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MDDUS


indemnity protection rather than the “occurrence-based” protection offered by MDDUS. Why is this important? Te importance lies in the gap of time between when an event might have been caused and when it comes to light in the form of a claim being made. With many risks there is little or no gap between cause and effect. For example, if you have a house fire, the effect is obvious and immediate and a claim is made in order to get you re-housed. In the world of clinical negligence, however, a significant period of time might elapse between cause and claim. Actuaries oſten work on an average of around 2.5 years between cause and claim but we know of many claims where a much longer period elapses. In one case the gap was well over 30 years. Clinical negligence is not unique in this respect and the same can apply to certain pharmaceutical risks, aerospace engineering and rail track


of claims-made protection ceases. Either there is no cover or a person has to purchase “run-off” cover for a set number of years. In the case of some of these new providers, run-off cover is mentioned and in the case of others it is not.


The “good” doctor


Another feature worth looking at is the tactic employed by these new providers in targeting “low-risk” groups. Te most obvious flaw in this approach is the notion that it is possible to select those who will not have claims. Te reality, as we certainly know at MDDUS, is that “good” doctors can still find themselves involved in extremely expensive claims. In A Century of Care, the history of the MDDUS, the first convener of the Council from 1902 to 1910 is quoted as having said: “No member of the profession, however long he may have enjoyed immunity from attack and however confident he may be


calls to attend a coroner’s inquest/fatal accident inquiry or referral to the GMC/GDC are all now essential elements of medical defence. An unhealthy focus on indemnity and claims of clinical negligence could easily lead someone to an organisation ill-equipped to provide the kind of rounded support that medical professionals so clearly need.


At MDDUS our members have access to a highly trained advisory service. All our advisers are medically or dentally qualified and available 24 hours a day to provide advice and assistance to members across the UK. Tey are backed by an experienced team of in-house lawyers who specialise in medico-legal matters. Our approach is to make our members aware of areas of potential risk and provide advice early on to try and prevent further escalation to regulators or the courts.


But perhaps the most important feature mutual protection


maintenance. A drug is launched, the engine fitted to the plane or the track bolted together and everything may be fine for many years until the first adverse effect is detected, the plane malfunctions or the train leaves the track due to a faulty joint. MDDUS has always believed that doctors are best served by occurrence- based protection because of this gap or “long tail” inherent in clinical negligence risk. Our occurrence-based indemnity provides protection for incidents that occur while a person is in membership, regardless of when the claim is made. Tis means that protection is afforded to a member even aſter they have stopped paying their membership, for example when they have retired or indeed died, provided that they were in membership when the circumstances giving rise to the claim occurred. In other words when the act, or acts, of negligence took place. In contrast, claims-made indemnity only offers protection if the claim is made or reported during the period of membership and was caused during that same period or an earlier period of continuous membership. Te real issue is what happens aſter a period


AUTUMN 2011


of the care with which he discharges his duties, can claim to be free from charges and claims against him. Such claims are made when they are least expected and deserved.” How true we have found these words to be over the years. It might only be a matter of time before these new providers experience a large claim from a doctor they had selected as a “good” risk and then it will be interesting to see the impact. Will they not renew that person or will prices have to rise for everyone? If we could predict who will have claims, we could not only


reduce cost but much more importantly we could stop patients being injured. If it could be done, I am sure that we and others would be doing it.


Sound advice


Indemnity is not the only factor to consider. Sound advice from qualified and experienced medical advisers, support and representation when there are complaints,


“Our business is to serve the needs of all members rather than to generate a profit from them”


to mention is that MDDUS is a membership mutual. Our business is to serve the needs of all members rather than to generate a profit from them. MDDUS doesn't have shareholders and does not pay dividends. Tat means all the income generated by subscriptions is invested back into the organisation and member services, and in the maintenance of a healthy reserve to cover legal costs and claims.


Tis takes us right back to 1902 and those early pioneers who grouped together to help each other. Tat concept of mutual


support is still at the heart of MDDUS and it is interesting to reflect over the past century that while new providers have appeared from time to time, none has stood the test of time. Te need for mutual protection and the strength that comes from it has stood us in good stead and continues to do so.


nProfessor Gordon Dickson is CEO of MDDUS


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