Frequently Asked Questions

Transcription

1 Group Professional Indemnity Insurance and Group Public & Products Liability Insurance Policies Australasian Society for Ultrasound in Medicine (ASUM) 2017/2018 Group Professional Indemnity Insurance Policy Frequently Asked Questions We are delighted ASUM has chosen Aon as their preferred insurance provider to meet the needs of members. We are proud to be affiliated with members advancing the clinical practice of diagnostic medical ultrasound for the highest standards of patient care. Q. What cover does the Policy provide? A. The intention of this Policy is to indemnify the Insured for civil liabilities arising from acts, errors or omissions in the performance of the professional services provided, that caused a financial loss/bodily injury to a third party. This includes cover for your own legal defence costs and compensation and legal costs payable to a claimant. Subject always to the Policy s full terms, conditions and limitations. Q. Who does the Policy cover? A. Sonographers who are financial members of ASUM and Sonographers in training who are associate members of ASUM who have applied for this insurance and received a Certificate/Schedule of Insurance in confirmation of cover. Q. What are the Limits of Indemnity (Sum Insured) under the Policy? A. Group Policy Shared Limit. Group Policy Limit of Indemnity: $10,000,000 any one claim and $30,000,000 in the total aggregate. Sub-limits may apply. As this is a Group Policy, the Limit of Indemnity and the total Aggregate Limit of Indemnity is shared by all the Insured s. This means that if the Limit of Indemnity and/or the total Aggregate Limit of Indemnity are exhausted by Claims against some of the Insured s during the Policy Period then there will be no cover remaining for the duration of that period of insurance. In accordance with the terms of the Group Policy the Insurer may agree to include additional Insured members during the Policy Period. Any inclusion of additional Insured Members during the Policy Period will not increase the Limit of Indemnity or the Total Aggregate Limit of Indemnity. The Insurer is not obliged to obtain the consent of the Insured before agreeing to extend the Group Policy to include new Insured Members during the Policy Period. Reference to Insured Member in this Proposal Form means a legal entity or natural person included as an Insured under the Group Policy by endorsement, and who is also a financial member of ASUM. Q. Does the Policy provide me with legal costs? A. Yes, subject to the Insurer s written agreement prior to any costs and/or expenses being incurred, the Policy will, in addition to the Limit of Indemnity, pay costs and expenses incurred by a member but always in accordance with the Policy s full terms, conditions and limitations. Page 1 of 7

2 Q. Does any Excess apply to the Policy? A. Yes. If you are an Employee the Excess is $250. If you are self employed the Excess is $520 each and every claim. Some features of the Policy also have an Excess attached to the cover provided. Please refer to the Group Policy wording which can be found at Q. Does the Policy provide cover for my past activities? A. Yes. The Policy s Retroactive Date is unlimited (excluding known claims and circumstances). The unlimited Retroactive Date means that it is the intention of the Policy to provide cover in respect of acts, errors or omissions arising from work performed prior to the Policy Period and always subject to a Group Policy being current at the time a notification is made. Also, this Policy is underwritten on a claims made and notified basis. This means that once you become aware of any Claim or any fact or circumstance which could possibly give rise to a Claim, you must notify the Insurer immediately in writing. Failure to notify the Insurer immediately in writing may result in a Claim being denied. Q. Will I continue to require Professional Indemnity Insurance when I retire or cease trading? A. Yes, you will continue to require this cover after you have retired or cease trading. This Policy has the added benefit of 7 years free Run Off Cover excluding known claims and circumstances subject to completed no claims declaration form. Subject to the ASUM Group Professional Indemnity Policy remaining in force with the current Insurer (CGU), the Policy will provide Run Off cover in respects of matters arising from work performed prior to you retiring or leaving the profession. Subject always to the member having been insured under the CGU policy and the Policy s full terms and conditions. Page 2 of 7

