Insist Risk Managers [Pty] Ltd, hereafter referred to as “the Company, was tasked by a group of medical professionals to develop a product for their members to assist them in cases of alleged malpractice and other related complaints and to offer an indemnity cover as well. Through thorough research over a period of two and a half years, we came up with a solution. Our two tier product was introduced to the public sector as well as the private sector, and was received with open arms. The endorsement of Government as well as signed contracts with the SAMDP shows that we are on the right track.

Our CEO, Hendrik Heystek has developed a legal insurance product as far back as 1989, and has since been developing products for a vast array of players in the risk industry. He has years of experience in managing of businesses (and rescuing failing businesses) and building brands in the risk industry.

One of the most contentious issues in our modern day society is healthcare. In our developing democracy it is of the utmost importance to provide quality affordable healthcare to underpin social development and economic growth. Government is overstressed and the initiative needs to come from business to assist government and other para-statals as well as international NGOs to strengthen and build structures to ensure that this aspect of our development is taken care off.

As we very well learnt from our Western counterparts, litigious professionals are on the prowl and have now shifted focus onto the medical profession in South Africa. With malpractice lawsuits skyrocketing up to an astounding 900% over the past seven years and insurers running for cover, this has become a burning issue for our professionals as well as other roll players in the industry. IRM, with a proven track record in developing insurance and related products, with experience in legal cover products dating as far back as 1989 and focused risk management skills, was tasked by a group of medical professionals to take an in-depth look into this issue and to come up with a solution. This was done by:

• An in-depth analysis of historical facts and worldwide development trends;
• A study of litigation history and medico-legal quasi-judicial procedures;
• An analyses of medical professional procedures and risks;
• A detailed analyses of quantified risk factors;
• A study of legal assistance rendered and outcomes;
• A study of traditional sectorial insurance and other indemnification models;
• A needs analyses of medical professionals;

This was all put together and measured against a number of models. Without indulging in the myriad of risk models and actuarial formulae, we clearly identified the essence of the solution by isolating the ominous looming currents:

• Poor or non-existent risk management;
• Unqualified legal practitioners are used to defend malpractice lawsuits;
• This results in enormous financial and other claim related costs;
• The above feeds the litigation volumes;
• Insurers are unable to cope and leaves it up to insured professionals to fend for themselves;
• Professionals employ unqualified attorneys and advocates;
• This results in bigger paydays for lawyers;
• The end result is higher premiums!

This is clearly a vicious cycle and without due care, this will spiral out of control!

The solution is clear.

• Pro-active risk management by employing legal professionals with the much needed expertise to assist medical professionals right from the outset. We need to be in the fold from the very moment a threat or demand is made;
• By doing this on a collective scale and by utilizing the IRM panel of experts model, cost of claims will be managed properly and with almost certainty regarding quantum;
• Legal certainty will be a huge spin-off as we will be on the forefront of medico-legal cases;
• Affordability is of the essence;
• Retention of practitioners;
• Legal service backed by contingency policy is the answer as traditional insurance models will fail due to a lack of proper risk management;
• IRM has been in the industry with a proven track record which will take insurers years to tap into;
• Market penetration will be phenomenal due to an understanding and general acceptance of the service model coupled with an affordable payment structure;
• The collective nature will create peace of mind and a sense of security in numbers with professionals;
• A service model which will be easy to manage and monitor. Ownership of the service supply chain is vital and key to this model;
• Proper underwriting is easy and manageable;
• Case history will be build up to add value to professional practises as well as medical council hearings;
• Government has bought in on the concept already;
• An all-inclusive legal protection plan will contribute to buy-inn on health professionals’ side.

This model is a perfect fit and leans itself to be easily adapted to include other sectors such as estate agents and retailers (consumer protection act) etc.

If it exists improve it. If it doesn’t, design it!