Medical Liability Insurance Key Terms

Know the language when searching for medical professional liability insurance

When searching for liability insurance, educate yourself on medical liability insurance key terms so that you understand your coverage and insurance company provider responsibilities. Every profession utilizes language or terminology specific to their practice, and the medical insurance world is no exception.

Knowing and understanding insurance language helps you find doctor malpractice insurance, dental malpractice insurance, nursing malpractice insurance or other healthcare liability insurance with the protection you want when faced with malpractice claims. In your search for professional liability insurance in the healthcare industry, consider the following:

1. Discover the difference between a medical liability insurance agent and a medical liability insurance broker.

2. Understand the word "claim" as it relates to your insurance.

3. Understand what settlement clauses and fee responsibilities mean within your medical liability policy.

 

Decide whether you want an "agent" or a "broker" to locate your medical liability insurance company

A medical liability insurance agent is committed to one insurance company, so the agent is able to give you a quote only from his or her company. When it comes to a medical liability insurance broker, you are that broker's client, so the broker wants you to receive the best quote possible from one of many reputable insurance companies. Check with friends, business associates, etc., for recommendations, and ask the broker to supply credentials and references.
Try: If you want an agent dedicated to one company to provide your malpractice insurance quote, see DocLiability.com, or, if you want a broker who compares companies and policies, check out The Doctors Company.

Seek specifics regarding the term "claim" with medical liability companies

Ask for clarification when comparing claims-made or occurrence coverage and incident reports or written demands for damages. Claims-made policies cover claims made during the active policy period, but occurrence coverage allows claims filed at any time as long as the incident occurred when the policy was in effect. Some insurance companies allow the physician to report an adverse outcome as a potential claim, while others require receipt of a written demand for damages (notice of lawsuit).
Try: Physician's News Digest provides a detailed explanation of claims-made and occurrence policies, and Medscape has answers and guidelines for incident report writing. You'll have to register at Medscape.

Know settlement clauses and fee responsibilities with your healthcare liability insurance coverage

Check to see if your policy has defense costs written as either "inside" (costs are subtracted from liability limits) or "outside" (liability limits remain in full) policy limits, and check to see if your settlement clause is a consent to settle clause and/or a "hammer" clause. Consent to settle clause means the insurance company must have your permission to accept a settlement claim, while a "hammer" clause still requires your permission to settle, but you are responsible for any costs above the proposed settlement should you opt out of settling.
Try: Stanzler Funderburk & Castellon provides information, such as reporting that defense costs policy limits often cause a conflict of interest with the insurance company and the insured. Modern Medicine offers deeper insight and explanation of consent to settle clauses, while PRMS examines the affects of the "hammer" clause.

 

• Exclusions in your medical malpractice insurance company policy state what the policy does not cover, so read the fine print closely.

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