MEDICAL MALPRACTICE PUBLIC LIABILITY AND ERRORS AND OMISSIONS INSURANCE FOR HEALTHCARE ORGANISATIONS

Transcription

1 MEDICAL MALPRACTICE PUBLIC LIABILITY AND ERRORS AND OMISSIONS INSURANCE FOR HEALTHCARE ORGANISATIONS

2 PROFESSIONAL INDEMNITY MASTER POLICY FOR MEDICAL PROFESSIONALS POLICY NO. FCO46345N SCHEDULE Insured Namibian Society of Physiotherapy Address PO Box Windhoek Professional Services Medical Malpractice, Errors and Omissions and Public Liability Period of Insurance From: 01/07/2014 To: 30/06/2015 Both days included Limit of Indemnity: Medical Malpractice: Public Liability: Deductible: Medical Malpractice: N$ 10,000, in the Annual Aggregate N$ 5,000, in the Annual Aggregate Private Practitioner: N$ 2, each and every claim except in respect of claim for dry needling where the deductible will be N$ 5, each and every claim Public Employee Physiotherapists: N$ 1, each and every claim Public Liability: Extensions N$ 1, each and every claim Limit for Criminal or Disciplinary Hearing Costs: N$ 250, in the Annual Aggregate Excess: N$ 1, each and every claim Retroactive Date 01/01/2001 Premium VAT N$ 81, N$ 12, Namifisa Levy N$ Stamp Duty N$ Total Premium N$ 94, Broker Commission 15% included in the premium Insurer Western National Insurance Broker Aon Windhoek Claims Notification SUBJECT TO THE CERTIFICATE WORDING ATTACHED In the event of non-payment of premium or if any debit order is rejected, subject to the provisions of the Financial Advisory and Intermediary Services Act No. 37 of 2002 and the Short-Term Insurance Act No.53 of 1998, the insurance in terms of the Certificate shall be of no force and effect. Issued at Windhoek this 16 th day of September 2014 Authorised Signatory Page 2

3 ENDORSEMENT TO CERTIFICATE NUMBER: FCO46345N CLAIMS WARRANTY It is hereby warranted that the Insured is not aware of any claims or circumstances that might be likely to give rise to a claim under this policy as at the 18 August 2014 (client s NMCD signed) Page 3

4 STATUTORY NOTICE TO SHORT-TERM INSURANCE POLICYHOLDERS IMPORTANT - PLEASE READ CAREFULLY - DISCLOSURE AND OTHER LEGAL REQUIREMENTS (This notice does not form part of the Insurance Contract or any other document) As a short-term insurance policyholder, or prospective policyholder, you have the right to the following information: 1. ABOUT THE INTERMEDIARY (INSURANCE BROKER) (a) Western Direct Ballot Street Western Square Windhoek (b) Amount of fees and commission payable pertaining to the secondary cover is as stated in the schedule 2. ABOUT THE INSURER (a) (Namibia) Physical Address : 1 st Floor, Western Square, Ballot Street, Windhoek Postal Address : P O Box 31366, Windhoek Telephone Number : (+264) Facsimile : (+264) (b) Claims may be instituted either telephonically or in writing directly to the Insurer. (c) Type of policy involved : Buildings Combined, Home Owners, Motor, Public Liability,. (d) Extent of premium obligations you assume as policyholder pertaining to the secondary cover is as stated in the schedule (e) Premiums and your monetary obligations: You agree to pay the premium. The amount of premium due, the frequency and date on which payment is due are contained in the schedule. If you do not pay the premium within15 days of the due date cover will be cancelled from midnight on the day before the due date. Where premium is payable monthly by bank debit order or by transmission account this 15 day extension only applies from the second month after our policy is issued. 3. OTHER MATTERS OF IMPORTANCE (a) You must be informed of any material changes to the information referred to in paragraph 1 and 2. (b) If the information in paragraphs 1 & 2 was given orally, it must be confirmed in writing within 30 days. (c) If any complaint to the intermediary or insurer is not resolved to your satisfaction, you may submit the complaint to the Namibian Institutions Supervisory Authority. (d) Polygraph or any lie detector test is not obligatory in the event of a claim and the failure thereof may not be the sole reason for repudiating a claim. (e) If the premium is paid by debit order: (i) it may only be in favour of one person and may not be transferred without your approval; and (ii) the insurer must inform you at least 3 days before the cancellation thereof, in writing, of its intention to cancel such debit order. (f) The insurer and not the intermediary must give reasons for repudiating your claim. (g) Your insurer may not cancel your insurance merely by informing your intermediary. There is an obligation to make sure the notice has been sent to you. (h) You are entitled to a copy of the policy free of charge. 4. WARNING Do not sign any blank or partially completed application form. Complete all forms in ink. Keep all documents handed to you. Make note as to what is said to you. Don't be pressured to buy the product. Incorrect or non-disclosure by you of relevant facts may influence an insurer on any claims arising from your contract of insurance. 5. PARTICULARS OF THE NAMBIA FINANCIAL INSTITUTIONS SUPERVISORY AUTHORITY WHO IS AVAILABLE TO ADVISE YOU IN THE EVENT OF CLAIM PROBLEMS, WHICH ARE NOT SATISFACTORILY RESOLVED BY THE INSURANCE INTERMEDIARY AND/ OR THE INSURER P.O.BOX 21250, Windhoek Tel : Fax : Page 4

