Tag Archives: Georgia

How I Helped a Surgical Ophthalmologist Find New Medical Liability Insurance Coverage in Georgia After His Malpractice Insurer Went Bankrupt

It’s six a.m., and the phone is already ringing. As I put down my coffee and pick-up the telephone, I hear a frantic voice on the other end that is too fast to understand. “Sir, sir,” I interjected, “please slow down as I can’t understand you.” The gentleman took a deep breath before saying, “Sorry, my name is Dr. Rodrigo Espinosa. I’ve been on vacation the last couple of weeks, and today I received notice that my insurance company has gone bankrupt. The policy ended three days ago, my practice manager quit yesterday and I have no idea where my insurance documents are. My specialty is Ophthalmology, which includes major surgery, and I’m working in Southeast Georgia.”

Unfortunately, these situations are all too commonplace for solo practicing physicians or small practices, no matter where they are located. Many times, these doctors work with medical malpractice insurance agents who are focused on larger clients and overlook their smaller solo physicians. Other times, these doctors are buying their medical liability insurance coverage direct from the insurance company and lack the true advocate an insurance agent can be. For Dr. Espinosa, it was the latter. He had been depending on his practice manager to purchase his medical liability insurance coverage directly from his insurer.

As the caffeine started to kick in, I was already formulating a plan of action for his medical liability insurance coverage. “Thank you for reaching out to us today,” I started. “First, let me just say we will find you coverage, but we’ll need to move quickly so we can close this gap in your coverage and pick up your prior acts history or nose coverage.” The concern here is his previous policy cancelled three days ago, which means not only is he currently uncovered, but all of his history (nose coverage) is exposed and uncovered as well.

Luckily for Dr. Espinosa, he ended up having no claims on his record and his medical license was in good standing. A claims-free record and medical license in good standing can go a long way in securing the best terms and premiums. I explained to him I would have the new rates shortly and will call him back to go over everything.

After about an hour the rates were ready and I was back on the phone with Dr. Espinosa, explaining the difference between the types of policies, claims-made and occurrence, and why the claims-made policies increase in premium over time. As I had suspected, Dr. Espinosa wasn’t aware of the differences or how the claims-made policy functioned.

Dr. Espinosa chose which company he wanted to proceed with and we began to complete his application for medical liability insurance coverage.

After another hour, we had the application and all supporting documents. I quickly submitted the application to the insurance company and requested they put a rush on it for us due to the time sensitivity of the situation.

Within 24 hours, we had our quote. Dr. Espinosa signed off in the morning and by the afternoon he had medical liability insurance coverage. Just another day in the life of a medical malpractice insurance account executive. 

Are you looking for medical liability insurance coverage in Georgia? Or any other state? Call 708-848-2300 and ask for David Leander and we’ll discuss all your options.

How I Saved a General Surgeon $40k on Medical Liability Tail Coverage

A general surgeon in Savannah, Ga., recently called me in need of help with the high cost of tail coverage she was offered by her employer. She was leaving a group practice and moving out of state to take a new job. When she informed the group she was leaving, they told her she would need to buy her own medical liability tail coverage to protect her prior acts during the time she worked for them. This was spelled out in her employment contract.

Most physicians don’t check their employment contract for who is responsible for purchasing medical liability tail coverage until it is too late. I always advise my clients to try and negotiate with a potential employer to have them pick up at least a portion of the tail cost upon exiting. The worst a potential employer can say is no, and like Wayne Gretsky once said, “You miss 100% of the shots you don’t take.”

The general surgeon was shocked to see the tail-cost quoted by the group’s medical malpractice insurance carrier was $132,000. A general surgeon, she knew the cost of medical liability tail coverage would be high, but never did she envision having to pay six figures just to change jobs — especially when she has never had a claim filed against her. The surgeon was also in the process of buying a new house in the state she was moving to, so funds were extremely tight. She felt she would need to take out a personal bank loan just to cover the cost of her medical liability tail coverage.

When I initially spoke this surgeon, she was frantic. She was actually contemplating changing her specialty to avoid being put in another situation like this in the future. I was able to calm her down and let her know there is a market for stand-alone tail coverage where savings can be found with an A-rated carrier. She was relieved to learn she didn’t have to buy tail coverage from the insurance company that covered her while she was employed by the group.

As I searched the marketplace and provided quotes for this surgeon, she began to see the light at the end of the tunnel as every quote I found in the stand-alone market was under $100,000. The question now was how low can I get the quote and how much can I save her? After all of all the carriers we work with responded, we were able to secure coverage for $97,000 — a savings of nearly $40,000.

