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images that are sent to them to screen
patients with diabetes for retinopathy,
the No. 1 cause of blindness in
Arthur J. Gallagher Regional
Managing Director Larry Hansard,
who suffers from frequent upper
respiratory infections, recalled his own
experience with telemedicine. “The
physician looked at my throat via
the real time video capability on my
smartphone,” Hansard said. There was
a prescription waiting for him at the
drugstore in 10 minutes.
Compare that experience
with having to wait days for an
appointment, then taking off from
work, driving a half hour or more,
waiting to be called in to see the doctor
and then driving back to the office.
type claims, most of the telemedicine
usage we are currently seeing is for
low-severity illnesses,” said Hansard.
The loss statistics that are available
for telemedicine professional liability
losses support Hansard’s statement.
A 2015 report from the Physician
Insurers Association of America
revealed that of 94,228 medical
professional liability claims in the
PIAA’s Data Sharing Project (DSP)
for the years 2004 through 2013, 196
claims were connected to telehealth.
The average indemnity loss for
a telehealth claim was $303,691,
compared to $328,815 for all MPL
claims within the DSP.
“Licensure is the big risk for
telemedicine providers, as they attempt
to match a patient with a physician
licensed in the state in which the
patient is seeking care,” Hansard said.
Many health care insurers will exclude
coverage for a claim if it’s proven that
the provider was not licensed in the
same state where the patient received
Imagine a scenario where a patient
is a passenger in a car that crosses the
state line between Texas and New
Mexico and is talking to a telehealth
provider on the phone. If the provider
is licensed in Texas, but not New
Mexico, and there is an adverse event,
the claim might not be covered.
“There are so many scenarios where
people could cross state boundaries
while on a telemedicine exchange,”
Hansard said most telemedicine
providers are using smart technology
so that they can track patients. But
“Some of the telemedicine providers
are relying on older technology
and they take the patient’s word for
where they are located at the time
of treatment,” Hansard said. “This
could lead to problems if the patient
misrepresents their location and
the physician is not licensed in that
Hansard looks at the international
use of telemedicine optimistically.
Imagine you are a supervisor on
an oil rig in Venezuela. If you had the
opportunity, would you rather consult
with your doctor back in Texas via
a teleportal, or have a face-to-face
consultation with someone you don’t
know as well. “I understand that there
are certain countries that will grant
a U.S. doctor automatic privileges in
those countries,” Hansard said. “If
that’s true just imagine the possibilities
for some of these telemedicine
companies to set up shop there.” &
DAN REYNOLDS is editor-in-chief of
Risk & Insurance. He can be reached at
“Why haven’t we been doing this
forever?” Hansard asked.
MINIMAL LOSS HISTORY
Telemedicine is growing quickly,
so its loss history has yet to be well-
established. As things stand, more than
70 percent of telemedicine interactions
are for fairly common conditions.
“We are not seeing high-severity-