5 Lloyd's Insurance This Insurance is effected with certain Underwriters at Lloyd's, London. This Certificate is issued in accordance with the authorisation granted to the Coverholder by certain Underwriters at Lloyd's (hereinafter called 'Underwriters'), whose syndicate numbers and the proportions underwritten by them can be ascertained from the offices of said Coverholder and in consideration of the premium specified herein, Underwriters do hereby bind themselves, severally and not jointly, each for his own part and not one for another, their Executors and Administrators. The Coverholder referred to herein is General & Professional Liability Acceptances (Pty) Ltd whose contact details appear at the end of this Certificate. The Insured is requested to read this Certificate, and if not correct, return it immediately to the Coverholder for appropriate alteration. In the event of a claim under this Certificate, please notify the Coverholder who is acting as the agent of Underwriters. CERTIFICATE PROVISIONS 1. Service of Suit. In the event of any litigation arising out of insurance assumed hereunder, Lloyd s South Africa (Pty) Ltd., The Forum, 15 th Floor, 2 Maude Street, Sandton 2196, South Africa, is required, in terms of the Short-Term Insurance Act No 53 of 1998, to accept service of suit against Underwriters. 2. Assignment. This Certificate shall not be assigned either in whole or in part without the written consent of the Coverholder endorsed hereon. 3. Complaints. If you have any complaints concerning your insurance, please contact the Coverholder. 4. Attached Conditions Incorporated. This Certificate is issued and accepted subject to all the provisions, conditions and warranties set forth herein, attached or endorsed, all of which are to be considered incorporated herein including the Schedule to the Certificate It is understood and agreed that wherever the words Insured/Company appear herein the same shall be deemed to read Insured/Underwriters respectively. This Insurance shall be governed by the laws of the Republic of Namibia, whose courts shall have jurisdiction in any dispute arising hereunder. Page 5

6 INSURING CLAUSE MEDICAL MALPRACTICE, PUBLIC LIABILITY & ERRORS AND OMISSIONS INSURANCE THIS IS A CLAIMS MADE AGGREGATE CERTIFICATE (WITH DEFENCE COSTS INCLUDED WITHIN THE LIMITS OF INDEMNITY) 1. WHEREAS the Insured, as defined herein, has made to Underwriters a written Proposal or Declaration bearing the date stated in the Schedule, a copy of which is attached containing particulars and statements which are hereby agreed to be the basis of this Certificate and are to be considered as incorporated herein, and the Premium (as stated in the Schedule) being received by Underwriters. 2. WE, THE UNDERWRITERS, to the extent and in the manner hereinafter provided, and subject to the Terms and Conditions of this Certificate HEREBY AGREE to Indemnify the Insured for Claims made against the Insured during the Period of this Insurance against all sums which the Insured shall become legally liable to pay as damages in accordance with the law of any country BUT NOT in respect of any judgment award or settlement made within countries which operate under the laws of the United States of America or Canada (or any order made anywhere in the world to enforce such judgment, award or settlement either in whole or in part), unless the Insured has requested that there shall be no such limitation and has accepted the terms offered by Underwriters in granting such cover which offer and acceptance must be signified by specific endorsement (including any reinstatement provision) to this Certificate, arising out of (i) MALPRACTICE (if included in the Schedule to the Certificate) Any bodily injury, mental injury, illness, disease or death of any patient caused by any negligent act, error or omission committed by the Insured in or about the conduct of the Insured's Occupation or business as stated in the Schedule, or Good Samaritan Acts, (hereinafter referred to as "Malpractice") (ii) PUBLIC LIABILITY (if included in the Schedule to the Certificate) Any bodily injury, mental injury, illness, disease or death of or to any person, or loss of or damage to tangible property of any person in connection with the Insured's occupation or business as stated in the Schedule, including the provision of food and drink, (hereinafter referred to as "Public Liability") (iii) ERRORS AND OMISSIONS (if included in the Schedule to the Certificate) Financial loss to third parties caused by any negligent act, error or omission committed by the