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Guangdong's Latest Guidelines on Promoting Medical Accident Insurance: Insurance Companies May Pay for Medical Accidents

Preface: On the 17th, Guangdong launched the Guangdong Medical Accident Insurance, a national demonstration project where medical risks are shared by both doctors and patients. Third-party experts from the medical dispute mediation committee determine medical losses, clarify medical liabilities and the compensation amount to be borne by doctors, and then the insurance company makes the payment. Medical liability insurance provides compensation when medical institutions have negligence or faults in their medical practices and should bear certain responsibilities, or grants appropriate humanitarian compensation based on the principle of fairness. The occurrence of doctor-patient disputes, even incidents of medical disturbances or violence, is significantly related to the serious information asymmetry between doctors and patients and the patients' insufficient understanding of medical risks. According to Wang, insured patients will have their emotions soothed after receiving timely compensation from accident insurance, which will reduce the occurrence of doctor-patient disputes and "medical disturbance" incidents.

It is inevitable for us to get sick in our lives; each of us will inevitably encounter some illnesses. What if there is an unexplainable medical accident like "the surgery was successful, but the patient died"? On the 17th, Guangdong launched the Guangdong Medical Accident Insurance, a national demonstration project where medical risks are shared by both doctors and patients.


 

The accident insurance has a fixed scope. Let's learn about the relevant regulations in detail: the insurance coverage includes accidental incidents during inpatient surgeries at all levels, providing timely economic compensation for inpatients in case of serious consequences of elective surgeries, operations, anesthesia, and postoperative complications, so as to reduce losses caused by surgical accidents.


 

In the past, the insurance system for doctor-patient disputes relied on medical liability insurance. Third-party experts from the medical dispute mediation committee would determine medical losses, clarify medical liabilities and the compensation amount to be borne by doctors, and then the insurance company would make the payment. Medical liability insurance addresses the compensation liabilities that medical institutions should bear. It provides compensation when medical institutions have negligence or faults in their medical practices and should bear certain responsibilities, or grants appropriate humanitarian compensation based on the principle of fairness.


 

Wang, Chairman of the China Doctor-Patient Dispute Mediation Alliance and Director of the Guangdong Harmonious Doctor-Patient Dispute People's Mediation Committee, introduced that according to the dispute handling statistics of the medical dispute mediation committee, there are cases where medical institutions are not liable and have no faults, in which case they do not need to bear corresponding medical compensation liabilities. However, for patients and their families, unpredictable sudden serious consequences are often unacceptable. The occurrence of doctor-patient disputes, even incidents of medical disturbances or violence, is significantly related to the serious information asymmetry between doctors and patients and the patients' insufficient understanding of medical risks.


 

Medical accident insurance has certain characteristics. One noticeable feature is that it is result-oriented. Even if the liability for some medical disputes is difficult to determine, the insured can still receive corresponding compensation from medical accident insurance and can promptly get help from the medical dispute mediation committee to assist in handling claims for medical accidents. Wang stated that insured patients will have their emotions soothed after receiving timely compensation from accident insurance, which will reduce the occurrence of doctor-patient disputes and "medical disturbance" incidents.