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Locum Cover

Few GPs and Practice Managers can doubt the importance of Locum Insurance; by far the vast majority of GPs will have their own individual plan or be part of a group Locum insurance scheme. Medical Money Management provides this guide to the different types of cover available.

If a partner becomes incapacitated due to illness or injury, a Locum will often need to be employed to cover his or her duties.  Locum costs have risen dramatically in recent years and the absence of suitable insurance can have significant financial implications for the Practice.  With average Locum costs at around £200 per session and reimbursement of these costs by the PCTs ever more hard to come by, it is essential that individuals and Practices check the type of cover they have, and more importantly, the level of benefits that would be payable in the event of a claim.

More Practices than ever are opting for a group Locum plan as they are generally available at a lower premium than for individual contracts.  In the event of a claim, the value of a group scheme is even more evident, with payment of benefits from the plan payable to the Practice, rather than to the individual. 

There are many features to look out for when comparing different insurance policies:

Permanent or Reviewable Cover

·                     Permanent cover (when available) guarantees insurance to remain in place without a change to the terms and conditions until a specified date, normally the insured person’s retirement age.  this plan tends to be the most expensive, and premiums may be reviewable.

·         Reviewable insurance plans reserve the right to review the terms and conditions applicable to the scheme as a whole, based on claims experience, rather than to individual scheme members. 

·         Annually reviewable schemes reserve the right to amend the terms applicable each year to reflect an individual’s claims history.  For example, if a doctor submits a claim for a particular condition, the insurer may remove cover for that condition in the future.  These tend to be the least expensive Locum insurance plans.

Medical History

Many insurers will insist on a lengthy medical questionnaire to be completed and may ask the applicant to undergo a medical examination.  Alternatively, some will dispense with the need for submitting evidence of health by stating that any condition experienced in the previous two years will be excluded until such time that the applicant has been free of symptom or treatment for a period of two years after the commencement date.

Locum Receipts

Most insurers require receipts for Locum expenditure before they will reimburse the GP or Practice.  Some will be more flexible, without necessarily having higher premiums, where a fixed benefit is payable, regardless of whether a Locum is employed or the duties of the incapacitated GP are carried out by another Doctor within the Practice.

Stress Related Conditions

Evidence suggests that claims for stress related conditions are continuing to increase, and this is a cause for concern for insurers.  Some have placed significant restrictions on the cover for such conditions, and attention needs to be focussed on this issue, particularly with the lower cost insurance schemes.

Maternity, Paternity and Family Emergency cover

Some insurance plans will pay a fixed benefit when absence is for maternity, paternity or family emergency leave, providing extra flexibility for GPs and Practices.

Suspension Cover

We all hope that we would never be suspended whilst being investigated by any Regulatory Body but are all aware that this does happen.  As this is becoming more of a concern to Practices, suspension cover has now been introduced by at least one of the major Locum insurance schemes.

Jury Service

With the changes to the Criminal Justices Act which came into effect in April 2004, we all have a legal obligation to serve as a juror when summoned to do so.  Jury Service usually lasts for up to two weeks.  During this time, a Practice may well employ a Locum, and may be able to submit a claim on their Locum plan if it includes Jury Service cover, typically at £250 per day.

Inflation Protection

You must check that your insurance will offer some form of inflation protection to take account of ever increasing Locum costs.  Many insurers do not offer any automatic inflation protection.

If you would like specific advice on this topic, please complete and return our web enquiry service form, so that one of our specialist advisers can assist you.