Read the case study presented at the end of Chapter 11, You Be the Judge, which begins, “During an unexpected heat wave,…” (Guido, p. 195):
- What provisions of an insurance policy would you consult to determine if an insurance company should pay such a claim, and what would the limits of the liability be?
- Is the nursing home insurance company correct in saying that this is a professional judgment issue?
- Which insurance company (the nursing home’s or that of the administrator of the nursing home, assuming she has coverage) should pay the court-ordered judgment?
- How would you decide the case?
Please combine all of these responses into a single Microsoft Word document for submission. Submit only completed assignments (not partial or “draft” assignments). Be thorough in your responses to adequately address all aspects of each question.
Submit only the assignments corresponding to the module in this section.
Assignment Expectations
Length: 700 words; answers must thoroughly address the questions in a clear, concise manner.
Structure: Include a title page and reference page in APA style. These do not count towards the minimum word count for this assignment.
References: Use the appropriate APA style in-text citations and references for all resources utilized to answer the questions. Include at least three (3) scholarly sources to support your claims.
Format: Save your assignment as a Microsoft Word document (.doc or .docx).
File name: Name your saved file according to your first initial, last name, and the assignment number (for example, “RHall Assignment 1.docx”)
Expert Solution Preview
Introduction:
The case study presented in Chapter 11 is related to the liability of an insurance company in paying a claim for damages caused due to heat wave conditions in a nursing home. As a medical professor responsible for designing assignments and evaluating student performance, I would like to provide answers to the following questions based on the case study:
1) What provisions of an insurance policy would you consult to determine if an insurance company should pay such a claim, and what would the limits of the liability be?
To determine if an insurance company should pay such a claim, I would consult the liability provisions of the insurance policy. The policy would specify the coverage limits, deductibles, and exclusions that apply to the claim. The insurance policy’s limits of liability would apply to the damages caused by the nursing home’s negligence. The insurance policy would also specify whether the nursing home is liable for damages caused by the heat wave conditions.
2) Is the nursing home insurance company correct in saying that this is a professional judgment issue?
The nursing home insurance company is incorrect in saying that this is a professional judgment issue. The damages were caused not by a professional judgment but by the negligence of the nursing home to provide adequate care during heat wave conditions. Negligence is not a professional judgment issue but a failure to provide the required standard of care.
3) Which insurance company (the nursing home’s or that of the administrator of the nursing home, assuming she has coverage) should pay the court-ordered judgment?
The nursing home insurance company should pay the court-ordered judgment. The nursing home is liable for the damages caused due to their negligence. Therefore, the nursing home insurance company is responsible for paying the damages.
4) How would you decide the case?
I would decide the case by examining the evidence presented in court and using legal principles to determine liability. The evidence would include the nursing home’s policies and procedures for providing care during heat wave conditions. I would use legal principles such as the standard of care, duty of care, and negligence to determine liability. Based on the evidence and legal principles, I would find the nursing home liable for the damages caused and order the nursing home insurance company to pay the damages.
Conclusion:
In conclusion, the liability of an insurance company in paying a claim for damages caused due to heat wave conditions in a nursing home requires a clear understanding of the insurance policy’s liability provisions. In the case study presented in Chapter 11, the nursing home was found liable for the damages caused due to their negligence, and the nursing home insurance company was responsible for paying the damages. As a medical professor responsible for designing assignments and evaluating student performance, it is important to understand the legal and ethical principles related to liability and insurance coverage in healthcare.
