6.8.2024 – Damage that occurs in connection with the practice of a profession can be very expensive and long-term for medical professionals. In special cases, there is a risk of license being withdrawn. Old contracts, on the other hand, often offer only inadequate protection. It is important to adapt the professional and non-professional risks over the course of a professional life. Only an individual risk analysis can show where there are gaps and what needs to be done, says specialist broker Rebekka Frühbuß.
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In addition to private liability insurance, which is probably important for every tort-capable citizen of the Federal Republic, professional liability insurance is probably the most important insurance for doctors.
This applies regardless of whether the doctor is in the final phase of his medical studies, is already employed, has his own practice, or is retired and in his free time. Because when it comes to medical liability, the profession of doctor becomes a calling and also extends to the area outside of regular working hours.
The legal basis
Rebekka Frühbuß (Photo: Mandy Krippl)
In the (model) professional code of conduct of German Medical Association Section 21 states that doctors are obliged to insure themselves adequately against liability claims in the context of their professional activities. In addition, according to Section 23a, sentence 1, d), it must be ensured that adequate professional liability insurance is in place for each doctor working in the company.
The explosive nature of the matter becomes clear when you read a ruling by the Munich Administrative Court, which was published on August 11, 2017 (M 16 K 16.398). In this case, a doctor (specialist in plastic surgery) took action against the government of Upper Bavaria because it had revoked his license to practice medicine.
The result was that if a doctor works without professional liability insurance despite being required to do so by law, this may justify revocation of his or her medical license in individual cases (paras. 25 – 27).
The tariff scope for professional liability insurance
While there are useful comparison calculators for other liability insurance policies that can help you find the right tariff, you will often come up against limits with standardized solutions for professional liability insurance for doctors. Ideally, professional liability insurance is tailored to the individual person to be insured and includes all activities that the practitioner carries out, in addition to the usual personal injury, property damage and financial loss.
A good professional liability insurance policy should therefore take into account not only professional activities in a clinic or practice, but also all additional risks. These could include, for example, special emergency services, expert opinions or even extra-occupational activities such as friendly services or first aid services.
A written risk analysis, which also includes signed proof of existing insurance coverage from an employer, is an essential part of the consultation. Especially with regard to possible disputes over liability issues.
Comparison calculators usually only cover a portion of the relevant criteria. Therefore, when preparing an offer for the customer, it is particularly important to take a look at the tariff books along with the risk analysis and/or to enter into direct dialogue with the relevant insurance companies or subject matter experts.
Amount of coverage
The amount of the coverage is also part of the analysis to be carried out. This quantifies the compensation limit for the individual claim and is usually found with most insurers as follows: 5,000,000 euros flat rate for personal injury and property damage and 250,000 euros for financial loss.
Normally, the insurer’s maximum payment for all insurance claims is limited to twice the sum insured. This amount is also entirely reasonable and should not be undercut. Unfortunately, there are still many doctors and medical practices whose sum insured is too low, for example three million euros.
Review old contracts
Often you will also come across old liability insurance policies from the 1980s or 1990s, which were taken out at the time for a coverage of one or two million DM and have not been adjusted since then.
In recent years, on the one hand, premiums for an appropriate level of insurance have increased; on the other hand, the services provided by insurers have also been expanded.
In the 1980s, damages and compensation for pain and suffering amounting to the equivalent of 30,000 to 50,000 euros were awarded, but the amounts gradually increased. In 2003, the Kiel Regional Court ruled that the injured party was awarded more than 500,000 euros for the first time. And this ruling was also made over a decade ago!
The advisor is therefore obliged to check existing liability contracts for possible underinsurance and to inform customers if they are underinsured.
Rebekka Frühbuß
