The following claim illustrates the value of legal expenses protection for professional practitioners who are vulnerable to patients or customers making accusations against them. In these cases individuals are unable to recover legal costs and experts' fees from the person making the complaint or from their professional body. Even if practitioners feel confident to represent themselves in person at a conduct or disciplinary hearing they could be exposed to significant costs needed to obtain an expert's opinion.
Background of claim
Our insured, who practiced as a chiropractor, was notified by his profession's regulatory body that it had received a complaint from one of his patients. The patient alleged that our insured's practice had published misleading or inaccurate statements on its website which gave the impression that our insured was a registered medical practitioner (when he is not); notes of the consultation were inaccurate; there had been a failure to record diagnosis and plan of care. Our insured was required to attend a Professional Conduct Hearing.
Establishing an insurance claim
We took advice and were satisfied that allegations of providing misleading or inaccurate information did not amount to acts of dishonesty and were not therefore caught by the "dishonesty" exclusion applicable under his policy. We appointed a lawyer to determine whether there were reasonable prospects of successfully defending the insured. The lawyer required a Chiropractic expert report to advise on the facts of the case in order to determine prospects of success. As the expert's report confirmed that none of the matters complained of were sufficient to constitute unacceptable professional conduct he was able to confirm that there were prospects of successfully resisting the allegations.
Prior to the hearing our insured's professional body served a further witness statement and two additional expert reports in which their expert opened up a new issue, which, simply put, brought to light the possibility that our Insured had technically gone beyond the neck and thoracic area when treating the patient’s neck symptoms. Our insured's lawyer obtained advice from a barrister and our expert’s views on this and engaged in further reading, which confirmed prospects of success continued in favour of our insured.
The case took five days to conclude and was successful in that our insured was exonerated of unprofessional conduct.
What the policy pays
We are currently awaiting receipt of the solicitor's invoice for costs and disbursements, however we expect to pay around £38,000 which includes fees for expert's reports (£11, 700), barrister's fees(10,800) and our insured's solicitor's fees and costs (£15,500).