How a botched surgery cost two doctors ₹28.5 Lakhs

In March 2010, a woman from Dombivali Mumbai, sought relief from severe body ache and exhaustion. She subsequently contacted two doctors for her treatment.
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Little did she know she was about to be pulled into a decade-long legal battle.

She alleged that the doctors performed surgery on her without her permission and without explaining the risks involved. Moreover, the surgery led to permanent damage to both of her ureters.
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In 2012, she filed a complaint against the two doctors with the State Consumer Disputes Redressal Commission.

Her complaint further stated that she had to get another surgical procedure with a different doctor a year later.
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The second surgery revealed that the damage to her ureters could only have occurred due to incompetence and negligence on the part of both doctors.

Claims of professional negligence are quite common across many professions.
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For this reason, professionals like doctors, lawyers, consultants, and other service providers opt for a special kind of insurance policy - Professional Indemnity Insurance.

Also known as Errors and Omissions, this insurance covers a service business or a professional.
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It indemnifies them against claims of gross misconduct, wrongdoing, or negligence made against them. This insurance covers the legal defence costs of the insured and any damages or compensation that they may be required to pay as per court decisions.
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In this case, the Commission ruled in favor of the woman last week and ordered the two doctors to pay ₹28.5 Lakhs along with a penal interest of 12% per annum if the doctors failed to make the payment within a month.
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On their part, the doctors claimed that they were cleared by the Maharashtra Medical Council and the National Medical Council, Delhi, and that there was no medical negligence.

They might decide to appeal the Commission’s judgement in a higher court.
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But for now, this decision comes as a huge relief to the woman who had waited over 10 years for justice.

What are your thoughts on this? Tell us in the comments.

Get more such insurance snapshots here : insights.verak.in
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#India #insurance #verakinsights

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More from @VerakInsurance

11 Sep
How were army veterans in New Delhi cheated out of Crores?

The Army Group Insurance Fund (AGIF) was established in 1981 for providing Life Insurance cover to retired army personnel. It also comes with a medical benefit and a deposit scheme for deceased personnel’s family.
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But recently, the fund was targeted by a group of insurance fraudsters.

The group’s modus operandi involved reaching out to army veterans and claiming to help them receive monetary benefits from the fund.
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They guaranteed army pensioners and next of kin large amounts of money as outstanding maturities and bonus from the AGIF, and subsequently demanded an upfront payment of 30-40k as “processing fees” for releasing the amounts.
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Happy Ganesh Chaturthi!

Ganesh Chaturthi is one of the most celebrated festivals across India. Each year the festivities span over 10 days and involve expensive Ganpati idols inside mandals laden with heavy gold ornaments.
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In fact, business skyrockets for insurance companies during these 10 days.
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They end up insuring over 100 big and small mandals for amounts ranging anywhere from ₹1 Lakh to a whopping ₹300 Crore.

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The problem was, insurance companies usually keep coverage for mental illness outside the purview of Health and Life Insurance policies. This has long been a point of contention, even though the 2017 Mental Healthcare Act expanded insurance coverage to mental illness.
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Is your age the only determinant of your #HealthInsurance premium?

#Premiums refer to the payment that you make to your insurance company so that they can take care of your medical expenses.

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The actual amount depends on how likely you are to require a payout in the future and how much your insurer might have to pay in such an event.

There are various factors that affect this amount:

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1) Your age: Health Insurance costs less in your youth. The older you get, the more likely you are to develop certain diseases- and so your premiums are higher.

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1) Hospitalisation, as well as pre and post-hospitalization expense
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Why are room rent caps such a big deal?

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Example- Mohan's health policy has a Sum Insured of ₹5 Lakhs and the Sub-Limit for hospital room rent is 1%. If Mohan is hospitalized, his insurer will only cover room rent costs up to ₹5000 per day (1% of ₹5 Lakhs).

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If his room costs more than that, he’ll have to pay the difference himself. You may think that doesn’t sound so bad. He'd probably have to shell out a few extra thousands at most, right?

Wrong

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