Tag Archives: medical malpractice insurance

Curi logo

Curi Announces Next Chief Executive, Retirement of Current CEO

Medical malpractice insurer Curi recently announced that Jason Sandner will take over as its next chief executive officer on July 1, 2021, when current CEO Dale Jenkins steps down after more than 25 years of service to the company. Sandner is currently the company’s chief operating officer and chief financial officer. Jenkins will continue to serve on Curi’s board of directors after his retirement.

“We believe Jason Sandner will help the company deliver ever-greater success to our member community,” said Robert Schaaf, MD, chairperson of Curi’s board of directors. “We looked for someone who has a passion for serving doctors and believes in the vision and strategy we’re aggressively pursuing. Jason is an extremely capable leader, and our search process proved to us that he is the very best person to lead Curi into the future.” 

Sandner was chosen to succeed Jenkins following a multi-month nationwide search led by Curi’s board of directors with the assistance of executive search firm Heidrick & Struggles. A senior executive with two decades of financial, operational and managerial expertise, Sandner has directed the financial strategy of Curi and its affiliates — including its insurance and investment operations — for more than a decade and was part of the team that oversaw its reorganization as a mutual insurance holding company, its expansion into a number of new states and the diversification of its product offerings outside of the medical professional liability space.

“When I started here at Curi almost 10 years ago, one of the first major initiatives I was a part of was the reorganization and restructuring of the corporation into the mutual insurance holding company that exists today,” Sandner said. “When we were at the front end of that restructuring, the long-range vision was that the restructured format would give us the opportunity to diversify, as we have done during the last eight years.”

Looking toward the future, Sandner sees opportunity in the current hardening of the medical professional liability insurance market.

“Growing in the soft environment we’re coming out of was difficult because there really was no price [insurers weren’t] willing to go to. Retention was incredibly high and dislocating business was very difficult. But this new market — with claims costs accelerating and rate pressures as they are — is creating some disruption and dislocation. It’s giving practices reason to question whether they’re with the right carrier and opening the opportunity for us to tell our value story. I see an opportunity to grow in a disciplined, measured way.”

Provided by Michael Matray of the Medical Liability Monitor

Malpractice Insurance Coverage during Covid-19 Pandemic

Please use the Medical Malpractice Insurance Company list below to find the most up-to-date COVID-19 Coverage Information.

We are committed to ensuring all healthcare professionals have the necessary information regarding how each medical malpractice insurance company will be handling coverage and claims during the COVID-19 Pandemic. Please contact us with any questions related to your policy and coverage.

We will update this page as new information is provided.
Last Updated 5-19-2020

Medical Malpractice Insurance Company List

Cunningham Group Resources

State Responses

Healthcare Professional Resources – COVID-19

  • Headspace: Take a moment and give back to yourself, you deserve it! Headspace is offering free access to Headspace Plus for all US Healthcare Professionals.
  • Starbucks: Free tall brewed coffee to anyone that identifies themselves as a first-responder or front line worker. This includes doctors, nurses, hospital and medical staff, police officers, firefighters, and medical researchers. (Through May 3, 2020)
  • Krispy Kreme: Free dozen donuts every Monday to healthcare workers. (Through May 11, 2020)
  • SweetGreen: The fast casual salad restaurant is delivering free salads and bowls to hospitals in the DC, Philly, Boston, NYC, San Fran, LA, Chicago and Houston areas.
  • Hertz: Free month-long rentals through April 30, 2020 for healthcare workers.
  • Are we missing something? Let us know!

Is New Mexico’s Compensatory Damage Cap the Next to Fall?

Arguments in favor of and against New Mexico’s medical malpractice compensatory damage cap were made last month, and now the question as to whether it is constitutional rests in the hands of five justices on the state’s Supreme Court. The compensatory cap limits economic and noneconomic damages, but not medical costs or punitive damages, to $600,000.

