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Basics of Medical Malpractice Insurance – “Terms that every physician should know”

Date Added: June 06, 2013 11:00:47 PM
• Retro Date – There is no coverage for any wrongful act that occurred prior to the retro date. For example, if you have a retro date of 01/01/2001, you can submit a covered claim to your current carrier for claim that happened anytime after 01/01/2001. If the act occurred prior to your policy retro date, your carrier will not respond. Always make sure your retro date is maintained before changing your malpractice insurance company; if the date changes you lose insurance coverage.

• Renewal Date- This is the date that the insurer has the right under your policy to change the price or terms of your coverage. You should get your renewal ideally 30 day prior, but no later than 2 weeks prior. Call your broker or insurer if your renewal offer is late.

• Claims Made Policy- Most Med Mal insurance policies are written on a claims made basis. A claims made malpractice policy covers any eligible claims brought during the claims made policy period. There are two events for claims made medical malpractice insurance coverage to apply. The incident must have occurred during the policy coverage period (from the retro date going forward) and it must be reported during the active policy year.

• Tail Malpractice Coverage or Extended Reporting Period– This is purchased when your claims made malpractice policy is cancelled: for retirement, the insurer non- renews your coverage or you cancel your coverage for any reason.

• Full Prior Acts Coverage- This is term for malpractice insurance quotes that means the insurer is covering you back to your retro date. Always check the date on the insurance quote or policy.

• Retro Date Inception Coverage- This means that the insurer is not covering your prior acts or back to your retro. They are only covering for acts that happened after your coverage goes into effect. If you buy this type of coverage, you should always buy tail coverage from your expiring/non-renewing insurance carrier to cover your retro date.

• Step Up Rate Adjustments- When you have a claims made policy the rate will increase each year until your retro date is a full 5 years old. The reason is, each year the insurer adds one more year of coverage to the retro. If you have a retro date younger than 5 years you will receive an increase, as the insurer adds to its risk of a claim.

• At five years completed retro date the policy is called a Mature Claims Made Policy. A Mature policy usually means that you will not have any additional premium increases unless you have changes to your risk (i.e. claims, new procedures…) or if the insurer decides to raise their overall prices.

• Occurrence Medical Malpractice Insurance- An occurrence malpractice insurance policy covers any claims that occur during any policy years that you had the coverage. You do not have to buy tail insurance with this type of coverage, because it covers wrongful acts that occurred during the policy period, whether the policy is currently active or not. Occurrence Med Mal is more expensive because it has more coverage and eliminates the need for tail coverage.

• Declaration Page- This page is normally toward the beginning of your malpractice insurance policy. It lists who is covered, the deductible, the limits of coverage, your retro date, your specialty, the effective date of the coverage and the annual premium. Always review the declaration page when you receive your policy and report any discrepancies to your broker or insurance carrier immediately.

• Policy Exclusions- Always read this section in your med mal policy, especially if you have surgical malpractice or OB med mal coverage. If services or procedures that you provide are listed as excluded, call your insurer and/or broker to discuss this immediately. If something is excluded, you have no coverage for that item.

HCP is national medical malpractice company who specializes in group medical malpractice insurance and surgical malpractice insurance.