Notice of the Sichuan Provincial Health and Family Planning Commission and Four Other Departments on Strengthening the Work of Medical Malpractice Insurance
Document No. [2015] 215 of the Sichuan Provincial Health and Family Planning Commission
To:
Health and Family Planning Commissions (Health Bureaus), Judicial Bureaus, Finance Bureaus, Traditional Chinese Medicine Administrations of all prefectures and cities;
Directly affiliated medical institutions under provincial commissions, centrally administered medical institutions in Sichuan;
Property insurance company branches at the provincial level, and the Sichuan Insurance Industry Association:
In accordance with the Opinions of the National Health and Family Planning Commission and Five Other Departments on Strengthening Medical Malpractice Insurance Work (Guo Wei Yi Fa [2014] No. 42), the Opinions of Sichuan Province on Accelerating the Development of Modern Insurance Services (Chuan Fu Fa [2014] No. 68), and the Interim Measures for the Prevention and Handling of Medical Disputes in Sichuan Province (Chuan Zong Zhi Wei [2012] No. 7), this notice aims to enhance the role of medical malpractice insurance as a primary mechanism for risk sharing, dispute resolution, and medical risk management. It further strengthens the medical malpractice insurance system in Sichuan Province and improves insurance coverage and service quality. Specific requirements are outlined below:
I. Recognizing the Importance of Medical Malpractice Insurance
Departments of health, justice, finance, traditional Chinese medicine, and medical institutions at all levels must thoroughly study and implement policies related to medical malpractice insurance. Insurance serves as a market-oriented mechanism for risk sharing, mutual aid, and social governance, playing a vital role in preventing and resolving medical disputes and fostering harmonious doctor-patient relationships.
Medical malpractice insurance transfers financial liabilities for medical damages from healthcare institutions to insurance institutions through contractual agreements, creating a "buffer zone" and "firewall" between doctors and patients. This mechanism facilitates the transfer of dispute resolution from medical institutions to third-party mediators, thereby maintaining medical order, optimizing the healthcare environment, and promoting the healthy development of the medical sector.
II. Collaborative Promotion of Medical Malpractice Insurance
Departments of health, justice, finance, insurance supervision, and traditional Chinese medicine must strengthen interagency coordination, eliminate buck-passing, and adhere to the principles of government guidance, market operation, fairness, and break-even with minimal profit. Key actions include:
Establishing a Multi-Layered Risk-Sharing Mechanism:
-
- Prioritize medical malpractice insurance as the primary form of risk mitigation, supplemented by medical risk mutual aid funds and medical accident insurance.
- Develop localized guidelines to encourage public hospitals (especially tertiary and secondary institutions) to participate in medical malpractice insurance. By the end of 2015, achieve 100% coverage for tertiary public hospitals and 90% coverage for secondary public hospitals.
Regular Coordination and Information Sharing:
- Hold joint meetings to explore effective collaboration models between healthcare and insurance industries.
- Establish information exchange systems to share data on medical quality, safety, and insurance claims.
Support from Local Governments:
- Secure political and financial support to create sustainable mechanisms for medical malpractice insurance.
Role of Insurance Institutions:
- Optimize insurance products and pricing based on hospital size, type, and risk profiles.
- Implement a rate adjustment mechanism linked to claims rates and hospital management performance.
Responsibilities of Medical Institutions:
- Incorporate medical risk-sharing mechanisms into hospital governance.
- Improve medical quality and safety to reduce disputes.
Functions of Medical Dispute Mediation Committees:
- Mediate disputes in accordance with laws and regulations, ensuring alignment between mediation agreements and insurance claims processes.
- Engage experts from medicine, law, and other fields to ensure fairness and consistency with judicial rulings.
III. Public Awareness and Advocacy
Departments and institutions must collaborate to promote public understanding of medical malpractice insurance through:
- Targeted campaigns to raise awareness of risk prevention, dispute resolution, and insurance benefits.
- Encouraging healthcare providers and patients to utilize mediation and insurance mechanisms.
IV. Supervision and Assessment
Incorporate Insurance Work into Performance Evaluations:
- Include medical malpractice insurance in "Safe Hospital" assessments and healthcare reform evaluation systems.
- Evaluate insurance service quality and claims efficiency.
Reporting and Problem-Solving:
- Regularly summarize best practices and challenges, reporting progress to provincial authorities.
Sichuan Provincial Health and Family Planning Commission
Sichuan Provincial Justice Department
Sichuan Provincial Finance Department
China Banking and Insurance Regulatory Commission Sichuan Bureau
Sichuan Provincial Administration of Traditional Chinese Medicine
July 3, 2015
End of Document