Professional Indemnity & Medical Malpractice & Liability Policy

 For Members of the SMTO  

This is to certify that in accordance with the authorisation granted under the Contract (the number of which is specified in the Schedule) to the undersigned by certain Underwriters at Lloyd's, whose names and the proportions underwritten by them, which will be supplied on application, can be ascertained by reference to the said Contract which bears the Seal of Lloyd's Policy Signing Office and in consideration of the premium specified herein, the said Underwriters are hereby bound, each for his own part and not one for another, their Heirs, Executors and Administrators, to insure in accordance with the terms and conditions contained herein or endorsed hereon.

 The Underwriters hereby agree, to insure against loss including but not limited to associated expenses specified herein, if any, to the extent and in the manner herein provided.

 If the any of the Insured Members shall make any claim knowing the same to be false or fraudulent, as regards amount or otherwise, this Certificate shall become void and all claim hereunder shall be forfeited.

 In Witness whereof this Certificate has been signed at the place stated and on the date specified in the Schedule by  

     H & L BALEN & COMPANY

Specialist Insurance Brokers for Complementary Health Professionals

33, Graham Road, Great Malvern, Worcs, WR14 2HU

Tel: 01684 - 893006   Fax:  01684 - 893416

Established 1950 – Over 47 years of Service, Support and Advice

SMTO BLOCK INSURANCE SCHEME WORDING

THIS IS A CLAIMS MADE AGGREGATE POLICY (COSTS IN ADDITION)

Whereas the Professional Association as named in the schedule, has made to Underwriters a written “no-claims” declaration and submitted a list of Insured Members that is hereby agreed to be the basis of this certificate and incorporated herein.  In addition, the premium must have been received by Underwriters in accordance with the agreed schedule of premiums, and a list of members regularly updated at agreed intervals.

 WE THE UNDERWRITERS, to the extent and in the manner hereinafter provided, hereby agree to indemnify the Insured member against all sums which the Assured shall become legally liable to pay as damages arising our of any bodily injury, mental injury, illness, disease or death of any patient caused by any negligent act error or omission committed by the Insured Member in or about the conduct of their occupation or business, or Good Samaritan Acts, (hereinafter referred to as "Malpractice") and pay in addition to the Limit of Indemnity all defence costs, expenses (including Claims handling) incurred with Underwriters' consent, such consent not being unreasonably withheld, in connection with any Claim which falls within this certificate.

It is further provided that Underwriters shall not be obligated to pay any Claim, judgment, award, defence costs or expenses, or to undertake or continue defence of any suit or proceeding after the Limit of Indemnity has been exhausted by payment of judgments, awards, settlements, defence costs, or expenses or after deposit of the applicable Limit of Indemnity in a court of competent jurisdiction, and that in such a case, Underwriters shall have the right to withdraw from the further defence thereof by tendering control of said defence to the Insured Member.

 PROVIDED ALWAYS THAT

Such Malpractice results in a Claim being first made against the Assured during the Period of Insurance as stated in item 7 of the Schedule and of which immediate notice has been given in accordance with Special Condition 2.

DEFINITIONS

(i)

The expression 'The Insured Member" shall be deemed to mean:

A Member of the Professional Association named above whose name has been submitted for inclusion under this policy and who has paid the appropriate Insurance Premium to either the Association or the Insurance Brokers concerned.

Cover for this individual may also extend to indemnity to any partnership, corporation, institution or such other entity that may have legal capacity or interest although not specifically named in the Schedule or List of Members.

It shall also mean any person who is has been or may become during the period specified in the Schedule, a principal or employer, partner, director, a member of any ethics committee, employee or volunteer of the Insured Member but only in respect of Claims arising from work undertaken on their behalf by the Insured Member. The personal representatives of the estate of any persons who would otherwise be indemnified under this policy.

(ii)

The expression "Good Samaritan Act" shall mean treatment administered at the scene of a medical emergency, accident or disaster by the Assured who is present either by chance, or in response to an S.O.S. call following a disaster.

(iii)

The expression "Claim" shall mean any of the events that the Assured is required to give notice to Underwriters in accordance with Special Condition 2.

(iv)

Except where the context otherwise requires, words denoting the singular include the plural and vice versa; words denoting any gender include all genders.

