Hamilton Fraser Cosmetic Insurance’s Senior Claims Technician, Emma Bracchi, has seen her fair share of claims over the years. In our latest blog, Emma reflects on her experiences, taking us through the lifecycle of a laser hair removal claim and how to resolve it.
If you’ve ever had a patient make a claim against you, you will know that it can be a very daunting and stressful time. The Hamilton Fraser Cosmetic Insurance team is here to help, with specialist claims handlers who can guide and support you through the entire claim process.
Here, I’m going to talk through the process of a laser hair removal claim where a patient suffered burns and blisters which resulted in scarring to both of their legs.
In the event of a patient suffering an injury from a treatment, you must notify your insurance company as soon possible. Even if the patient hasn’t mentioned that they will be making a claim, it is still important to make sure that your insurer is informed as the injury could give rise to a formal claim at a later date. Patients can make a claim up to 3 years after a treatment has taken place.
In the event of a claim, Hamilton Fraser Cosmetic Insurance has an experienced claims team that will take all of the details associated with the treatment, including what the treatment was, where and when the treatment took place, and who carried out the procedure. We then request a full copy of the patient’s file, a summary of events from the treating practitioner and all correspondence between the client and the patient. When the treatment involves a laser we will also request the laser manual, the protocol and the practitioner’s training certificates. It is therefore important that practitioners have easy access to these documents. If the patient has contacted a solicitor, we will also need a copy of the solicitor’s correspondence.
As part of the claims process we will ask how you feel the treatment went and if you believe that there were any issues, for instance perhaps the laser settings were wrong. It is crucial that, if you made a mistake or an error, you are completely open and honest with us from the start as this will prevent any delays in investigating liability. It is important to remember that we are only human and errors can, and do, occur. This is the prime reason why you take out insurance and we are here to help!
Once all the relevant information has been received, your insurance company will appoint one of their panel solicitors to fully investigate and deal with the matter on your behalf. It is common for these solicitors to ask a number of questions at the beginning of the claim process as they may require clarification on parts of the patient’s file. The solicitor will complete their investigations and will then provide their view on whether liability should be admitted by the practitioner.
Here are two examples of where a claim went from this point:
The patient followed the before care to the letter, doing exactly what they were told to do. A patch test was completed prior to the procedure taking place, to which the patient had no adverse reaction. On the treatment day, the practitioner used the wrong setting and the patient complained that her legs were burning. The treatment was stopped by the practitioner, but the patient’s skin was already extremely red and had started to blister.
In this particular scenario, the liability fell with the practitioner as the recommended settings were changed resulting in the patient becoming injured. The solicitor therefore appointed a specialist to assess the patient’s burn and the extent of the scarring. A suitable offer was then made to the patient (or this could be to their solicitor if they appointed one).
There may be some negotiations on settlement amounts but once the offer is accepted, the insurance company pays the costs for the amount awarded, the patient’s solicitor’s costs and the defence costs for their own solicitor. The client would only be responsible for their excess amount and any VAT element on the defence costs if they are VAT registered.
The patient had an initial patch test with no adverse reactions. As a result they came in for the laser treatment and it was a successfully completed by the practitioner. The recommended laser settings were used and there were no issues noted on the day by the patient or practitioner.
A month after the treatment had taken place the practitioner received a solicitor’s letter alleging that the patient had suffered from burns to their legs following treatment.
In this case, Hamilton Fraser Cosmetic Insurance gathered all the relevant information related to the patient and the insurer’s panel of solicitors began to investigate the case further.
Firstly, they requested a copy of the patient’s GP medical records and hospital records (as the patient had to attend A&E with the burn). As a result of this investigation it was found that the patient had gone on holiday to a hot country post-treatment and had therefore not followed the aftercare advice that had been provided by the practitioner (there was documented evidence that the practitioner had provided this to the patient).
Due to this, liability was denied as there was no negligence on the practitioner’s behalf. Once a claim has had liability denied, the solicitor keeps the file open for a further 12 month period following the last contact point to give the patient’s solicitor time to challenge the denial. A challenge to the denial would be subject to extensive medical evidence proving that our practitioner had in fact been negligent.
This situation would therefore incur defence costs only and the practitioner would be responsible for the excess amount as usual, or the defence costs if they fall within the client’s excess amount.
In the event of a claim it is important to be open, honest and transparent with your insurer. Keeping comprehensive patient files, and carrying out a careful patient selection, consultation and consenting process, as well as being sure to communicate after care advice to your patients is vital to help protect you in the event of a claim.
Most importantly, the cases above both highlight why cosmetic insurance is so important for practitioners in helping to provide peace of mind should the worst happen. Find out more about Hamilton Fraser Cosmetic Insurance, and how it can help support your business, here.
Emma has 19 years of insurance claims experience and is Cert CII accredited. In 2007, Emma joined Hamilton Fraser as a claims handler, drawn to the position because of the dedicated claims team working to help customers throughout the claims process. Emma provides assistance to help guide our practitioners through difficult circumstances to prevent any customer dissatisfaction from developing into formal claims.