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Who and What Does PRI Cover?

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which may have occurred while you had a policy in force, regardless of when a claim is reported, even if the policy is no longer in force.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

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

802 West Park Avenue, Bldg. 3, Suite 302, Ocean, NJ 07712

NY Medical Malpractice Insurance: Part-time Discounts

19 Nov 2012
19, Nov Nov, 2012
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NY physicians and surgeons who work limited hours can qualify for part-time discounts on their malpractice insurance premiums. These discounts apply to physicians & surgeons who limit their medical practice to 20 hours or less per week. However, Some Risk Retention Groups may offer higher discounts for part-time practitioners who limit their practice to less than 10 hours per week.

Discounts

The following discounts are applicable for part-time (less than 20 hours/week) practice:

1. 50% discount for physicians in the non-surgical specialties

2. 35% discount for the following specialties:

  • Neurosurgery
  • General Surgery
  • Plastic Surgery
  • Obstetrics and Gynecology
  • Orthopaedic Surgery
  • Cardiac Surgery
  • Vascular Surgery
  • Gynecology
  • Otolaryngology, incl. Cosmetic Plastic
  • Plastic and Reconstructive Surgery
  • Colon and Rectal Surgery
  • Urology, incl major surgery
  • Emergency medicine

 

For more information or help with your medical malpractice coverage, you can trust the experienced professionals at PriMed Consulting. PriMed Consulting is an independent medical professional liability agency serving NY & NJ.

Phone: 800.528.3758. Email: info@primedconsulting.com. www.primedconsulting.com
802 West Park Avenue, Bldg. 3, Suite 302, Ocean, NJ 07712

~Michele

NY Medical Malpractice Insurance – Claims–made Vs Occurrence

14 Nov 2012
14, Nov Nov, 2012
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Physicians and surgeons who are Contemplating buying Medical Malpractice Coverage or are reviewing their current malpractice coverage would benefit from a clearer understanding of how the two types of policies are priced. A better understanding of the premiums could save you significant premium dollars.

The following information applies to most standard market carriers such as MLMIC & PRI.

Both types of policies provide coverage of upto $1.3/3.9 Million (Per claim/Aggregate).

What is an Occurrence Policy?

This kind of policy provides coverage for claims that may arise from incidents that ‘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: A physician had an Occurrence policy in effect from January 2000 to January 2008, at which time the existing policy was not renewed, or coverage was switched to another insurance carrier. In February of 2009, a patient treated in 2007 filed a claim against the physician. Since the physician had an Occurrence policy in effect in 2007, the insurance carrier that insured him in 2007 would provide coverage for the claim, based on the 2007 coverage.

What is a Claims-Made Policy?

This type of 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. Therefore, a physician is only covered if the claim is actually filed while the policy is in force. To be protected for claims that are reported after the policy has been canceled, you must purchase ‘tail coverage‘, (Extended Reporting Period endorsement), or obtain similar protection from a subsequent 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’ must be obtained to cover your exposure from your first day of claims made coverage.

For example: A physician had a claims-made policy from January 2000 to January 2008, at which time the policy was not renewed, and tail was not purchased. In February 2009, a patient treated in 2007 files a claim against the physician. The physician would have no protection against this claim, because the claim was not reported during the policy period. However, there would be coverage for this claim if tail coverage was purchased; if you became eligbile for free tail coverage; or if you switched insurance carriers and the new carrier provided ‘prior-acts or nose coverage’.

Pricing:

Because there is often a significant lag time between when a treatment was administered and the filing of a malpractice claim, Claims made premiums for the first few years are relatively low when compared to the rates for Occurrence policies. However, Claims made premiums increase rapidly on an annual basis, until they level off in year 8. The premiums for Claims made coverage are calculated as a percentage of the Occurrence rates that are in effect at the time.

  • Claims-made Coverage Year% of Occurrence premium
  • 1 31% of Occurrence premium
  • 2 64% of Occurrence premium
  • 3 85% of Occurrence premium
  • 4 94% of Occurrence premium
  • 5 99% of Occurrence premium
  • 6 102% of Occurrence premium
  • 7 104% of Occurrence premium
  • 8 105% of Occurrence premium

Please note that the above premium information is for MLMIC. PRI and other NY standard market carriers also offer Claims-made & Occurrence policies, however, the percentages mentioned above may differ among carriers.

For more information, and a free consultation on your medical malpractice coverage options, please call PriMed Consulting. PriMed Consulting is an independent medical professional liability agency serving NY & NJ.
Phone: 800.528.3758. Email: info@primedconsulting.com. www.primedconsulting.com
802 West Park Avenue, Bldg. 3, Suite 302, Ocean, NJ 07712

MLMIC Claims-made coverage: Free tail-coverage eligbility

12 Nov 2012
12, Nov Nov, 2012
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Physicians and surgeons who have a Claims-made medical malpractice insurance policy with MLMIC may be eligible for Free tail coverage. Here are some of the eligibility criteria:

  • In the event of the insured’s death, or permanent and total disability
  • Permanent and total retirement from the practice of medicine after he/she attains the age of 65 or older and has been insured on a claims made basis by an authorized insurer for 5 or more consecutive years
  • Permanent and total retirement from practice after an insured attains the age of 55 or older, and has been insured on a claims made basis by an authorized insurer for 10 or more consecutive years; or,
  • Regardless of age, the insured retires and has maintained claims made coverage with an authorized insurer for at least 10 consecutive years, provided the last 5 consecutive years were through MLMIC.

