Patient insurance safeguards the rights of both the patients and the medical staff. This section includes information aimed at healthcare professionals and providers and member insurance companies of the Finnish Patient Insurance Centre.
According to the Patient Injuries Act, all healthcare providers must have patient insurance that provides compensation for injuries covered by this Act. Patient insurance can be taken out either at your insurance company or the Patient Insurance Centre until the end of year 2020. Any party liable to take out insurance but neglecting to do is according to the Patient Injuries Act obligated to pay a penalty premium, which may be as much as 10-fold to the normal premium.
Bodies under the obligation to take out insurance are:
- Self-employed healthcare professionals in healthcare occupations who are, or can be, registered by the National Supervisory Authority for Welfare and Health (Valvira).
- Companies that offer healthcare services and have healthcare professionals (either in employment or service relationship) registered by Valvira in their employ.
- Companies offering emergency medical services, including those in which the emergency medical services are carried out by other than healthcare professionals.
- Pharmacies for the part of prescription medicines sold.
- Hospital districts for the part of public health care provided within their jurisdiction.
- Government agencies and public bodies for the part of healthcare services provided in them.
Students and trainees are in an equal position to the personnel in the company or institution under the supervision of which the traineeships take place. Other persons and companies offering care services (e.g. natural health care) are not under the obligation to take out insurance according to the Patient Injuries Act and therefore cannot take out patience insurance. Their insurance cover is to be arranged through liability insurance.
For more information on patient insurance, please contact the Patient Insurance Centre and its member insurance companies.
Patient insurance covers all health care provided within the geographical area of Finland. The same restriction applies to telemedicine.
For treatment to be considered to have been given in Finland, it is required in principle that both the patient and the healthcare professional providing the care are physically within the borders of Finland.
However, in established compensation practice, situations where a healthcare provider operating in Finland acquires healthcare services from abroad are also regarded as healthcare services. For example, when an interpretation of an X-ray image taken in Finland takes place abroad or when a Finnish healthcare provider consults foreign parties without the patient having an independent treatment relationship in the other country, are deemed treatment provided in Finland.
As a rule, all examinations and treatment that only partly take place in Finland, e.g. if the patient and the physician are in different countries while the treatment is administered, are excluded from the scope of application of the Act.
However, as an exception to the aforementioned, the scope of application of the Act is interpreted to include situations in which either the patient or the healthcare professional providing the treatment is temporarily staying abroad for non-treatment-related reasons, and the treatment is arranged with a remote connection. This is typically the case when the treatment relationship has started when both parties are in Finland and, after the treatment visit and examinations, further treatment is agreed upon during telephone consulting or using electronic communication equipment. The fact that the patient has travelled abroad for a vacation after the treatment visit and answers their physician’s call during their vacation, has no effect on their patient security.
However, a prerequisite for the application of the Act is that a treatment relationship has clearly been formed in the manner required by law with a healthcare provider registered in Finland. If the treatment is organised in the form of treatment provided abroad, the Patient Insurance Act is not applicable.
Treatment provided without medical grounds (aesthetic surgery)
Even when treatment is not provided for an illness or injury, it can be considered medical and health care within the meaning of patient insurance legislation, and thus an activity falling under the obligation to take out patient insurance.
For example, aesthetic surgery not aimed at restoring or maintaining the state of the patient’s health but conducted purely with the aim of altering the patient’s physical appearance on aesthetic grounds, falls under the scope of patient insurance.
Injection treatment administered on aesthetic grounds is also considered medical and health care if the injections are administered by a healthcare professional. A healthcare professional providing injection treatment services must always have a patient insurance policy.
The use of some medicinal substances is restricted. For example, administering treatment involving botulinum toxin has been classified as a treatment requiring a high level of medical expertise by the Supervisory Authority for Welfare and Health (Valvira), and thus treatments involving this substance must be administered under the supervision of a physician. In practice, the injections can be administered by a nurse who, in addition to having the required medical competence, has undergone training specifically focusing on administering botulinum toxin injections. However, responsibility for the care always falls on the physician under whose supervision the treatment is provided.