The general surgeon I worked with was very happy with the savings, but she still felt it was than she could afford to pay at one time. Because the majority of medical liability tail coverage policies have to be paid in full at the time of purchase, she asked if there was any way I could assist her with finding a payment plan. While I shared that I thought it would be unlikely, I did reach out to my underwriter to ask. I explained the situation, pleaded her case and they agreed to offer her a three-year payment plan, with one-third of the total premium due each year. My client was overjoyed.

This situation could not have gone better for her. Not only did we place the general surgeon’s coverage with an A-rated carrier, we also saved her an extremely large amount of money and were still able to coordinate a payment plan for her. My client was able to buy her medical liability tail coverage and still purchase her new home and continue on with the next chapter of her professional life.

If you would like help in obtaining a quote for medical liability tail coverage, call 708-848-2300 and ask for Tim Arnieri.

Lawmakers Look to Keep Affordable Care Act Guidelines, Reimbursement Requirements Out of Medical Liability Lawsuits

Note: The article below first appeared in the May 2013 issue of the Medical Liability Monitor, a monthly newsletter reporting on the medical professional liability insurance and risk management industries.

With the American healthcare delivery system bracing itself for a deluge of new patients who will gain access to medical treatment by the end of this year through provisions in the Patient Protection & Affordable Care Act, state medical societies, physician coalitions and the American Medical Association (AMA) have been lobbying lawmakers to exclude newly mandated medical guidelines and reimbursement requirements from admissibility in medical professional liability lawsuits. These groups and their allies argue that the reimbursement requirements intended to steer the healthcare system from a fee-for-service model to one rooted in outcome quality are a Pandora’s box for the plaintiff’s bar to exploit in litigation.

“Healthcare providers in our districts and across the country fear [that] federal healthcare legislation leaves them vulnerable to new forms of liability for simply providing personalized care to their patients,” wrote Reps. Phil Gingrey, MD, and Henry Cueller in a letter to their colleagues in the U.S. House of Representatives. “As you know, the Patient Protecton & Affordable Care Act created new required standards of care for medical providers. Should these standards not be met, medical providers are at risk of being sued regardless of the medical outcome.”

The solution crafted from model legislation provided by the American Medical Association and introduced by Gingrey and Cueller is the Standard of Care Protection Act of 2013. The Act would not amend or change the Affordable Care Act, but would create a rule of construction in federal statute clarifying that lawsuits could not be based simply on whether medical providers followed the national guidelines created in the new healthcare laws.

“This bill would protect physicians and other healthcare providers from new liability exposure resulting from national care and practice standards or guidelines derived from the Patient Protection & Affordable Care Act and federal programs,” wrote James L. Madara, MD, executive vice president and chief executive of the AMA, in a letter supporting the Standard of care Protection Act. “In addition, the bill preserves state medical liability laws. The ACA included multiple provisions concerning the establishment and implementation of national care and practice standards and guidelines for health care providers.  [The Standard of Care Protection Act] makes it clear that the care standards and guidelines detailed in the ACA as well as federal programs cannot be used to create new causes of legal action against physicians providing care to their patients, nor do they supersede state liability laws.  Physicians should not have to worry about potential new causes of action or liability exposure in an age of developing and implementing new ways to improve the quality and efficiencies of care.”

The same week that Gingrey and Cueller introduced their legislation, the Georgia General Assembly passed similar legislation. The Georgia Provider Shield Act says that any medical guideline or reimbursement criteria developed or implemented under any federal law cannot be construed as a standard of care to establish a physicians’ negligence in a medical malpractice or product liability suit. Gov. Nathan Deal is expected to sign the bill.

Similar bills are expected to be introduced in state houses across the country.

Poll Shows Georgia Doctors Favor New Medical Malpractice System

Patients for Fair Compensation recently conducted a poll of 330 Georgia physicians on whether they would support the creation of a new Patient Compensation System in cases of medical malpractice. According to the survey, 96 percent of Georgia doctors polled agreed a new system would reduce healthcare costs, and 95 percent said they would support legislation for implementing the system in Georgia were it to be pursued by the state legislature. Patients for Fair Compensation is a special interest group lobbying for reform of the nation’s medical malpractice legal system.

In cooperation with two state legislators in Florida, Patients for Fair Compensation got its Patient Compensation System introduced in the state legislature. Known legislatively as the Compensation for Personal Injury or Wrongful Death Arising Out of Medical Injury Act, or SB1588/HB1233, the legislation would address incidences of medical malpractice through an administrative—rather than litigious—process. Medical malpractice claims would be handled in a no-fault manner, more akin to Florida’s workers compensation system. According to Patients for Fair Compensation, the new system would be more fair than the present system, weeding out frivolous claims and compensating actual injured patients in a more timely fashion. The bills stalled in the last session of the Florida Legislature.

