Professional medical & hospital liability: Frequently asked questions
- I received a notice of claim from a patient. What should I do with it?
- Do I need to buy additional liability insurance?
- How much insurance coverage do I have through the university?
- When I leave university employment do I need to purchase tail coverage to cover my liability exposure from clinical activities that occur during my university employment and as part of my university employment?
- Are university physicians covered for activities outside of university facilities?
- Will the university pay for my time lost from work when I have to appear at depositions and trials?
- I am applying for hospital privileges and/or for commercial insurance. The hospital/HMO/insurance company wants to contact my insurer for my claims history. Who should I tell them to contact?
- I am a Professor Emeritus. Am I covered for work I perform at or for the university after I retire?
- What should I do after a serious adverse event?
Immediately upon notice of a claim or the receipt of a summons & complaint, please contact your facility risk manager so they can review the allegations. Depending on the type of allegations, your campus/facility risk management office will forward the claim to the appropriate program for appropriate handling.
If you receive a summons & complaint in a civil action related to your university employment, the following information pertains:
When the regents or university is named as the Defendant: university employees are not authorized to accept a Summons and Complaint on behalf of the regents or university. All attempts to serve must be referred to the Office of the General Counsel. Process Servers may be informed that the General Counsel will accept service of a Summons and Complaint by mail at the following address:
Office of the General Counsel of The Regents
1111 Franklin Street, 8th Floor
Oakland, CA 94607-5200
When the regents or university and Individual Employee are named as Defendants: Individual Employee should accept service on his or her own behalf but make it clear that he or she is not accepting for the regents or university. The Individual should note the time, date of acceptance and how the documents were served (by mail, personal service, or left with someone else). The Process Server should be referred to the Office of the General Counsel regarding service of the regents or university. The employee should immediately notify the Office of the General Counsel about personal acceptance. The phone number for the Office of the General Counsel is (510) 987-9800. The General Counsel's Office will coordinate with the employee the appropriate course of action.
Not for work performed within the course and scope of your university employment.
The university provides defense and indemnification of university employees under the California Tort Claims Act for alleged negligent acts and/or omissions that arise from the performance of activities within the course and scope of university employment. The limits of the self-insured retention program vary annually and excess insurance is purchased.
When I leave university employment do I need to purchase tail coverage to cover my liability exposure from clinical activities that occur during my university employment and as part of my university employment?
No. The university defense and indemnification is occurrence based and tail insurance is not required to cover potential liability exposure arising out of university employment activities.
Physicians, surgeons, and dentists are covered for medical malpractice for all licensed professional activities of a medical nature wherever performed so long as those activities are performed within the course and scope of university employment. Business and Finance Bulletin (BUS-9) provides examples of approval and documentation required to demonstrate the activities conducted were done within the course and scope of university employment.
Interns, residents, and fellows are only covered for activities performed within the scope of their formal program and approved affiliations. This specifically excludes coverage for "moonlighting."
The university does not provide compensation through the Professional Medical & Hospital Liability program for time away from clinic/work that is required for participation in depositions and/or trials. The university will pay travel expenses for former employees to appear at depositions and trials, however, expenses will reimbursed in accord with the university's travel policy.
Requests for claims history for UC employed physicians and dentists should be directed to the risk manager of the UC medical facility where you are currently or were last employed.
It depends on whether or not the work is performed within the course and scope of a "recall" appointment. The title "Professor Emeritus" is an honorary title provided to certain retirees and does not, by itself, entitle the retiree to benefits of employment, such as university defense and indemnification. If services are to be provided to the university, the individual must have a recall appointment to be eligible for defense and indemnification of allegedly negligent acts and/or omissions arising out of the course and scope of such work.
When a serious adverse event occurs, sincere sympathy and compassion expressed to the patient and/or family is often the most important response to help diffuse a potentially volatile situation. These are very emotional circumstances and the patient/family will want to know what happened. Often the facts of the event are not fully known immediately after such an event. The health care team should refrain from making derogatory or accusatory remarks about the care and immediately begin the following positive measures:
Assess the situation and communicate with the patient and family:
- Contact the institutional risk manager and complete any institutional reporting requirements (potential claim, medical device failure, etc.) if indicated.
- Determine who from the health care team will discuss the event, with whom (the patient and/or responsible family member), and when.
- Identify the factual information about the event and ascertain if there is consensus among team members.
- Identify how the details of the event, the outcome, and the treatment plan will be explained.
- Maintain contact with each other and the patient/family for questions. Repeated requests for an explanation of the event are a common reaction of angry or anxious patients and family members.
- Organize a family meeting if several relatives are involved in the patient's care or if treatment decisions are complicated.
- Empathize with the patient and family; offer emotional support. If appropriate, apologize for the patient's distress, without admitting liability and without making guarantees or promises regarding compensation for care.
- Accept responsibility for follow up of serious complaints, but do not accept or assign blame, or criticize the care or response of other providers.
The medical record:
- Review the medical record to ensure that the record accurately reflects the factual events and any follow-up needed or done as a result of the incident.
- Do not alter or obliterate prior written entries. If appropriate to accurately reflect the factual events, add a late entry as the next entry in the medical record by labeling it, "Late Entry" and dating/timing the late entry.
- Avoid writing in the record any information unrelated to the care of the patient (e.g., "incident report filed," "legal office notified"). DO NOT INCLUDE COPIES OF INCIDENT REPORTS OR PEER REVIEW DOCUMENTS IN THE MEDICAL RECORD.