Consumer Protection Act and Medical Profession - Doctors and Medical Practitioners (Guidelines)

Email Print This Page bookmark
Font : A-A+

Doctors and Medical Practitioners (Guidelines)

The policy will indemnify any act committed by the insured, who shall be a Registered Medical Practitioner, giving rise to any legal liability to Third Parties. The Insured includes the policy holder and his qualified assistants or employees named in the proposal.

The act has to be committed during the period of insurance commencing from the retroactive date.
In the normal course all claims for compensation have to be legally established in a court of law. However, insurers may arrive at compromised settlement if prima-facie liability exists under the policy.
Jurisdiction applicable will be Indian Courts.

The limit of indemnity granted under the policy for any one accident or any one year (per accident per policy year ) will be identical.

No short period policies are permitted. However, in case of cancellation of the policy by the Insured short period scale rates as provided for will be applicable.

Registered Medical Practitioners shall be classified as :-

(1) Physicians (2) Pathologists (3) Oncologists (4) Cardiologists (5) Psychiatrists (6) Radiologists or Roentgenologists (7) General Surgeons (8) Plastic Surgeons (8) Orthopaedic Surgeons (10) Urologists (11) Abdominal Surgeons (12) Thoracic Surgeons (13) Neuro-Surgeons (14) Cardio-Vascular Surgeons (15) Otorhinolaryngologists (16) Protologists (17) Ophthalmologic Surgeon (18) Ophthalmologic Physician (19) Obstetrician & Gynaecologist (Excluding Surgery) (20) Physician & non-specialist (21) Other Practitioner-describe Surgeon. fully.

Minimum Premium Rs. 100. - No Compulsory or Voluntary Deductibles are applicable.

Insurance Rating for Medical Establishments -

Rs. 3 per 1000 on AOY limits plus
Rs. 5 per each in patient plus
Rs. 1 per out-patient.
(Number of patients to be as per previous yearís record or the anticipated number of patients during the year whichever is higher.)

Radioactive treatment Additional premium of 1 (other than X-ray) on total premium.

The indemnity in respect of any one person would be limited to 25% of the Any One Year (AOY) limit under the policy.

Minimum Premium under one policy : Rs. 1000.

Compulsory Excess and Voluntary Excess are applicable.

Exclusions:

1. No liability shall attach to the Company in respect of -

i. Any criminal act or any act committed in violation of any law or ordinance :
ii. Services rendered while under the influence of intoxicants or narcotics ;
iii. The performance by dentists and dental surgeons of :(1) general anaesthesia; or (2) any procedure carried out under general anaesthesia unless performed in a Hospital :
iv. The use of drugs for weight reduction ;
v. Cosmetic surgery ;
vi. Third party public liability ;
vii. Claims arising from any condition directly or indirectly caused by or associated with Human T-Cell Lymphotropic Virus Type III (HTLV III) or Lymphadenopathy Associated Virus (LAV) of the mutants derivaties or variations thereof or in any way related to Acquired Immune Deficiency Syndrome (AIDS) or any Syndrome or condition of a similiar kind howsoever it may be named.

2. The Policy does not cover liability -

1. assumed by the Insured by agreement and which would not have attached in the absence of such agreement ;


2. arising out of deliberate, wilful or intentional non-compliance of any Statutory provision ;


3. arising out of loss of pure financial nature such as loss of goodwill, loss of market, etc ;


4. arising out of all personal injuries such as libel, slander,false arrest, wrongful eviction, wrongful detention.,defamation, etc. and mental injury, anguish or shock;


5. arising out of fines,penalties, punitive or exemplary damages ;


6. directly or indirectly occasioned by happening through or in consequence of war, invasion, act of foreign enemy, hostilities (whether war be declared or not),civil war, rebellion, revolution, insurrection or military or usurped power ;


7. directly or indirectly caused by or contributed by :-

i. ionising radiations or contamination by radioactivity from any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel;
ii. the radioactive, toxic , explosive or other hazardous properties of any explosive nuclear assembly or nuclear component thereof;

8. arising out of genetic injuries caused by X-ray treatment/diagnosis or treatment /diagnosis with radioactive substances, in respect of professional services rendered by the Insured prior to the Retroactive Date in the Schedule.

9. the deliberate conscious or intentional disregard of the insuredís technical or administrative management of the need to take all reasonable steps to prevent claims ;

10. injury / death to any person under a contract of employment or apprenticeship with the Insured when such injury / death arises out of the execution of such contract.

It may be noted that the amount paid as premium for obtaining a Professional Indemnity Insurance Policy qualifies as deductible expense under Sec. 36 of the Income Tax Act.


The doctors /hospitals may contact the Insurance Companies or their Agents for obtaining more information on the subject.

