Innovation in the healthcare landscape has allowed progress, especially since the Covid-19 pandemic, towards increasingly personalized patient care. Fernando Bandres, Professor of Legal Medicine at the Complutense University of Madrid (UCM), describes this current as “technoscience of the 21st century”, a “technological eye” intended to predict the evolution of a user and with its own “legal interferences” by leaving objective damage aside to focus on the Risk assessment. But this is not the only challenge facing the sector, submerged in other technical and legislative debates that directly affect the relationship between insurers and policyholders.
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“Relyens has become a true risk manager” |
On the impact of technology and legislative changes in the approach to medical coverage, the fourth legal conference organized by Reliancea European mutual insurance and risk management group, a benchmark event in the sector that has brought together authoritative voices from the legal, health, administrative and academic fields at the School of Legal Practice in Madrid to invite reflection on the importance of control risks and to reinforce the mutual trust between insured companies, centers and patients.
From the traditional vision of insurer to risk manager
In this ever-changing scenario, Paula Castroviejo, deputy executive director of Relyens in Spainhas valued the organization of this type of meeting to “identify the challenges” of the sector and “expose different points of view to propose efficient solutions”.
Castroviejo, who has been in charge of inaugurating the event, has given as an example the evolution of Relyens, a union of Sham and Sofaxis, which thus takes “one more step, after almost 100 years of history”, to “act and innovate in the health sector and build a world of trust”. “For us, this is a very important year because it is the year of transformation. We wanted to change our traditional vision of an insurer to one of risk management”, she highlighted.
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Paula Castroviejo, Deputy Executive Director at Relyens in Spain. |
Subsequently, Fernando Bandrés intervened, who agreed on the challenge posed, from a legal perspective, by the new technological context that prevails in Spanish healthcare, where “the transition from uncertainty to risk” (so that the symptoms or pathologies that a user is going to suffer before they occur can be predicted) already allows the practice of “precision and personalized medicine” which, he added, must be approached “from a human perspective”.
“Technology is generating a new concept that I call technological humanism. We have to understand that these tools are a very valuable instrument that has to be directed towards the patient, who is the one who gives meaning to what is done”, he concluded.
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Fernando Bandrés Moya, Doctor of Medicine, specialist in Clinical Analysis, Legal and Forensic Medicine, Professor of Legal Medicine at the UCM Faculty of Medicine. |
“The Insurance Contract Law, in its article 20, is out of context”
During the first of the tables that have made up this Relyens event, focused on the jurisprudential developments of the Article 20 of the Insurance Contract Law, Hope Hernandoresponsible for the Legal Department of Public Hospitals of Chironsaludhas influenced the need to reinforce the “collaboration” between the insured, insurer and health center not only to “manage more efficiently and effectively” the cases of damage caused during clinical practice but also “to analyze the risks more imminently”.
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“Collaboration between insurer and insured is essential” |
Hernando has valued the importance of making the patient “the center of care.” “We want him to be happy, and in those cases in which damage may have been caused, he should be compensated.” For this, there is a insurance policy which covers this type of damage and which, “in those cases in which the center has acted as it should”, protects professionals.
However, the person in charge of Quironsalud’s Legal Department has defended better control of the legislation to correct possible weaknesses in the Law regarding compensation for medical actions. According to Bernardo Ybarradirector of the Health Area of Munoz arrivesone of them is related to this article 20 of the LCS, specifically with the important cost that is generated in the compensation due to interest during the judicial process.
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Bernardo Ybarra, Director of the Health Department of Muñoz Arribas. |
“With article 20, eventual liability can be doubled, tripled and even quintupled. This has a direct effect on healthcare, because this premium can affect public and private services”, stressed Ybarra, who has defended “moving towards the modification” of the regulations. A Ley “decontextualized”he added, that weighs down the expectations of the insured to exercise their right of defense.
In this sense, he recalled that these charges currently reach 20 percent, as established in the 80s. The punitive interest should be in relation to the legal interest and the IPC of each historical moment”, he pointed out.