Insured in or about the conduct of their occupation or business as stated in the Schedule and arising directly or indirectly out of a breach of duty owed to a patient. (Hereinafter referred to as Errors and Omissions ) And pay all Defence Costs incurred with Underwriters' consent, such consent not being unreasonably withheld, in connection with any Claim which falls within this Certificate, provided that the total amount payable in respect of damages and Defence Costs shall not exceed the Limits of Indemnity as stated in the Schedule; 3. IT IS FURTHER provided that Underwriters shall not be obligated to pay any Claim, judgment, award, Defence Costs, or to undertake or continue the defence of any suit or proceeding after the Limit(s) of Indemnity have been exhausted by payment or agreement to pay, any Claim, judgment, award, settlement and Defence Costs, or after deposit of the applicable Limit(s) of Indemnity in a court of competent jurisdiction, and that in such a case Underwriters shall have the right to withdraw from the further defence thereof by tendering control of said defence to the Insured, subject however to any reinstatement conditions which may be endorsed to this Certificate. PROVIDED ALWAYS THAT: (a) (b) Such Malpractice, Public Liability or Errors and Omissions results in a Claim being first made against the Insured during the Period of Insurance as stated in the Schedule and of which notice has been given in accordance with General Condition 2 (I) There shall be no indemnity hereunder for any Claim made against the Insured for Malpractice committed prior to the Retroactive Date specified in the Schedule (ii) There shall be no indemnity hereunder for any Claim made against the Insured for Public Liability, or separate allegations arising out of the same event, which happened prior to the Retroactive Date specified in the Schedule (iii) There shall be no indemnity hereunder for any Claim made against the Insured for Errors and Omissions committed prior to the Retroactive Date specified in the Schedule (iv) For the purpose of determining the Limit of Indemnity and Excess applicable, any Claim which is based upon combined allegations of Malpractice, Public Liability and/or Errors and Omissions, or separate allegations arising out of the same event, shall be dealt with as though it were a Claim arising out of Malpractice as defined in clause 2(i) and is limited to the sum specified in the Schedule for Malpractice. Page 6

7 DEFINITIONS (i) (a) (b) (c) The expression "the Insured" shall be deemed to mean: The Party (ies) named in the Schedule; Any employee or other party for whom the Insured is responsible, but only in respect of work performed by the employee or other party on behalf of the Insured; The personal representatives of the estate of any person who would otherwise be indemnified under this Certificate. (ii) The expression "Good Samaritan Act" shall mean treatment administered at the scene of a medical emergency, accident or disaster by the Insured who is present either by chance, or in response to a S.O.S. call following a disaster. (iii) The expression "Claim" shall mean any event or series of events arising from one originating cause and for which the Insured is required to give notice to Underwriters in accordance with General Condition 2. (iv) The expression "Defence Costs" shall mean all costs, fees and expenses (including representation at Coroners Inquest) incurred in the defence or settlement of any Claim. (v) The expression "Products" shall mean any solid, liquid or gaseous substance or component part thereof. (vi) The expression "Period of Insurance" shall mean the period as stated in the Schedule. (vii) The expression Schedule means Schedule to the Certificate (viii) Except where the context otherwise requires, words denoting the singular include the plural and vice versa; words denoting any gender include both genders. EXCLUSIONS UNDERWRITERS shall not be liable for: (i) (ii) (iii) Any Claim arising out of any Malpractice or Public Liability or Errors and Omissions occurring prior to the inception date of this Certificate if the Insured on such date knew or could have reasonably foreseen that such Malpractice or Public Liability or Errors and Omissions might be expected to be the basis of a Claim Any Claim arising from any circumstance or occurrence, which has been notified, to any Medical Defence Organisation and/or Insurer prior to the inception of this Certificate Any Claim which is the subject of Insurance Indemnity or Assistance provided by any Medical Defence Organisation. This Certificate shall not be drawn into contribution thereto. (iv) Any claim arising out of a specific liability assumed by the Insured under contract which goes beyond the duty to use such skill and care as is usual in the exercise of the Insured's activities stated in the Proposal Form unless Underwriters' prior agreement has been