(v)

The expression “run off” referred to later in this policy means the period after discontinuance of membership of this Insurance Scheme where cover for previous acts performed still needs to be maintained in order to provide ongoing protection.

(vi)

It is understood and agreed that if the Insured Person works as an employee or for another organisation, this policy will indemnify the employer or organisation, but only in respect of the work performed by the Insured Person on their behalf.

  EXCLUSIONS  

(i)

Any Claim arising from activities not stated in the Member’s Insurance Certificate, unless sight of qualifications and underwriter’s prior approval has been obtained.

(ii)

Any Claim arising out of any Malpractice occurring prior to the inception date of this Scheme if the Assured on such date knew or could have reasonably foreseen that such Malpractice might be expected to be the basis of a Claim and has not declared this to Underwriters prior to cover.

(iii)

Any Claim arising from any circumstance or occurrence that has been notified under any Insurance incepting prior to this certificate.

(iv)

Any Claim in respect of which the Assured is entitled to indemnity under any other Insurance except in respect of any Excess beyond the amount which would have been payable under such other Insurance had this certificate not been effected.

(v)

Any Claim arising out of a specific liability by the Assured under contract which goes beyond the duty to use such skill and care as is usual in the exercise of the Assured’s normal activities, UNLESS Underwriters' agreement has first been obtained an endorsement made upon the certificate and such other terms and conditions as may be imposed be accepted

(vi).

Any Claim made against a Director or an Employee of the Assured, serving in a managerial or executive capacity, which shall be defined as an "Officer", by any third party arising solely and directly from a breach of any duty as an Officer

(vii)

Any claim by any person for bodily injury, mental injury, disease or death incurred contracted or occurring while under a contract of service or apprenticeship with the Assured, or for any breach of any obligation owed by the Assured as an employer to any employee, or any Claim in respect of which compensation is available under any Workers' Compensation scheme or plan. However, this exclusion shall not apply to any Claim arising out of any bodily Injury, mental injury or death of any employee that is caused by any negligent act, error or omission of an Assured, where the employee is a patient of the Assured.

(viii)

(ix)

Any Claim directly or indirectly caused by, or contributed to, by, or arising from; ionising, radiation or contamination by radioactivity from any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel or from the radioactive toxic explosive or other hazardous properties of any explosive nuclear assembly or nuclear component thereof.

(x)

Any Claim arising from war, invasion, acts of foreign enemies, hostilities, (whether war be declared or not) civil war, rebellion, revolution, insurrection, military or usurped power or confiscation or nationalisation or requisition or destruction of or damage to property by, or under the order of any government or public or local authority.

(xi)

(xii)

Any fines or penalties.

(xiii)

Any Claim emanating from work performed abroad, other than actions brought against the Insured person in a Court of United Kingdom Jurisdiction.

(xiv)

Any Claims or liability arising from a condition directly or indirectly caused by or associated with Human T-Cell Lymphotropic Virus type III HTLV III) or Lymphadenopathy Associated Virus (LAV) or the mutants derivatives or variations thereof or in any way related to Acquired Immune Deficiency Syndrome or any syndrome or condition of a similar kind howsoever it may be named. However, this exclusion does not apply to Claims or liability arising out of treatment by the Member of any person suffering from A.I.D.S. or H.I.V. Positive that would have been covered by this certificate in the absence of this exclusion.

SPECIAL CONDITIONS  

1

a)

The statements and particulars contained in the Declaration Form attached hereto are true

b)

During the Period of Insurance the Assured shall give immediate notice in writing of any alteration which materially affects the risk; and

2

During the Period of Insurance the Insured Member shall give immediate notice in writing of;

a)

Any Claim for Malpractice or alleged Malpractice made against them or

b)

The receipt of notice from any person of an intention to hold them responsible for any Malpractice or

c)

Any conduct or circumstance may give rise to a Malpractice Claim being made against the Insured Member

3

The Assured shall at all times;

a)

Maintain accurate descriptive records of all professional services and equipment used in procedures which shall be available for inspection and use by Underwriters or their duly appointed representatives insofar as they pertain to any Claim hereunder; and

b)

Retain the records referred to in 3(a) above for a period of at least seven (7) years from the date of treatment and, in the case of a minor, for a period of at least seven (7) years after that minor would attain majority; and

c)

