Choosing a Malpractice Carrier

November 2, 2018

Every year during your medical career you will evaluate and choose a malpractice insurance carrier. This coverage is essential to protect you, your practice, and the assets that you work so hard to acquire. Insurance companies are rated by outside agencies, and your attorney can explain the meaning of different ratings to you and advise you on the minimal rating (and risk) that you should require. You and your attorney should review the company’s financial health, their track record in defending physicians, and their approach with regard to settling cases without the need for public litigation (which can impact your public image) and the process that they use for evaluating such claims. 


You and your attorney should understand whether the policy offered is a claims-made policy or an occurrence policy. A claims-made policy covers all claims made during the term of the policy; an occurrence policy covers all claims which happened during the policy period, even if those claims are raised substantially later. You will also want to fully understand the exclusions from coverage, as those types of claims will result in you paying for your own defense and paying for your own settlements or judgments.


With advice from your attorney, you need to understand what acts, omissions, procedures or events can result in the carrier withdrawing coverage and terminating your defense, or voiding your coverage altogether. You should inquire as to whether tail coverage is available from your carrier, to protect you against past claims made against you and claims that may be made against you in the future. 

Because patients frequently pair their legal claim with a complaint to the state medical board, you will want to know whether the insurance carrier covers your representation in resolving those administrative claims as well. 


Insurance premiums are expensive, but the cost of the policy should not be the most important factor in choosing a malpractice carrier or a particular insurance policy with a carrier. A poor policy with coverage exclusions that might arise during your practice can be just as bad as no coverage at all. 


You are not without resources in evaluating and selecting insurance companies. Your professional association or society will have referrals to insurance carriers that are experienced in handling plastic surgery claims, and the attorneys that such companies use will also have experience in understanding plastic surgery claims and representing plastic surgeons in the defense of such claims. You can ask your colleagues about their experience with various insurance carriers; some are more responsive than others. And you will want to ensure that calling your representative to discuss a problem patient is encouraged by the company, rather than negatively impacting their assessment of your practice.  


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