obtained and such specific liability is endorsed upon this Certificate with the acceptance of such other Terms and Conditions as may be imposed (v) Any Claim arising out of the manufacture of any Products, or the construction, alteration, repair, repackaging, servicing, or treating of any Products sold, supplied or distributed by the Insured, or any Claim arising out of the failure of any product to fulfil the purpose for which it was designed, or to perform as specified, warranted or guaranteed. This exclusion however does not apply to the compounding, manipulation, preparation or packaging of any medicine undertaken in terms of the Scope of Practice as defined in the act(s) governing the dispensing of medications by doctors or pharmacists, if licensed to do so. Nor does this exclusion apply to medical products sold, supplied or distributed but not manufactured by the Insured (vi) Any Claim made against any Director or Officer or Employee of the Insured, arising from any unlawful or negligent act, error or omission, actual or alleged breach of trust, breach of warranty of authority or breach of duty committed or attempted by such Director or Officer or Employee where such Claim is made solely by reason of his holding the position of Director or Officer or Employee of any Company and having acted in that capacity (vii) Any Claim by any person for bodily injury, mental injury, disease or death incurred, contracted or occurring while under a contract of service or apprenticeship with the Insured, or for any breach of any obligation owed by the Insured as an employer to any employee, or any Claim in respect of which compensation is available under any Workers' Compensation Scheme and or similar legislation. However, this Exclusion shall not apply to any Claim arising out of any bodily injury, mental injury or death of an employee, which is caused, by any negligent act, error or omission of an Insured, where the employee is a patient of the Insured. (viii) Any Errors and Omissions Claims arising from any professional services rendered which are not in the conduct of the Insured's business or occupation as a provider of Healthcare Services, unless stated in the Schedule (ix) Any Errors and Omissions Claims arising from or brought against the Insured by a company in which the Insured has a controlling interest unless the original Claim emanates from an independent third party (x) Any Cross Liabilities which shall be deemed to mean Claims made against any Insured party by any other Insured party (xi) Any Claims arising out of or directly or indirectly from the insolvency or bankruptcy of the Insured (xii) Any Claims arising out of Infringement of Copyright, Registered Designs, Trade Marks or Passing Off or any Infringement of any Data Protection Act (xiii) Any Claim directly or indirectly caused by or contributed to by: (a) (b) (c) Any act in violation of any law or ordinance Any dishonest, fraudulent or criminal act of the Insured The performance of the activities of the Insured whilst under the influence of intoxicants or narcotics excluding Page 7

8 medication prescribed and/or administered by a properly qualified doctor as well as any over the counter drugs which are being taken at the time for recognised medical complaints or conditions (xiv) Any Claim directly or indirectly caused by, or contributed to by, or arising from ionising radiation(s) or contamination by radioactivity from any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel or from the radioactive, toxic, explosive or other hazardous properties of any explosive nuclear assembly or nuclear component thereof (xv) Any loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, resulting from or in connection with any of the following regardless of any other cause or event contributing concurrently or in any other sequence to the loss: (a) (b) War, invasion, acts of foreign enemies, hostilities or warlike operations (whether war be declared or not), civil war, rebellion, revolution, insurrection, civil commotion assuming the proportions of or amounting to an uprising, military or usurped power; or Any act of terrorism. For the purpose of this exclusion an act of terrorism means an act, including but not limited to the use of force or violence and/or the threat thereof, of any person or group(s) of persons, whether acting alone or on behalf of or in connection with any organisation(s) or government(s), committed for political, religious, ideological or similar purposes including the intention to influence any government and/or to put the public, or any section of the public, in fear. This also excludes loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, resulting from or in connection with any action taken in controlling, preventing, suppressing or in any way relating to (a) and/or (b) above. If the Underwriters allege that by reason of this exclusion, any loss, damage, cost