3 Group Public and Products Liability Insurance Policy Frequently Asked Questions Q. What cover does the Policy provide? A. The intention of this Policy is to indemnify the Insured for amounts they shall become legally liable to pay as compensation for Personal Injury, Property Damage or Advertising Liability caused by an Occurrence in connection with the Insured's Business. Subject always to the Policy s full terms, conditions and limitations. Q. Who does the Policy cover? A. Sonographers who are financial members of ASUM and Sonographers in training who are associate members of ASUM who have applied for this insurance and received a Certificate/Schedule of Insurance in confirmation of cover. Q. What are the Limits of Indemnity (Sum Insured) under the Group Policy? A. Group Policy Shared Limit. Group Policy Public Liability Limit of Indemnity: $10,000,000 each and every occurrence, Group Policy Products Liability Limit of Indemnity: $10,000,000 each and every occurrence and in the aggregate. Sub-limits may apply. As this is a Group Policy, the Limit of Indemnity and the total Aggregate Limit of Indemnity is shared by all the Insured s. This means that under the Products Liability section of the Policy if the Limit of Indemnity is exhausted by Claims against some of the Insured s during the Policy Period then there will be no cover remaining for the duration of that period of insurance. In accordance with the terms of the Group Policy the Insurer may agree to include additional Insured members during the Policy Period. Any inclusion of additional Insured Members during the Policy Period will not increase the Limit of Indemnity or the Total Aggregate Limit of Indemnity. The Insurer is not obliged to obtain the consent of the Insured before agreeing to extend the Group Policy to include new Insured Members during the Policy Period. Reference to Insured Member in this Proposal Form means a legal entity or natural person included as an Insured under the Group Policy by endorsement, and who is also a financial member of ASUM. Q. Does the Policy provide me with legal costs? A. Yes, the Insurer will pay all expenses incurred by them, all costs taxed against the Insured in any suit defended by the Insurer, and all interest on the entire amount of any judgement which occurs after the entry of the judgement and before the Insurer has paid or tendered or deposited in Court that part of the judgement which does not exceed the limit of the Insured's liability thereon, reasonable expenses incurred by the Insured at the Insurer's request in assisting the Insurer in the investigation or defence of any claim excluding loss of earnings, but always in accordance with the Policy s full terms, conditions and limitations. Q. Does any Excess apply to the Policy? A. Yes. $500 each and every claim. Some features of the Policy also have an Excess attached to the cover provided. Please refer to the Group Policy wording which can be found at Page 3 of 7

4 General Frequently Asked Questions Q. Can Medical Practitioners have cover under the Policies? A. Medical Practitioners can be covered for the provision of sonography services only. Please note that there is no cover provided for the provision of Medical Practitioner services. Q. Can you purchase cover under one Group Policy without having cover under the other? A. Your options for cover are Group Professional Indemnity Insurance ONLY or Group Professional Indemnity Insurance and Group Public and Products Liability Insurance together. You are unable to purchase cover under the Group Public and Products Liability Insurance Policy ONLY. Q. What is the cost of this insurance? Please see below table noting pricing for each state/ territory factoring in Stamp Duty: Professional Indemnity only Self- Employee Employed Professional Indemnity /Public & Products Liability Employee Self-Employed NSW $ $ $ $ ACT $ $ $ $ SA $ $ $ $ VIC/WA/TAS/NT $ $ $ $ QLD $ $ $ $ The above amounts include all charges. A tax invoice for the purpose of claiming any Input Tax Credits you may be entitled to will be issued upon receipt of your premium payment and confirmation that you are a financial member of ASUM. Q. Who is the Insurer? A. CGU Professional Risks, CGU Insurance Limited ABN AFS Licence Important Note: The abovementioned information is a summary only. For full details of Policy terms and conditions please refer to the ASUM Group Policy (issued by your insurer) at Page 4 of 7

5 Changes in Policy Wording In order to ensure that you are aware of all of the differences in cover however, we have also attached the below table which outlines the differences between the expiring wording and the new wording and your coverage. We ask that you carefully review the table to ensure that the coverage of the policy meets your circumstances and needs. Enhancements The following are new coverage items provided by the new wording, which are not provided under the current wording Section Sub-Section Explanation of Enhancement 3 The cover we provide 3.3 Claim Investigation Costs Payable in addition The costs of defending a claim, such as fees for legal representation or expert witnesses, are covered by the Policy. The new wording pays such costs in addition to the Limit where they are incurred in Australia and New. This means the that Limit of Liability is dedicated to paying the compensation component of any Claim, and an amount equal to the Limit is separately available to pay Claim Investigation Costs. The following are new coverage items provided by the new wording, which are not provided under the current wording: 4 Policy extensions 7 What is not covered 8 General terms and conditions New Extensions Pollution Coverage 8.15 Claims Condition - Allocation Prior Corporate Entities (4.12): the policy covers prior corporate entities through which the Insured previously traded. For cover to apply, information about those prior corporate entities must be provided to the Insurer. Loss Mitigation (4.17): this cover essentially rewards the Insured for taking steps to avoid a claim. The policy covers costs incurred where steps are taken by the policyholder to mitigate or rectify an error which would otherwise result in a Claim. $100,000 is available for any one matter, and up to $200,000 is available for all such matters within the policy period. Breach of Warrant of Authority (4.20): the policy provides cover where the Insured, or a person acting on behalf of the Insured, unintentionally breaches a warranty of authority. Interested Party (4.21): this cover applies where the Insured has contracted to provide Professional Services to a third party. Such third parties will be covered by the policy for their vicarious liability for the actions of the Insured that is, where the third party is held liable, but the fault for that liability actually lies with the Insured. The Pollution Exclusion (7.17) in the new wording now has a write back for design that is, the policy now covers pollution results from any design work, advice or specification performed by the Insured (provided such work is captured by the description of Professional Services in the policy Schedule). This clause provides a process for resolution of a disagreement between the Insurer and the Insured, in circumstances where a Claim involves matters that are both insured and uninsured. Page 5 of 7

