How Med Mal Ins Companies View Claims

Female PhysicianAlthough we sometimes forget, med mal ins companies at their most basic, are the same as every insurance company. Money in in the form of a premium comes into the med mal ins companies, the companies invest the premium as best they can, and money comes out of the companies for payments of med mal ins claims and for defense of claims. It’s important for physicians and medical providers to understand the basics of med mal ins so that they can keep costs down and maintain consistent coverage. To see a list of our major med mal ins companies, see our Site Map page.

The most important thing to remember from a med mal ins agent’s point of view is to be honest and upfront regarding claims and claim history. Most med mal ins companies do not go back further than 10 years when reviewing claims and some med mal companies will do a National Practitioner Data Bank report on the doctors that they cover. Forgetting to list a claim or intentionally leaving a claim out when applying for coverage will void the policy and may leave you uncovered if another claim arises. The lesson that we can’t stress enough is to be honest and upfront at all times.

The agents at Cunningham Group approach claims in a slightly different manner than other agents. When we apply to med mal ins companies on behalf of a client that has had a claim or multiple claims, in most cases we provide additional material and market the doctor as an excellent risk for the company. For instance, we may recommend that the physician does an online risk management course or we may look to see what the payouts for the claims were, and if they are minimal, we will explain this to the med mal ins company underwriter.

Most of the admitted med mal ins companies won’t accept a physician that has had multiple claims in the last five years. Med mal companies don’t like to see large payouts out and claims on your record, but they especially don’t like to see multiple claims over a short time period; med mal ins companies view this as a pattern. As every physician knows, any type of claim can be a disruptive experience, and can impact a physician both personally and professionally. Don’t hesitate to contact one of our agents if you have claims in your history or you’re worried about how a new claim may impact your med mal coverage in the future, please contact the agents at Cunningham Group. The conversations are always confidential and non-legal, med mal-related advice is always free.

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