or expense is not covered by this insurance the burden of proving the contrary shall be upon the Insured. In the event any portion of this exclusion is found to be invalid or unenforceable, the remainder shall remain in full force and effect. (xvi) Any Claim arising from the ownership, possession or use by or on behalf of the Insured of any motor vehicle or trailer for which compulsory insurance is required by law, other than Claims arising from damage to any motor vehicle or trailer temporarily in the Insured's custody or control for the purpose of parking (xvii) Any Claim arising from the ownership, possession or use by or on behalf of the Insured of any aircraft, watercraft or hovercraft, other than Malpractice arising from the emergency transportation of any patient accompanied by the Insured (xviii) Any Claim arising from damage to property owned, leased or hired or under hire purchase or on loan to the Insured or otherwise in the Insured's care, custody or control other than clothing or personal effects, except where such clothing or personal effects have been left unattended. (xix) Any Claim arising from: (a) Personal injury or bodily injury or loss of or damage to, or loss of the use of property directly or indirectly caused by seepage, subsidence pollution or contamination (b) The cost of removing nullifying or cleaning-up seeping, polluting or contaminating substances (xx) Any Claim arising directly or indirectly out of asbestosis or silicosis or other fibrosis of the lungs or any other illness or disease related to infection of the respiratory system following continuous or continual inhalation or ingestion or any substance or other illness or disease (xxi) Any fines, penalties, punitive or exemplary damages (xxii) The Excesses stated in the Schedule, except that this Exclusion shall not apply in respect of Defence Costs incurred with Underwriter's written consent. Sanction Limitation and Exclusion Clause The Insurer shall not provide cover nor be liable to pay any claim or provide any benefit hereunder to the extent that the provision of such cover, payment of such claim or provision of such benefit would expose the insurer or any member of the insurer s group to any sanction, prohibition or restriction under United Nations resolutions or the trade or economic sanctions, laws or regulations of any country Birthing, Maternity and Obstetrics Exclusion The Company shall not be liable for any Claim arising from birthing, obstetrics, and maternity. DEFINITION: For the purposes of the policy, the definition of maternity/obstetric includes any claim which relates directly or indirectly to the medical care of pregnancy, newborn children, childbirth or the care of the mother after the birth, together with any treatment which is incidental to or as a consequence of such treatment. The definition of maternity /obstetric includes but it not limited to: ante-natal care or treatment (including radiology and pathology), birth by any delivery method, midwifery, neonatal treatment including subsequent treatment in CU or similar unit. The definition applies to treatment or care given to mother and/or baby and extends to include claims by family or dependants. Where a claim arises partly from maternity/obstetrics and partly from some other cause, the higher excess shall apply to the whole of the claim Page 8

9 GENERAL CONDITIONS General Conditions 1, 2, 3 and 4, are conditions precedent to the right of the Insured to be defended or indemnified under this Insurance. It is understood and agreed that: 1. (a) all statements, particulars and documents referred to or contained in the Proposal hereto are true, and (b) During the Period of Insurance the Insured shall give as soon as practicable notice in writing of any alteration, which materially affects the risk. 2. During the period of the Insurance the Insured shall give immediate notice in writing to Underwriters via the Broker or Agent named herein of: (a) Every letter of Claim writ summons or process for Malpractice or alleged Malpractice against the Insured; or (b) Every letter of Claim writ summons or process for Public Liability or alleged Public Liability against the Insured; or (c) Every letter of Claim writ summons or process for Errors and Omissions or alleged Errors and Omissions against the Insured; or (d) The receipt of notice from any person of an intention to hold the Insured responsible for any Malpractice or Public Liability or Errors and Omissions; or (e) Any conduct or circumstance which is likely to give rise to a Claim for Malpractice or Public Liability or Errors and Omissions being made against the Insured; or (f) The receipt of notice from any person of an intention to hold any employee or other person performing work on behalf of the Insured responsible for any Malpractice or Public Liability or Errors and Omissions; or (g) Any conduct or circumstance by any employee or other person performing work on behalf of the Insured which is likely to give rise to a Claim for Malpractice or Public Liability or Errors and Omissions being made against the Insured; or (h) Any knowledge the Insured has that materials goods services or actions specified designed or recommended by the Insured or by a party for whom and for which the Insured is responsible have failed to meet the standard required and which might give rise to a claim against the Insured which (regardless of the Deductible) may be the subject of indemnity under this Certificate. If the Insured gives notice as required by (d) or (e), any Claim subsequently made against the Insured shall be deemed to have been made during the Period of Insurance. 