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Who should pay patients for medical errors? Kazakhstan is adopting a law on malpractice insurance - P4H Network

Who should pay patients for medical errors? Kazakhstan is adopting a law on malpractice insurance

For the first time in history, Kazakhstan is adopting a law on medical malpractice insurance.
 

The Minister of Healthcare of the Republic of Kazakhstan, Azhar Giniyat, presented the draft law to the lower chamber of Parliament – Mazhilis. This law was developed in response to the instructions by the Head of State earlier this year. The Minister of Healthcare noted that they analyzed international best practices, looked at medical malpractice lawsuit statistics and complaints from individuals and legal entities in 2018–2020 involving more than 14 thousand cases. The Ministry of Healthcare also analyzed various models of malpractice insurance.

The most suitable mechanism for insuring professional consequences for cases, taking into account the development of Kazakhstani society, is an adapted market mechanism for malpractice insurance model – through involvement of existing insurance companies, and pre-trial settlement of conflicts between patients and providers, such as in Sweden, Canada, the USA, Japan and Turkey.

“Taking into account the experience of past years, according to the analysis of existing practice and discussions with various stakeholders – the public, public and private sectors, we decided to implement a model of professional liability insurance of medical workers that involves purchasing liability insurance plans from existing private insurance companies, where the cost of insurance premiums will be borne by the employer – a medical organization, with planned introduction of licensing of individual providers (medical professionals) to increase the responsibility of participants in the malpractice insurance system” A. Giniyat said.

According to this model, complaints will be initially reviewed at the level of the internal audit service of a health care organization, potentially with the involvement of insurance companies, using elements of mediation, as well as with the involvement of medical professional associations. The issue can be resolved in the medical organization at this stage without going further to court.

If the patient does not agree with the outcome of the audit service review, the complaint will be transferred to the territorial branch of MoH agency on medical and pharmaceutical control.

In case when they decided the patient deserves compensation, the materials will be transferred to the insurance company where the medical organization was insured for professional liability of its employees. The payment will be carried out by the insurance company for only those cases that were approved by the Ministry of Healthcare.

The amount of the payout is determined by statistical actuarial calculations, depending on the degree of risk, the specialty, etc. Taking into account the social orientation of the health care sector, at the initial stage of this insurance system, we will have maximum limits for the payout by insurance companies, clarified the Minister.

From 2023, it is proposed insurance premiums will be paid at the expense of the employer, and starting from 2025, it is proposed to divide the cost of the insurance premium between the medical organization and the medical worker, which will lead to joint responsibility.

 

Source: Ministry of Healthcare