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Jaime Noguera, Relyens legal manager in Spain; María Jesús Hernando, responsible for Judicial Claims and Complex Relyens in Spain; and the lawyer José Luis Consuegra. |
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Roberto Valls, partner of Roberto Valls Abogados SLP; Eduardo Asensi, member of DAC Beachcroft; and Julio Albi, partner at DAC Beachcroft. |
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Teresa Peña, lawyer in the Contentious Legal Area at De Lorenzo Abogados; Ofelia De Lorenzo, partner at De Lorenzo Abogados; and Pablo Montalvo, head of the Legal-Contentious Area at De Lorenzo Abogados. |
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Alicia Álvarez and Jesús Pellón, lawyers from the College of Physicians of Cantabria. |
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Laura Martínez, Key Account Manager at Relyens; Antonio Sáez, National Director of the Public Sector at Asterra Partners; and María Estéfano, director of Large Accounts Asterra Partners. |
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Natalia Hormaeche, Legal Department of the Infanta Cristina Hospital; Emilio Lizarraga, external lawyer at Relyens; Arturo Mengual, head of legal services at the Tagus University Hospital; and María Fernández, legal adviser at the Infanta Sofía University Hospital. |
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Javier Moreno, partner-director of MBE Legal; Matilde Vera, sub-directorate of Legal Advice at SAS; Teresa Guzmán Alonso, chief lawyer at SAS, Ignacio Boj, managing partner at MBE Legal; and Isabel Hurtado, head of the Patrimonial Responsibility Area of Sermas. |
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Maite Viñeta, medical director at Aon; Eduardo Asensi, member of DAC Beachcroft; Roberto Pesquera, head of the Sacyl Inspection Service; and Íñigo Cid-Luna, member of DAC Beachcroft. |
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Carlos Reyes, partner of Llago-Aguado Abogados; Beatriz Aguado, partner at Llago-Aguado Abogados; Agustín Navarro, lawyer specializing in Health Law in Fornés; Carlos Fornés, director of Fornés Abogados; and Inés Augé, commercial director at Relyens. |
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Ignacio Boj; Isabel Hurtado, senior graduate technician in the area of Patrimonial Responsibility in the Sanitary Field of Sermas; and Noemí Luis, Relyens claims manager in Spain. |
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Daniel Estévez, responsible for Claims at Relyens; and Roberto Pesquera, head of the Sacyl Inspection Service. |
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Image of the Relyens Legal-Legal Conference. |
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María del Mar Tapia, claims technician at Aleix Advocats, Claudia Giner, legal technician; Iván Fernández, Compliance lawyer; Noemí Luis; José Luis Consuegra; and Ana Belén Panera, claims manager. |
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Juan Ignacio Morales, member of the Barcelona College of Physicians; Carles Martín, head of the Legal Medicine unit of the Barcelona College of Physicians; Noemi Luis; Josep Arimany, director of the Praxis area of the College of Physicians of Barcelona; Josep Benet, medical manager of the Rely Medical Department and collaborator at the Barcelona College of Physicians. |
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Maria del Mar Tapia, Laura Martinez and Ana Belen Panera. |
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The lawyers Emilio Lizarraga, Raúl Sánchez and Esteban de Arespacochaga. |
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Manuela Castilla Fernández, head of the Sermas Patrimonial Responsibility service; Juan Ignacio Díaz Marcos, head of the Patrimonial Responsibility Area; María José Corazón Galindo, head of the Technical Coordination Unit; Mercedes Velázquez, member of this Unit; and Inés Puentes, head of the legal department of the Fuenlabrada hospital. |
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Bernardo Ybarra, Esperanza Hernando, and Mª Jesús Hernando. |
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María Jesús Hernando, Fernando Bandrés, Paula Castroviejo; and Santiago Delgado, director of the Abascal Medical-Legal Unit. |
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General aspect of the Relyens Legal-Legal Conference. |
Although it may contain statements, data or notes from health institutions or professionals, the information contained in Redacción Médica is edited and prepared by journalists. We recommend to the reader that any health-related questions be consulted with a health professional.