2 Beijing hospitals now offer surgical insurance

Beijing's You'an Hospital and Anzhen Hospital have started to offer surgical insurance programs, following an increasing number of medical disputes.

Since Jan 24, patients being treated in the departments of surgery, interventional therapy and obstetrics at You'an Hospital can purchase a surgical accident insurance by paying 300 yuan ($48) to 4,500 yuan, to be insured for death or surgical complications during procedures or observation afterwards.

"Some surgical accidents are caused by individual health conditions instead of medical malpractice, such as when the patient is very old or when they have some kind of allergy that we didn't know about beforehand. As a result, the company running the medical liability insurance doesn't pay for these accidents," said Yang Yu, director of the hospital's patient-doctor relationship office.

In recent years, the subjects of more than half of the hospital's medical disputes were categorized as accidents not covered by medical liability insurance, yet some patients or their families harassed the hospital, forcing it to pay, Yang said.

The hospital cooperated with an insurance company to design insurance plans against such accidents during specific procedures.

Unlike the medical liability insurance program, which is purchased by hospitals and their medical staff, surgical accident insurance is offered to patients or their family members.

If a patient with the insurance suffers surgical complications or even death during or shortly after a procedure, the hospital's expert panel examines the cause of the damage.

The patient or their family members sign the claim if the panel concludes that the damage was not caused by medical malpractice.

It takes about three days after the claim is submitted for payment to be transferred to the beneficiary's account, but if the patients or their families refuse to sign, professionals from a third party will re-examine whether the hospital should be held responsible for the damage, Yang said.

The payment is swift because the insurance company assesses the claim, said Xing Yuying, general manager of an insurance broker that helped You'an find an insurance company to run the program.

"Whereas in processing a medical liability insurance claim, not only the insurance company, but also the Medical Dispute Mediation Committee and even the courts are involved, thus extending the time span before payment," she said.

The Medical Dispute Mediation Committee is a third party funded by the city's government to mediate medical disputes.

Xu Xuemin, an official at Anzhen Hospital who takes care of medical disputes, said the swift payment could simplify some medical disputes, especially those between the hospital and clients who have financial difficulties or are less educated.

Since November, an insurance company has been selling tailored insurance plans for patients undergoing heart surgery at Anzhen Hospital.

By paying 1,400 to 2,000 yuan, a patient may be eligible for up to 140,000 yuan compensation. The insurance company can process the claim within seven days, Xu said.

"Doctors are not gods. However, it's not easy for patients who lack a professional background to understand that what medical science can do is limited and there are risks that can't be totally avoided," he said.

Deng Liqiang, director of the legal affairs department of the Chinese Medical Doctor Association, welcomed the hospitals' efforts, saying that such insurance can help people who lose family members and have spent their savings on medical treatment.

Patients are more likely to take out insurance against surgical accidents when insurance companies cooperate with hospitals, Xing said.