Give to the Underwriters or their duly appointed representatives such information, assistance signed statements or dispositions as Underwriters may require; and

d)

Assist in the defence of any Claim without charge to the Underwriters; and

4)

the Member shall not disclose to any person the terms of this certificate. No liability shall be admitted. No arrangement, offer, promise, or payment cost or expense shall be made by the Insured Member without the written consent of the Underwriters. Underwriters shall be entitled to take control of the defence of any Claim or to prosecute in the name of the Member for their own benefit any Claim for indemnity or damage or otherwise against any third party and shall have full discretion in the conduct of any negotiations or proceedings on the settlement of any Claim; the Underwriters will not settle any Claims without the consent of the Member.  However, if, the Member refuses to consent to any settlement recommended by the Underwriters or their legal representatives and elects to contest or continue any legal proceedings then the liability of the Underwriters' shall not exceed the amount for which the claim could have been so settled plus the costs and expenses incurred with their consent up to date of such refusal, and the Member agrees to indemnify Underwriters for the amount of any judgment, award, settlement, costs and expenses which Underwriters are found obligated to pay after the date of such refusal; and

5)

if a payment is made to dispose a claim which exceeds the Limit of Indemnity available under this certificate, Underwriters' liability in respect of the costs and expenses of the Assured shall be for such proportion of the total costs and expenses incurred as the Limit of Indemnity under this certificate bears to the total amount paid to dispose of the claim against the Insured Member

6)

Underwriters may cancel this Insurance by giving thirty (30) calendar days’ notice such notice shall be given in writing and may be served by registered mail, telex or facsimile transmission, or be hand delivered to the address of the Member as advised by their Profession Body. Any notice sent by registered mail shall be deemed to have been served seven (7) calendar days after dispatch and any notice sent by telex or facsimile shall be deemed to have been served at the time of dispatch. If Insurance is so cancelled the Underwriters shall retain only the earned portion of the premium computed from day to day.

7)

In the event that any internal or invasive procedure is performed by the Insured: -­

a)

Hypodermic needles are used once only.

b)

Any instrument having need to contact or penetrate tissue will be either: -­

(i)

used once only and discarded or

(ii)

will be sterilised in an approved autoclave before reuse or

(iii)

sterilised by immersion in one of the following specified:

Gluteraldehyde -  1 percent for not less than two hour or

Gluteraldehyde -  2 percent for not less than one hour or

Sodium Hypochlorite   -  0.5 percent for not less than one hour.

c)

Any surface, which has received spillage of human or animal body fluid or has been contacted by human or animal tissue, shall be thoroughly cleansed by one of the solutions set out in (b) (iii) above.

1.

This lnsurance is extended to cover Libel & Slander as follows: -

This certificate will indemnify the Member for sums which the Insured become legally liable to pay in respect of claims made upon them in direct consequence of any Libel and Slander uttered by the Assured or Breach of Confidentiality in their professional capacity as stated in the Schedule. This Insurance shall not extend to any communication or contribution to the press, radio or television unless previously agreed with underwriters.

The liability of the underwriters for damages shall not exceed the limit of indemnity as stated in item 3 of the schedule as respects any one claim nor the limit of indemnity as stated in item 3 of the schedule in the aggregate as respects all claims made and within the coverage afforded by this endorsement. The aforementioned aggregate limit of liability as respects all claims shall be part of and not additional to the aggregate limit of liability stipulated in the certificate to which this endorsement attaches and of which it forms part. As used in the endorsement, the term claim shall include all defence fees and expenses incurred in connection therewith.

2.

This insurance is extended to cover Professional Indemnity as follows: -

Not exceeding the Limit of Indemnity as stated in item 3 of the Schedule, (within and not in addition to the Limits of Indemnity stated in the Schedule) Paragraph 2 of the certificate (the Insurance Clause) is not restricted to liability to pay damages arising out of "bodily injury or mental injury to or death of any patient" and covers all sums of which the Assured shall be held legally liable to pay for damages and Claimants' Costs and Expenses caused by or alleged to have been caused by error, omission or negligence in professional services rendered or which should have been rendered by the Assured or any person acting for or on behalf of the Assured.  Wherever the word "Malpractice" appears herein the same shall be deemed to include any other error, omission or negligence in professional services.

a)

The following Exclusions are applicable to extension 2 only: -

Employers' Liability

i)

arising directly or indirectly from bodily injury, sickness, disease or death sustained by any person arising out of and in the course of his or her employment by the Assured under any Contract of service or apprenticeship or for any breach of any obligation owed by the Assured as an employer to any employee

Land, buildings etc.

ii)

arising directly or indirectly from ownership, possession or use by, or on behalf of the Assured of any land, buildings, aircraft, watercraft, vessel or mechanically propelled vehicle.

