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More changes to the NY Malpractice standard market

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More changes to the NY Malpractice standard market

13 Mar 2019
13, Mar Mar, 2019
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Hospitals Insurance Company (HIC) and FOJP Service Corporation (FOJP), together with Mount Sinai Health System, Montefiore Health System & Maimonides Medical Center have entered into an agreement to sell HIC and FOJP to The Doctors Company (TDC) for $650M. The deal is proposed to close in 2019, if approved by the NYS Dept of Financial Services. Both carriers are admitted in the NY market, but this has the potential of improving the status of both companies.

One of the outstanding questions is how the filed rates of both HIC and TDC will be impacted. Currently, HIC has more competitive rates, but are restricted to insuring providers who work at one of these hospitals. The rates at TDC are higher, but they do have the advantage of offering their Tribute Plan, established in 2007 and exclusive to TDC. It is a retirement plan that is very attractive to physicians who can recoup some of their malpractice payments to the carrier over time. TDC sets aside 10% of the premiums for eligible members, which are put into a “subscriber savings” plan for every year that they are with TDC and can be claimed once the provider retires from practice, also building carrier loyalty.

The Doctors Company is relatively new in the NY marketplace, but has been offering malpractice solutions to providers in the other 49 states for many years. They were founded in April of 1976 & headquartered in Napa, California. They are 100% member owned, making them the largest physician-owned insurer in the nation. Since 2008, they have acquired several insurance companies, adding to their financial strength and presence in the malpractice arena. They are rated A by AM Best and Fitch Ratings.

Hospitals Insurance Company was established 40 years ago & writes $180M in premium volume. Their target market is physicians that provide care in at least one of the hospital systems mentioned above. They recently expanded their market to include physician extenders in 2018. They are rated A by AM Best.

FOJP provides insurance & risk management advisory services to academic hospitals, long term care facilities, and social service agencies in the metropolitan NY area. They were established in 1977 to help identify & mitigate risk factors to control losses.

Why Do Health Professionals Seek Coverage with MLMIC?

13 Jan 2015
13, Jan Jan, 2015
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If you’re a physician practicing in New York, you’ve probably heard of Medical Liability Mutual Insurance Company, or MLMIC. MLMIC is one of the largest malpractice insurance companies in the country, and one of the most prominent NY carriers that can provide protection against a malpractice lawsuit.

What Kind of Policies Does MLMIC Offer?

MLMIC offers two types of Malpractice insurance policies: Occurrence and Claims-Made. It is critical for healthcare practitioners to know the difference in order to make an informed decision.

Occurrence policies provide coverage for claims that may arise from incidents which may have occurred while you had a policy in force, regardless of when a claim is reported, even if the policy is no longer in force. Thus, Occurrence coverage provides long-term continuing protection for the physician. For example, if a malpractice claim is filed say five years after the incident occurred, and the physician or dentist was protected under an Occurrence policy five years ago, the carrier that covered them at the time would provide coverage for any covered claims. Occurrence policies provide the value of long-term coverage over the years.

A Claims-made policy provides protection for claims that ‘arise and are reported’ while you have a policy in force. You are covered up to the policy limits in effect at the time the claim is reported. To be protected for any claims which are reported after the malpractice policy has been canceled, you must purchase ‘tail coverage’, (Extended Reporting Period endorsement), or obtain similar protection from a subsequent malpractice insurance carrier. A claims-made policy must continue in force to provide protection, or be replaced by tail coverage. When you elect to change claims-made carriers, ‘Prior Acts Coverage’ or ‘Nose’ coverage must be obtained to cover your exposure from your first day of claims made coverage.

Which Healthcare Professionals Can MLMIC Cover?

Physicians

Physicians in private practice must obtain malpractice insurance to protect themselves from the defense and liability costs of a malpractice lawsuit. They have the option of either Occurrence or Claims-Made coverage, with the additional option of supplemental insurances such as Professional Entity coverage. With the skyrocketing costs of defending and settling a malpractice lawsuit, physicians have to be careful about their choice of a malpractice insurance carrier.

Dentists

Like physicians, dentists have the option of purchasing either Occurrence or Claims-Made policies. MLMIC also offers additional Tail Coverage or Nose Coverage to pair with their Claims-Made Coverage. Tail Coverage provides coverage for malpractice claims reported after the initial coverage has expired. Nose Coverage, in contrast, covers claims relating to incidents during the time the dentist was covered under a prior insurer.

