Do I need to take out an insurance policy?
All authorised private practice healthcare professionals and their place of employment, public or private, are covered by the compensation scheme.
What is meant by “authorised private practice healthcare professional”?
Authorisation is understood as a state authorisation issued by the authorities.
Private practice is understood (in accordance with § 8, section 1 in the executive order on coverage area) as healthcare professionals who on an independent private basis conduct their business and, in connection with this, offer services to patients. The executive order is interpreted such that healthcare professionals who perform treatments without an actual practice (a clinic) are not covered by the law. For example, this includes doctors and physical therapists who are associated with sports clubs, organisations, etc. Injuries arising in connection with such treatment are not covered by the law. One must be both a private practitioner and authorised to be covered by the compensation scheme.
Are all licensed health professionals covered?
No. There are services from licensed healthcare professionals which are not covered by the patient insurance scheme. For example, injuries caused by authorised healthcare professionals employed in nursing homes, social institutions, private firms, public jobs (other than hospitals), pharmacies, etc.
Two conditions must be met before a healthcare professional in primary care is covered by the law: they must be licensed and in private practice.
Does the patient have to complain to the Patient Complaints Board first?
No. Injury claims do not have to be submitted to the Patient Complaints Board before being reported to the Patient Insurance Association and vice versa.
Why is it not possible for the appeals board and the Patient Insurance Association to use the same claim?
The Patient Insurance Association and the Patient Appeals Board are two separate institutions and do not interact in any way whatsoever. We do not exchange cases and we make decisions on the basis of different paragraphs of the law. The appeals board examines whether there are grounds for criticising a healthcare professional; we focus on whether an injury has occurred. Therefore, a case processed by both institutions can have two different results.
Will my name be published if my case is recognised?
The Patients Insurance Association does not publish names of individuals.
How is the connection between the injury and the treatment determined?
It can be difficult to determine the actual cause of a patient’s injury. It is a question of proof. In both Sweden and Denmark, the law stipulates that it must be “highly likely” that the injury can be attributed to the examination and treatment. There must be more than a 50% likelihood of cause for an injury to be recognised.