What is Professional Liability Insurance for Healthcare Professionals?

Also known as medical malpractice insurance, professional liability coverage protects healthcare workers from financial risk associated with patient bodily injury, medical expenses, and property damage. As with any legal-laden issues, the cost associated with risk mitigation can be substantial. And it’s not solely about paying claims, because insurers also spend a considerable amount of money investigating and defending claims before a suit ever makes it to court. With so much money at risk, proper insurance coverage is a necessity.

There are two basic types of coverage to consider: occurrence-based or claims-made:
• Occurrence-based: this type of policy covers a loss that occurs during the active insurance policy period, even if the claim is filed after the policy is cancelled.
• Claims-made policy: this type of policy covers any claims reported during the active policy period, regardless of when the injury/loss happened.

Outside of either of these types of coverage, providers should also consider purchasing extended reporting endorsement (tail) coverage, which indefinitely extends the time during which claims may be reported. Tail coverage can be very expensive to purchase due to its perpetuity of liability.

Due to the fact that claims can be made long after the date of service, premiums for claims-made policies are lower than occurrence-based policies. However, in order to balance out the risk, claims-made policy rates increase rapidly year-over-year.

Professional liability coverage is mandatory due to the large financial risk at stake. Policies can be underwritten by individual insurance companies or collective risk retention organizations. Very large healthcare organizations are sometimes self-funded, wherein they establish an account or trust to pay these types of expenses.

It’s important to note that not all liability comes from medical errors, so your liability insurance also needs to cover expenses related to data breach mitigation and regulatory requirements, such as HIPAA compliance.

Contact us today if you have questions about what type of coverage is best suited for your practice. We would be happy to help you review your options.

Choosing Your Medical Malpractice Insurance Carrier 

One of the biggest decisions a physician makes is who they choose as their medical malpractice insurance provider. Hopefully price isn’t the only barometer for decision making, because many insurers provide different services at different price points. Naturally, you want an optimal plan at a reasonable price, but there are other factors to consider, such as:

  • Personal/professional references  
  • History and experience
  • State-based licensure
  • Coverage limitations and exclusions
  • The fine print

Armed with the above information, it is easier to compare carriers side-by-side, and see exactly what your insurance dollars get you. Also, if you specialize in a specific area, you may want to focus on insurance providers who have clients similar to your practice. They will have the most experience with your specific needs.

The list of questions you could ask potential insurance carriers is pretty lengthy, so stay focused on what is important to you. For example, 

  • Do you have a large Medicare patient base? Then focus on carriers with extensive experience in federally mandated compliance requirements.
  • Are you concerned about local laws and need a liaison to navigate potentially complicated waters? Then you are probably better served by a local agency than a national firm that doesn’t provide the opportunity to develop local relationships. This may end up being of the utmost importance, should a lawsuit go to trial.
  • Would you benefit from additional guidance and tools, such as data analysis? Then choose a firm that offers a suite of services, not just basic malpractice coverage.

Click here for ideas about additional questions to consider.

Keep in mind that insurance carrier selection is not a one-time event. Your coverage should be evaluated annually, including a quick check of the competition. But your evaluation is not completely based on your carrier. Take a look at your practice’s history over the past year. Not just whether you’ve had to file claims, but take stock of whether any significant changes you’ve made might affect your malpractice coverage needs.

Contact us today if you have questions about the process of choosing a medical malpractice insurance provider. We would love to put our expertise to work for you.

The Benefits of a Solid Risk Management Plan

It’s imperative to be proactive in healthcare. Not only in caring for your patients and staff, but also to stay ahead of any inherent risks to your business. A solid risk management plan reduces your liability in the first place, and acts to minimize litigation (should it happen). This protects not only your financial standing and assets, but also your firm’s market share, accreditation, reimbursement levels, brand value, and community standing.

One major benefit of instituting a risk management plan is that it improves patient outcomes too. A heightened awareness of processes, especially documentation, instills a sense of professionalism across your entire team, including both healthcare workers and office staff. This in turn reduces errors, which improves patient satisfaction and strengthens your reputation in the community. It also increases your bottom line by reducing expenses.

Risk management, at a basic level, is the responsibility of everyone employed at your business. But since everyone already has a full plate of responsibilities, their role is usually more reactive (to specific events) than proactive (looking at the big picture). You also need an expert on your team. Depending on the size of your practice, it might make sense to hire a risk manager. However, more often than not, your budget simply doesn’t have the room to take on a full-time salaried position. Partnering with a third-party risk management firm might be the perfect compromise.

Speaking of third parties, a level of risk is both assumed and mitigated whenever you contract with third parties. Not just for malpractice management, but for any services. Consider basics, such as records management and document shredding services. These may seem like simple tasks, but everything related to healthcare records needs to be considered under the watchful umbrella of compliance. Data sharing, storage, and destruction all fall under that umbrella.

Contact us today if you have questions about risk management and outsourcing those types of responsibilities. We would love to put our collective experience to work for you.

CARE and OmniSure: A Solid Partnership

CARE Professional Liability Association has partnered with OmniSure Consulting Group, a risk management and loss-control firm, to provide you with complimentary access to Risk Fitness®, which is an online tool that helps reduce your professional risk. This includes the RiskFit® library, email tips, and the RiskFit® helpline.

As the program name implies, it’s designed to ensure your firm’s well-being. The experts that manage the helpline could be considered your trainers. The health of your risk management plan is dependent on more than a single site visit for a cursory assessment. It is not a static event. A healthy risk management plan requires curating over time, introducing best practices as they are learned and new policies as they are developed.

The RiskFit helpline can help you with questions about your professional practice, risk mitigation, and regulatory-related issues. In addition to calling, you can also send an email to helpline@omnisure.com. You might know your business best and have great relationships with your patients, but you shouldn’t be expected to know every nuance of every change in laws and regulations. You need a resource you can depend on. That’s what the RiskFit helpline is to you … a lifeline.

Every company has its own risk management challenges. It’s important to partner with an organization that can provide insight about gaps, concerns, and challenges from an outside party’s perspective. Many claims and lawsuits can be traced to poor risk management and inattention to detail. In the daily barrage of work, these elements are easy to overlook. Some areas that usually end up lacking are documentation, follow up, and patient communication. It’s easy to become complacent.  

Contact us today. We can help you maximize your RiskFitness tools through our partnership with OmniSure. The collective knowledge and experience we all bring to the proverbial table makes us better-informed resources for each other.