Hospitals

MLMIC has been providing medical professional liability coverage for hospitals and other healthcare facilities since 1975. MLMIC offers comprehensive risk management programs designed to minimize the liability risks of their insured hospitals and healthcare facilities. These programs help reduce the frequency and severity of claims, thereby resulting in lower malpractice insurance costs.

What if You Don’t Have Time to Research Insurance Policies?

You’re a busy healthcare professional, and managing your malpractice insurance should be the least of your worries. If you wish to explore more options for malpractice insurance in New York for yourself, your group practice or your health care facility, please contact PriMed Consulting. 800.528.3758. www.primedconsulting.com

Physicians: Why MMIP (Medical Malpractice Insurance Pool) may be an option.

13 Jan 2015
13, Jan Jan, 2015
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MMIP, or the Medical Malpractice Insurance Pool, is New York’s malpractice insurance liability program for doctors with a history of malpractice claims. For physicians and other health care providers who cannot get coverage through the other standard carriers such as MLMIC or PRI, either due to adverse malpractice claims experience or other licensing issues, MMIP would be their ‘go to’ company.

“The Superintendent of Financial Services has, by regulation (Regulation No. 170), established the New York Medical Malpractice Insurance Plan (“MMIP”), to provide for the equitable distribution, of eligible health care providers and facilities unable to obtain insurance in the voluntary market, to authorized medical malpractice insurers.” Individuals and facilities unable to obtain medical malpractice insurance in the voluntary market, and who have been declined by at least three insurers (or the number writing the coverage if less than three) may apply with MMIP.

MMIP cannot refuse coverage to any physician who applies for coverage, so long as they are actively licensed to practice in the state of NY. However, having this guarantee of getting malpractice coverage comes at a price: MMIP’s published premiums are approximately 3 times that of the standard premiums charged by PRI & MLMIC.

Claims-made & Occurrence coverage:

MMIP offers both types of malpractice coverage: Claims-made and Occurrence. In addition, physicians insured by MMIP can also apply for the Section 18 Excess coverage through their primary hospital.

Free tail coverage:

MMIP offers the same type of tail coverage as PRI and MLMIC.

How Does MMIP Work?

In 2012, New York had the highest payout in the nation for medical malpractice lawsuits: $677 million (Westgate, A., 2012). It’s no wonder that several physicians experience problems getting malpractice insurance coverage for issues like:

  • Excess claims and settlements
  • License issues
  • Hospital privilege revocation
  • Sanctions from the Board

If PRI & MLMIC non-renew or decline coverage due to the above reasons, the alternative could be MMIP. MMIP malpractice insurance is accepted in every hospital in the State of New York. In other words, having MMIP allows you to keep working while knowing that you have a policy to address any future claims.

Alternatives to MMIP

The New York malpractice insurance market has seen the emergence of RRG’s, or Risk Retention Groups. These group self-insurance plans work to cover physician liability from medical malpractice claims, and their competitive rates make them an attractive offering to physicians who pay high premiums with the Pool.

However, we suggest that physicians analyze the benefits of any RRG plan before making a purchase. While the premium rates are lower, you should make sure that the hospitals and facilities you work at accept the RRG policy. MMIP is state regulated and accepted by all hospitals in New York.

The fact is that MMIP’s high premiums could be a deterrent to some physicians who may find it difficult to continue their practice: For example, surgeons insured by MMIP may see their malpractice premiums to be three times higher!! Ob/Gyns could be charged premiums of $500,000 or above based on their claims experience! These premiums may be unsustainable for some physicians. RRG’s are a cost-effective alternative to physicians who cannot get coverage on the voluntary market.

Find Your Best Rate with PriMed Consulting

If you are a physician or dentist having trouble getting reasonable coverage, contact PriMed Consulting, an insurance agency with years of experience helping healthcare professionals get malpractice insurance throughout New York. 800.528.3758. www.primedconsulting.com

Who and What Does PRI Cover?

13 Jan 2015
13, Jan Jan, 2015
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Physicians Reciprocal Insurers or PRI, is the second largest malpractice insurance carrier in the state of New York. PRI has been serving the needs of NY healthcare providers and facilities for over 30 years.

