Choose the Best Medical Indemnity Insurance. Is TEGO Legit?

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Doctors, dentists, nurses and allied health professionals are required by law to have medical indemnity insurance. 

There are six insurance companies in Australia that provide cover. 

Many of us signed up to whichever organization offered a freebie during medical school.

Is there a difference between cover provided and do you have the best cover at the best price?

What is the deal with the new player, TEGO who has been drastically under quoting other MDOs?

Costs vary dramatically.  Insurance is often offered free to students as these organizations recognize many will remain loyal throughout our career.

The largest factors in the price of indemnity premium  include

  • Employer indemnified or not
  • Specialty risk (procedural specialties higher risk)
  • Your previous history of claims

Doctors training in public hospitals are employer indemnified, and premiums are likely to be a few hundred dollars per year. 

If you start private practice, general practice or locum work, this work is not employer indemnified.  Premiums will increase significantly. 

Indemnity premiums for self employed individuals are based on annual billings and specialty. 

Higher risk and very highly paid procedural specialists e.g. O&G can incur eye watering annual premiums of up to $50,000! 

Luckily, for those starting out in private practice, huge discounts of up to 80% are often offered to get you on board. 

Of course, this means premiums can sky rocket after the first 4-5 years. 

If you are in this situation, it is worth getting a quotes for the first 5 years to compare.

Premiums of tens of thousands of dollars can be unmanageable, despite high billings.  Gross billings don’t always reflect net income, particularly in specialties with high overhead costs.

The government provide the Premium Support Subsidy scheme, subsidizing premiums for eligible doctors including:

  • Procedural GPs in a rural area
  • Private practice clinicians whose premium > 7.5% gross private income

Check whether your eligible for the Premium support subsidy scheme

TEGO

Run Off Cover Scheme

Confusingly, there is government run off cover, and your insurance companies run off cover.

Government run off cover is free insurance cover, based on the last insurance contract. 

It is designed to allow retiring doctors to continue cover for previous private practice work without paying insane premiums.

You are also eligible for run off cover if you are taking maternity leave and stopping private practice.   

If you leave private practice for reasons other than maternity, permanent disability retirement aged over 65 years or permanently leaving the country, you will need to purchase run off cover from your insurer. 

Insurance company run off cover may be available for those working in public healthcare, taking parental leave or retiring.  This may reduce your premium significantly, but still keep active a policy that will cover you in case of claims made after you have ceased work. 

Important Exclusions You Won't be Covered For

- Not Telling Your Insurer As Soon As Possible

Medical indemnity insurers can refuse to cover a claim if you fail to inform them as soon as you know there may be an issue.

If there is a chance of an adverse outcome or patient legal action, it’s worth giving them a call.  They will quickly reassure you if the claim is nonsense, but it is noted on file just in case. 

It will also make calling your indemnity company less of a terrifying prospect if the worst happens and you do have an adverse event one day. 

The vast majority of doctors report their insurers acting compassionately and supportively when they have called. 

- Illegal Activities, Sexual Harrassment and Assault

We are all shocked and horrified when we hear a doctor somewhere has abused their position of power and harmed their patients, or colleagues.  If you do something indefensible, once it is proven you are on your own. No insurance is going to cover this sort of behaviour. 

Watch out for the sex offender doctor who is now a property advisor

- If You Do Not Have an Active Policy At The Time of the CLAIM (not incident leading to claim)

Medical indemnity insurance in Australia is “Claims-made”.  This means that insurance will cover your claim if your policy is current at the time of the claim (perhaps when you are no longer working as a medical professional).

This is why run off cover is essential.  A claim can be made years after medical treatment.  You may have no idea there is an issue until after retirement.  Even if the claim has no basis, there could be huge costs involved in fighting it. 

Retroactive cover is also important for this reason.  If you are changing insurers, check your retroactive date. 

- Telehealth when Your Patient is Overseas

Some of the insurers will cover overseas practice if you are completing a short term fellowship and have discussed it with your MDO prior.  Otherwise, treating patients overseas is generally not covered. 

I have not been involved in health myself, but know many doctors have due to COVID.  If your patient is dialing in from their holiday overseas (because you’re their favourite doctor) you may not be covered if there is an issue. 

TEGO

TEGO - The New Kid on the Block

TEGO is the newest insurance disrupting the industry.  Many doctors have found significantly cheaper premiums with TEGO. 

TEGO tell us this is because premiums are based on your personal risk as a doctor, not just your broad professional category. 

So if you are a low risk doctor, you may be able to lower your indemnity cost with TEGO.  Doctors with a history of claims may find they are unable to get a quote from TEGO, or it is very expensive.

TEGO is owned by Berkshire Hathaway, so has huge financial backing. 

It has no “in house” lawyers unlike most MDOs.  Instead, TEGO contract lawyers as required. This keeps costs down, but has led to some concerns that it may motivate to settle a case quickly rather than defend your good name. 

The concern is not evidence based so far, most doctors insured by TEGO seem happy with the product.

TEGO is likely to quote you very low for the first year, but premiums may increase once they have your business.  This may still be cheaper than other insurers. 

They offer a “Policy matching” policy clearly intended to steal businesses from the other MDOs.  Many are nervous to put their insurance with such a new player.  Matching your original insurers policy offers reassurance that the cover is just as adequate. 

Finally, Business for Doctors has a relationship with TEGO through which a further 5% discount can be achieved. 

Aussie Doc has no relationship with BFD, TEGO and no experience with TEGO’s insurance products. 

If price is your primary concern with indemnity cover, and you are low risk, get a quote from TEGO and read the PDS.

Comparing Medical Indemnity Insurance

 

AVANT

TEGO

MDAN

MIPS

MIGA

Policy Matching

Yes

Legal advice

24 hr

24hr

08:30-20:00

24 hr by healthcare professional

24 hr

Indemnity cover

$20 million with multiple sub-limits

Unlimited

Individual

$20 million total – $10 million per claim

Unlimited but multiple sub-limits

Good Samaritan cover

Y

Y

Not mentioned in PDS

Y

Y

Volunteer medical work

Y

Y

Y

Y

Clinical trials cover

Y except trials involving pregnant women, gene therapy, use of stem cells or children < 16 years

 

Y

Y

Y

Cover for international cover

Y (T&Cs)

 

Y (T&Cs)

Medicare or health care fund audit

Y

Y

Y

Y

Coronial inquiries

Y

Y

Y

Y

Telehealth services

Y

Y

Y

Y

Won’t cover “inappropriate telehealth”

Needlestick Cover

$250K

Y – Variable

$25K

$100K

Tax Audit

$50K

Y              

I have summarized from what I can find on each company’s PDS.  No responsibility is taken for accuracy or that it is up to date when you read this.  It’s just to give you an idea.  It’s important that you read the policy’s PDS carefully yourself.

TEGO

Ask Your Colleagues

There may be fine details that make one policy advantageous over another in your chosen specialty. Asking colleagues for their recommendations may identify  issues important for your career. 

Who Will You Speak to?

If you need to call your medical indemnity insurance, I would imagine you are going to be in a very stressful situation. 

It is important that you receive appropriate support. 

Would you rather initially talk to a doctor or lawyer? 

I would rather talk to a colleague who understands the medical situation and can hopefully reassure me!

I hope this has been helpful in the overwhelming decision to choose a medical indemnity provider.  Get some quotes and read the PDS’ now you have a rough outline of what to expect. 

Aussie Doc Freedom is not a financial adviser and does need offer any advise.  Information on this website is purely a description of my experiences and learning.  Please check with your independent financial adviser or accountant before making any changes.

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