Medical Malpractice Insurance - what are the pitfalls?

Specialist insurance for cosmetic practitioners

Medical Malpractice Insurance: What are the Pitfalls?

Eddie HookerCEO

Hamilton Fraser Insurance3rd Floor | Kingmaker House | Station Road | New BarnetHertfordshire | EN5 1NZ

Telephone: 0800 63 43 881 | Fax: 0845 310 [email protected] | www.cosmetic-insurance.co.uk

AgendaInsurance Requirements for Cosmetic Practitoners

What to look out for

Natalie Crane

Marketing & Communications Manager


Let’s Get Social

@cosmeticcover#aestheticinsight



Poor patient selection

Process of obtaining consent is poor- Lack of benefit not mentioned - Complications not mentioned

Patient expectations

Experimental nature of treatment not discussed

What Can Go Wrong?

Adverse outcomes- Scaring- Asymmetry

- Lumps- Pigment

- Pain- Infection

Not managing complaints

Not managing aftercare

Not keeping adequate patient records


Prevention is Better Than Cure

If you do not consent a patient properly and the treatment is not successful (even if that is not your fault) you could be successfully sued

Informed consent is fundamental to a successful defense

Ensure that you can produce evidence that consent has been taken


Tips for Taking Consent

Practitioner and patient guide each other between information scarcity and information overload

Use easy to understand language

Check the patient can comply with the necessary after care

Warn of the risk of disappointment

If it helps use diagrams to explain the risks or benefits

Ask if the patient has any specific concerns

Ask yourself whether you are satisfied that the patient has listened and understood

Do not view consent as a single event


Tips for Documenting Consent

Consent is a clearly documented, well evidenced collaborative process

Consider giving the patient a leaflet setting out risks and benefits – always document this

Consider giving the patient a leaflet on the aftercare

If you have used any diagrams or illustrations keep them with the notes

Take before and after photos

Document any specific or unusual issues raised by your patient


Most Common Incidents Notified

Notified to Hamilton Fraser Cosmetic Insurance

- 21% Fat Reduction (including Laser/Radio Frequency/ Ultrasound Assisted Liposculpture treatments)

- 20% Laser (including facial rejuvenation and hair removal)

- 18% Hyaluronic Acid Dermal Filler

- 14% Botulinum Toxin

- 14% Other (including Chemical Peels, Medical Needling, General Beauty Treatments etc.)

- 13% Other Dermal Fillers

21%Fat Reduction

20% Laser

18%Hyaluronic Acid

Dermal Filler

14%Botulinum

Toxin

14% Other

13% Other Dermal

Fillers


How Much Does a Claim Cost?

Average claims values on successful claims between 2007 and 2011

Enter our competition

Guess correctly to win a prize!

Laser Hair Removal Claim

£

Dermal Filler Claim

£

Body Contouring Claim

£

Body Contouring Claim

£

Botulinum Toxin Claim

£

Dermal Filler Claim

£

Laser Hair Removal Claim

£

Chemical Peel Claim

£

Case Study

The Claimant

- 26 year old woman

- Body Tite procedure (Radio Frequency Assisted Liposuction) on her upper and lower abdomen, arms and back

The Defendant

- A registered doctor

- Consented the patient

- Specifically indicated the potential risk of a poor result and explained that it could take up to 6 months to see the full results of the procedure


The Claim

Allegations

She could see no visible difference and claimed that the procedure was performed negligently and was ineffective

The Claimant alleged

The Defendant did not spend sufficient time on the Claimant’s procedure and as a result it was unsuccessful;

The Claimant was caused unnecessary pain and suffering as a result of the alleged inappropriately performed procedure


The Outcome

The Claimant’s solicitors made an offer of £6,500

£3,000 was a fair reflection on general damages and £3,500 was the cost of the procedure

Letter of Response denying liability was served on the basis of the Defendant’s evidence and his note keeping

Did not pursue the claim and we were successful in getting the claim dropped


Key Lessons

Even though an ‘injury’ has not been suffered by a Claimant they still try to make a claim

As well as advising of the risks of a procedure, it is crucial to advise about poor results and to document this in the notes and have a signed consent form to that effect

Without the signed consent form the Defendant could have been at significant risk


Do’s and Don’ts

Issue Do’ s ✓ Don’ts ✗Verbal Complaints

• Listentothecustomer• Sympathiseandexplain,makingsureyouarereassuringinnature• Tryandofferanearlierfollowupappointment• Keepdetailednotes

• Don’tadmitliabilityeither verbally or in writing

• Don’tmakean offer of refund or complimentary treatment before consulting with your insurance broker

• Don’tindicate you have insurance

• Don’tignoretheproblem and hope that it goes away

Letters of Complaint

• Notifyyourinsurancebrokerimmediately• Passonallcorrespondenceunansweredtogetherwith

patient notes and your proposed response

Missed Appointments Following a Complaint

• Telephonepatientregardingtheirno-showandunderstandwhy

Refund Request

• Understandwhytheywantarefund• Offerafurtherappointmentifnecessarytomaintaingoodwill

Request to see Notes

• Understandwhytheyrequireacopyoftheirnotes• Obtainwrittenconsentfromthepatientpriortoreleasing

notes to anyone

Economy & Finance

Medical Malpractice Insurance - what are the pitfalls?