Dishonesty

iii)

arising directly or indirectly from any dishonest, fraudulent, malicious or illegal act or omission of the Assured.

Infringement

iv)

alleging Infringement of Copyright, Patents, Registered Designs, Trade Marks or Passing-off.

Contractual liability

v)

arising directly or indirectly from any Liability assumed by the Assured under any express Warranty, Agreement of Guaranteeing unless such liability would have attached to the Assured notwithstanding such express Warranty, Agreement or Guarantee.

Property damage

vi)

arising directly or indirectly from damage or destruction to Property.

Insolvency/bankruptcy of the assured

vii)

arising out of or relating directly or indirectly from the insolvency or bankruptcy of the Assured

Seepage & pollution

viii)

based upon, arising out of or relating directly or indirectly from or in consequence of or in any way involving seepage, pollution or contamination of any kind.

3.

This Policy is extended to cover Products Liability as follows :-

It is hereby agreed that Underwriters will indemnify the Member against all sums which they shall become legally liable to pay as a sub-limit of, and not additional to the limit as specified in item 3 of the schedule for compensation to a patient or other individual in respect of:

a)

bodily injury (which expression includes death and illness)

b)

damage to property (which expression includes loss of property)

arising out of an accident and caused by goods manufactured, formulated or dispensed.

4.

This Policy is extended to cover Public Liability as follows: -

It is hereby agreed that Underwriters will indemnify the Member against all sums which they shall become liable to pay as a result of claims arising out of any bodily or mental injury, illness, disease or to any person, or loss of or damage to tangible property of any person in connection with the Assured’s professional duties, ownership of property used for professional purposes, or from activities in the course of the business, including the provision of food and drink and in respect of damage to property leased or rented to the assured (hereinafter referred to as “Public Liability”).

5.

If membership of this scheme discontinues, cover for “run – off” is provided as follows: -

A.

In the event of Death or prior Permanent Retirement in event of ill health, disablement or ceasing to work -for an unlimited period, provided this Block Scheme remains with Underwriters.

B.

In the event of Maternity Leave or Serious Illness or Disablement, for a temporary period of up to one year from the date of discontinuing work.  Member can then rejoin the policy and pay an appropriate premium for the remainder of the policy year.

C.

In the event of ceasing to be a member and / or discontinuing to practice and/or for any other reason, for up to a three year period: alternatively for an unlimited period from the termination date of cover for the Insured Member at one year’s premium, subject to underwriters approval and provided this Block Scheme remains with Underwriters thereafter.

6.

In the event of Criminal Allegations or Disciplinary Hearings against the Insured member: -

Insofar as any allegations of sexual impropriety are concerned, Underwriters at their discretion may offer an ex-gratis refund of legal defence costs in the event of the Insured Member being found subsequently innocent. Insofar as Disciplinary Hearings arising from allegations of misconduct of the Insured Member by own Association £25,000 of Legal & other Defence Costs can be provided.

7. 

Multi-therapy

The insured Member is covered for additional therapies for which a recognised qualification has been obtained, provided such therapies are defined on the certificate, or agreed subsequently with underwriters.

 E.U. DISCLOSURE CLAUSE (UK)

 Notice to the Assured

 The Parties are free to choose the law applicable to this Insurance Contract.  Unless specifically agreed to the contrary this insurance shall be subject to English Law.

 E.U. DISCLOSURE CLAUSE (Scotland)

 Notice to the Insured Member resident in Scotland

 " It is hereby noted and agreed that where the E.U. Disclosure Clause (UK) refers to English Law, the policy is amended to read Scottish Law".

 Any enquiry or complaint should be addressed in the first instance to your Scheme Broker: -