When a patient falls off the exam table

December 16, 2005

A patient passed out after receiving a PPD test and fell off the exam table, fracturing her jaw and breaking several teeth. Our malpractice insurer says that her hospital and dental bills should be submitted to our general office insurance company. Is that correct?

Q: A patient passed out after receiving a PPD test and fell off the exam table, fracturing her jaw and breaking several teeth. Our malpractice insurer says that her hospital and dental bills should be submitted to our general office insurance company. Is that correct?

A: The answer depends on the contract language of both policies. But it's likely your general office insurer will say your patient fell off the table as a result of malpractice or professional negligence.

To further complicate matters, in some states the patient's health insurer is considered the primary payer, so it should receive the bills. In others, health insurance is secondary, but the health insurer is still obligated to pay, after which it can sue to recover from the liability or malpractice carriers.