Enacted in 1976, the New Mexico Medical Malpractice Act defined the standard of care, established a state-sponsored patient compensation fund, implemented statute of limitation guidelines, mandated the screening of all alleged cases of medical malpractice and capped the amount of recoverable damages in medical liability trials. In 2018, District Judge Victor Lopez determined that the compensatory cap improperly interfered with a plaintiff’s constitutional right to a trial by jury.

The underlying case, Siebert v. Okung, alleges Rebecca Okun, MD, an obstetrician/ gynecologist and employee of Women’s Specialists of New Mexico, performed a hysteroscopy on Susan Siebert. The procedure created a hole in Siebert’s uterus and intestine. Okun failed to notice these holes and sent Siebert home after the procedure.

Siebert became infected because of the perforations, requiring numerous surgeries, followed by extensive in-patient hospital and rehabilitation center care. She spent months on a ventilator and a feeding tube. She lost her job and suffered permanent brain damage.

Siebert sued Okun and Women’s Specialists of New Mexico in District Court, where a jury found for Siebert and against the defendants in the amount of $2.6 million.

Following entry of judgment, the defendants moved for a reduction in the judgment based on the language of the New Mexico Medical Malpractice Act, which provides that,  except for medical care and related benefits, medical malpractice damages are to be capped at $600,000. Siebert opposed the motion, arguing the cap is unconstitutional.

District Judge Victor Lopez agreed with Siebert and held the cap unconstitutional. He primarily found that the cap abridged the right of trial by jury, but also determined other constitutional rights might be “implicated,” including equal protection, due process and separation of powers. He refused to reduce the judgment.

The defendants appealed to the New Mexico Court of Appeals, which forwarded the case directly to the New Mexico Supreme Court without any ruling on the merits by the Court of Appeals.

During last month’s hour-long oral arguments before the New Mexico Supreme Court, Bennett Cooper, attorney for Okun and Women’s Specialists of New Mexico, emphasized that what is at stake is not just the compensatory damage cap, but the entire Medical Malpractice Act, due to issues of severability. In other words, should the compensatory damage cap be determined unconstitutional, all the protections afforded by the Medical Malpractice Act would likewise disappear.

“Over 40 years ago, the legislature protected patients and physicians of New Mexico by securing the availability of medical malpractice insurance,” Cooper argued. “This was a reasonable, prescient approach and likely the most pro-patient medical malpractice reform law anywhere in the country. The district court’s ruling on the issue of jury rights endangers the entire medical malpractice act.”

Lisa Curtis, the attorney representing Siebert, argued that the New Mexico Constitution is very specific in that every New Mexican has the right to have damages determined by a jury.

“In New Mexico, the right to trial by jury, as it has heretofore existed, shall be secured to all and remain inviolate,” Curtis stated before the Court. “An inviolate right constitutionalizes the jury’s role. In fact, our Second Judicial District Judge Lopez found that [the compensatory damage cap] violates Susan Siebert’s specific inviolate constitutional right to a jury trial. The jury awarded Ms. Siebert $2.6 million in compensatory damages, and very importantly here, the defendants moved to reduce, or limit, the jury’s verdict … If you were to eviscerate the jury’s finding on damages, then you are eviscerating the jury’s right to make a determination of the case and the facts of it.”

The New Mexico Supreme Court is expected to reach a decision in Siebert v. Okun sometime next year. Keep an eye on our News Section for the latest updates.

New Jersey CEO happy with his medical malpractice insurance

How I Helped a Client in a Time Crunch Get Medical Malpractice Insurance in New Jersey

As someone who specializes in medical malpractice insurance, every day can be an exciting day as the worlds of medicine, insurance and the law all smash together — not to mention egos and hurt feelings. A great example is when I helped a company get its medical malpractice insurance in New Jersey.

I had a very interesting interaction the Spring of 2019. The CEO of a medium-sized locums company that specializes in radiology, general medicine and cardiology in Newark, N.J., contacted us in a panic. His current insurance company had elected to exit the medical malpractice insurance business and was notifying all of its insureds that they were going to be non-renewed.

What made this interesting is that the CEO represented an atypical practice. The locums company contracted with hospitals and universities to provide physicians on an as-needed basis. This also included a telemedicine component.