According to the Georgia survey, 90 percent of doctors reported that the Patient Compensation System favored by Patients for Fair Compensation would decrease the cost of medicine by removing the need to practice defensive medicine. The Georgia Supreme Court recently overturned the state’s cap on non-economic damages in medical malpractice cases.

Opponents of the Patient Compensation System proposed by Patients for Fair Compensation say that it’s no surprise that doctors favor a no-fault system. Without the threat of a lawsuit or blame should they make an error, there would be no check on their behavior.

Opponents also point to studies that show that while strict tort reforms—like those found in California and Texas—have decreased the cost of medical malpractice insurance, there is no evidence to show that the cost of healthcare has gone down.

Click here for a look at historic medical malpractice insurance rate data in Georgia.

Some New Georgia Med Mal Reform Ideas

Stressed Out Physician We here at MyMedicalMalpracticeInsurance.com like to hear new ideas regarding tort reform –or new ideas of any kind regarding med mal reform. Although Georgia isn’t one of the worst states in terms of med mal rates, and rates have been relatively stable, we always see room for improvement. We just read an article detailing a plan for Georgia med mal reform that could have a nice effect on Georgia med mal rates.

So, as you may know, almost two years ago, Georgia med mal reform suffered a serious blow. Their $350,000 cap on noneconomic damages was thrown out and there has been little talk of anything since to replace it. The author of this article suggests doing away with the current legal system entirely and replacing it with an administrative law system, similar to a workers’ compensation system. We’ve heard this idea before and there’s a lot to like about it. It would reduce massive payouts, speed the process, and be a much more predictable process. And, maybe, just maybe, Georgia med mal rates could drop.

The man behind this Georgia medical malpractice reform plan is Richard L. Jackson, who has an advocacy group called Patients for Fair Compensation –although he is not a patient but a health care executive. And, he says his initiative is primarily based on feedback he has heard from physicians regarding their rampant practice of defensive medicine. Jackson believes that a plan of this kind could significantly work to reduce the practice of defensive medicine, in addition to all of the above-mentioned positives. And, Jackson is not only working to pass this legislation in Georgia, he’s also working to pass similar legislation in Florida. We’ll keep you posted.

If you would like to review Georgia med mal rates for the last 10 years, or get a free quote for your medical malpractice insurance, contact us today.

Georgia Physicians Must Disclose Lack of Med Mal Coverage

Side Note: Georgia physicians have a new rule to play by. If a physician in the state of Georgia does not have physician liability insurance, he or she must disclose this to his or her patients. “Going bare,” as it is often called, is pretty uncommon, and should be, for several reasons. We here at MyMedicalMalpracticeInsurance.com understand that the high cost of med mal insurance is daunting for physicians –which is why we work with so many providers to help get you the lowest price available and coverage that is tailored to your needs –so you don’t have to pay for what you don’t need. And, although the cost of med mal insurance is high for physicians, and it’s tempting not to pay the premiums, the risks of going bare, both financially and professionally, are far greater. If a physician is sued for med mal, found guilty, and does not have med mal coverage, the physician must pay the awarded damages and all related expenses out of his or her personal assets. One successful med mal case could prove devastating to a Georgia physician’s career without med mal coverage.

The good news is that Georgia physician liability rates have largely held steady for the last few years. We here at MyMedicalMalpracticeInsurance.com track the average med mal insurance rates in each state for several specialties. We welcome you to view the med mal insurance rates for Georgia physicians for the last 10 years.

Are you a Georgia physician looking to lower your Georgia med mal policy cost? If so, contact us today for a free quote.

Ben Watson’s malpractice bill becomes law
Posted: May 14, 2011 – 10:29pm
From Savannahnow.com
By Morris News Service

Physician thinking about med mal insuranceATLANTA — Physicians now must make public if they are not covered by medical-malpractice insurance with the signing into law Thursday legislation by the General Assembly’s only doctor.

Rep. Ben Watson, R-Savannah, sponsored House Bill 147. It requires physicians to make the disclosure in routine surveys done by the state.

The full article can be found here.

Loopholes foil pill mill prosecution in Florida, Georgia

Side note: Prosecuting a “Pill Mill”, individuals who seek out multiple prescriptions of commonly abused prescription drugs for the sole purpose of illegal resale, often requires the same expense and level of expert testimony as a medical malpractice lawsuit. Since prescription drugs are legal the possession of the drugs is not a crime. Criminal intent often requires weeks, and months, of surveillance and expensive testimony to prove that a crime is a being committed. Take for example the case of Gayla Durham and Davis Howell who were caught shoplifting in a Jacksonville Florida Old Navy store last December. Police discovered several bottles of OxyContin on Davis Howell and multiple empty pill bottles scattered about their car. Even though the criminal attempt seemed obvious prosecutors ended up dropping the charges citing a lack of evidence.

