If you are a physician working in the corrections field, you need to ask this question: “Does my insurance adequately cover me for all possible liability?”
I get this question at a lot of conferences, and the answer is usually maybe. There are a lot of factors to consider when making sure you have adequate coverage, claims and risk management support from your carrier whether you work as a sole proprietor, are part of a group or work for a public entity. This is more critical now than ever because budget constraints have led to leaner staffing and overcrowding in many systems putting more pressure on the staff to deliver quality care in an environment with increasing infectious, chronic and mental health disease for an at risk population.
Most medical malpractice carriers will say that they will cover up to a specific percentage of the physician’s time in correctional medical. We have heard variations from 5 percent to 50 percent. In those instances you need to dive much deeper than just the percentage the carrier references because there are many different roles that a physician has depending on their employment by the system or the contractual situation with the sub-contractor, public entity or county.
Most systems have a Responsible Health Authority (RHA). The RHA is responsible for the facility’s healthcare services and arranges for all levels of healthcare and assures quality, accessibility, and timely health services for inmates. The RHA may be a physician, health administrator, or agency – for example, a state department of corrections. The carrier needs to fully understand the role of the physician at the facility.
- Physician acting as the RHA only.
- Physician acting as RHA and evaluating and/or hands-on treatment of individual inmate patients.
- Physician contracted for medical evaluation or assessment only. All medical treatment is referred to an outside private physicians or community health center for actual treatment.
- Physician contracted for part-time (as few as 2 hours per month) for medical evaluation or treatment but has another private practice unrelated to corrections. This can be as minimal as on-call emergency physician services on weekend when regular staff is not scheduled.
The physician’s role at the facility plays a big part in how their coverage is handled if a suit is filed.
Next, the physician has to be sure they have proper coverage and claims support for issues specific to correctional medical. Here are a few examples:
- How are civil rights (Section 1983) and deliberate indifference claims handled under the policy?
- Does their insurance provide additional insured, hold harmless and indemnity (contractual liability) in favor of the public entity or county if the physician contract requires it?
- Does the carrier have panel counsel for pro se or civil rights cases? What is their experience in these types of cases?
- Does their insurance provide coverage for abuse and molestation? Is the definition broad enough to cover an assault and battery allegation?
There are many issues to consider when making sure you have proper coverage and claims support as a physician working in correctional facility. If you are a physician and would like more information, you or your insurance agent can contact us with questions or clarifications.