3. The Insured shall at all times: (a) Maintain accurate descriptive records of all professional services and equipment used in procedures which shall be available for inspection and use by Underwriters or their duly appointed representatives insofar as they pertain to any Claim hereunder (b) Retain the records referred to in 3. (a) Above for a period of at least five (5) years from the date of treatment and, in the case of a minor for a period of at least five (5) years after that minor attains majority, and (c) Give to the Underwriters or their duly appointed representatives such information, assistance, signed statements or depositions as Underwriters may require (d) Assist in the defence and investigation of any Claim or potential Claim without charge to the Underwriters. 4. The Insured shall not disclose to any person the terms of this Certificate, no liability shall be admitted, no arrangement, offer, promise, or payment, shall be made or cost or expense incurred by the Insured without the written consent of the Underwriters. Underwriters shall be entitled to take control of the defence of any Claim or to prosecute in the name of the Insured for their own benefit any Claim for indemnity or damages or otherwise against any third party and shall have full discretion in the conduct of any negotiations or proceedings on the settlement of any Claim. The Underwriters will not settle any Claim without the consent of the Insured. However, if the Insured refuses to consent to any settlement recommended by the Underwriters or their legal representatives and elects to contest or continue any legal proceedings then the liability of the Underwriters shall not exceed the amount for which the Claim could have been so settled plus the costs and expenses incurred with their consent up to the date of such refusal, which in any event will not exceed the Limit of Indemnity as specified in the Schedule and the Insured agrees to indemnify Underwriters for the amount of any judgment, award, settlement and Defence Costs which Underwriters are found obligated to pay after the date of such refusal. 5. Underwriters may cancel this Insurance in the event of non-payment of premium by giving thirty (30) calendar days' notice. Such notice shall be given in writing and may be served by registered mail, telex or facsimile transmission, or may be hand delivered to the address of the Insured as stated in the Schedule. Any notice sent by registered mail shall be deemed to have been served seven (7) calendar days after dispatch and any notice sent by telex or facsimile shall be deemed to have been served at the time of dispatch. If this Insurance is so cancelled the Underwriters shall retain only the earned portion of the Premium computed from day to day. 6. Any dispute concerning the interpretation of the Terms, Conditions, Limitations and/or Exclusions contained herein is understood and agreed by both the Insured and Underwriters to be subject to the laws of the Republic of Namibia. Each Page 9

10 party agrees to submit to the jurisdiction of any court of competent jurisdiction within the Republic of Namibia and to comply with all requirements necessary to give such court jurisdiction. All matters arising hereunder shall be determined in accordance with the laws and practice of such court. 7. Sanctions and embargo clause Notwithstanding anything to the contrary in the policy the following condition shall apply: a. If, by virtue of any law or regulation which is applicable at the inception of this policy or which becomes applicable at any time thereafter, providing coverage to the insured and/or paying a claim and/or providing a benefit under the policy directly or indirectly breaches an embargo or sanction, the insurer shall not indemnify nor make any payment or provide any economic benefit to the insured or to any other party under this policy to the extent that it would be in breach of such law or regulation. b. In circumstances where the payment or provision of a valid and otherwise collectable claim or benefit may directly or indirectly breach an embargo or sanction, then the insurer will take all reasonable measures to obtain the necessary