What are the Leading Home Health Care Insurance Claims?

January 9, 2016

As we’ve discussed in previous articles, in the past decade there has been a significant rise in the elderly population as well as a greater desire among seniors to receive medical care in the comfort of their home. This has been positive for the booming home health care industry, but should not overshadow the fact that the individuals who run and work for home care organizations are exposed to many potential insurance losses. The following are some of the most common patient-related home care insurance claims, as well as how these losses can be controlled.

Medication Errors

These types of errors can occur due to several reasons: not administering medication when scheduled, giving the wrong dosage of medication, a failure to administer the correct medication, etc. There are various risk management tools that can be utilized to help prevent the medication errors. For example, the American Academy of Family Physicians recommends that all healthcare providers be trained to ask their patients – (or the patient’s family members  if the patient is non-communicative)  if they have any allergies or reactions to medications, latex, or food any time the caregiver is administering a new drug to the patient in question. This type of error can most certainly increase the potential for a lawsuit, and Business Professional Liability Insurance coverage can be secured for the home care organization to help address these unfortunate scenarios.

Bodily Injury to a Client

These types of claims typically occur after a client has been moved with the help of a home care firm employee, or after a patient has a slip, trip or fall incident due to the alleged action or inaction of a home care firm employee. Quality training must be provided for all employees and independent contractors so they know the proper ergonomics and patient transfer techniques to use. Another type of bodily injury claim common in home care settings is scalding due to an overheated bath. Insureds/homeowners should be required to check and lower hot water heater temperatures to prevent water from reaching too high of a temperature for the patient.

General Negligence

A home care firm employee may be found legally responsible for harm caused to a patient due to perceived or actual negligence. The individual employee is not the only person at risk of financial loss however; the home care firm itself may be accused of negligent hiring or screening, negligent supervision, failure to maintain adequate health and safety policies, failure to keep the premises reasonably safe and free of hazards or train an employee on how to do so, and failure to provide adequate medical treatment. In order for this type of loss exposure to be insured, all hiring, training, and operational procedures should  be documented.

Abuse

This type of claim is actually not a common occurrence, but home care firms can certainly face allegations or losses of this kind. Identifying elder abuse in the home care setting has been a current events topic in recent years; often times elderly patients may appear confused as to how an injury actually occurred. This could raise suspicions, according to an article published by the Annals of Long-Term Care, and cause both family members and outside health care providers to question the care being provided by the home care firm; therefore bringing on a claim of abuse.   Even if the firm has to “defend” their standards of care without an actual lawsuit, costs can be incurred which can be covered by an appropriate insurance policy for the entity.

This is a brief overview of the most common insurance claims we see in regards to patient-injury related losses, all of which can be addressed with professional and general liability business insurance coverage through Manchester Specialty Programs. In our next blog article, we will discuss property damage related claims that can and do occur in the home care setting. In the meantime if you have any questions about our coverages, please contact us today at 1.855.972.9399.