Lack of trust standing in the way of patient insurance fund

Pärnu Hospital (illustrative).
Pärnu Hospital (illustrative). Source: ERR

Healthcare providers could be looking at a mandatory liability insurance obligation in a few years' time that would make it possible for patients to turn to insurance companies for compensation for errors in treatment. The creation of a patient-friendly private fund recently failed due to changes to the system of pensions that eroded the insurance sector's trust in the state.

It is very difficult for people who have suffered health damage due to errors in treatment to get compensation in Estonia. For the past decade, Estonia has tried to adopt a solution that is working well in Finland and where compensation for treatment errors is paid out by a bespoke fund. Creating such a fund in Estonia was near the home stretch this spring but failed once again.

"The Finnish model has proved very effective from the point of view of patients and insurance providers. Unfortunately, it requires massive initial investment that companies were prepared to make years ago, while the courage of insurance providers to invest major sums in Estonia has lessened in the wake of the country's recent pension reform," said Mart Jesse, head of the Estonian Insurance Association.

The sector has proposed laying down mandatory liability insurance for healthcare institutions in which case the creation of a patient insurance fund could be discussed again three years later.

"It would mean changing more than a few things in the bill, including different planning and regulation of IT solutions, in addition to omitting certain sections," Heli Paluste, head of the healthcare network department at the Ministry of Social Affairs, said.

Should the planned amendment materialize, persons who have suffered health damage would have to take their damages claim to an insurance provider that has a contract with their doctor. In some cases, several insurance providers would have to be consulted to find those responsible for the error in treatment.

"So that the person could turn to a neutral party, file their damages claim and have it processed without bias. That is one of the principles of the amendment," Paluste said.

Lawyer Merike Roosileht said that many people do not know what to do if there has been an error in treatment or how to prove they have suffered health damage. Right now, patients can demand compensation directly from the healthcare provider or by turning to court. "One needs to be able to prove an error in treatment was made and that lasting health damage has been done in both cases," Roosileht added.

Around 70 percent of medics have liability insurance today, while there are still hospitals with no such contracts in place.

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Editor: Marcus Turovski

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