By Paul Pinkham

When Gayla Durham and Davis Howell set off a security alarm at a Jacksonville Old Navy store in December, it appeared to be a simple shoplifting case.
But it quickly turned into a drug bust when police found three bottles of oxycodone and a bottle of Xanax on Howell that were prescribed to Durham at a Tampa pain clinic. Empty pill bottles littered their car.

The case was bolstered by two acquaintances who told officers the pills were intended for resale in North Carolina. Durham, 47, and Howell, 29, were charged with oxycodone trafficking.

Weeks later, prosecutors dropped the charges, citing insufficient evidence. They acknowledged the quantities of drugs were trafficking amounts but noted that they were in prescription bottles.

“The problem we face is … that you can legally possess prescription drugs,” said Assistant State Attorney Matthew O’Keefe, a division chief who signed off on the dismissals.
Police and prosecutors in Northeast Florida and Southeast Georgia say routine traffic stops that yield large quantities of pills are tough to take to court, but it’s even harder to bring down a pill mill.

Those investigations usually require weeks or months of planning and undercover work, said Jacksonville Sheriff’s Office Sgt. Tom Racer, who works with the prescription drug squad at the multi-agency North Florida High Intensity Drug Trafficking Area.

Read the Rest of the Article

Georgia House braces for medical malpractice tort reform rulings

side note: This seems to be how tort reform is unfolding in almost every state with tort reforms laws that cap non-economic damage on the books—court overturns legislation; legislators re-legislate.

ATLANTA — A top GOP legislator vowed that lawmakers would quickly bolster Georgia’s new tort reform laws if any pieces are struck down by the state’s top court.

House Majority Leader Jerry Keen said Tuesday that lawmakers would “react and react quickly” if the Georgia Supreme Court struck down any part of the 2005 overhaul.

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Challenges to medical liability caps go before Georgia, Maryland high courts

side note: State Supreme Courts in Georgia and Maryland will rule on non-economic damages for liability cases, will they overturn legislation?


High courts in Georgia and Maryland will decide the fate of caps on non-economic damages in medical liability cases in each state, two of the latest attempts to undo such award limits.

The Georgia Supreme Court case stems from a February trial court decision rejecting the constitutionality of the state’s $350,000 cap. Oral arguments began Sept. 15 in Atlanta Oculoplastic Surgery v. Nestlehutt.

Maryland’s Court of Appeals is set to hear arguments Nov. 5 on whether the state’s caps apply only to cases that are arbitrated.

Because of the constitutional and public policy issues at play, the two cases went to their respective high courts. Physicians in both states are pledging to defend the caps, which they credit with easing liability insurance costs and keeping doctors in practice.

The cases involve high stakes for patients and physicians, and undermining the reforms “would be a step backward” in access to care gains, said Rebecca J. Patchin, MD, chair of the AMA’s Board of Trustees. The Litigation Center of the American Medical Association and State Medical Societies joined the Medical Assn. of Georgia and MedChi, the Maryland State Medical Society, in filing separate friend-of-the-court briefs in their respective state cases. Liability insurance premiums in Georgia declined by 18% after the state capped noneconomic damages in 2005.

MedChi CEO Gene M. Ransom III said the cases also highlight the need for federal endorsement of tort reform as part of national health system reform, particularly for states struggling to pass measures to contain unaffordable liability costs. In light of the legal threats to caps, “federal health reform that includes tort reform becomes even more crucial,” he said.
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Georgia Court to Consider Medical Malpractice Limits

side note: Herein lies the constitutional question as to whether caps on non-economic damages are in violation of a state Constitution. There are a lot of States that have these caps in place, will other State Supreme Courts follow? Do you think these caps on non-economic damages are Constitutional? This could have a major effect on Georgia medical malpractice insurance rates.


Georgia’s top court is set to decide the fate of a 2005 law that limits pain and suffering damages awarded in medical malpractice cases.

The Georgia Supreme Court is scheduled to hear a case Tuesday weighing the merits of a $350,000 limit on jury awards for malpractice victims’ pain and suffering.

A Fulton County judge struck down the provision in February, declaring it unconstitutional. But supporters appealed the ruling, arguing that the caps don’t violate the state constitution.

The caps were at the center of a rancorous debate that dominated the 2005 legislative session.

Doctors and hospitals said the measure would help curb malpractice insurance rates. But trial lawyers said they put an arbitrary price on a victim’s life.

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