NY STATE ADMITTED CARRIERS:
- Medical Liability Mutual Insurance Company (MLMIC): MLMIC is the oldest and largest carrier in the State. MLMIC is an admitted carrier, hence physicians insured through MLMIC have the State Guaranty Fund to protect them in case of insolvency of the carrier. In addition, MLMIC insured physicians may be eligible for the Section 18 Excess Insurance program for $1/3 Million in coverage that is provided at no cost to physicians.
- The Doctors Company: The Doctors Company is a California carrier that has recently entered the NY market. They have shown a great commitment to the state as they have become an admitted carrier in NY. They also write as a RRG in an effort to remain competitive on NY's large groups. TDC is a physician owned carrier that is governed by doctors. TDC has a physician focus and provides their insureds with top notch support and service.
- Physicians™ Reciprocal Insurers (PRI):PRI is the second largest carrier in the State, doing business since 1982. Like MLMIC, PRI is also a State admitted carrier that makes their insured physicians eligible for the Section 18 Excess Insurance program, as well as the State Guaranty Fund in case of insolvency of the carrier.
- Hospitals Insurance Company, Inc. (HIC): HIC has a long-standing relationship with five hospitals in the New York City area. HIC provides more than 1,200 Voluntary Attending Physicians with Primary Professional Liability Insurance. HIC also underwrites Excess (Section 18) Professional Liability Insurance for physicians throughout New York State. The five hospitals that HIC covers are: Beth Israel Medical Center, Mount Sinai Medical Center, Maimonides Medical Center, Montefiore Medical Center, and New York Eye & Ear Infirmary.
- Medical Malpractice Insurance Pool (MMIP): Often referred to as the insurer of last resort, MMIP provides insurance for physicians and other health care providers who are not able to get insurance in the voluntary market due to underwriting reasons such as: excessive claims activity, excessive settlements, revocation of license issues, temporary revocation of hospital privileges, Medical Board sanctions, etc. It is no surprise that MMIP charges premium rates that are well above those charged by PRI or MLMIC, sometimes as high as 200-300% of standard rates.
- Academic Group: The Academic Group consists of two independent insurance companies and an insurance management company. The first company was founded by physicians and dental professionals to meet the unique professional liability insurance needs of teaching faculty, and owned and governed by members. The second company now provides insurance solutions for medical professionals beyond academia through their Risk Retention Group, Academic Medical Professionals Insurance Exchange (AMPIE).
New York, especially the five boroughs (Bronx, Brooklyn or Kings County, New York County, Queens and Richmond) and Long Island, have some of the highest malpractice rates in the nation. NY is one of the states that has not enacted any kind of tort reform capping payouts, resulting in steadily increasing premiums.
RISK RETENTION GROUPS:
- MedPro RRG
- Applied Medico-Legal Solutions
- Coverys
- Oceanus
- Care
New York has seen a proliferation of RRGs in the last few years. RRGs can be a viable alternative for many physicians and medical groups. We suggest that physicians and/or practice administrators carefully evaluate their coverage options, understand the various benefits of standard carriers vs. RRGs, and select a plan that suits their needs.
Your medical malpractice insurance is one of the most important coverages that protects you and your practice. We are pleased to provide you with a comprehensive look at RRGs in NY, and we do hope that this will assist you in making informed, long-term decisions.
What is a RRG? A RRG is a liability insurance company that is owned by its members. Under the Liability Risk Retention Act (LRRA), RRGs must be domiciled in a state. Once licensed by its State of domicile, a RRG can insure members in all states. Because the LRRA is a federal law, it pre-empts State regulation, making it much easier for RRGs to operate nationally. The Liability Risk Retention Act (LRRA) is a federal law that was passed by Congress in 1986 to help U.S. businesses, professionals, and municipalities obtain liability insurance which had become either unaffordable or unavailable due to the liability crisis in the United States.
KEY CONSIDERATIONS FOR NY PHYSICIANS
- Guaranty Fund Protection: Policyholders insured by NYS licensed carriers (such as MLMIC & PRI) are protected by the State’s $1 Million per claim guaranty fund in the event of insolvency of the carrier. However, RRG policyholders are not protected by the guaranty fund in case the RRG becomes insolvent; making it extremely important to find a RRG with strong financials and a conservative business model. The NYS Property/Casualty Insurance Security Fund (Guaranty Fund) provides a safety net protecting policyholders of NYS licensed carriers.
- Free Excess Coverage: Physicians who are insured by a NYS licensed carrier are eligible to get $1 Million of Excess coverage provided by the State. Excess coverage is currently provided at no cost to physicians who have primary limits of $1.3/$3.9M from a NYS licensed carrier, and who complete the requisite risk management course. Physicians are expected to have this application processed through their primary affiliated hospital.
Physicians who purchase their primary coverage from a RRG are not eligible for the $1 Million of free excess coverage. They do however have the option to purchase higher limits of primary coverage offered by some RRGs to offset the lack of the free excess coverage.
- Coverage Forms: NYS licensed carriers provide both types of coverage, Occurrence and Claims-made. Most RRGs provide Claims-made coverage, while only a handful offer both types.
- Premium Savings: RRGs typically charge less than the standard premiums offered by NYS licensed carriers. In some cases, the savings can be substantial.
- State Regulation: NYS does not regulate RRGs. RRGs can set their own premium rates, policy forms and claims handling practices, without filing for and requiring approval from NYS Department of Insurance.
- Hospital Credentialing Requirements: Some hospitals do not grant staff privileges to physicians who are insured by an RRG. This scenario is changing rapidly, as many hospitals recognize the crisis some physicians face, and are accepting physicians insured by a few select RRGs. It is important to check with your hospitals to see which RRGs are currently accepted.
One of the primary benefits some physicians can expect from RRGs is a sometimes significant premiums savings. This is especially true in cases where physicians have an above-average claims experience, or other licensing/disciplinary issues.
The list of RRGs offering coverage in NY is expanding, providing more and more options to NY physicians.
In recent years, Risk Retention Groups (RRGs) have entered the NY market, offering competitive premium rates. As more and more hospitals in NY are now accepting physicians insured by RRGs, physicians considering MMIP, or those physicians who are not able to get insurance in the voluntary market can also consider their options with the various RRGs offering malpractice coverage in NY.
PriMed Consulting is an independent medical malpractice insurance agency, with access to several carriers in the voluntary market, as well as RRGs. For more information on which carriers and/or RRGs would be the best fit for your and your hospital, please contact PriMed Consulting at800.528.3758. Or Email: info@primedconsulting.com
Based on