December 27, 2022

The document on insurance of professional responsibility of medical workers was approved in the Mazhilis

The deputies of the Majilis approved the draft law “On amendments and additions to some legislative acts of the Republic of Kazakhstan on health issues”.

“As you know, Article 270 of the Code “On the Health of the People and the Healthcare System” legislatively establishes the right to insurance of professional liability of medical workers in case of harm to the life and (or) health of the patient when they provide medical care. In order to implement the legal and financial protection of medical workers and the guaranteed rights of patients to compensation for harm, it is necessary to gradually introduce a system of insurance of professional liability of medical workers, which will improve the quality of medical care,” Minister of Health of the Republic of Kazakhstan Azhar Giniyat said at the plenary session of the Majilis, presenting the bill.

She stressed that in international practice, a system of compulsory professional liability insurance is used to protect health workers through the creation of foundations and associations (Sweden, Canada, Denmark), as well as through private markets (USA, Germany, Japan, Turkey).

“The obligation to insure their professional responsibility is imposed on medical workers or healthcare organizations. Based on the above international experience, an adapted market insurance model based on the models of the USA, Germany, Japan and Turkey is proposed as the optimal mechanism for insuring professional liability of medical workers, taking into account the development of the Kazakh society. Patient support services are being created in medical organizations,” the Minister noted.

According to this model, consideration of the complaint will be carried out by a special commission with the involvement of experts and interested parties using elements of mediation, as well as with the involvement of specialized medical associations. At this stage, the issue can be resolved in the medical organization itself.

“If the patient does not agree with the decision of the Service, the complaint can be considered in the territorial division of the Medical and Pharmaceutical Control Committee to provide an expert opinion. In case of a positive result, the materials on the complaint, including the conclusion of the forensic medical examination, will be transferred to the insurance company where the medical organization was insured. Payment of compensation for the damage caused to the patient will be made by the insurance company. In case of refusal of payment and dissatisfaction, the patient has the right to go to court,” the head of the Ministry of Health said.

The amount of the insurance premium will be determined taking into account the degree of responsibility of the medical worker on the basis of approved actuarial calculations, depending on the degree of risk.

“Based on the above, the Ministry proposes a developed adapted model of imputed insurance of professional liability of medical workers through existing insurance companies, with the maximum amount of financial liability of the insurer, with financing through the tariffs of medical services, where the employer acts as the policyholder, and the medical organization enters into a collective agreement with the insurance company,” A. Giniyat added.