Insurance Policy Payment Terms: A Detailed Look at What Needs to Be Considered When Signing Up
빛이 없는 길을 걷는 듯해도, 법은 당신이 다시 일어설 수 있도록 돕는 단단한 손잡이입니다.
A Korean medicine practitioner contacted me by phone about an incident involving an 80-year-old patient who fell while undressing for physical therapy on the treatment bed in the acupuncture room. The patient lost balance and hit their head on the floor, leading to a brain hemorrhage.
At the time, the nurse was preparing to assist with the physical therapy by standing beside the bed, and the patient had closed the curtain for privacy before undressing. The accident occurred during this process, and the nurse was unable to act in time as the patient suddenly fell off the bed. The clinic owner, who was providing acupuncture to another patient, was also unable to prevent the fall. The patient was subsequently transferred to a different hospital for further treatment.
Medical Professional's Responsibility
The primary issue in this case is liability. The question arises as to which insurance policy would apply for compensation: the medical malpractice liability insurance (professional liability insurance) or the facility safety management property insurance (comprehensive property insurance).
Insurance adjusters consider that this incident may not be related to the practitioner's medical process but rather to the lack of safety measures on the treatment bed, such as the absence of safety bars. They believe that this accident could have been prevented with appropriate facility management, like installing safety bars or using a safer bed mat. The question then becomes which insurance should be applied in such a situation.
However, the insurance company plans to apply professional liability insurance, which covers the practitioner’s medical malpractice, arguing that the incident occurred due to the practitioner’s failure to ensure the safety of the patient during treatment. They argue that the 80-year-old patient had reduced balance, and the bed was too narrow, which created a higher risk of falling during the process of undressing. The practitioner is being held responsible for not taking necessary precautions, such as instructing the nurse to assist the patient during the process.
Reviewing Property Insurance
In contrast, I believe that the responsibility lies more with the safety of the facility rather than the medical professional’s treatment. To hold the clinic responsible, it is essential to establish that the patient’s fall during undressing was due to inadequate safety measures on the treatment bed, such as the lack of safety bars or the failure to assist the patient properly. This would be considered a failure in facility safety management rather than a medical malpractice issue.
Therefore, I suggested that, in this case, applying comprehensive property insurance for facility safety management would be more appropriate than applying professional liability insurance for medical malpractice. If the insurance company insists on holding the practitioner liable, I recommended limiting their responsibility to 60% of the compensation, considering the patient's age and medical history, and setting the compensation amount at 10 million Korean won as a fair amount.
Careful Examination of Insurance Terms
However, in this case, it is essential to carefully examine the terms and conditions of the insurance policies that the practitioner has signed up for. If the accident falls under both professional liability insurance and comprehensive property insurance coverage, it would be advisable to negotiate and equally divide the compensation between the two policies. Of course, the best approach is to thoroughly review the insurance terms before signing up for coverage in the first place.
Additionally, considering the rising number of falls among elderly patients, people with disabilities, and others at risk, I believe there needs to be a system improvement where safety measures, such as installing safety bars on treatment beds and ensuring the presence of a caregiver, are mandatory before any treatment is provided.
Bucheon Personal Rehabilitation Lawyer 개인회생 상담 신청
끝없는 빚의 터널 속에서도 빛은 있습니다. 개인회생과 파산은 절망이 아닌 희망의 과정입니다. 변호사는 당신의 곁에서 그 길을 열고, 당신이 다시 서도록 돕는 이정표가 되어줄 것입니다.
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