A medical practice can be named as a defendant in legal proceedings, usually in addition to, but sometimes instead of, the medical practitioner(s) who provided the care to the patient.

For example the patient has been seen by a number of doctors, or a locum who isn’t permanently with the practice, and it is unclear which (if any) of them has been negligent. Another example may be where the patient’s injury was a result of the actions or advice of a practice staff member and not an individual doctor.

Avant’s Practitioner Indemnity Insurance Policy is designed to protect the interests and needs of the doctor. It provides cover for claims made against the individual doctor and may include some limited cover for their practice if the doctor meets the definition of ‘sole trader’ (as defined in the policy).

Avant’s Practice Medical Indemnity Insurance Policy is designed to protect the practice (business entity). It covers the legal costs of defending the practice and its employees against allegations and complaints, as well as patient loss or injury. Avant’s Practice Medical Indemnity also covers:

• employment issues
• complaints, inquiries and investigations brought by a state health complaint entity or criminal or coronial investigations
• responding to an audit
• reputation of the practice
• advertising and anti-competitive behaviour.

While a practice policy does not cover doctors employed by the practice, they have their own individual policies, it will protect the practice as far as if they are brought into the claim because of the actions of one of the employed doctors.

There is limited cover under Avant’s Practitioner Indemnity Insurance Policy for a doctor’s practice but the doctor would need to meet the definition of ‘sole trader’ as defined in the policy and wholly control the business. It includes cover for practice staff for particular civil claims, but not for disciplinary board or criminal or coronial inquiries.

A practice receives an audit notification from Medicare. The practice manager is unsure of how they should prepare, what information they will be required to provide to Medicare and have concerns regarding patient privacy.

The Medicare scheme is complex and rapidly changing, with reforms introduced in July 2018 giving Medicare stronger debt recovery powers impacting both doctors and their employers. Practices are increasingly exposed to scrutiny and getting reliable up-to-date advice can be difficult.

In a case such as this, Avant would assist the practice to understand their obligations and work with them to prepare an appropriate response. As Australia’s largest medical defence organisation, Avant has extensive experience and the capability to assist practices to meet their obligations and to respond appropriately to audits conducted just by Medicare, but also the Australian Taxation Office or private health insurers.

A doctor prescribes a patient an iron infusion, which is administered by the practice nurse.

The patient alleges the nurse administers the infusion incorrectly, causing nerve damage and subsequently sues the medical practice for the nurse’s actions.

Avant would engage lawyers to protect the medical practice in the legal proceedings and the nurse’s actions would be investigated. If the patient’s allegations are substantiated then the claim would proceed to alternative dispute resolution measures, such as mediation in an attempt to resolve the claim without going to a hearing.

A practice manager experiences a breakdown in the working relationship between a contracted doctor and other employees of the practice, and is subsequently considering terminating the doctor.

In this case, Avant can provide key tips for managing workplace employment issues and disputes. We can also assist the practice to understand the distinction between reasonable and poor performance management, communication issues and bullying from a legal perspective.

Avant would encourage and support the practice manager to resolve the internal conflicts with the contracted doctor as informally as possible. If the issues are note resolved Avant can provide advice on the appropriate steps to take before terminating the contracted doctor, including mediation.

Broadly speaking Avant’s practice policy provides the insurance cover, which includes:

• patient injury and loss claims
• employment issues
• complaints, inquiries and investigations brought by a state health complaint entity or criminal or coronial investigations
• responding to an audit
• reputation of the practice
• advertising and anti-competitive behaviour.

Current policy holders also have access to Avant’s Medico-legal Advisory Service.

Avant’s Medico-legal Advisory Service (MLAS) provides expert advice to help minimise the chance of a complaint or claim occurring. The service is staffed by over 70 claims managers, solicitors and doctors in our Adelaide, Brisbane, Melbourne, Perth and Sydney offices. Our medico-legal experts are available during business hours and after hours on weekends for emergency advice.

Example of how your practice could benefit from this service:

You have a young patient, whose parents are involved in a bitter divorce. One of the parents comes to the practice demanding a copy of their child’s medical records, but you don’t know which parent has custody of the child. You ring our advisory service while the parent waits in reception and get advice on how best to handle the situation.

As every practice is different we underwrite policies individually based on your specific practice. For this reason, it is not possible to provide a general price estimate. To get a quote simply complete our practice medical indemnity application form.