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A Journal on Forensic Medicine
Minerva Medicolegale 2006 March;126(1):25-44
Risk insurance for doctors and dentists
Dipartimento di Anatomia Farmacologia e Medicina Legale Università degli Studi di Torino, Torino, Italy
The notion of risk as defined by Legal Medicine, Law, Clinical Medicine, Work Medicine, Epidemiology, Hygiene and Public Health is presented. A note follows on the evaluation of risk which shows that risk can never be reduced to zero: it was on this premise that insurance protection was born. To insure risk, the Civil Code (CC) offers 2 possibilities: private type contracts and cover of a social nature (compulsory). The Natio-nal Insurance Institute against Accidents at work and Vocational Diseases (INAIL) is the institution that manages on behalf of the government one of the compulsory insurance schemes whose purpose is to guarantee the right to health at the place of work and the right to resources adequate to living requirements in the case of accident or disease caused by work. The legislative evolution began with the Consolidated Act of 1965 and ended with the Decree 38 of 2000 in which the role of INAIL is rationalized and directed at treatment and indemnity in case of accident or vocational disease; at prevention in the work place; at rehabilitation and reinsertion of the worker in social as well as working life. Considered generically, accident and vocational disease are identical because both consist of a fortuitous event, unexpected, superior to the resistance of the organism affected, damaging. In operative detail, protection of the former introduces the insurance modalities of the latter. In summary, protection of vocational disease situations operates as an extension of insurance against accidents at work and is regulated by the same general standards; the notion of the vocational disease is unique and characterized by the exposure to specific risk determined by the work processes listed in arts. 1, 206, 207, 208 of the Consolidated Act in force; by the causal relationship with these processes. The special nature of social protection identifies other risk profiles: specific, general aggravated, atypical, accidental, voluntary, elective. The categories of health professionals insured by INAIL are illustrated: employees in the public sector, physicians and radiologist technicians, teachers and students. By way of comparison we report, in conclusion, a few ideas of private insurance against accidents, permanent invalidity due to disease, refund of medical expenses, surgical expenses, clinics and homes, life, long-term care, dread disease and the professional responsibility of the operator towards third parties to cover responsibility linked to the exercise of the health professions by the general physician and dentist.