authorisation to make such payment or provision. STANDARD EXTENSIONS DEFENCE COSTS CRIMINAL It is hereby understood and agreed that this Certificate is extended to indemnify the Insured for all legal costs and expenses incurred with the Underwriter's written consent, such consent not being unreasonably withheld in the defence of criminal proceedings brought against the Insured where the conduct giving rise to such proceedings is alleged to have occurred during a consultation with or treatment of a patient PROVIDED ALWAYS THAT: (a) Notification of the circumstances giving rise to the criminal proceedings has been given in accordance with General Condition 2; (b) For the purposes of this insurance, the criminal proceedings shall be deemed to be a "Claim" (c) There shall be no cover hereunder for proceedings commenced prior to inception of this Certificate or arising from circumstances which on or before inception, the Insured was aware (or should reasonably have been aware) might give rise to proceedings. (d) "Proceedings" includes an appeal against the outcome of any initial proceedings; (e) The Underwriters shall not be liable hereunder for the payment of any fines, penalties, vindictive or exemplary damages; (f) The total amount payable in respect of such costs and expenses shall not exceed the Limit for Criminal or Disciplinary Hearing Costs as stated in the Schedule. INQUIRY DEFENCE COSTS - DISCIPLINARY AND CORONERS INQUEST It is hereby understood and agreed that this Certificate is extended to indemnify the Insured against all legal costs and expenses incurred with the Underwriter's written consent, such consent not being unreasonably withheld, in connection with any legal representation of the Insured at any duly constituted professional disciplinary tribunal or inquiry or coroners inquest (hereafter referred to as the Inquiry) relating to any matter which may form the subject of a Claim which falls within this Certificate, provided that the total amount payable in respect of such costs and expenses shall not exceed the Limit of Indemnity for Disciplinary Hearing Costs as stated in the Schedule. PROVIDED ALWAYS THAT: (a) The circumstances giving rise to the Inquiry could also give rise to civil proceedings and that in the event of such civil proceedings, but for exclusion (xiii) (b), the Insured would be entitled to indemnity under this insurance; (b) Notification of the circumstances giving rise to the Inquiry has been given in accordance with General Condition 2; (c) (d) (e) (f) (g) For the purposes of this insurance, the Inquiry shall be deemed to be a "Claim"; There shall be no cover hereunder for an Inquiry commenced prior to inception of this Certificate or arising from circumstances which on or before inception, the Insured was aware (or should reasonably have been aware) might give rise to a professional disciplinary tribunal, inquiry or coroner s inquest; "Inquiry" includes an appeal against the outcome of any initial inquiry, hearing or proceedings; The Underwriters shall not be liable hereunder for the payment of any fines, penalties, vindictive or exemplary damages; The total amount payable in respect of such costs and expenses shall not exceed the Limit for Criminal or Disciplinary Hearing Costs as stated in the Schedule. Notwithstanding the aforegoing, Disciplinary Hearing Costs with respect to a breach of the Health Professions Act No. 56 of 1974 as amended from time to time or any other Statute governing the professional activities of a healthcare worker as well as any ethical codes, shall be deemed to be covered herein DEFAMATION EXTENSION It is hereby understood and agreed that this Certificate is extended to indemnify the Insured for Claims made against the Insured for Defamation committed without malice by reason of words written or uttered by the Insured in or about the conduct of their occupation or business as stated in the Schedule. Page 10

11 It is a Condition precedent to the right of the Insured to be defended or indemnified hereunder that in the event of a Claim the Insured shall, upon the reasonable request of Underwriters, issue an apology and expression of regret, the form and content of which are to be approved by Underwriters. If on receipt of such a request from Underwriters the Insured refuses to issue such an apology and expression of regret, Underwriters shall not be liable to defend or indemnify the Insured in respect of any damages, costs and/or expenses incurred after the date of such refusal. Underwriters shall not be liable for: (i) Any Claims arising from the contents of any journal or publication, or in any communication or contribution to the press or media (ii) Any Claims arising from Defamation committed or alleged to have been committed against professional adversaries or business competitors (iii) Any fines, penalties, punitive or exemplary damages (iv) Any Claims arising from any