403例涉医责险医疗损害赔偿案件回顾性分析及完善医责险问题探讨

Compensation for medical damage in 403 cases involving medical liability insurance: a retrospective analysis and suggestions

随机抽取2014年1月至2019年1月中国裁判文书网中涉及医疗责任保险的403例医疗损害赔偿案件,对其一般特征进行分析,并根据保险公司介入医疗损害赔偿诉讼的时间顺序,划分为诉讼中介入与诉讼后介入两大类案件,从医院等级、医疗科室、医疗过错、损害后果、鉴定结果5个方面展示了医责险分担医疗损害赔偿责任的情况,发现诉讼中介入的案件,医责险分担医疗损害赔偿责任存在结果导向性;诉讼后介入的案件,法院过少考虑医疗侵权相关因素;同时,医责险介入医疗损害赔偿诉讼可提升判决公正性和认可度等特征。通过专项立法的方式具体化强制性医疗责任保险,结合相互制与股份制各自的优势不断完善医疗责任保险模式,并增强保险公司参与医疗诉讼和非诉讼处理程序的意识,可以在充分保障患者权利的同时,提升医疗质量安全,有效预防医疗纠纷。

A total of 403 medical damage compensation(MDC)litigation cases involving medical liability insurance(MLI)during the period from January 2014 to January 2019 were randomly selected from China Judgments Online(http://wenshu.court.gov.cn).After the analysis of their general features,these cases were divided into two major categories-cases during litigation and cases after litigation-according to the timing of the insurance company’s involvement in MDC litigation.The liability for MDC shared by MLI was presented with regard to hospital grade,medical departments,medical malpractice,damage consequences,and identification results.It was found that the MDC liabilities shared by MLI in the litigation cases were often results-oriented.In post-litigation cases,the courts had few considerations on medical tort liability.Meanwhile,the involvement of MLI in MAC helped to improve the fairness and acceptance of judgments.Therefore,it is important to enforce mandatory MLI through special legislation,continuously optimize the MLI models by exerting the advantages of both mutual insurance and shareholding health insurance,and enhance the awareness of insurance companies to participate in medical litigation and non-litigation procedures,so as to protect patient rights,improve medical quality and safety,and prevent medical disputes.