Why PRI?

PRI serves the medical community throughout New York State and provides competitively priced malpractice insurance premiums to practicing physicians, chiropractors, and dentists. In addition, PRI also offers customized solutions for hospitals and various healthcare facilities.

PRI’s three main attributes are:

  • Comprehensive professional liability products
  • State of the art risk management support, and
  • Outstanding customer service.

Physicians Reciprocal Insurers works on the premise of aggressive claims management. In other words, physicians with coverage can expect to receive timely responses to their malpractice lawsuits. However, professionals cite that PRI’s greatest resource is its risk management program which includes online education, reference books, and discount incentives for completing risk management programs.

In addition to covering individuals, PRI also serves:

  • Hospitals
  • Medical Schools
  • Nursing homes
  • Medical Colleges
  • Other Medical Facilities

Competitive premiums:

The aggregate malpractice claims payout in New York was $677 million dollars in 2012 (Westgate, A. 2012). It is no wonder that NY physicians are looking for competitively priced malpractice insurance as the premiums have increased steadily over the years.

PRI offers competitive premiums and discounts for several specialties in NY. Besides competitive premiums, PRI also offers aggressive claims handling and risk management services that can help mitigate the claims losses experienced by physicians. PRI also offers locum tenens coverage.

Corporation coverage:

PRI also offers extra liability limits for Professional entities (such as PC, PLLC) at no additional charge, if all physicians in the group are insured by PRI. This is a tremendous benefit for practices of two or more physicians in NY.

Types of Coverage Offered:

PRI offers Occurrence policies, which provide coverage for claims that may arise from incidents which may have occurred while you had a policy in force, regardless of when a claim is reported, even if the policy is no longer in force. Thus, PRI’s Occurrence coverage provides long-term continuing protection for the physician. For example, if a malpractice claim is filed say five years after the incident occurred, and the physician or dentist was protected under a PRI Occurrence policy five years ago, PRI would provide coverage for any covered claims. Occurrence policies provide the value of long-term coverage over the years.

PRI also offers Claims-made policies. PRI’s Claims-made policies provide protection for claims that ‘arise and are reported’ while you have a policy in force. You are covered up to the policy limits in effect at the time the claim is reported. To be protected for any claims which are reported after the malpractice policy has been canceled, you must purchase ‘tail coverage’, (Extended Reporting Period endorsement), or obtain similar protection from a subsequent malpractice insurance carrier. A claims-made policy must continue in force to provide protection, or be replaced by tail coverage. When you elect to change claims-made carriers, ‘Prior Acts Coverage’ or ‘Nose’ coverage must be obtained to cover your exposure from your first day of claims made coverage. PRI also offers free tail coverage to physicians who satisfy the State requirements for free tail coverage.

Applying for Physicians Reciprocal Insurance

Physicians have to meet PRI’s underwriting criteria before being approved for coverage. If you need help with your malpractice insurance options, please contact PriMed Consulting, a leading malpractice insurance broker exclusively serving NY & NJ. 800.528.3758. www.primedconsulting.com.

NY Medical Malpractice: Professional Entity Coverage

8 Jan 2015
8, Jan Jan, 2015
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Do you need to cover your Professional Entity against potential malpractice lawsuits?

It is important for physicians and practices to understand ‘who’ and ‘what’ is covered under a medical malpractice insurance policy, as well as the limits and exclusions.

Practices should strive to obtain coverage for the physicains, the Entity (LLC, Partnership or Corporation, PC), as well as any licensed employees.

An employer can be held liable for the acts of the employees. If there is a professional corporation or Entity, that Entity may hold the business assets or accounts receivable. It is quite conceivable that the Entity may be named in a lawsuit that is primarily against one of the physicians or employees of the Entity. This makes it extremely important to ensure that the issue of Entity coverage is addressed in your malpractice policy.

Most malpractice insurance carriers offer entity coverage with shared limits to solo practices, usually without charging additional premiums. However, if there are two or more practitioners in the group, you can get separate limits of liability for the Entity. This Entity coverage is offered at no additonal premium by some carriers, while others may charge upto an additional 10% of the groups total premium to add this coverage.