Tail Coverage, or Extended Reporting Period (ERP) rules may differ between NY standard market carriers (such as MLMIC & PRI) and Risk Retention Groups. If you care contemplating a change to your current medical malpractice coverage, or exploring malpractice insurance coverage for the first time, call PriMed Consulting. PriMed Consulting is an independent medical professional liability agency serving NY & NJ.

Phone: 800.528.3758. Email: info@primedconsulting.com www.primedconsulting.com
802 West Park Avenue, Bldg. 3, Suite 302, Ocean, NJ 07712

Source: MLMIC Website

MLMIC: Cost of purchasing Tail Coverage on a Claims-made policy

7 Nov 2012
7, Nov Nov, 2012
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What is a Claims-made policy, and why is tail coverage necessary?

What is a Claims-Made Policy?

A Claims-made policy provides protection for claims that ‘arise and are reported’ while you have the policy in force. Coverage is provided up to the policy liability limits in effect at the time the claim is reported. Therefore, a physician is only covered if the claim is actually filed while the policy is in force. To be protected for claims that are reported after the policy has been canceled, you must purchase ‘tail coverage‘, (Extended Reporting Period endorsement), or obtain similar protection from a subsequent 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’ must be obtained to cover your exposure from your first day of claims made coverage.

There are circumstances in which the only option available may be to purchase tail coverage on an existing claims-made policy. The cost of purchasing Tail coverage on a claims-made policy is determined by the following factors:

  1. Territory or County the practice is located in
  2. Limits of liability
  3. Number of years Claims-made coverage was in continuous force
  4. Changes in classification during the previous coverage years
  5. Changes in territory, or limits of liability during coverage period.

The cost of Tail coverage is calculated as a percentage of the Occurrence premium in force at the time of purchasing Tail coverage.

  • Claims-made Coverage Year% of Occurrence premium
  • 1 74.8%
  • 2 122.1%
  • 3 146.4%
  • 4 162.4%
  • 5 173.3%
  • 6 181.0%
  • 7 186.7%
  • 8 190.6%

The above premiums are a one-time cost to purchase coverage that will protect against any covered malpractice claims in the future. Evidently, the cost of purchasing tail coverage can be astronomical, especially for surgeons. It will be extremely beneficial to explore all your options before commiting yourself to purchasing tail coverage or switching your current coverage.

Physicians and surgeons looking to make changes to their coverage based on their future plans and retirement goals would benefit from a comprehensive review of their malpractice insurance. Please call PriMed Consulting at 800.528.3758. Email: info@primedconsulting.com www.primedconsulting.com. 802 West Park Avenue, Bldg. 3, Suite 302, Ocean, NJ 07712

PriMed Consulting is an independent medical professional liability agency
serving NY & NJ.

Source: MLMIC website

New York Medical Malpractice Insurance: Voluntary Attending Physician (VAP) Program

5 Nov 2012
5, Nov Nov, 2012
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Physicians’ Reciprocal Insurers (PRI) & Medical Liability Mutual Insurance Company (MLMIC) offer VAP programs & discounts to their physicians. VAP discounts are available to physicians who have privileges at hospitals that are insured by one of the above two insurance carriers.

VAP Discounts

: If the hospital of principal affiliation AND the physician are both insured by the SAME carrier (PRI or MLMIC), the physician (Voluntary Attending Physician) is eligible for the following discounts totalling 12%

Risk Management Discount

: 5%. This online or class adminstered course also allows physicians to be eligbile for a 5% discount on their malpractice premiums, as well as the Section 18 Free Excess coverage of $1/3 Million through the hospital of their primary affiliation.. Please read our article on Section 18 Excess coverage for updates.

Joint Defense Discount

: 7%. Eligible physicains applying for this discount would have to agree to a Joint Defense if named in a lawsuit with any other physician who is insured by the same carrier under the same program.

We stronly urge physicians to understand the pros and cons of the VAP program and the benefits or discounts this program can provide. For more information or help with an application, please contact PriMed Consulting at 800.528.3758. Email: info@primedconsulting.com   www.primedconsulting.com.

PriMed Consulting is an independent medical professional liability agency serving NY & NJ. 802 West Park Avenue, Bldg. 3, Suite 302, Ocean, NJ 07712

MLMIC Risk Management Discounts & Programs for NY Physicians

31 Oct 2012
31, Oct Oct, 2012
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MLMIC’s Risk Management programs are designed to help their physicians to improve patient care, and prevent injury or negative outcomes and the resultant lawsuits.

CME Accreditation

MLMIC is accredited by MSSNY to provide CME for physicians. MLMIC utilizes conventional formats and new technologies, including an Internet-based format, to provide and deliver its CME programs. Satisfactory completion of these CME courses allows physicians to earn AMA PRA Category I credits™, the applicable premium credit, as well as qualify for participation in the medical malpractice excess insurance program.

5% Premium Credit

MLMIC offers a 5% discount on malpractice insurance premiums for two consecutive years upon completion of the risk management courses offered pursuant to the NY State Insuarance Department regulations. (Reg 124). The premium credit will be effective in the policy period following the one in which the physician completes the course.

MLMIC also encourages its insured physicians to invite members of their office staff, including physician extenders, to attend these risk management programs. Attendance certificates are provided, upon request, to non-physician participants who complete these courses.

There is no fee for MLMIC policyholders or their employees who wish to participate in these programs.

To explore all your malpractice insurance options, and maximize your savings through discounts offered, please contact PriMed Consulting at 800.528.3758. Email: info@primedconsulting.com. PriMed Consulting is an independent medical professional liability agency serving NY & NJ. 802 West Park Avenue, Bldg, 3, Suite 302, Ocean, NJ 07712.

Source: MLMIC website

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