We will not be discussing these types of insurance in this presentation.)

9 Auto This is fairly simple. This covers autos. BUT there are several types of coverage that can apple to every car. Liability Uninsured/Underinsured No Fault Med Pay Collision/Comprehensive Garage/Garage Keepers Liability

10 Auto Liability Coverage Liability insurance covers you in the event you are in a covered car accident and it is determined the accident is a result of your negligent actions. In other words, you are legally liable for the damages to another person s property or injury.

11 Auto Collision Coverage If the car is a involved in a covered accident, collision coverage will pay for the repairs (or replacement) to your car. Deductible will apply.

12 Auto Comprehensive Coverage This is a broad coverage that provides coverage to your auto in the event of perils other than covered accidents. Such things might include rock damage to windshield, hail, wind, flood, hitting animals, etc. A deductible will usually apply.

13 Auto Uninsured/Underinsured Coverage When someone is legally responsible for damages related to an accident, you won't receive any payment if they don t have liability coverage. Or if they have low liability limits you might receive less than you need to cover the cost of damages if your damages exceed their coverage amount. These types of coverages on your car are designed to take care of that.

14 Auto No Fault Coverage (PIP) These coverages vary from state to state and not all states have these coverages. In North Dakota they cover certain expenses (Medical, Funeral, Cost of loss or services, Some wage loss benefits) that a person incurs in an accident, regardless who is at fault. Not only does this cover the passengers in the car but also pedestrians and bicyclists you may hit.

15 Auto Medical Payments Pays for medical expenses and funeral expenses that occur to a car s occupants. This coverage is not sold in North Dakota. The No-Fault Coverage takes the place of Auto Med Pay.

16 Garage Keepers and Garage Keepers Legal Liability Seldom an issue for hospitals, unless you have valet parking. These two coverages are similar but one protects cars in you possession the other covers damage to other cars in non-owned cars you are driving. These two coverages are often sold as a package or combination coverage.

17 Property Coverage Generally covers insured property for various perils. There is usually a deductible Coverage can be specified perils or all risk or some combination. May be endorsed to include some property of others that is in your care, custody, and control.

18 Bonds Not really insurance, but closely related. Main types we re concerned about are Surety Bonds and Fidelity Bonds. Some property coverage include Employee Dishonesty Coverage..really a form of a Fidelity Bond.

19 Aircraft Be aware that most general and professional coverages don t cover aircraft liability. But generally, you are covered for liability for injury to your patients for loading or unloading them into aircraft under your general or professional coverages.

20 MARINE INSURANCE OCEAN MARINE will probably never apply to your facility. INLAND MARINE doesn t need to involve water. Is a type of property coverage. May involve equipment, radio towers, etc.

21 Directors and Officers Coverage. This coverage may protect directors and officers from personal financial liability when the company cannot or will not indemnify the director or officer. This coverage may protect the company when the company indemnifies the directors and officers. For example, when shareholders file suit against the directors.

22 D&O Continued This coverage varies somewhat from insurance company to insurance company. This coverage may include coverage for regulatory liability and liability arising out of employment and other issues.

23 Professional Insurance Generally, you will have two types of professional insurance. Facility (includes nurses, techs, and other staff). Physicians (includes medical, osteopathic, and chiropractic physicians, dentists, psychologists, and mid-levels). Each provider must be individually listed on the policy.

24 Professional Coverages Generally covers damages arising out of the providing or failure to provide professional services. The colloquial term is malpractice coverage. Coverage limits can be shared or separate.

25 General Liability Coverages This coverage is for damages you are legally required to pay for Bodily Injury and Property Damage as a result of a covered incident. Personal Injury Coverage may cover other actions arising out of defamation, wrong imprisonment, false arrest, detention, wrongful eviction, wrongful entry, etc. Generally does not cover property of others in your care, custody, or control.

26 General Liability pays for that which you are legally obligated to pay. Medical Payments coverage applies to visitors, with some exceptions. Liability must be clear or likely for payment to be made Subject to policy exclusions and limitations Applies to medical bills, with some limitations

27 So, now are you totally confused???

28 Wait.there s more.. Claims made or occurrence coverage. Excess and umbrella coverage Self insurance Liability deductibles and retentions Captive insurance companies And let s not forget shared v. separate limits for professional coverage.

29 Now, what about these situations What covers the loss of your patient s hearing aids (glasses, jewelry, etc)? Getting out of a car.auto No Fault or Premises Medical Payments? What about Medicare? What about injury to a volunteer? Other situations????

30 REMEMBER!!!!! Insurance is complicated. You as a healthcare facility should rely on an insurance professional who specialized in hospital and other professional coverage. They will help guide you through the maze of insurance and make sure your facility has the insurance coverage it needs.

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32 Thank you!!!! Coverys Risk Management All materials are subject to copyright. Reproduction without prior permission is prohibited. This information is intended to provide general guidelines for risk management. It is not intended and should not be construed as legal advice.