Insurance for veterinarians

Pet insurance companies will often ask for clinical record information to assist with processing a claim. In the event that a claim is denied, this information may then be provided to the client as part of the explanation as to why the claim has been denied. This means that the clinical records created, and owned, by the veterinarian can end up in the hands of the client. And this potential outcome has led to some veterinarians feeling reluctant to hand their clinical records over to a pet insurer.

Handing clinical records to an insurer – what are the risks?

When considering handing records to a pet insurer, it’s important that a veterinarian is mindful that the records may be seen by the client. But what does this mean for a veterinarian? Not only is there a chance that records can be seen by a client during a pet insurance claim process, but records can also be seen for other reasons by a State Veterinary Board or a professional indemnity insurer. This is one of the reasons why it’s an expectation that records are always written in an appropriate and professional manner. Comments in the record should always be objective and relate to the treatment provided. Unprofessional comments in the clinical record that are then seen by a client are likely to lead to an unhappy client who may complain about the veterinarian’s conduct.

Some veterinarians may be concerned that another risk of the clinical record being seen by a client is that information contained in the record may lead to a complaint by the client and that the complaint won’t be covered by the veterinarian’s professional indemnity insurer. What is and isn’t covered by a professional indemnity insurance policy is detailed in the policy wording. Unless what is recorded in the clinical record amounts to an admission of liability, or otherwise triggers an exclusion clause in the policy, the fact that a client sees a veterinarian’s clinical record is rarely the basis upon which a claim is denied. If a claim is to be denied by the professional indemnity insurer, it’s generally as a result of other actions of the veterinarian, not the action of sharing the record.

There is a possibility, albeit slim, that the client may read the clinical record and form a conclusion that the veterinarian has acted in a manner which is inappropriate or negligent. However, this possibility shouldn’t be a reason to not share the clinical record. It’s important to remember that you can’t stop a client from complaining if they feel they have a reason to do so; it is their right. However, it’s also important to remember that this is why veterinarians have their professional indemnity insurance, to protect them when a claim is made against them.

Not handing clinical records to an insurer – what are the risks?

While there are some risks to consider when handing clinical records to a pet insurer, veterinarians should also understand that there are risks to consider when they choose to not hand over those records. If a veterinarian opts to not share the clinical record with a pet insurer when a client has made a claim, it’s possible that a claim won’t be processed and the client will not be able to receive the rebate they may otherwise be entitled to. Veterinary care can be considered expensive for many clients. Those who take out pet insurance are choosing to buy insurance to attempt to assist with veterinary costs. For them to not be able to make use of that pet insurance would mean they’re paying full costs for the treatment as well as an insurance premium that isn’t being utilised. This occurring may well upset and frustrate the client, and it is often the frustrated clients who are more likely to complain.

A veterinarian also needs to consider the importance of maintaining clients to keep their business running successfully. A situation where one veterinarian refuses to share clinical records with pet insurers, yet another veterinarian does share them, could lead clients choosing their veterinarian based on who will support their pet insurance claims.

Don’t forget…

• Sharing information within a clinical record is not usually the reason for a professional indemnity claim being denied.
• Always keep detailed, accurate and up-to-date records of all clinical consultations and treatment.
• The information contained within a clinical record should always be professional and objective.
• Whilst the veterinarian is the owner of the clinical record, be sure you have the client’s permission prior to sharing the record with a pet insurer.
• If there is any situation that a veterinarian thinks could lead to a claim against them, they should notify Guild Insurance immediately by calling 1800 810 213.

Guild Insurance Limited ABN 55 004 538 863, AFS Licence No. 233 791. This article contains information of a general nature only, and is not intended to constitute the provision of legal advice. Guild Insurance supports your Association through the payment of referral fees for certain products or services you take out with them.