6 The new policy wording has also resulted in some reductions of coverage which may impact your current policy. A comprehensive list of these changes is below and we would urge you to review in conjunction with your new policy wording to understand how your coverage may be affected. Your Aon Client Executive is also on hand to discuss these changes. Section Sub-Section Your Current Wording Your New Wording The current wording covers the Insured s costs of legal representation where they are required to appear at any official investigation or inquiry. 4 Policy Extensions 4.2 Enquiries Cover Extension 4.5 Lost Documents Extension Claim Preparation Costs Extension Consultants, Sub-Consultants and Agents Extension 4.18 Fraud & Dishonesty Extension The current wording provides cover where the Insured loses documents and cannot find them after diligent search. The document may belong to a third party (such as a client), or may belong to the Insured. The current wording pays for professional fees and other expenses insured by the Insured when preparing for a covered Claim. This presumably includes cover for the Insured s internal costs. Cover is sub-limited to $25,000 per policy period. The current wording provide cover for the Insured s consultants, sub-contractor and agents, where such third parties are performing the insured Professional Services for or on behalf of the Insured, and while under the control and supervision of the Insured. The current wording provides cover where the Insured is held vicariously responsible for any fraud or criminal conduct committed by its Employees, or by a consultant, sub-contractor or agent. now only covers vicarious liability for the actions of an Insured. The new wording provides cover for a legal or quasi-legal inquiry only. It s unclear what might constitute a quasi-legal proceeding and what might not; as such, we prefer the broader wording of the current cover, which doesn t require the investigation to be legal or quasilegal. The new wording only provides third party loss cover that is, cover only applied to the loss of a third party s document, and not to loss of the Insured s own documents. The new wording does not provide this cover at all. The new wording does not provide this cover at all. The new wording does retain cover for the Insured s vicarious liability, where the Insured may be held liable for the actions of its consultants, subcontractors or agents. The new wording provides cover where the Insured is held vicariously responsible for any fraud or criminal conduct committed by its Employees, but does not cover the Insured s vicarious liability for the actions of its consultants, sub-contractors or agents. Page 6 of 7

7 Section Sub-Section Your Current Wording Your New Wording The current wording excludes cover where an Insured The new wording applies a broader exclusion in addition to the brings a Claim against another Insured (including above, it also excludes claims made by: where a Subsidiary company brings a Claim against an Companies in which the Insured holds a great than 10% Insured). interest; 7.4 Related Parties Exclusion Trusts of which the Insured is a trustee or beneficiary, or in which the Insured has a financial interest; and A person or entity who has more than 10% of the voting rights in the policyholder entity. Claims made by these parties will potentially be covered by the current wording, subject to all other terms and conditions of the current wording. 7 What is not covered 8 General terms and conditions New Exclusions 8.8 Claims Condition Senior Counsel This clause is a claims condition, and provides that the Insured need not contest (defend) a Claim unless Senior Counsel provides advice that the Claim is defensible. The cost of acquiring Senior Counsel s opinion is paid by the Insurer, in addition to the policy Limit. Insolvency Exclusion (7.7): the new policy excludes cover where a Claim in any way relates to the insolvency of the Insured. This exclusion is not imposed by the current wording. Deregistration (7.12): the new wording excludes cover where the Insured provides Professional Services while the Insured was not legally registered or certified (provided of course that the Insured is so required to be registered/certified). This exclusion is not imposed by the current wording. Profit (7.6) (and reiterated in the definition of Cover (9.4): this exclusion is really in the way of a clarification, confirming that the policy is not intended to provide cover for any component of profit. It is likely that the current wording operates in a similar manner, though it does not expressly contain this exclusion. As such, this exclusion is reported as a derogation in the words, but probably isn t a derogation in reality. The new wording provides similar cover, however the cost of acquiring Senior Counsel s opinion now forms part of Claim Investigation Costs that is, forms part of the costs insured by the policy. Page 7 of 7