Liability: who carries the can?
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A health care system or individual hospital should consider establishing a captive insurance company if any one of the following situations exist: The organization's professional liability program is arranged with a self-insured retention of $500,000 or more, or consideration is being given to such an arrangement. A trust fund has been established for a self-insured exposure--professional liability, workers' compensation, or employee benefits. A portion of the organization's professional liability excess insurance program is arranged with an insurer that uses a fronting insurer. The organization currently sponsors, or is considering sponsoring, a physicians' liability insurance program for medical staff members. If any of those situations exist, a comprehensive feasibility study should be undertaken, preferably by an independent, objective organization that does not have a financial interest in the outcome of the study.
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Agency relationships are an intrinsic characteristic of the discipline of radiology. In the practice of the specialty, many individuals and groups act as agents for the radiologist. Understanding the basic elements of agency law is desirable for an appreciation of the liability incurred by the professional.
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