Separate limits of coverage of $1M each claim/$3M Aggregate may be available to a Professional Entity. A Professional Entity is the ‘Professional service corporation (PC), Professional LLC, Partnership or LLP’ of an insured physician.

To be eligible for coverage, the Professional Entity must meet the following eligibility requirements:

PRI (Physicians’ Reciprocal Insurers)

PRI provides Entity coverage to a physician groups (such as a PC or PLLC) for no additional charge. The physicians and extenders in the group would have to meet PRI’s underwriting criteria AND be insured by PRI in order to qualify for this coverage. This is a huge savings for groups: Some other carriers can charge upto 10% of the total premiums to add Entity coverage.

MLMIC:

MLMIC can provide Entity coverage for an additional charge. This premium charge is calculated as a percentage of the total premiums for all physicians in the group combined. Additionally:

  • MLMIC must insure at least 75% of the members and/or employed physicians of the entity;
  • The Professional Entity must be incorporated in NY State;
  • Members and employed physicians, surgeons or physician extenders in the practice must be acceptable based on MLMIC’s underwriting standards; and
  • All members, employed physicians and/or physician extenders must carry individual limits of insurance of at least $1M/$3M.

Risk Retention Groups:

Entity coverage guidelines differ amongst RRGs. While most RRGs (Such as Medpro RRG) offer separate limits of coverage for the Entity, the additional premiums charged may differ from one carrier to the other. It would be advisable to review all possible options before deciding on the best possible malpractice insurance solution for your practice.

For more information, and to explore all your options, please contact PriMed Consulting at 800.528.3758. Email: info@primedconsulting.com. PriMed Consulting is an independent medical professional liability agency, serving NY & NJ.

Source: Carrier websites

What is a stand alone “tail” policy?

21 Apr 2014
21, Apr Apr, 2014
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If you are looking for options to “tail out” or purchase an extended reporting period, we can help. At PriMed Consulting, we can obtain various tail quotes for you so you do not need to pay the high premium you may have been quoted by your current carriers. We have access to many carriers in NY & NJ that will look at your exposure over the time you have been on your Claims-Made policy. These carriers will determine a competitive premium in line with your particular risk.
A “stand alone tail” or an extended reporting period is a policy to cover any claim that could be made from a patient seen after yourclaims-made retroactive date. This can cover you after you have retired or if you have gone on to a hospital policy, a new claims-made policy or changed over to occurrence. Tail policies can be unlimited; where they cover you for an unlimited period of time or can be written to only cover you for a certain period of time, maybe 5-10 years. It is important tail of some form be purchased so you have coverage should a claim come in once you claims-made policy is no longer in effect.

For help exploring your Medical Malpractice Insurance Stand Alone Tail Policy please call PriMed Consulting.

New Jersey Health Information Technology Extension Center (NJ-HITEC)

5 Dec 2012
5, Dec Dec, 2012
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EMR Meaningful Use:

Under the Health Information Technology for Economic and Clinical Health (HITECH) Act, eligible health care professionals and hospitals can qualify for Medicare and Medicaid incentive payments when they adopt certified EHR technology and use it to achieve specified objectives. Eligible professionals and hospitals may qualify for incentive payments for the adoption, implementation, upgrade or demonstration of meaningful use of certified electronic health record technology. To qualify for incentive payments, standards of meaningful use requirements must be met either by Medicare or Medicaid EHR incentive programs.

The New Jersey Health Information Technology Extension Center (NJ-HITEC) is a federally recognized Regional Extension Center program funded through the recovery act and supported by the New Jersey Institute of Technology. Under the guidance and oversight of the Office of the National Coordinator and administered by the New Jersey Institute of Technology, NJ-HITEC’s program will assist 5,000 New Jersey area primary care providers by providing hands on staff, services, and technology. The same services are available to specialists for a fee that is dependent on the level of service and support required by a practice.

-HITEC’s service offering includes education and training activities, membership in the regional extension center, assessment of current office practices, workflows and technical capabilities; recommendations of appropriate EHR solutions that meet end-user specific needs; coordination of services to implement, adopt, and use new technologies appropriately and the assurance that every member of the regional extension center can meaningfully use these systems. Visit www.njhitec.org for details.

