As the crisis in malpractice insurance quickly becomes past history, more insurers are offering coverage to doctors in Florida. This checklist will help you make better decisions on which insurer is best for you.
- How long has the company insured physicians in your state?
- What is the history of their rate charges in your state and elsewhere? Ask about the number of rate increases or decreases the carrier has had in the past several years.
- Is a large concentration of the company’s policyholders in a higher risk territory or specialty? If the carrier has a larger insured exposure in higher rated territories like Dade, Broward, and Palm Beach counties or in higher risk medical specialties it could cause claims to soar and the carrier could incur a larger loss impact. As a result of this exposure, the carrier could impose severe rate changes or worse, leave the state. This creates many concerns including policyholder non-renewals, lost vesting of tails, and could jeopardize the quality of defense for open claims.
- What is the company’s policyholder surplus?
- What is the company’s overall medical professional liability premium volume in your state and how many doctors do they insure?
- Are the policy exclusions outlined and clearly defined?
- Are the policy definitions clear and straightforward?
- Does the information on the application become part of the insurance agreement?
- What are the “tail” provisions upon termination of the policy? Does the “tail” coverage offer unlimited duration or is it limited to a certain number of years? What are the retirement requirements for “tail” coverage? The policy should have provisions for vested tails upon retirement, disability and death.
- Is defense coverage offered outside or inside the limits of liability? (It should always be outside.)
- What is the claims coverage “trigger?” A “demand trigger” is so unfavorable that you should always insist on a trigger that recognizes an “incident report.” If you accept a demand trigger (and you often aren’t asked) the company will not defend any incidents you might report until the incident turns into a written demand or claim against you. This can cause serious problems when changing carriers. The new company, and your previous company, will exclude the incident from coverage because you had prior knowledge of and reported the incident to your previous insurer.
- How is your corporation, professional association or other entity covered? Can you endorse the policy to properly cover a corporation for free on a shared limits basis or can you purchase separate, affordable corporate coverage? Is vicarious liability coverage included in the separate corporate policy? (It should be.) Even if you are a solo practitioner and have formed a closely held professional association, it should be named on the policy.
- How are your employees covered? What about coverage for any skilled ancillary personnel like physician assistants or surgical assistants who are often excluded from coverage under the standard policy forms?
- Who are the companys defense lawyers? Are they local attorneys and do they have experience in defending medical professionals? If you are sued, will your case be handled by a senior member of the legal firm or assigned to a less experienced associate?
- Is legal defense coverage offered for investigations by various state and federal regulatory agencies such as Agency for Healthcare Administration (AHCA), the Florida Board of Medicine, and OSHA? What are the policy limits for this coverage and can it be increased?
- Is the “Retroactive Date,” sometimes called a “prior-acts date”, the same as your previous policy? Your retroactive date is critical. You should personally check the date on your policy each year. Remember that when switching companies, it is usually better to keep the same retroactive date with your new company rather than purchasing a “tail” and going onto a first year claims-made policy.
Is your policy effective date the same as your previous policy? (It must be the same to avoid gaps in retroactive coverage.)
