The indemnities paid by the insurer of health professionals are reaching new heights. The MACSF recorded almost 4,300 declarations in 2015.
Medical errors are expensive. In 2015, the MACSF paid more than 60 million euros in compensation. The insurance of health professionals published its figures on claims on October 13. She points out that the amounts are getting higher and higher. Prosecutions remain stable but many. Over the year, nearly 4,300 claims were declared by policyholders – medical or paramedical professionals and care establishments. Personal injury clearly dominates: it accounts for almost half of the claims.
Dental surgeons in turmoil
General practitioners are the most likely to report claims, that is to say to be the subject of legal proceedings by their patients. The attacks can be physical or material. If general practitioners are more concerned, it is also because they are the most numerous members of the MACSF. Neurologists represent the second most popular specialty.
Doctors are not the only ones targeted by complaints. Dental surgeons completed 1,600 claims, in front of veterinarians and paramedical professionals as well as midwives. If, among dental health specialists, the trend is downward, this is not the case among maïeuticiennes and healthcare establishments.
Number of criminal complaints filed in 2015. Source : MACSF
The danger of group actions
The claims report shows that the most numerous lawsuits are not necessarily the most expensive. In 2015, the average amount of compensation increased while the number of declarations was stable. From now on, 17% of the compensation exceeds a sum of 100,000 euros. Expert physicians, radiotherapists and stomatologists are the ones who demand the least expenditure from MACSF.
Pediatrics, obstetrics and gynecology and neurology, on the other hand, have a particularly strong impact on these expenses. This is explained by the fact that the consequences are more serious in these sectors or affect a young child. This assumes lifetime compensation. In fact, the most costly claims are those that cause cerebral palsy, as insurance explains. When the impairment is lasting, the one-off compensation is coupled with a life annuity. The amounts can then amount to millions for a single individual.
In healthcare establishments, “the origin of declared claims varies little over the years”, underlines the Managing Director of Sou Médical, Nicolas Gombault. Medical or surgical accidents largely dominate, closely followed by the risk of nosocomial infections. Prosecutions for poor organization of structures are less present. But the insurer underlines a new emerging risk, which all policyholders face: group action, authorized by decree on September 29. “This procedure announces the arrival of new disputes against health professionals”, augurs the MACSF. The impact could be major on the balance between premiums and expenses.
Sanitary scandals that persist
Defective breast prostheses, prescriptions for drugs with devastating side effects … The health scandals that have erupted in France since 2010 continue to affect the finances of the MACSF. The insurer confirms that the “serial claims” persist. In the Mediator case, for example, 200 statements are still open. Files that are still running despite the age of the scandal, unearthed in 2010. That of PIP prostheses is slowly closing: 24 lawsuits are still in progress.
The Dépakine affair, on the other hand, has only just begun. 28 claims were declared to the MACSF. Among the health professionals targeted, 11 are general practitioners. The impact of this scandal should be major: sodium valproate, indicated against epilepsy or bipolar disorders, causes serious malformations in the fetus. A peculiarity that augurs well for major indemnities both in terms of amount and duration.
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