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Premium case of diminishing returns

It’s almost five years since it became mandatory for all doctors in Australia to have medical indemnity insurance.

I come from the low tax state, Queensland, where it was never essential to have indemnity insurance, though public Queensland doctors had always had discretionary cover for work performed at a public hospital.

The discretionary nature of that cover was tested at times, leading to a bitter dispute between Visiting Medical Officers and Queensland Health.

At that time, I was unimpressed by the disingenuous nature of Queensland Health’s insurance, and ventured onto talk-back radio to vent my spleen.

I was introduced as “Doctor Bruce from the Sunshine Coast”, lest my true identity become known and my employer discipline or dismiss me for daring to speak publicly.

My point back then was that if I wasn’t properly insured, then the patients weren’t covered either.

Next time I’ll have to choose a more discrete moniker because, after getting off the air, I had three friends call me to ask whether that was yours truly on the radio.

I do recall as a medical student being told to never practise without insurance, and it was always my routine to ask colleagues who they were insured with before entering into an on-call arrangement.

As more international medical graduates arrived from countries with differing degrees of litigation, this became a more interesting conversation.

One newly-arrived colleague told me that he was indemnified “by the Church” who owned the hospital that he worked at.

Could there be any better cover than that, I wondered!

It’s hard to imagine how anyone would even dream of practising as an un-insured doctor, but national legislation eventually mopped up the recalcitrant.

In the same breath, it doesn’t make sense to not insure your car, or does it?

Having owned a car that is 18 years old and worth about $3000 (if I’m lucky), I have dutifully forked out $750 every year for fully comprehensive cover.

At first that seemed cheap, when I considered that my car had cost me $68,000 in 1997.

But that $750 has seemed to become increasingly steep as my car drifts further south in value.

Unlike lawyers who have a four-figure excess on their indemnity policies, doctors don’t pay any excess at all, which will always be comforting when that inevitable writ arrives.

I’ve just done the maths with an on-line tool that tells me I have a 42 per cent chance of having a complaint made against me to a regulator in the next two years, which reminds me that I must practise even more defensively.

In my practice, that might mean refusing to see anyone where there might be any risk of self-harm or any possibility of a side-effect arising from the prescribing of complex medication regimes.

It’s a bit like owning a car but never driving it, just in case you have an accident.

Excesses in motor vehicle insurance can be steep. My current policy carries an excess of $600 for myself, and another $1300 if an un-listed driver younger than 18 years crashes my car.

That means I’m paying a premium of $750 a year for a car which, if written off, might return me a payout of $1100.

I’ve done my sums and decided to down-grade to a third party property policy for $150, and to keep the number of the wreckers in my glove box if I have a bingle.

Well done I thought.

There is, after all, no point in paying for insurance you don’t really need.

Now that brings me to reviewing my life insurance.

Do I really need it?

Safe motoring,

Doctor Clive Fraser