‘No insurer willing to cover physicians’

Not one of the insurers licensed to do business in the CNMI is willing to provide insurance coverage for physicians at the Commonwealth Health Center, according to the Office of the Attorney General.

According to Christopher Timmons, chief of the OAG Civil Division, the Commonwealth Healthcare Corp. has inquired with all companies licensed to sell insurance products in the CNMI whether they provide or are willing to provide insurance to medical doctors at CHC and not one had an affirmative response.

The CHC inquiry was in compliance with Superior Court Associate Judge Joseph N. Camacho’s order requiring the CNMI government to seek information about the availability of liability insurance coverage for its healthcare professional staff.

In the same order dated Aug. 28, 2017, Camacho temporarily stayed the medical malpractice lawsuit filed by Remedio Elameto and her husband, Pedro Pua against the CNMI government and former CHC doctors Gary Ramsey and Rajee Iver.

In the government’s report to the Superior Court last Friday, Timmons said he notified CHC last Aug. 28 about Camacho’s order.

That same day, Aug. 28, CHC personnel contacted by telephone seven insurance companies doing business on Saipan, Timmons said.

He said six companies responded negatively and one asked that the inquiry be made in writing.

The following day, Aug. 29, Timmons met with CHC personnel to discuss steps to be taken to satisfy Camacho’s order.

He said that, last Sept. 11, CHC sent written inquires to all insurers licensed to sell insurance products in the CNMI seeking information as to their willingness to provide coverage for CHC healthcare professionals, and to provide information as to what data they would need to see in a request for proposals.

Timmons disclosed that out of 22 firms contacted in writing, two responded that they do not offer this type of insurance and one responded with the information they would need to see to determine whether they would be willing to provide coverage in the Commonwealth.

Timmons said the remaining 19 companies did not respond.

He said CHC staff also called each and every insurer listed in the CNMI telephone book to inquire as to the availability of coverage, but none gave an affirmative response.

He said CHC has not contacted insurers that are not licensed or authorized by the CNMI insurance commissioner. In this case, that would be Commerce Secretary Mark Rabaulinan.

Attorney Claire Kelleher-Smith, who is counsel for Elameto and Pua, earlier said that a problem that has been plaguing the CNMI for years is the lack of medical malpractice insurance covering doctors practicing at CHC.

The other problem, Kelleher-Smith said, is the government’s improper reliance on the Government Liability Act, rather than obtaining medical malpractice insurance.

“This problem has been preventing victims of medical malpractice at CHC from obtaining meaningful recovery. That is the real problem,” said Kelleher-Smith.

She discussed the lack of medical malpractice insurance issue in Elameto’s and Pua’s notice of non-opposition to the conditional stay of the implementation of the portion of Camacho’s order finding provisions of the Government Liability Act unconstitutional, during pendency of the government’s appealg.

In his order in connection with the couple’s lawsuit last Aug. 11, Camacho invalidated the substitution provisions of the Government Liability Act.

Camacho ruled that the Government Liability Act’s damages cap, substitution provision, prohibition on punitive damages, and restriction on the availability of jury trials fail constitutional examination.

The ruling has prompted the Office of the Attorney General and Ramsey to file a joint request for the court’s immediate issuance of an order staying this case pending their appeal of Camacho’s decision with the CNMI Supreme Court.

In support of the joint request, CHCC chief executive officer Esther L. Muña had notified the OAG that the hospital would cease performing non-emergent surgical procedures starting Aug. 16, 2017 until the court overturns its ruling.

Muña said that medical malpractice insurance is not available in the Commonwealth apparently because the size of the medical community in the CNMI is too small to create a sufficient risk pool.

CHC is the only hospital and surgical facility on Saipan.

Elameto and Pua are suing the CNMI government and Iyer and Ramsey for medical malpractice, bad faith, and emotional distress and loss of consortium.

Elameto claimed that a surgical team at CHC left a 15-centimeter long surgical clamp in her abdomen during a surgery to address her irregular periods and ovarian cysts at CHC on Saipan in August 2000.

Elameto disclosed that it was in June 2014 or almost 14 years later when the surgical clamp was discovered and removed at Guam Memorial Hospital.