Legal Literacy - Doctor's professional insurance is becoming increasingly important in the modern era due to the increasing risk of malpractice and lawsuits. This article discusses the importance of doctor's professional insurance, the object of insurance, and its benefits in protecting doctors and their reputations.

The Importance of Doctor's Professional Insurance in the Modern Era

Insurance products are increasingly experiencing an increase in fulfilling the needs of human life. This increase is due to the increasing number of legal problems arising from human actions. Today, insurance is able to provide protection for the medical profession which has a high level of risk if it cannot be overcome. The impact of this risk comes from negligence or intentional acts by the medical profession that cause losses or even death to the patients they treat.

Referring to Law Number 36 of 2009 concerning medicine through Article 27 paragraph (1) that “Health workers have the right to receive remuneration and legal protection in carrying out their duties in accordance with their profession”. The form of legal protection in carrying out duties in accordance with their profession can also be in the form of doctor's professional insurance. Insurance according to Law Number 40 of 2014 concerning insurance that

  1. Insurance is an agreement between two parties, namely the insurance company and the policyholder, which is the basis for the receipt of premiums by the insurance company as compensation for:
  2. providing compensation to the insured or policyholder for losses, damages, costs incurred, loss of profits, or legal liability to third parties that may be suffered by the insured or policyholder due to the occurrence of an uncertain event; or
  3. providing payments based on the death of the insured or payments based on the life of the insured with benefits whose amount has been determined and/or based on the results of fund management

In insurance products, there is also the insured's responsibility to third parties that may be caused by the insured. In the medical world, before serious treatment such as surgery is carried out, there is a therapeutic agreement. The therapeutic agreement itself only protects the interests of the patient and limits the actions of doctors that have fatal consequences. However, if the patient suffers losses as a result of surgical actions by the doctor, it is highly likely that the patient or the patient's family will take legal action for the losses they have suffered.

The Relationship between Doctor's Professional Insurance Products and Doctor Protection

The protection of the medical profession is mandated by the constitution and applicable laws regarding medicine. In the implementation of doctor protection, it is not balanced with patient protection, which will actually be a risk for the medical profession. Referring to Article 50 paragraph (1) of Law Number 29 of 2004 concerning Medical Practice that

Doctors or dentists in carrying out medical practice have the right to:

  1. obtain legal protection as long as they carry out their duties in accordance with professional standards and standard operating procedures;
  2. providing medical services according to professional standards and standard operating procedures;
  3. obtaining complete and honest information from the patient's family; and
  4. receiving service fees

The provisions of Article 50 paragraph (1) letter a of Law Number 29 of 2004 still create legal problems for the medical profession if as long as the doctor or dentist has carried out his duties according to professional standards and operational procedures but the patient suffers losses, he will still be punished if he is unable to prove his actions. The existence of this legal symptom itself means that doctor's professional insurance has a relationship in minimizing losses experienced by a doctor. The form of the legal relationship of doctor's professional insurance for a doctor's loss is;

  • As ordinary human beings, doctors have the potential to make mistakes or negligence in their work (malpractice), such as misdiagnosis or negligence in treating patients, even though they have been careful and always try to implement SOPs;
  • Doctor's mistakes and negligence can result in losses for patients, both financial, physical, mental, and even death
  • In general, users feel they have paid dearly for medical services, so they will feel disadvantaged if the results do not meet expectations, or when the disease gets worse, without an acceptable explanation
  • People are increasingly aware of the law, and know that the medical profession is not immune from legal claims

 Insurance Coverage Object for the Medical Profession

It can be seen that the object of insurance in an insurance policy is an important thing that will be promised through the policy. The policy itself is authentic proof of the rights and obligations that will be fulfilled by the insurer and the insured. The insurer can provide coverage if the insured has paid the premium on the policy based on the agreed agreement. The object of doctor's professional insurance coverage can include;

  • Compensating for physical/mental/death injury losses from third parties caused by malpractice by doctors or their employees;
  • Reimbursement of attorney or court fees, where legally the doctor is proven to be responsible to a third party (limited to civil cases)
  • Guaranteeing doctor's negligence while on duty outside the scope of daily practice due to urgent or emergency situations

 In the object of coverage in doctor's professional insurance is part of the principles of insurance, namely Indemnity and Proximate Cause. Principle Indemnity is a mechanism that requires the insurer to provide financial compensation (indemnity) in an effort to place the insured in the financial position he had just before the loss occurred.

Then, the principle Proximate Cause is that if the insured object experiences a disaster or accident, the first thing the insurance company must and will do is to find the main active and efficient cause that can drive a series of uninterrupted events that ultimately cause the accident. Professional insurance for the medical profession aims to provide compensation for losses incurred from actions taken as a doctor. The form of compensation is to pay compensation for losses suffered by third parties and restore the doctor's reputation in the eyes of the public.

Doctor's professional insurance products as an effort to defend and prove that the treatment is in accordance with applicable professional standards and procedures. However, the Medical Practice Law does not explicitly regulate professional insurance as an effort to defend and provide legal protection for a doctor. Indeed, some cases experienced by the medical profession have actually been carried out in accordance with applicable standards and procedures but are still said to have committed malpractice, causing harm to patients. The vulnerability of criminalizing a doctor is able to give birth to professional insurance products as a legal effort and restore his good name in the eyes of the public.

Conclusion

Professional insurance products in the medical profession are a legal defense for medical actions that have been taken against patients even though losses arise. Professional insurance products for the medical profession are a legal protection measure while carrying out their profession in the event of vulnerability to criminalization of the medical profession. Insurance as a form of reducing the burden of losses for the insured does not only prioritize financial loss management but also as an effort to defend in the eyes of the law. Therefore, professional insurance products are a legal implementation due to the increasing legal problems that occur in society.

For those of you who want to know more about the rights and obligations of doctors in medical practice, read the following article on Legal Literacy: "Rights and Obligations of Doctors in Medical Practice".

Hope this article is useful!