Nevertheless, injection treatments involving filler materials that do not require a prescription (such as hyaluronic acids or PRP injections) can be administered by persons who are not healthcare professionals. Since these treatments are not administered by healthcare professionals, they are not covered by patient insurance.
First aid stations at events and other volunteer work
All medical and healthcare providers must take out a patient insurance policy for patient injuries resulting from the treatment provided. The obligation to insure also applies if a healthcare professional has agreed verbally or in writing to volunteer work in advance. Such volunteer work can be working at the first aid station of a sports competition, a festival, a concert or other event, for example. The obligation to insure applies both if the professional is compensated for the work or if the work is provided purely as volunteer work.
A healthcare professional who agrees to provide first aid at an event is responsible for ensuring that they have the required patient insurance for the task.
If the first aid is provided under an organisation, such as the event organiser or a company or association taking on the overall responsibility for first aid during the event, the obligation to insure falls on said organisation.
If all healthcare professionals providing first aid at the event have a valid patient insurance policy that also covers first aid, the event organiser or the party responsible for first aid does not need to take out a separate patient insurance policy for the event. However, the organisation assuming overall responsibility for providing first aid is always responsible for ensuring the activities are appropriately insured. It is prudent to check the coverage of the existing insurance policy with the insurance company that awarded the policy, your trade union or the Patient Insurance Centre.
The obligation to insure does not apply if a healthcare professional provides first aid in an unexpected situation to a person requiring urgent care outside the facilities of a healthcare provider. From 1 January 2021, such urgent care provided by a healthcare professional is covered by patient insurance directly by virtue of patient insurance legislation (for more information, see section Healthcare professionals’ duty to assist)
Healthcare professionals’ duty to assist
The Patient Injuries Act, valid until 31 December 2020, is not applied to treatment provided by a healthcare professional happening to be at a site of an accident and providing treatment as urgent care, for example. According to the new Patient Insurance Act that enters into force on 1 January 2021, the new Act will be applied in situations where a healthcare professional happening to be at the site of an accident provides urgent care.
Healthcare professionals do not need to have a separate insurance policy for providing urgent care in an emergency situation outside a healthcare facility, such as on the street or at a public event. These situations are covered by patient insurance directly by the virtue of the provisions concerning the healthcare professionals’ duty to assist.
Even if the healthcare professional providing urgent care has a valid patient insurance policy, patient injuries occurring during these situations are not compensated under that policy. Instead, the Patient Insurance Centre will compensate the injury, and the expenses are allocated to the pay-as-you-go system.
Insuring temporary workers
According to section 6 of the Patient Insurance Act, all professionals providing medical and health care must have a valid insurance policy covering patient injuries in the scope required by legislation. This obligation applies to organisations, associations, self-employed professionals and employers who employ healthcare professionals.
This means the Patient Insurance Act applies both to the activities of healthcare professionals and the activities occurring within the operational units of healthcare providers.
The insurance policy must be taken out by the employer on behalf of the healthcare professional in their employ, or by the independent professional directly from an insurance company providing patient insurance policies. An independent professional can also fulfil the obligation to insure with a group insurance or self-funded group insurance policies provided as a member benefit by trade unions. A healthcare provider can also take out patient insurance on behalf of a partner.
The employee is responsible for insuring the healthcare professionals in its employ. Agencies hiring employees as temporary workers and subsequently providing temporary workers to healthcare providers are also considered to be employers and as such, under the obligation to take out patient insurance. In such cases, the party under the obligation to insure is the agency providing temporary workers, not the healthcare unit in whose facilities the health care is provided. Independent professionals must ensure that the treatment they provide is covered by a patient insurance policy. This also applies to non-Finnish professionals and businesses operating in Finland.
Persons who provide care via public healthcare services but are self-employed or employed by a private company are not covered by the patient insurance policies of public healthcare operators.