Inspection

To view our Loss Prevention Standard that supports this checklist, please view the following link: https://broker.aviva.co.uk/documents/view/aviva_claims_defensibility_for_the_health_and_care_sector_lps.pdf

Claims Defensibility for the Health and Care Sector
Claims Defensibility Checklist

1. There is a documented safety management system in place that is reviewed at least annually or when changes occur?

2. Risk assessments identify all activities, are documented and reviewed regularly?

3. Accidents are reported and records maintained?

4. Staff know how to report suspected spurious or fraudulent claims to Aviva?

Accident Investigation

5. Accident investigations are undertaken by trained and authorised persons?

6. Accident investigators are appropriately trained and competent, and report quality is monitored?

7. Investigations identify root causes effectively and implement appropriate remedial action?

Documentation

8. Training and competency records are maintained and up to date?

9. There is an inventory, tests and inspections in place for all physical precautionary measures and records are maintained?

10. Systems are in place to keep up to date with risk exposure changes, e.g. non-injury incident reporting, regular communications with external agencies (e.g. police and local authority), new and emerging risks that may give rise to future claims?

Monitoring and Review

11. Random monitoring of the quality of documentation is undertaken?

12. There is a review of claims trends undertaken that includes all interested parties, e.g. via claims review meeting?

13. Where liability has to be admitted, a review of the reasons why is undertaken?

14. Do insurance, risk and health & safety work closely together to identify emerging trends and put into place preventative measures?

COVID-19 Specifics

15. If you have taken in NHS patients, can you timeline this and demonstrate the isolation facilities both prior to the 15th April 2020 and afterwards?

16. Are you implementing the measures recommended by Public Health England plus others to minimise transmission of COVID-19 (this includes clinical procedures as well as other hygiene and social distancing measures)?

17. Do you have procedures in place to manage suspected or confirmed COVID-19 cases in staff or service users?

18. Do you have procedures in place to monitor and implement any revised guidance from Public Health England, etc?

19. Have you been able to maintain adequate levels of appropriate PPE to manage risks from COVID-19?

20. Have you experienced any difficulties in obtaining appropriate PPE?

21. Do you have records to support purchases and/or attempted purchases of appropriate PPE?

22. What arrangements do you have in place for staff testing of COVID-19 and can you show the revisions to this plan?

23. Do new starters receive adequate training before commencing work?

25. What COVID-19 training is given to employees, how is this delivered and are records maintained?

25. Have absence and return to work procedures been reviewed to incorporate the latest guidance on isolation of employees with suspected or confirmed COVID-19?

26. Are safeguarding standards being maintained during the pandemic?

Completion

Additional Comments

Completed by: (Name and Signature)

Please Note:

This document contains general information and guidance only and may be superseded and/or subject to amendment without further notice. Aviva has no liability to any third parties arising our of ARMS' communications whatsoever (including Loss Prevention Standards), and nor shall any third party rely on them. Other than liability which cannot be excluded by law, Aviva shall not be liable to any person for any indirect, special, consequential or other losses or damages of whatsoever kind arising out of access to, or use of, or reliance on anything contained in ARMS' communications. The document may not cover every risk, exposure or hazard that may arise and Aviva recommends that you obtain specific advice relevant to the circumstances.

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.