Seafarer’s Medical & Role of P&I Club

 

Seafarer’s Medical & Role of P&I Club

INTRODUCTION

• Seafarer medical cases represent the largest single category of people claims handled by the P&I Clubs. 
• As any type of medical event could potentially occur at sea, P&I Clubs must be responding to emergent events on board and be ready to work with medical service providers who take the lead in treatment, medevac when necessary (and possible) or disembarkation to the nearest hospital or clinic when the vessel reaches port.
• Medical treatment of seafarer’s on board the world’s ocean-going vessels, and ashore if they require additional medical care, often involves a class of specialized insurance firms, Protection and Indemnity (“P&I”) Clubs, especially if the costs are likely to be high.
• P&I Clubs are mutual associations that provide insurance to ship owners, operators and charterers facing third party liability claims from a number of diverse parties, including seafarers, passengers, stevedores, nautical pilots and others.

SEAFARERS V/S P&I CLUB

• It is important to remember that there is no direct insurance relationship between the people who may require medical attention and the Club. The Club simply ensures the liability on behalf of Member (that is the ship owner or operator, ) when illness, injury or death occurs on or near the vessel.
• The Club becomes involved with medical care issues because it will certainly pay for them when the Member submits its reimbursement claim.
• It is important to remember that there is no direct insurance relationship between the people who may require medical attention and the Club. The Club simply insures the liability on behalf of  Member (that is the ship owner or operator, ) when illness, injury or death occurs on or near the vessel.
• The Club becomes involved with medical care issues because it will certainly pay for them when the Member submits its reimbursement claim.

WHY P&I CLUB

• The ship owner often does not have the staff or expertise to deal with an unfolding medical event in real time, so the Club is brought in to handle the matter as it unfolds and to follow up with medevac companies, tele medical providers, clinics and hospitals, as necessary.
• Each Club has a world-wide network of correspondents working in ports around the world who act locally on their behalf.
• The IG Clubs have staff who specialize in handling medical issues on board vessels and who work with medical providers when incidents occur.

PERSON COVERED UNDER P&I CLUB

• The insurance cover extends beyond crew and passengers to other persons who board merchant ships world-wide. For instance, there is P&I liability cover for stevedores, pilots, inspectors, security guards and the many other third parties who board working vessels.
• It even extends to stowaways on vessels who may be injured, become sick, or die while on board.

WORKING OF P&I CLUB IN MEDICAL EMERGENCY

• The hospital or clinic receiving the patient will, on most occasions, work directly with the local correspondent rather than  with the P&I Club itself.
• However, for Clubs to become directly involved with medical providers if and when necessary and depending on the part of the world where the incident is unfolding.

MEDEVAC (MEDICAL EVACUATION)

• P&I Clubs and ship operators have access to medevac providers world-wide both private and public.
• How the event will be handled depends on the seriousness of the medical incident, the need to launch a helicopter or fast sea-launch and the location of the vessel at the time of the incident.
• The costs associated with a medical evacuation vary greatly. Many Coast Guard authorities do not charge for their services, while others may charge ‘full rates’.
• When charges are billed to the ship owner, the liability is covered by the P&I Club.

TREATMENT IN OVERSEAS PORT

·         Medical treatment facility where it is given should be certified.

·         P&I Insurance cover is available for the costs of the level of medical treatment and maintenance which is necessary to ensure that the crew will receive proper treatment and care bearing in mind the following.

 

1. The type of illness and injury.
2. The location of the vessel when the need for medical treatment  arose.
3. The urgency with which immediate treatment must be given.
4. The standard of treatment available in the country where the crew is domiciled.

REPATRIATION

·         Many physicians who are unfamiliar with the standard of care in foreign countries are sometimes reluctant to release a patient who has suffered serious injuries or is being treated for a significant illness to their homeland for continued care. In response, the P&I Club can appoint a local healthcare professional to act on the Club’s behalf and who can be in direct communication with the treating physician.

·         Working as a team, the parties arrange in advance for the receiving hospital to be ready for the repatriated seafarer when he or she arrives and so that treatment can begin immediately.

BENEFITS FOR DISABILITY AND DEATH

·         After the immediate medical concerns are addressed and the seafarer is repatriated home, P&I Clubs remain involved with follow up care and the assessment of disability.

·         most employment contracts contain disability compensation clauses which pay out a US dollar amount to the seafarer depending on the extent of the disability and whether it is temporary or permanent.

·         Often there is a difference of opinion on the disability rating provided by the treating physician and the ship owner or employer.

·         In this situation, the case may end up in arbitration or the local court system depending on the jurisdiction involved.

·         When a ship owner or employer is forced to defend a legal claim from a seafarer, the costs and expenses associated with the defense are covered under the P&I cover.

