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Alteration Of Medical Records Exclusion

Definition

An exclusion found within the majority of physicians professional liability insurance policy forms that eliminates coverage for claims involving the alteration of medical records. The following scenario illustrates how this exclusion would apply. An anesthesiologist uses the wrong type of anesthetic on a patient, given the nature and duration of the operation being performed. As a result of the error, the patient wakes up before the operation is completed and eventually sues the anesthesiologist. But before receiving the lawsuit, the anesthesiologist changed the patient's medical record to indicate that he used the correct type of anesthetic. This exclusion would eliminate coverage for the patient's lawsuit, given the dishonest nature of the anesthesiologist's conduct in deliberately changing the patient's medical record in an attempt to absolve himself from liability. The rationale for this exclusion is that in the vast majority of situations where physicians alter medical records, they do so in an attempt to remove or eliminate evidence of their medical negligence in treating a patient. Accordingly, it is not the intent of insurers to cover intentionally dishonest conduct of this kind.

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