Another obstacle to improving patient care?

http://www.ncbi.nlm.nih.gov/pubmed/21249987

Does Medical Error Disclosure Violate the Medical Malpractice Insurance Cooperation Clause?.
Banja JD.
In: Henriksen K, Battles JB, Marks ES, Lewin DI, editors. Advances in Patient Safety: From Research to Implementation (Volume 3: Implementation Issues). Rockville (MD): Agency for Healthcare Research and Quality (US); 2005 Feb.
Advances in Patient Safety.

Excerpt
Medical malpractice insurance policies customarily contain a “cooperation” clause requiring insureds to cooperate with the insurer's efforts to defend the insured against a claim. A common stipulation in this clause forbids the insured from “admitting liability” to an injured or harmed party. Health professionals often understand this clause to have a chilling effect on the truthful disclosure of medical error, which is morally required of physicians when they know that a harm-causing error has occurred. This paper offers a two-part response to the fear that medical error disclosure might result in a denial of malpractice insurance coverage. Part one describes various legal precedents wherein insurers successfully invoked the cooperation clause to deny coverage in instances of liability admission. This paper shows, however, that the legally sanctioned reasons for denying coverage in these cases address factors other than an insured's truthful and honest disclosure of what happened to a claimant. Consequently, these cases do not support the belief that legal precedents discourage the truthful disclosure of harm-causing medical errors. Part two of this paper proposes that the cooperation clause's prohibition of admission of liability in instances of medical error disclosure might well be unenforceable, and that the clause might not even be actuarially sound.