negligent provider selection
A key source of liability for a managed care organization (MCO), that arises
from an MCO's negligence in selecting (or retaining) a healthcare provider who
is deficient in delivering healthcare services, and such deficiency produces
an injury. MCOs owe a duty to their subscribers to investigate the competence
of their healthcare providers and to exclude those who pose a foreseeable risk
of harm. Coverage for this exposure is afforded by a managed care liability
insurance policy. Such claims have also been made against employers in which
employees allege that the employer negligently selected an MCO
or health insurer under an employee benefit plan.
Links for IRMI Online Subscribers Only:
IWC XV.F;
PLI XVI.P