PLI Claim No fica on Guide

Transcription

1 PLI Claim No fica on Guide 2nd November 2016

2 PLI Claims No fica on Guide Contents Introduc on... 3 Triggers for Claim No fica on... 3 Scope of Prac ce. 5 Members Obliga ons. 5 Important Note... 5 Claims Process.. 6 Responding to Claimants.. 8 Contact Details. 9 Guidance for Comple ng the Claim Form. 10 Detailing of Treatments or Advice

3 Introduc on Any claim or incident that challenges the professional integrity of CSP Members creates stress and anxiety for the Members concerned. Following these simple guidelines will ensure that expert help is engaged at an early stage of the proceedings. This is a guide to the procedures for claims no fica on only. It is not intended to be exhaus ve and does not in any way alter the Terms and Condi ons of the Medical Professional Liability Policy or the Public Liability Policy. In the event of any conflict, the Terms and Condi ons of the CSPs Medical Professional Liability Policy and/or the Public Liability Policy will take precedence over the guide to the procedures for claims no fica on. Triggers for Claim No fica on It is a requirement of the policy that you no fy Insurers as soon as possible of any actual or poten al claim, circumstances or incidents that may reasonably be expected to give rise to a claim. You should seek the advice of the CSP brokers if you are unsure whether to report an incident or not. 3

4 The following list is illustra ve, but not exhaus ve, of the types of incidents and events that require no fica on by Members as soon as possible under the PLI scheme. No fiable Claims No fiable Circumstances Any Le er from a pa ent/client or their legal representa ves informing you that legal proceedings have been commenced against you Any Le er from a pa ent, client, or their legal representa ves sta ng that legal proceedings are intended against you Any indica on that the pa ent intends to pursue enquiries which may lead to a poten al claim for inappropriate treatment or advice Any formal le er of claim rela ng to the treatment or advice given Any adverse incident which has resulted in personal injury or property damage Le er from a pa ent, solicitor (or other legal representa ve ac ng on the pa ent s behalf) reques ng you to release your pa ent s records for inves ga on, Coroners verdict on a deceased pa ent where the verdict suggests some lack of care or other failings in care A pa ent withholding fees due, on clinical grounds e.g. alleged failure to diagnose, misdiagnosis, inappropriate treatment or failure to refer on Formal pa ent complaint on any aspect of the care provided by you Publica on by a third party (e.g. a newspaper) of allega ons about standards of care given by you Where you are aware of any adverse incident that could give rise to a claim e.g. falls, personal injury, burns from electrotherapy devices, damage to third party property etc. or other adverse incident No fica on from the HCPC that a complaint has been received where pa ent harm is alleged or suspected Where an inves ga on into an adverse incident is required as part of your statutory or professional Duty of Candour requirements. If a Member is unsure whether an incident or circumstance should be reported, please contact the CSP s insurance brokers with as much informa on as possible. 4

5 Scope of Prac ce If you are unsure whether an ac vity or modality is within the overall scope of the profession, please contact the CSP on The CSP insurance scheme does not cover ac vi es that are considered to be outside the scope of physiotherapy prac ce. Members Obliga ons There is a requirement under the insurance scheme for Members to act quickly and no fy insurers via the CSP immediately they become aware of a claim or of an adverse incident which may give rise to a claim. Failure to do so may prejudice Members Rights under the policies. Important Note It is not possible to register poten al claims with insurers unless the claims process on the following pages are followed. Failure to register circumstances which might lead to poten al claims, or the repor ng of actual claims as soon as prac cably possible may prejudice members rights to cover. 5

6 Claims Process Members should ini ally contact the CSP s Enquiry Handling Unit preferably by on enquiries@csp.org.uk or by post to the Enquiry Handling Unit Chartered Society of Physiotherapy 14 Bedford Row London WC1R 4ED or by telephone on If the no fica on involves a claim under the CSP insurance scheme, details will be passed to the CSP s Insurance Brokers for the following ac on:- The brokers will send the Member an acknowledgement enclosing a claim form for comple on and a copy of these guidance notes The completed claim form should be returned to the CSP s brokers at the following address:- Graybrook Insurance Brokers Limited 8 Chandlers Way South Woodham Ferrers Chelmsford Essex CM3 5TB Or by to enquiry@graybrook.co.uk For assistance in any aspect of the no fica on, please speak to one of the broker s professional advisors on

