Błąd medyczny - nowy reżim odpowiedzialności odszkodowawczej : nowe zasady ustalania odszkodowania i zadośćuczynienia w przypadku zdarzeń medycznych

• Autorzy: Aldona Wnęk , Katarzyna Policha

Warianty tytułu

Medical Failure - New Regime of Insurance Liability : New Rules of Loss Assessment and Granting Compensation for Medical Failures

• Języki publikacji: PL

Abstrakty

W dniu 28 kwietnia 2011 r. Sejm uchwalił ustawę o zmianie ustawy o prawach pacjenta i Rzeczniku Praw Pacjenta oraz ustawy o ubezpieczeniach obowiązkowych, Ubezpieczeniowym Funduszu Gwarancyjnym i Polskim Biurze Ubezpieczycieli Komunikacyjnych; wejdzie ona w życie z dniem 1 stycznia 2012 r. Ustawa ta stanowi przełom w regulacjach dotyczących odpowiedzialności za tzw. "błędy medyczne". Dlatego też - jednakże w ograniczonych ramach niniejszego artykułu - warto przybliżyć nowe regulacje oraz podjąć próbę ich pierwszej oceny. W ustawie z dnia 6 listopada 2008 r. o prawach pacjenta i Rzeczniku Praw Pacjenta (dalej: ustawa) wprowadzono blok regulacji dotyczących zasad i trybu ustalania odszkodowania i zadośćuczynienia w przypadku tzw. zdarzeń medycznych (które to czynności powierzono Wojewódzkiej Komisji do Spraw Orzekania o Zdarzeniach Medycznych). Mają one stanowić - w zamierzeniu - alternatywny do sądowego tryb dochodzenia roszczeń. (fragment tekstu)

EN

January, 1 2012 is the date of implementation of an Act of April, 28 2011 concerning patient's rights, Patients' Rights Officer and Act on compulsory insurance, the Insurance Guarantee Found and the Polish Motor Insurer's Bureau. The following regulation can be perceived as a turning point in regulations concerning an issue of liability for so-called "medical failures". This article is an attempt to closely examine new provisions and evaluate them. Authors present new regulations being an alternative for legal course of claim settlement. They take a closer look on provisions concerning rules and methods used for damage and compensation assessment in case of medical events. Moreover, they present a model based on two principles: making provincial committees specialized in issuing medical decisions deal with medical events and paying out indemnity from the compulsory third party liability insurance of hospital providing health service. Medical event is a key concept in designing the new provisions. Authors indicate potential doubts which may occur in jurisdiction in the light of former claims to which an insured was entitled due to infringement of patients' rights established by law. Special attention is devoted to place of the new provisions in the system of compensation law. Details concerning the functioning of provincional committees issuing decisions concerning medical events are presented, paying special attention to procedural aspects: rules concerning committee proceedings, subjects entitled to launch a procedure, deadlines etc. These matters are described from the point of view of the Polish Civil Code (with a special attention paid to code exemptions). Authors also describe the role of an insurer with whom a hospital management concludes an insurance contract regulated by provisions concerning medical activity. The rights and duties of an insurer are indicated including his role in stipulation of an indemnity. Authors analyze the provisions in terms of pursing a claim actio directa and its possible limitations (terminal scope of insurance protection pertaining to claims made and loss manifestation). Authors, separately describe aspects of compulsory third party liability insurance concerning damages caused as the result of medical events. In the light of Act regulating insurance activity, an entity conducting medical activity is obliged to obtain third party liability insurance against damages being an effect of medical events determined by provisions concerning patients' rights and Patients' Rights Officer. They indicate what consequences an exhaustion of maximum amount has or a situation when a hospital fails to conclude an insurance contract and is obliged to pay compensation. Moreover, the author describes a lack of responsibility of the Insurance Guarantee Found and insurer's subrogation claim directed to liable entity. The last element discussed in the article is a description of regulations concerning no fault liability regime illustrated by examples of Nordic system. In the last part of the article, authors point at limitations of the new model and suggest a solution in which a government will take a guarantee liability in case of an insurer's liability exclusion. (original abstract)

Słowa kluczowe

PL

Odpowiedzialność odszkodowawcza; Odszkodowania; Medycyna; Błędy medyczne

EN

Liability for damages; Compensation; Medicine; Medical errors

• Czasopismo: Rozprawy Ubezpieczeniowe
• Rocznik: 2011
• Numer: nr 2(11)
• Strony: 106--123

Twórcy

autor

Aldona Wnęk

• Radca prawny

autor

Katarzyna Policha

• Radca prawny