SICK WAGES TO SEAFARERS

 

·         Seafarers are also entitled to the payment of sick wages for a contractually defined period of time following the medical incident.

·         Once repatriated, the payment of sick wages is based upon confirmation from the treating physician/clinic that the patient remains sick or injured, i.e. not fit for duty.

·         P&I Clubs (through their network of local correspondents) therefore also work in close cooperation with these medical providers to ensure that the seafarer is reporting to the clinic and that wages are being paid by the local manning agent.

PASSENGERS

·         A majority of the world’s ocean-going ferry, passenger and cruise vessels are insured by the IG Clubs.

·         Responding to passenger incidents can be quite different from seafarers on merchant cargo vessels because many passenger ships have doctors and nurses on board who attend to the matter on an immediate basis.

·         Resulting medical malpractice lawsuits against medical staff almost always include the vessel owners as a defendant.

·         Clubs therefore work closely with medical professionals and other expert witnesses when defending cases in court.

GROUPS OF PERSON AS PER P&I CLUB

·         There are numerous other people who work or attend on board merchant vessels and who thereby expose themselves to risk while doing so. Most P&I Clubs divide these groups into three:

·         Those carried on board.(Navigational pilots are a good example of persons carried on board.)

·         Not carried on board(When the ship is tied up at berth all third parties who board are not carried on board.)

·         Saved at sea.

·          

The main distinction between the first two groups is whether the vessel is moving or not. If moving, then such persons are ‘carried on board’. If not, then such persons are ‘not carried on board’.

 

‘’SAVED AT SEA’’

 

·         Ocean going vessels are required by law to alter course and attempt to save life at sea when they are near a marine casualty or other marine incident.

·         It could also involve an injured or seriously ill person aboard a nearby vessel which does not have the ability to land a medevac helicopter or steam quickly enough to the nearest port in order to save the person .

·         In these types of cases, the vessel may make direct contact with its P&I Club. Many of the costs and expenses associated with saving lives at sea are covered by the P&I insurance policy, so it is natural for the Club to be closely involved from the outset.

STOWAWAYS, REFUGEES AND MIGRANTS

·         It is not uncommon for stowaways to be seriously injured or killed on board, for instance when hiding in enclosed spaces with limited air supply or being crushed by heavy equipment or anchor chains.

·         Refugees and migrants often take unsafe pathways due to large numbers of people setting out to cross the sea in overcrowded and unseaworthy vessels. Many who survive need medical treatment for injuries or conditions which have arisen during the transportation, such as hypothermia and intestinal illnesses.

·         In these types of cases, the vessel may make direct contact with its P&I Club.

COMPENSATION FOR LOSS OF PERSONAL EFFECTS OF CREW MEMBERS / PASSENGERS

 

·         Since the Ship is the temporary home of Crew members during their periods of service it is important that they be allowed to take on board personal belongings that can support their welfare.

·         However, such personal effects can be lost or damaged during the period of service and most contracts of employment oblige the employer to reimburse Crew members for such loss or damage regardless of whether it has been caused by the fault or negligence of the Member.

·         Some employment contracts oblige the employer to reimburse the Crew member only if the effects are lost or damaged as a result of a total or constructive loss of the Ship, or as a result of a major casualty.

·         whilst other contracts oblige the employer to reimburse the Crew member for all accidental loss or damage that may arise during the course of the Crew member’s service on board the Ship. 

·         However, most contracts also impose a limit on the employer’s liability for such loss or damage (commonly in the range of USD 2,000-4,000 per Crew member) and require the Crew member to submit written details of the items lost or damaged and of their value together with supporting documentation. 

·         Similar liability for loss of or damage to personal effects may also arise under international convention, statute or the common law.

·         P&I club may also have an obligation to pay compensation for loss of personal effects of crew members / passengers.

·         Liability to pay compensation for loss of or damage to personal effects belonging to a member of the crew is based on crew agreement and contracts.

·         Liability of payments to crew is excluding valuables, cash, negotiable instruments and objects of a rare or precious nature.

MODE OF OPERATION ( P&I )

·         A P&I club is a mutual insurance association that provides risk pooling, information and representation for its members.

·         Unlike a marine insurance company, which reports to its shareholders, a P&I club reports only to its members.

·         Originally, P&I club members were typically ship owners, ship operators or demise charterers, but more recently freight forwarders and warehouse operators have been able to join.

·         Whereas the assured pays a premium to an underwriter for cover which lasts for a particular time (say, a year, or a voyage), a P&I club member instead pays a "call". This is a sum of money that is put into the club's pool, a kind of "kitty".

·         If, at the end of the year, there are still funds in the pool, each member will pay a reduced call the following year; but if the club has made a major payout (say, after an oil spillage) club members will immediately have to pay a further call to replenish the pool.

 

BE SAFE