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.
Further 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 outcome
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).
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