Are You Protected?

By now most of you will have made your way through the maze associated with the recent Professional Indemnity (PI) Insurance changes. The COCA Executive was very concerned with the escalation in premiums and conditions that were placed upon chiropractic and osteopathic PI insurance. When we communicated our concerns to the broker, we were informed that three main factors were in play over the proceeding twelve-month period.

The September 11 tragedy continues to have enormous worldwide ramifications, and will most likely do so for some considerable time to come. Adding to this, there was the crash of HIH Insurance here in Australia, which also greatly impacted upon the insurance industry as a whole. Finally, and probably most significant, there was a huge increase in claims against chiropractors over the past year or so.

These factors have precipitated a turbulent time for the insurance industry. This is reflective in most forms of insurance, but in particular for health-care practitioners in relation to PI insurance.

Those of you who have followed these influences on PI insurance will know that medical specialist, and especially areas considered high risk such as obstetrics and neurosurgery, have premiums that are extremely costly. The premiums are so high, that in some instances, specialists have chosen to leave practice rather than pay the premiums. Fortunately, chiropractic and osteopathy are relatively low risk in comparison.

COCA, through the work of our insurance sub-committee, has been able to negotiate an arrangement with Aon Professional Services in conjunction with the underwriter Royal and Sunalliance. This sees the premium increases limited to approximately 20%, as opposed to increasing 300%. How has this been done?

During negotiations, it became clear that claims arising from chiropractors in particular had certain common trends. Risks associated with these trends could be addressed via a risk management strategy. Hence the broker and underwriter were of the view that by undertaking a risk management program, practitioners would reduce their risk, and this in turn would be reflected in the premium that they would attract.

We are in a climate where third parties such as insurers, workers compensation authorities and transport/motor accident authorities are requiring practitioners to be more accountable both in Australia and overseas. Due to this, it is inevitable that we are required to maintain high standards in patient care and administration of our practices, often by means imposed by regulatory bodies. Some may argue that to have these measures imposed upon them impinges on their ability to make clinical judgements and run their practices as they see fit. However, the need for standardisation of practice procedures is long overdue in manual therapy generally, and chiropractic and osteopathy have a great deal to contribute to this area. It’s a great opportunity for both professions to be seen to be leading the way.

In reviewing the area of risk management there appears to be very little in the way of established guidelines in place in the literature. This is in contrast to clinical practice guidelines, which have been developed in several countries over the past decade. Most do little, if anything, to address the issue of risk management and risk minimisation in chiropractic and osteopathic practice.

One of COCA’s primary roles is in providing continuing education for its members, and there is a definite need to provide an educational tool for risk management. The COCA Executive, under the guidance of the insurance sub-committee, has developed a distance education risk management program for our members. Upon successful completion of this program the practitioner is entitled to a significantly reduced PI premium under the Aon policy. This distance education module should be available by the time you read this (see details elsewhere in COCA News). If you have registered your intention to undertake the COCA Risk Management Program when you filled out your policy application with Aon, you should receive this shortly.

Although COCA had planned to establish a Risk Management Program in the near future, the recent events has seen the need to accelerate the development of this program. In an effort to be proactive, we hope that we can in some way help to raise the bar with respect to risk management and minimisation for the chiropractic and osteopathic professions. With the support of the membership, we can show interested third parties that we are responsible and interested in being able to minimise the risk of injury to our patients, and in turn reduce the incidence of claims. Although somewhat clichéd, the answer does rest in our hands.

Peter Werth
National President