infringement of any Data Protection Act. LOSS OF DOCUMENTS EXTENSION It is hereby understood and agreed that if during the Period of Insurance stated in the Schedule the Insured shall discover that any Documents, the property of or entrusted to the Insured and which should be in the custody of the Insured have been destroyed, irrecoverably damaged, lost or stolen, and after diligent search cannot be found, the Underwriters will indemnify the Insured: 1. For all sums which the Insured will become legally liable to pay as damages in consequence of such Documents having been so destroyed, irrecoverably damaged, lost or stolen, and 2. For all costs and expenses incurred by the Insured in replacing or restoring such documents. However, any Claim for costs and expenses shall be supported by bills or accounts, which shall be subject to approval by Underwriters or their duly appointed representatives. The expression "Documents" shall be deemed to mean deeds, wills, maps, plans, records, books, letters, certificates, forms and documents of any nature whether written, printed or reproduced by any other method (other than bearer bonds, coupons, tickets, bank notes, currency notes, negotiable instruments, Computer Systems' records and, in respect of 1 above, medical records) Underwriters shall not be liable for: (i) Any Claim arising out of any infringement of any Data Protection Act (ii) Any Claim arising from libel and/or slander (iii) Any Claim arising from breach of confidentiality. BREACH OF PROFESSIONAL CONFIDENTIALITY EXTENSION It is hereby understood and agreed that this Certificate is extended to indemnify the Insured for Claims made against the Insured during the Period of Insurance stated in the Schedule arising from any Breach of Professional Confidentiality in or about the conduct of their occupation or business as stated in the Schedule. Underwriters shall not be liable under this extension for: (i) Any Claims arising from libel or slander. (ii) Any Claims arising from the loss of any documents the property of or entrusted to the Insured, or the costs and expenses incurred by the Insured in replacing or restoring such documents. (iii) Any Claims arising from any infringement of any Data Protection Act. DISHONESTY OF EMPLOYEES EXTENSION It is hereby understood and agreed that this Certificate is extended to indemnify the Insured for Claims arising out of financial loss to third parties caused by dishonest fraudulent or criminal acts of employees of the Insured in or about the conduct of the Insured's occupation or business as stated in the Schedule and for which the Insured shall become legally liable. Underwriters shall not be liable under this extension for: (i) (ii) (iii) (iv) (v) Any Claims arising from any professional service rendered which is not in the conduct of the Insured's business or occupation as stated in the Schedule, Any Claims made against any person who is, has been or may become during the Period specified in the Schedule, a principal, partner, director, a member of any ethics committee, employee or volunteer of the Insured named in the Schedule in respect of Claims arising from work undertaken that is not on behalf of the Insured, Any Claims made by any Company in which the Insured has a controlling interest unless the original Claim emanates from an independent third party, Cross Liabilities which shall be deemed to mean Claims made against any Insured party by any other Insured party, Any Claims arising out of or relating directly or indirectly from the insolvency or bankruptcy of the Insured or a company that the Insured has a controlling interest, Page 11

12 (vi) Any Claims brought about or contributed by the Insured(s), (vii) Any Claims arising out of Infringement of Copyright, Registered Designs, Trade Marks or Passing Off or any Infringement of any Data Protection Act, (viii) Any Claims arising out of or relating directly or indirectly to loss of documents, breach of confidentiality, libel, slander or defamation. it is a condition precedent to the right of the Insured to be defended or indemnified hereunder that the Insured shall during the Period of Insurance give immediate notice in writing of the discovery of reasonable cause for suspicion of fraud or dishonesty on the part of their employees, whether giving rise to a claim under this extension or not, and the Underwriters shall not be liable for any claims arising from any loss sustained resulting from any act committed after the date of such discovery on the part of the employee or employees concerned. JURISDICTION ENDORSEMENT Notwithstanding the terms contained within the Insuring Clause of this Certificate, it is further understood and agreed that the Insured will only be defended or indemnified under this Certificate for Claims made in the following country or countries: 1. Republic of South Africa 2. Botswana 3. Namibia 4. Lesotho 5. Swaziland Page 12