EMR Discounts

Physicians and practices that successfully implement EMR and EPW are eligible for discounts on their medical malpractice insurance. NJ-HITEC members who satisfy certain requirements can qualify for exclusive med-mal discounts which are in addition to all other discounts. This program is available for physicians who have their medical malpractice insurance through MDAdvantage of NJ.

For more information or questions regarding your medical malpractice insurance, please call PriMed Consulting at 800.528.3758. Email: info@primedconsulting.com

~Gabrielle

NJ Med-Mal Discounts: Orthopaedic Surgeons of New Jersey (OSNJ) & OSPA (Orthopaedic Surgeons Purchasing Alliance)

28 Nov 2012
28, Nov Nov, 2012
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The Orthopaedic Surgeons of New Jersey (OSNJ), through the OSNJ Medical Liability Insurance Purchasing Alliance, has arranged for discounts on medical liability insurance purchased through MDAdvantage of New Jersey. These med-mal discounts are 12 ½ % for General Orthopaedists and 7 ½ % for Orthopaedists who do Spine.

For the majority of Orthopaedic Surgeons, this will equal a discount of $6,000 on their annual med-mal premiums every year.

MDAdvantage is a medical malpractice insurance carrier dedicated to NJ physicians. MDAdvantage is rated A- (Excellent) by A.M. Best.

PriMed Consulting has worked with OSNJ for many years to provide medical malpractice insurance services for their members. PriMed’s services are available at no cost to you.

If you have any questions or need more information on your medical malpractice insurance, please contact PriMed Consulting (Ask for Dana, Prem or Gabrielle) at 800-528-3758.

~Dana

NY Medical Malpractice Insurance: ‘Claims-free’ Discount

26 Nov 2012
26, Nov Nov, 2012
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NY Physicians who have excellent malpractice claims experience can now qualify for additional discounts on Their Malpractice Insurance Premiums. The NY State Insurance Department approved a new Claims-free discount of 7.5% for qualifying physicians, effective July 1, 2011.

To qualify for the claims-free discount a physician must:

  1. Have been in practice for a minimum of five years, AND
  2. Have no open claims (or suits), and no closed claims (or suits) with any paid indemnity or expense within the past 5 years – regardless of the incident date or report date.

Any physician who is claims free for the 5-year period immediately preceding will qualify for the discount. The discount will also apply to new applicants who provide claims free loss histories and meet the qualifications above.

How you can qualify:

  • If you are insured with a NY admitted malpractice insurance carrier such as PRI or MLMIC, and have insured by them for over 5 years, the carrier may have all pertinent information to determine if you qualify for the discount. If need be, the carrier can ask for additional information.
  • If you are a new applicant for medical malpractice insurance, you would need to provide claims information and claims reports for the previous 5 years.

We can help: :

The experienced professionals at PriMed Consulting can provide assistance with your options and make it easy to apply for your medical malpractice coverage. PriMed has been working with physicians in NY since 1996. Our objective is to provide you with the most competitive premiums, without sacrificing value or stability. PriMed Consulting: 800.528.3758. Email: info@primedconsulting.com

NY Medical Malpractice Insurance: New-to-practice Discounts

21 Nov 2012
21, Nov Nov, 2012
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Physicians and Surgeons who enter private practice (either solo or joining a group practice) immediately after completion of their training can qualify for New Doctor discounts on Their Medical Malpractice Insurance. In some cases, physicians who immediately after their training became hospital employees, but are now starting their private practice (solo or joining a group), may also qualify for the New Doctor discount.

Discounts for New to Practice physicians are for full-time practitioners. If you are working part-time hours, it would be best to review the part-time premiums and compare with the New Doctor discounted premiums to ascertain the best possible solution for your practice. New Doctor discounts and Part-time practice discounts cannot be combined or stacked. In addition, there are other discounts that may be available to you as well.

The New Doctor discounts are as follows:

  • Claims-Made Policies – 50% first year; 25% second year; 25% third year;
  • Occurrence Policies – 50% for the first year.

We can help :

The experienced professionals at PriMed Consulting can provide assistance with your
options and make it easy to apply for your medical malpractice coverage. PriMed has been working with physicians in NY since 1996. Our objective is to provide you with the most competitive premiums, without sacrificing value or stability.

PriMed Consulting: 800.528.3758. Email: info@primedconsulting.com

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