Notice on improving medical liability insurance solutions

(en.nhfpc.gov.cn)

Updated: 2014-08-04

Leading the efforts to expand coverage and improve services of medical liability insurance

Departments including the provincial health and family planning administration, the judicial administration, finance, insurance supervision, and traditional Chinese medicine management should be fully aware of the importance of developing medical liability insurance. They should also lead efforts to establish effective insurance that coordinates both with local governments and Party committees. Local support is crucial to the development of medical liability insurance as it can help establish a sustainable insurance system and settle medical disputes by creating a favorable political environment.

The departments of health and family planning and traditional Chinese medicine management must organize and mobilize medical institutions, especially public ones, to expand the coverage of medical liability insurance and not to miss anyone qualified. By 2015, tertiary public medical institutions need to make sure all medical workers are covered by the insurance, and secondary ones’ insurance coverage should reach at least 90 percent. Meanwhile, grass-roots medical organizations including government-run ones should pilot insurance to find a more suitable risk-pooling mechanism and reduce professional medical risks. Non-public medical institutions are also encouraged to do so. Various kinds of insurance should be introduced and developed in order to improve the nation’s risk-pooling mechanism.

Medical organizations of all categories must set up a liability-sharing program in case of incidents concerning medical quality and safety. Medical damages should be considered part of the overall performance ratings of medical workers. This is to enhance their awareness of responsibility.

Judicial administration departments must provide guidance in accordance with laws to mediating medical disputes before they are taken to the court. People’s mediation committees have to receive every petition for mediation in time and settle medical disputes according to the law. It’s unacceptable to refuse a petition simply because the medical institution is not covered by the medical liability insurance. The departments need to work out a good system and refine the workflow process, while standardizing the format of mediation protocols and establishing a viable mechanism to combine mediation and compensation. These protocols should be referred to by insurance companies in settling medical disputes.

Local finance departments must provide more support for medical liability insurance in order to bring its role in risk pooling into full play. Insurance premiums should be included on the expenditure list of medical institutions.

Insurance regulatory departments need to strengthen their supervision, management and assessment of insurance companies. They must make sure insurance contracts and clauses continually improve but also maintain reasonable premium rates, thus balancing payments and a narrow margin of profit. This will make the medical liability insurance more attractive.