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 its 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 a managed care organization
or health insurer, under an employee benefit plan.
Links for IRMI Online Subscribers Only:
IWC XV.F;
PLI XVI.P