Professional health liability: essential coverage

The practice of a health profession exposes practitioners to considerable legal and financial risks on a daily basis. A simple diagnostic error, a poorly executed technical gesture or a lack of information can make the professional liable and lead to compensation reaching several million euros. Professional liability insurance (RCP) thus constitutes the healthcare professional's first defense against the hazards of their activity.

An essential legal obligation

Since the Kouchner law of March 4, 2002 relating to the rights of patients and the quality of the health system, all health professionals working in a self-employed capacity have been required to take out professional civil liability insurance. This requirement is codified in article L.1142-2 of the Public Health Code.

Concerned: general practitioners and specialists, dental surgeons, midwives, nurses, physiotherapists, speech therapists, chiropodists-podiatrists, osteopaths, as well as private health establishments. Lack of insurance is punishable by a fine of 45,000 euros and a ban on practicing.

The essential guarantees of the RCP health contract

A well-structured professional health liability contract must cover several aspects:

Operational civil liabilitycovers damage caused in the course of daily activity: fall of a patient in the waiting room, damage to entrusted property, incident linked to the premises.

Medical professional civil liabilitycompensates for damage resulting directly from acts of care: diagnostic error, technical fault, failure to inform the patient, nosocomial infection in certain cases.

Legal protectioncovers defense costs in the event of proceedings before civil, criminal or ordinary courts, as well as before the Conciliation and Compensation Commission (CCI).

The minimum guarantee amounts are set by Decree No. 2011-2030 of December 29, 2011: 8 million euros per claim and 15 million euros per year of insurance for high-risk medical professions.

Factors influencing the insurance premium

The cost of CPR varies considerably depending on several parameters: the specialty practiced (an obstetrician surgeon will pay much more than a general practitioner), turnover, seniority, past claims, and the level of deductible chosen. Obstetrician-gynecologists and orthopedic surgeons are among the most exposed, with annual bonuses that can exceed 25,000 euros.

Loss declaration: good reflexes

In the event of a patient's complaint, the professional must declare the loss to his or her insurer within five working days in accordance with article L.113-2 of the Insurance Code. It is advisable never to acknowledge responsibility directly to the patient and to quickly transmit the entire medical file, correspondence received and any factual element useful for analysis.