What if a patient asks for your insurance details?

In your private practice, has a patient ever asked you whether you have insurance, or for your insurance details? Did the question put you on edge?

There are situations where the question may be innocent. It could demonstrate that the patient is appropriately cautious in selecting a surgeon. A patient sensible enough to ‘do their homework’ might be more likely to consider your clinical advice and warnings carefully.

By contrast, for patients to whom you have already provided advice or carried out a procedure the “do you have insurance?” question might carry worrying overtones, regardless of whether the patient has otherwise expressed any dissatisfaction with your advice or the procedure. Unless your patient happens to work in the insurance industry and is asking out of mere professional interest, it is difficult to avoid drawing the inference that the patient is, at some level, thinking about making a complaint or claim.

So how do you answer the question?

Having an indemnity arrangement is compulsory for surgeons in private practice. Therefore there is no downside to confirming to your patient that you have appropriate indemnity arrangements in place. There is no obligation to provide any more details, and it is best not to. Revealing those details without your insurers’ express authority might be a breach of the terms of your policy with them. Also, giving details of your policy might influence your patient (or his or her lawyers) when deciding whether to bring a claim or not, or for how much.

Is there anything else you need to think about? Absolutely! If the context of the insurance question, the patient’s demeanour or other comments gives you any concern that he or she is thinking about making a complaint or claim, then you need advice about whether to make a precautionary notification to your insurers. Incision members have access to a 24/7 notification and medico-legal helpline to provide that exact sort of assistance.

What if the request for your insurance policy details comes from solicitors appointed by your former patient? Some patients’ solicitors do state in correspondence that the surgeon “should” or “must” provide his or her insurance details within a short time. However, surgeons should not respond to any such request until they have had proper advice, because in most situations the patient’s solicitors are simply not entitled to know the details of the surgeon’s policy.

This article is an extract of a more detailed and extensive guidance note available only to Incision members

About the author

Joanne Staphnill, Partner - DWF LLP

Joanne Staphnill

After reading Law at Cambridge, Joanne was called to the Bar in 2003 and her work in pupillage included many clinical negligence and high-value personal injury cases. She re-qualified as a solicitor in 2006, and since then has regularly defended clinical negligence claims and has excellent experience in resolving claims through the pre-action protocol, alternative dispute resolutions and through the courts. Joanne always aims to understand whether a claim may affect the clinician’s professional reputation and takes pride in guiding clients who are unfamiliar with the legal process. Joanne and the DWF team continue to provide legal assistance and support and she produces extensive risk management materials for Incision members.