1. INSURANCE ISSUES FOR HOMECARE PROVIDERS Tony Gill FCII First Ireland Insurance Brokers

2. First Ireland First Ireland are one of Irelands largest Insurance Brokers specialising in arranging Insurance cover for the care sector. First Ireland are based in Parkgate Street (Opposite Heuston Train Station) and operate nationwide. Tony Gill FCII Chartered Insurance Broker is Joint Managing Director and has been with First Ireland since 1984 during which time has led its expansion into the Care Sector First Ireland have exclusive insurance facilities for the Care Sector Notice This presentation is a general synopsis and should not be taken as individual advice

3. “Accident” Claim Risks Homecare providers face substantial “accident” claim litigation risks carrying out their business This potential comes from staff through workplace injuries but there is also potential from clients and their families from “slips n’ trips” and care related issues Workplace injury presents by far the greatest claims potential ( Employers Liability) To protect themselves Homecare providers need to have very solid insurance coverage In conjunction with this insurance, they also need to have very extensive Health & Safety and Incident & Claims management programmes

4. Current Legal Environment Compensation Culture well established – have accident will sue ! Courts seem very pro - claimant Low threshold to win significant damages by claimant High threshold to defend even where claimant partly at fault The Injuries Board getting squeezed out of claims with majority of our claims now going through legal system via solicitors Significant increases in level of court awards in last 2 years

5. Effect on Insurance Premiums Premium levels follow claim levels Higher claims costs = Higher premiums California Compensation = California Premium New Solvency rules for Insurance companies require claims reserves to be increased which is by and large being funded by higher premiums Shareholders and Regulators putting pressure on Insurers to correctly price the coverage they give leading to general rate increases and specific sector increases Other factors are putting upward pressure on premiums including increased wages, compulsory reimbursement of disability social welfare payments upon settlement, low interest rates

6. The Insurance Market for Homecare A lot of Insurers avoid the business – the majority in fact avoid due to various fears eg remote working, perceived medical exposures, Its been a volatile insurance market with several insurers eg RSA – Zurich – Hiscox – Ecclesiastical exiting the sector over the last few years A small number of specialist Insurers both here in Ireland and the UK provide capacity to the sector First Ireland have established relationships with these insurers so as to be able to offer bespoke packages specifically for Homecare risks.

7. What Insurance to Have The key coverages are : Employers Liability Public Liability including care extension Medical malpractice if care goes beyond a certain medical level There are other miscellaneous insurances that are relevant eg Office, Directors &Officers Liability, Legal Expenses including Employment Practices Liability but we will focus on the above

8. Key Insurance Coverage Required Employers Liability –Standard cover €13m Premium is calculated as percentage of payroll(s) Clerical /supervisors low rated Carers high rated Public Liability – Standard cover €6.5m Premium is calculated as percentage of turnover Homecare Public Liability extended to include Care risk excluding medical work as defined but will include wound dressing – administration of oral drugs – peg cleaning If Care extends into medical arena a Medical Malpractice policy may be required Medical Malpractice – Standard Cover €6.5m Premium is calculated as percentage of turnover weighted by degree of medical work Taken out if medical related activities beyond normal care occur

9. Health & Safety Management Main causations of claims – Back related and Slip n’ Trips Hard to defend against unless Employee Training and Health & Safety Risk Assessment paperwork is perfect Paperwork includes risk assessments, health and safety statement, documented training particularly if any lifting involved and is key to any defence decision Back injury claims can come from domestic work and general care situations – they are the hardest to defend ( and quantify) Signed off training is best – before,during and after each training module by the employee

10. Incident & Claims Management Accident notification procedure should be in place so employee call accident in and make statement over phone in real time Solo remote working alters usual witness possibility so immediate investigation by employer essential. Immediate notification to Insurers of incidents essential for investigation while information is fresh – this is a policy condition Defence strategy decided based on information available Any human factor background information useful Early intervention often saves on cost

11. Conclusions Accept that we live in a litigious environment Risk assess and document all activities carefully Document all training with employee sign offs Have accident report procedures that work for remote workers Immediately investigate and document any incidents Notify your Broker immediately Keep an interest in on going claims Keep your insurance up to date !

12. First Ireland Contacts First Ireland Homecare Insurance Contacts Tony Gill FCII |Joint Managing Director | First Ireland 15 Parkgate Street | Dublin 8 | Ireland DD: +353 (1) 882 0859 Mobile: +353 (87) 2540113 Email: tgill@firstireland.ietgill@firstireland.ie Mr. Keith Gill CIP | Associate Director| First Ireland First Ireland House|15 Parkgate Street | Dublin 8 DD: +353(1)882 0848 Mobile + 353 (87) 2409 439 Email - kgill@firstireland.iekgill@firstireland.ie First Ireland Risk Management Ltd trading as First Ireland is Regulated by the Central Bank of Ireland