What the policy covers:
Broadly, NZMPI’s policies provide cover for the following:
- The Insured’s legal liability arising out of the performance of the Insured’s medical duties or functions. In most cases this would cover for example awards of exemplary
damages, or damages awards made by the Human Rights Review Tribunal.
- The costs of legal advice and representation incurred in defending any indemnity claim, or any investigation, inquiry of proceeding arising out of the performance of the Insured’s medical duties or functions. This would cover, for example, the costs of legal representation before the HDC, the Health Practitioners Disciplinary Tribunal, the
Medical Council, ACC, and before a coroner.
- The reasonable costs of travel and accommodation incurred, and loss of earnings suffered, by the Insured by reason of the Insured having to attend any investigation, inquiry or proceeding, (to a maximum of $1,000 per day, or $15,000 in all).
- Reimbursement of an order for costs made against the Insured by any court or tribunal, (to a maximum of $20,000).
- Reimbursement of monies payable pursuant to a settlement agreement entered into by the Insured with the consent of NZMPI, in respect of a claim covered by the policy, to a maximum of $100,000.
- The policy also provides cover for the cost of legal advice and representation in responding to or defending any criminal investigation or proceeding arising out of the good faith performance of the Insured’s medical duties or functions. However this cover is subject to an important qualification. If it should be discovered subsequently (for example, upon conviction of the Insured) that the claim was brought about “by the dishonest fraudulent criminal malicious deceitful or willful act or omission or conduct of
the Insured”, then NZMPI is entitled to recover from the Insured the sums it has expended in providing legal advice and representation. The right to “claw-back” monies
expended in advising and representing the Insured, does not apply in the case of a manslaughter conviction.
What the policy does not cover:
It is important to understand what the policy does not cover. These exclusions and limitations
are set out in the policy wording. They include:
- Any claim or liability arising out of an employment relationship, (for example a disciplinary process or a disciplinary sanction such as dismissal, which results from a
patient complaint or an adverse event).
- Any liability on the part of the Insured to pay any fine, penalty or tax.
- Any obligation to refund professional fees.
- Any claim brought about by a material failure to comply (without reasonable justification) with the MCNZ publication Sexual Boundaries in the Doctor/Patient
Relationship – A Resource for Doctors.
These are certain obligations upon a practitioner making a claim under the policy. Most importantly, the Insured is obliged to provide NZMPI with immediate written notice of any claim, or of any circumstances which could reasonably be expected to give rise to a claim. Furthermore, the Insured is obliged to disclose voluntarily to NZMPI all information relevant to any claim, and not to provide information which is false or misleading. In cases of non-compliance with these conditions, the Insured’s cover is likely to be compromised. In cases of serious non-compliance, cover could be declined or withdrawn.
If you have further questions about what our policies cover or would like to request a copy of our policy wording, please contact us on 0800 102 220 or email us at email@example.com.