Post a Comment

Comments should be on the topic and should not be abusive. The editorial team reserves the right to review and moderate the comments posted on the site.
Notify me when reply is posted
I agree to the terms and conditions
Kapil999 

I was appointed to run a clinic from a hospital facility. The management one day suddenly closed the premises, with all my belongings trapped inside, without giving me any notice. The treatment of many patients was under way and they feel lost. I have complained to police for cognizable offences and also written to the state medical bodies highlighting the manner in which the premises was shut down in my absence. Are any clauses of medical act violated in this sudden and unannounced closure of a medical facility? Dr K G

Rajeev2009 

I have booked two tickets under PNR no. 4408538575, for travelling from bangalore to delhi by 12213 duranto express on 27-06-2015. But on 23-06-2015 i have received a message regarding cancellation of train, then i called railway enquiry no. 139 in this regard and they told that train cancellation can only be confirmed on 27-06-2015 morning and also advised that i have not to cancel the ticket now but after departure time of the train i have to file the TDR online through irctc website. But when i open the site next day the ticket cancellation option said that it is too late too be cancelled and TDR option said that TDR can only be filled after charting and departure. So I could not cancel my tickets and contact the irctc helpline 011- 39340000 and they told to send an email in this regard on [email protected] and they issue me a Ticket No. 1686501, But they also refused the return on 12/07/2015 by saying that I have filled the TDR very late on 03/07/2015, which had to be filled within 72 hours of train departure time. As I have said earlier wihen I make cancellation of ticket irctc website refuse it and when I file TDR irctc site told that TDR can only be file after charting done and departure of train, no other method is describe there. The method of sending email is only come to know by me when I contacted irctc helpline. This is duty of Railway and Irctc to let the passenger know about the refund procedure in case of cancellation of train. So I want back all my money which is Rs.5636.17/- as train is cancelled by railway itself.

abhi0786 

I need suggestion regarding the doctors bill. Doctor is giving me bill for 17000 for 3 day for my wife's treatment. She was not admitted to the clinic, just for three days doctor given her 2 bottle of saline everyday. Doctor is having clinic not the hospital. Can you suggest what can i do?

chit123 

I want to complain against shiv medicos in H block ashok vihar for not giving proper bills for medicines purchased and also not verifying or asking for any prescription and seselling medicines without prescriptions...

nagercoil123 

This letter is with reference to the wrong or unwanted medical procedure and hiding the truth regarding my health. Dr. S.Selvamani, Senior Consultant and Interventional cardiologist [ Reg. No: 36009] done procedures like TPI CAG Successful PTCA with BVS (Bio Resorbable Vascular Scaffold) to RCA done on 18-19-2013. I was discharged on 28/09/2013 with the discharge summary as General Condition is GOOD and I thought that I had a single vessel block and that it was cleared by PTCA method and I can continue a normal life. After Discharge,( since the hospital is around 250 Km away from my home town ) I went to another cardiologist in my home town , He took ECHO and stated the extra points like Dialated LA/LV , Grade 3 Diastolic Dysfunction , Moderate PAH , Sclerotic aortic value and minimal effusion behind inferolateral wall , moderate to severe MR, posteriorly directed wall hugging jet ( MR dp/dt 982) and the Global EF is 33 % although Meenakshi Mission Hospital and Research Centre, Madurai took ECHO they didn't reveled the above points in their discharge sheet and the cardiologist Dr.S.Selvamani ,didn't prescribed the medicines which will improve the EF % . Now I am taking T.Planeb, T.Cardarone and T. Cardace to improve the condition of the heart prescribed by an another cardiologist to improve the pumping capacity of the heart, which was failed by Dr. S. Selvamani. So I suspect that Dr. S. Selvamani didn't diagnosed or gave importance to the pumping capacity of my heart and he did wrong or unwanted procedure like PTCA and temporary pace maker installation. Dr. S. Selvamani, procedures makes me to spend around Rs.4,50,000 ( Rupees Four lacs and fifty Thousand ) at Meenakshi Mission Hospital and Research Centre, Madurai and now I am spending more money on review and other lab and ECHO procedures to improve the EF% of my heart. I strongly believe that I have been treated wrong / unwanted procedures at Meenakshi Mission Hospital and Research Centre, Madurai by Dr. S.Selvamani. I am ready to submit any medical documents and willing to go any more procedures to prove that I had been treated at Meenakshi Mission Hospital and Research Centre, Madurai in unwanted or neglected medical procedures.

View all Comments (26)

Medindia Newsletters

Subscribe to our Free Newsletters!

Terms & Conditions and Privacy Policy.

Find a Doctor

Stay Connected

  • Available on the Android Market
  • Available on the App Store

Facebook