Questions? Find answers below on a range of topics.
If you require further information, contact us at 888-355-5551.
General Physician Liability Questions
The practice of medicine is risky in and of itself. People sue their physicians for a variety of reasons, including negligence, but frequently due to anger and a need to place blame. For physicians, malpractice is typically defined as a deviation (an act or failure to act) from the accepted standard of care that results in injury to a patient. It is important to note that while physicians want the very best outcome for their patients, the law does recognize that good outcomes are not always attainable.
Medical professional liability insurance, sometimes known as medical malpractice insurance, is a type of professional liability insurance that protects physicians and other licensed healthcare professionals from liability associated with wrongful practices resulting in bodily injury, medical expenses and property damage, as well as the cost of defending lawsuits related to such claims.
A medical professional liability insurance policy covers bodily injury or property damage as well as liability for personal injury such as mental anguish. The complexity involved in discovering negligence results in a higher percentage of premium dollars going toward defense and cost containment expenses. Medical liability insurers spend substantial funds investigating and defending claims where there is an adverse patient outcome not resulting from negligence.
Tail coverage is supplemental coverage to a claims-made policy for incidents that occurred while claims-made insurance was in effect but had not yet been brought as a claim by the time the insurer-policyholder relationship terminated.
Premiums usually are calculated according to broad specialty groups or classes, based on the average statistical risk of physicians practicing in that specialty. That rate can be revised for an individual physician or group of physicians based on factors such as his or her degree of specialization, the risk of certain procedures that the physician performs as part of his or her practice, and the physicians own claims experience. Medical professional liability insurance costs tend to vary among states as well.
Deciding how much insurance to buy means choosing the appropriate policy limits. This is a personal decision, depending on a number of considerations, including the physician’s specialty, the risk it entails, where the physician practices and any requirements imposed by states, hospitals or other entities with which the physician has relationships. Physicians should consult with their broker about appropriate policy limits.
MDAdvantage Coverage Questions
MDAdvantage offers medical professional liability coverage in a variety of forms. Click here to see what’s available in your state.
Many healthcare providers choose professional medical malpractice insurance without looking closely at the policy, but that strategy can leave insurance policyholders open to claims that are not covered. MDAdvantage offers a range of coverage options to meet the specific needs of a physician’s practice. Click here to view the coverage options available in your state.
MDAdvantage’s risk management program includes a varied menu of services that continually evolves to meet the needs of its policyholders. The risk management service offerings include:
- On-site practice assessments
- Live and web-based education programs
- Office staff workshops
- CME articles
- Customized webinars
Through the MDAdvantage Risk Management Incentive Plan, premium discounts are available to physicians who participate in risk management activities and utilize certain risk-reducing office systems.
If you have a broker, you can request that he or she obtain a quote from MDAdvantage. If you do not have a broker, contact our Policyholder Services Department directly at 888-355-5551.
As a medical liability insurance company that strives to meet the unique needs of physicians and their practices, MDAdvantage offers its insureds additional protection through our Supreme Advantage coverage. This coverage is automatically provided as one endorsement to each physician’s existing medical professional liability policy providing a combined single limit of $50,000 (subject to policy terms and conditions), and includes Employment Practices Liability Insurance (EPLI), Privacy and Data Security Insurance (PDSI) and Medical Practice Administration Insurance (MPAI).
Claims-Related Questions
Physicians, along with members of their office staff, should be continuously on guard for signs that a professional liability claim is being considered by a patient or a representative of the patient. The following events may trigger an “alert” that a potential claim is being developed:
- a written request for medical records from the patient or his/her attorney (accompanied by an appropriate HIPAA authorization)
- a subpoena to provide medical records
- a subpoena to appear in person with original medical records, and/or
- a subpoena to appear at a deposition
From the physician’s perspective, a lawsuit begins with a summons and complaint. These are legal documents delivered or mailed to a physician’s home, office, or hospital. Alternatively, a physician may receive a claim letter from a patient or the patient’s attorney demanding compensation.
As soon as a physician receives notice of a claim, he or she should immediately notify the MDAdvantage Claim Department at 888-355-5551, and will be asked to provide general details regarding the medical care provided to the patient.
He or she will also be asked to send the original summons and complaint and a copy of the entire chart and any other relevant medical records to MDAdvantage. A Medical Liability Claim Specialist will contact the insured physician to discuss details of the case. If the claim results in a suit, the Medical Liability Claim Specialist will assign the case to one of our approved defense counsel who specializes in medical professional liability litigation. Defense counsel, the Medical Liability Claim Specialist and the insured will work closely to evaluate liability and, when required, coordinate the defense.
A subpoena is a legal document issued in the course of a lawsuit, which is used to compel the attendance of a person to testify or to produce books, papers, documents or other objects at a judicial proceeding or deposition. The type of subpoena a physician is most likely to receive is a request for the medical records of a patient he or she has treated. However, it should be noted that a record request from a patient or from his/her attorney, accompanied by a HIPAA release, does not require an actual subpoena.
MDAdvantage recommends that one or more staff members in each practice be trained to appropriately “screen” and handle record requests and subpoenas. Report all subpoenas relating to patient care to the MDAdvantage claim staff as soon as it is received. A MDAdvantage Medical Liability Claim Specialist will be available to answer any questions and direct the practice on the steps to be taken next.
