Protocols · teleconsultation · supply of materials
Professional indemnity – Wound care
A wound care organisation draws up treatment advice that others carry out. Your protocol travels to district nursing teams and GP practices, and a mistake in it multiplies.
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In brief
The distinctive risk of a wound care organisation is that your knowledge is multiplied. A formulary, treatment protocol or decision tree is applied by district nurses, practice nurses and residential homes to clients you never see. If there is a mistake in the indication for compression or in the advice on materials, it carries through into every application. So look at the series claims arrangement: it determines whether claims from the same cause come together under one sum insured.
You also carry liability for your own staff under Article 6:170 of the Dutch Civil Code and Article 6:171 of the Dutch Civil Code can apply to self-employed people you engage. Expressly place consultants, wound care nurses and specialists hired in within the class of insured persons, or require a policy of their own. Remote consultation calls for a protocol setting out when a physical assessment is compulsory and who carries ultimate responsibility.
If you also supply or hire out materials, you are a supplier as well as an adviser. Loss caused by a defective product falls under Article 6:185 of the Dutch Civil Code and not under this policy, and the costs of recalling a batch are covered nowhere on professional indemnity insurance. Wound photographs and files are also special category personal data. A breach involving them belongs on a cyber insurance.
This page deals with one situation. The full overview is on Compare professional indemnity insurance (BAV).
What actually goes wrong here
Four subjects that arise as soon as your advice is carried out by other hands.
Protocols that others carry out
Keep version control on every protocol and record which organisation received which version. State when the protocol may not be applied and who must be called in that case. Without version control you cannot show, when a claim arises, which advice applied at the time, and that makes defending a series of claims virtually impossible.
Remote consultation
In a teleconsultation your specialist assesses an image someone else made, with that person's lighting and framing. Record the minimum data that must be supplied, what you will and will not say on that basis, and that the treating care provider remains responsible for the observation on site.
Supply and hire of materials
As soon as you supply dressings or hire out pumps, a second liability track opens up. Keep records of batch numbers and issues, so that you can recall selectively if there is a defect. For equipment placed with clients, Article 6:77 of the Dutch Civil Codeapplies: towards the client you are liable for the unsuitable auxiliary item, including where there is a manufacturing fault.
Exclusions that often arise here
Outside the cover are: recall and destruction costs for materials supplied; recovery of amounts invoiced by a health insurer or care administration office; administrative fines and penalty payments; intent and wilful recklessness (Article 7:952 of the Dutch Civil Code); and injury to your own staff, which runs through Article 7:658 of the Dutch Civil Code to the public and employers' liability insurance.
What does your premium depend on?
- Annual turnover of the organisation: the basis for the premium and the sum insured
- Number of wound care consultants: including self-employed contractors you hire in
- Share of advice to third parties: protocols and consultations for other care providers weigh heavily
- Supply or hire of materials: determines whether product cover is needed alongside
- Series claims arrangement: decides whether claims from one protocol are counted together
- Retroactive and run-off periods: necessary because harm from wound care shows late
Insurers weigh these details differently. That is where your saving is.
What is covered
| Situation | AVB | BAV |
|---|---|---|
| A residential home applies your formulary to a client it was not meant for and tissue necrosis follows | No | Provided that |
| A GP practice holds you liable for the extra treatment costs after advice from your consultant | No | Yes |
| A client you have never seen brings a claim against you directly over the advice given to his district nurse | No | Provided that |
| Your consultant damages the floor at a client's home with a mobile pump | Yes | No |
| A client demands compensation because his wound does not close despite correct treatment | No | No |
| A competitor alleges that your decision tree is based on his method | No | No |
Because one piece of advice lands with dozens of clients, it is not the individual line but the annual maximum that sets your real room for manoeuvre.
Frequently asked questions
This is what people ask us most.
Our advice was applied incorrectly by the district nursing team. Who is liable?
That depends on what exactly went wrong. If the advice was correct but the performance was not, liability lies with the organisation carrying it out. If the advice was unclear or incomplete, it comes back to you. That is why your records must show what information you received, what you advised and what conditions you attached.
We also supply dressings. Is that co-insured?
Not on professional indemnity insurance. Loss caused by a product supplied falls under product liability and calls for separate cover on public and employers' liability insurance. The costs of recalling a batch are usually not included there either. That is a separate arrangement you have to make.
What is a series claim provision and why does it matter to us?
It provides that claims arising from the same cause are treated as one claim, with one sum insured and one excess. In an organisation where one protocol is used with dozens of clients, that is the difference between a covered loss and a shortfall. Set the sum insured against that, not against a single individual case.
We keep wound photographs in our system. Is that an insured risk?
Not on this policy. Wound photographs are health data and therefore special category personal data. If they get out, that is a data breach and not a professional error. The costs of investigation, notification and remediation, and liability towards the people concerned, belong on cyber insurance. Fines from the Dutch Data Protection Authority remain excluded there as well.
Read more
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