Insurance, complaints and claims handling - Hamilton Fraser

The third Aesthetics Business Conference (ABC), held at the Royal College of Physicians on 26 September, was a resounding success. The speaker sessions were packed with valuable insights for both experienced practitioners and start-up businesses within the aesthetic industry.

Hamilton Fraser’s Cosmetic Account Handler, Shelly Hemmings, led the first session, focusing on various aspects of the insurance side of best practice in aesthetics. With delegates describing her presentation as ‘incredibly informative’ and ‘professional’, here is a recap for those of you who missed it.

Shelly spoke extensively about the importance of having a comprehensive insurance policy in place, different types of claims that practitioners may encounter, and provided top tips for preventing claims in the first instance.

Opening her talk on the topic of medical malpractice and its importance to aesthetic practitioners, Shelly quickly engaged the audience by asking whether they would get in a car if they knew it wasn’t insured. With the unanimous answer from delegates being “no”, Shelly then questioned why anyone would agree to work on patients knowing they didn’t have adequate insurance in place.

Shelly pointed out that Hamilton Fraser’s standard policy covers medical malpractice, with a £5m limit of indemnity that protects practitioners administering cosmetic treatments anywhere in the UK.

She also highlighted that Hamilton Fraser can insure multiple entities, such as limited companies and partnerships, simultaneously under a type of policy called a “Corporate Policy”. This policy can be extended to protect the partners and employees of the main company.

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The difference between an insurance policy and membership of a defence union

Shelly raised an important point about the distinction between an insurance policy and membership of a defence union, and provided an explanation of the differences.

Key differences include:

At Hamilton Fraser, we encourage our practitioners to have both insurance and a membership with a defence union. This is because an insurance policy is a contract between the insurance provider and their client, in which the provider outlines the conditions under which they are able to protect clients in the event of a claim. However, a Defence Union membership exists to offer general medical advice and serve as an extension to an already existing medical cover.

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The distinction between complaints and claims

Another important topic covered by Shelly was the distinction between complaints and claims.

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Complaints

Shelly explained that a complaint can be defined as any expression of dissatisfaction, whether written or verbal. In Hamilton Fraser’s experience, complaints typically arise when a patient is dissatisfied with a treatment, the aftercare process, the results of the treatment, or has experienced unexpected side effects or injury as a result of the treatment.

It was also noted that common service-related complaints, such as delayed appointments, poor customer service, and price of treatments, would not be covered under the medical malpractice protection. However, Shelly suggested that in these scenarios practitioners should refer to the Cosmetic Redress Scheme, which is designed to help practitioners deal with complaints of this nature. By joining the scheme, practitioners will have access to specialist members’ resources, such as templates they can use for complaint procedures and advice on handling complaints.

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Handling a complaint

Shelly recommended some keys steps that practitioners should take to protect the integrity of their business should they receive a complaint.

Step 1 – Acknowledge receipt of the patient’s complaint within 24 hours

• This is not a legal timeframe, but it is important to prioritise the complaint so that the patient understands that their issue is being taken seriously
• Resolving the complaint quickly and efficiently will prevent the issue from escalating and reduce the likelihood of incurring costs to their company

Step 2 – Provide an estimated timescale for resolution

• It can be difficult to provide a timescale, but again, doing so will help make the patient feel comfortable that their issue is being resolved in a timely manner

Step 3 – Investigate the complaint

• It is imperative that a thorough and honest investigation into the treatment is carried out

Step 4 – Provide a summary of your findings

• An objective, professional, and comprehensive summary of the patient’s treatment must be reported, including findings
• Practitioners must not admit liability
• Avoid defensive language

Step 5 – Conclusion and next steps

• The investigation should result in a satisfactory outcome between the practitioner and the patient
• Provide a formal response which outlines the next steps, which could be
• To thank the patient for drawing attention to their concerns and explain that, following a thorough investigation into the complaint, it has been determined that there will be no further action required

OR

• As a gesture of goodwill, offer further treatment to resolve the side effects that they may be experiencing

Shelly advised that if a practitioner is unsure of how to conclude the matter, it is best to get in touch with their insurance provider for support. For example, at Hamilton Fraser our in-house claims team can offer support and advice on the best course of action, which will not impact on your policy premium.

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Claims

Shelly explained that a claim is an application for compensation under the terms of an insurance policy where an allegation of negligence has been made against the medical professional. Formal claims are typically received in the form of a solicitor’s letter, which signifies legal intervention. This is generally accompanied by a request for compensation on the patient’s behalf.

Shelly noted that mistakes can occur in any industry and advised practitioners not to take it personally if a claim is made against them. She also advised them not to act or contact a patient before consulting their insurers, as doing so could jeopardise their reputation and business.

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Handling a formal claim

In the event that a practitioner receives a formal complaint, they must report it to their insurer immediately. They must then provide the following documentation:

• Solicitor’s letter/compensation request
• Consultation and consenting documentation
• Photographs – (before treatment)
• Any leaflets or electronic documents
• Training certificates
• Any correspondence between them and the patient
• A summary

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In addition to this, Shelly offered some tips on how practitioners can prevent a claim from being made against them in the first instance.

1. Patient selection

• It is important to ensure from the beginning that your potential patient is suitable to undergo the requested treatment by following a thorough patient selection process
• If there are any indications during the consultation that they may not be suitable for the treatment, or that you cannot meet their expectations, it may be worth advising the patient that you do not feel you are the right practitioner for them

2. Understand their motivations and manage their expectations

• This helps practitioners to determine whether or not a patient is right for them
• When discussing the patient’s expectations, it is important for practitioners to be honest as to whether they feel they are achievable – be sure to document these conversations during the consultation process

3. Make sure that you document everything and have time-stamped photos

• This is good business practice and also a requirement for our insurance policy
• Before and after photographs of the patient are required for each and every treatment

4. Ensure that the patient understands the aftercare advice given

• Provide patients with either an electronic copy or a hard copy of the aftercare information that is required

5. Be contactable post treatment

• It is important for practitioners to be available to contact post-treatment
• If a practitioner is unavailable, they must provide contact details for an appropriate professional that is available
• This will ensure that the patient gets full support after receiving treatment and can help to avoid any problems should they develop any side effects post treatment
• If a patient is unable to contact their practitioner they may become concerned

6. Ensure that you have a comprehensive complaints procedure in place

• Taking the above steps into consideration can help prevent a claim from being made against you, but it is always best to have a comprehensive complaints procedure in place
• Some practitioners worry that having a complaints procedure in place will encourage an increased number of complaints. However, it can actually help to reassure patients and will enable practitioners to feel confident and prepared that they have a clear process in place in the event that they do receive a complaint

Visit our website for more advice on how to handle complaints effectively.

Shelly concluded her presentation by reminding the practitioners in the audience that it takes years to build a successful business, but only seconds to destroy it. With regards to having an insurance policy, Shelly added: “Some of you may be lucky enough to never need it, but in the event that you do, you will not regret the cost!”

For more information on how you can protect your business with a comprehensive cosmetic insurance policy visit our website or get in touch with our expert team on 0800 6343 881.

Did you know Hamilton Fraser also have a content hub packed full of useful guides and advice for aesthetic practitioners.