Risk Management and Liability Mitigation in Medical Travel PDF

Risk Management and Liability Mitigation in the Medical travel industry “What if something goes wrong for a medical traveler?” HOW DOES THE LIABILITY EXPOSURE OF THE MEDICAL TRAVEL INDUSTRY AFFECT THE HEALTHCARE COMPANY? Risk management provides a solution, and a venue to stand out from the compe...

Risk Management and Liability Mitigation in the Medical travel industry “What if something goes wrong for a medical traveler?” HOW DOES THE LIABILITY EXPOSURE OF THE MEDICAL TRAVEL INDUSTRY AFFECT THE HEALTHCARE COMPANY? Risk management provides a solution, and a venue to stand out from the competition. There are two lines of defense, liability insurance and accident insurance. Insurance has helped industries be on the developing edge of emerging markets by allowing those at risk to transfer it to an insurer. The Individual Medical Traveler Unforeseen expenses from a medical complication Immediate and long-term expenses Additional expenses of unforeseen emergent care or corrective care once the patient returns home A medical malpractice occurrence An accident that occurs in the course of travel to and from a medical destination Facilitators, Receiving Hospitals and Employers−Both direct and indirect or vicarious liability associated with a mishap from implementing a medical travel benefit or managing a person’s healthcare Managed healthcare liability, broadly defined, includes services and activities performed whether by the organization itself or performed by others on the organization’s behalf (vicarious liability) and it includes these activities whether they are provided on paper, in person, electronically, or in any other form. Services and activities of financial advisor include all of the following: Provider selection Utilization review Care coordination Advertising, marketing, selling, or enrollment for sponsored benefit plans Claim services Establishing provider networks Cont’d Reviewing the quality of medical services or providing quality assurance; design or implementation of financial incentive plans Wellness or health promotion education Development or implementation of clinical guidelines, practice parameters, or protocols Approval of payment for covered medical services or directives on what services would be allowable Services or activities performed in the selection, administration, servicing, or management of, including but not limited to, handling records in conjunction with such plans, or affecting enrollment, termination, or cancelation of coverage for participants under such plans SOLUTION Risk management provides a solution, and a venue to stand out from the competition. There are two lines of defense, liability insurance and accident insurance. Insurance has helped industries be on the developing edge of emerging markets by allowing those at risk to transfer it to an insurer. Liability Insurance MANAGED HEALTHCARE LIABILITY Includes vicarious liability--the liability associated with the act of another party Includes defense costs. Includes damages and settlements Is available from a few carriers in the United States You will need a local representative to purchase this type of coverage in your home country. Accident Insurance FIRST-PARTY COVERAGE These types of policies do not require one to recover from an at- fault party. The claimant is also the insured. Claim payments are intended to make the injured party whole and mitigate the need for a lawsuit against an at-fault party Accident insurance has long been used as a risk mitigation tool. Your everyday and common liability policies include a no- fault accident benefit for the purpose of mitigating a liability claim proceeding. Some types of coverage typically on a medical travel accident policy Additional medical or surgical treatment as the result of a complication Accidental death and dismemberment Disability Repatriation of mortal remains Family coordination Household modification Loss of reproductive function 24/7 International assistance service Who is buying this coverage? Coverage can also include an accidental injury not associated with the procedure: that is, the taxi accident or trip and fall that could be blamed on the result of traveling for a medical procedure. Individuals-- alone or through medical travel facilitators, appointed agents or directly online Groups Employers are providing this for all employees when they utilize the medical travel benefit on their group plan Hospitals/facilitators are including the coverage on every patient to mitigate liability exposure  In summary Insurers can help transfer business risk and exposure by providing defense costs coverage when the recourse in the international setting is tested. Insurers can work with attorneys to determine the legal system that will preside at their expense and not yours. Insurers can provide the settlements to make an injured party whole again. Lastly, insurers create standards for care by underwriting an exposure, because they will not insure an exposure that they feel has not taken a professional and educated approach to their business model or management. Insurance provides the deep pockets and keeps the hands out of your pocket.