7 Claims Process (con nued) The claim form should be returned with as much informa on as possible including:- Copies of all correspondence including s Contracts of Employment/Terms of Engagement where applicable Notes of any telephone conversa ons, text messages etc. The brokers will submit a copy of the claim form to the CSP for verifica on of Membership and Scope of Prac ce The brokers will confirm HCPC Registra on (and any other regulatory obliga ons where treatments were undertaken outside of the United Kingdom) Subject to sa sfactory replies, all documents will then be submi ed to the relevant insurer, for registering as a poten al claim under the MPLC Limited Medical Malprac ce policy or Travelers Insurance Co. Ltd. Public Liability policy. The insurer s own Medico Legal Team or Kennedys Solicitors on behalf of the MPLC will then be engaged to manage the claim direct with the Member un l finalised or closed. It should be noted that the CSP are not involved with the management of the claims process other than ini al verifica on of Membership and Scope of Prac ce. The majority of allega ons received by Members are unfounded, but the process of resolving the various issues and establishing whether or not negligence has taken place, can be a long and slow process. 7

8 Responding to Claimants The Ministry of Jus ce governs the process of all Civil Proceedings in England. The procedure is governed by the Civil Procedures Rules: h ps:// ce.gov.uk/courts/procedure-rules The process for managing clinical disputes is covered in the Pre-ac on Protocol for the Resolu on of Clinical Disputes and can be found at h ps:// ce.gov.uk/courts/procedure-rules/civil/protocol/prot_rcd Once you have received no fica on from the pa ent or their solicitor that proceedings have started, you must act within defined me frames. The CSP s insurance brokers and/or the underwriters or solicitors ac ng on their behalf, will advise you what to do. You should not enter into correspondence with the claimant or their solicitors once insurers have been no fied apart from:- Acknowledging receipt of any correspondence received Informing the claimant or their legal representa ves that your insurers have been no fied of the ma er Providing the contact details of your insurers or the CSP s insurance brokers so that all future correspondence can be directed to them and not yourself Providing copies of clinical records to solicitors if wri en consent is provided to you by the pa ent Invoicing for the cost of releasing clinical records where appropriate The Member should not at this stage discuss with any party (other than the claims team) the treatment or advice given, nor on any allega ons made, or provide any offer of compensa on, or make any admission of liability without the insurers consent. 8

9 Contact Details CSP Insurance Brokers The Chartered Society of Physiotherapy Graybrook Insurance Brokers Limited 8 Chandlers Way South Woodham Ferrers Chelmsford Essex CM3 5TB enquiry@graybrook.co.uk Enquiry Handling Unit Chartered Society of Physiotherapy 14 Bedford Row London WC1R 4ED enquiries@csp.org.uk Telephone: Telephone: Medical & Professional Indemnity Insurers The MPLC Claim Solicitors The MPLC Limited Regal House Queensway P.O. Box 1446 Gibraltar info@the-mplc.com Kennedys Solicitors 25 Fenchurch Avenue London EC3M 5AD Telephone: Telephone: Public Liability Insurers Travelers Insurance Co. Ltd London Road Redhill Surrey RH1 1NA ukcall@travelers.com Telephone:

10 Guidance for Comple ng the Claim Form Failure to complete the claim form correctly may result in delays in processing your claim and may result in the forms being returned to you for correc on. On comple ng the claim form please follow these simple rules:- Use block capitals or type your form Write legibly Complete all sec ons Do not leave blanks write N/A or N/K if unable to complete the informa on Include all addresses where asked for all par es named in the form Enclose all Employment Contracts or other Contracts rela ng to your Terms of Engagement Enclose copies of all correspondence from the claimant and/or their solicitors Enclose a copy of the pa ent s wri en consent where received to release records to third par es Enclose copies of all informa on and advice sheets given to pa ents Do not use terms such as see notes enclosed or see enclosed documents or see a ached. Forms completed using these terms will be returned to you for amendment If the claim involves equipment, you should also no fy the MHRA (please see their website ) h ps:// The Underwriters and their Solicitors will use the contents of your claim form to process your claim. 10

11 Detailing of Treatments or Advice The CSP is not able to receive and process any clinical records which may be a ached to the claim, therefore, the details of your assessment, treatment and advice must be clearly stated on the Claim Form. You may describe the treatment/advice given in any manner you feel appropriate, however, you may find it helpful to consider the four pillars of physiotherapy prac ce and describe your treatment/advice accordingly. The pillars of physiotherapy prac ce are:- Massage covering all forms of massage and so ssue handling techniques Exercise and Manual Therapy including all forms of exercise prescrip on (with or without equipment) and manual treatments encompassing mobilisa on and manipula on to the body structures (with or without equipment) Electrotherapy use of any electro-physical agent Kindred Treatments other modali es or interven ons for example but not limited to acupuncture, injec on therapy, prescribing ac ons, cogni ve modali es and other means used to deliver physiotherapy You are also asked to detail any products supplied and advice given:- Products describe any taping, strapping, support, splint, brace, cast, sling, bandage or dressings etc. given or used Advice describe what the advice related to: it might be advice rela ng to a pillar of prac ce, a product or something else determined by assessment e.g. workplace or lifestyle advice. If you gave an advice or exercise sheet, state the date and version of the document given to the claimant on the form and enclose a copy of the document for the insurer s records. 11