The CEO went on to tell me that his current agent had not provided an alternative option even though he had contacted them two months ago. The locums company was running out of time as their insurance policy’s expiration was fast approaching. He continued to tell me that he had reached out to another agent for help about a week ago. This caused another ripple as the new agent had the CEO sign an appointment letter, or BOR (broker of record). This removed his current agent as the agent on file with the insurance companies the original agent was working with.

The CEO then received an angry call from his original agent. The CEO tried to explain to the original agent that he was nervous since they were running out of time to find coverage and wanted to see if anyone else could help. He didn’t know the BOR would remove the original agent.

The original agent explained that he no longer wanted to do business with this CEO. The agent went even further by sending a letter to the CEO asking him to find a new agent for their other lines of insurance, which was their workers comp and business office package. Since this policy didn’t renew until the summer, I explained that we will handle the professional liability first and then deal with the general, property and workers comp afterwards.

Medical malpractice insurance is handled at the state level and New Jersey’s medical malpractice insurance climate can be unpredictable. I calmly explained to the CEO why they were running into so much trouble. A lot of the problem had to do with the fact that the original agent didn’t have access to many other insurance companies and didn’t inform the CEO of this. The agent he recently signed the appointment letter with also didn’t have access to many different companies, so their options were limited as well.

I explained to him that I wouldn’t have them sign a BOR for the companies they are waiting to hear back from. I shared with them the step-by-step process we were going to take in order to accomplish the task before the expiration date. After explaining that I would exhaust the marketplace and find an option, he quickly started to gather all of the documents to send to me.

After only 20 minutes, I could hear a sense of relief from the CEO as they finally felt they were on the right path. They also started to ask more important questions, such as how do they know they are going with the right insurance company? How much medical malpractice insurance do they need? How much will the malpractice tail be?

About four days after submitting their documentation to all insurance companies who specialize in medical malpractice insurance, we received a competitive offer from an A rated company.

The CEO was ecstatic. He couldn’t believe they were looking at a medical malpractice quote for his doctors so quickly after speaking with me. There were only two days left to secure the new policy at this point.

What helped turn this problem around so quickly is that I collected a lot of details about who they were, what they were doing and the situation they were in. Having all of the details really helps the underwriters at the insurance companies.

We try and follow the same path with everyone, which is to listen to their situation and concerns, and provide a clear path forward — explaining each step along the way. In addition, it’s vital to provide context so they understand the back and forth of underwriting a medical malpractice insurance policy.

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

Doctor's reviewing claim data

Coverys Red Signal Report Details Evolving Risks of Primary Care

For primary care physicians, diagnostic errors are the leading type of malpractice claim, accounting for the highest proportion of indemnity paid, according to a just-released Primary Care Red Signal Report from Coverys. The analysis of primary care claims is the second in a planned series of claims-trend reporting intended to identify risks and illuminate safety vulnerabilities within the U.S. healthcare delivery system.

“In primary care, the big area of concern is missed and delayed diagnoses,” said Robert Hanscom, Coverys vice president and co-author of the report. “To a number of people, that may come as a surprise, but it’s because many of those claims involve a missed cancer diagnosis. A lot of times, doctors aren’t even aware that they’ve missed a diagnosis until way, way after the fact when they suddenly receive a claim letter or are named in a lawsuit. We want primary care physicians, who are constantly making diagnoses, to know that, in fact, this is an area of great vulnerability for them.”

There is no question that the risk profile for primary care physicians has expanded with the evolution of the specialty. The Primary Care Red Signal Report notes that the primary care physician role has become increasingly challenging, with yesterday’s family doctor now accountable for all aspects of the patient care continuum, including referral management, management of multi-morbidities and transfer to longterm care, all while keeping a sharp eye on utilization, appropriate level of care and patient quality metric outcomes.

Following are some highlights from the Primary Care Red Signal Report:

  • Among the top clinical conditions associated with a diagnostic failure in primary care, cancer cases are the most frequent, constituting 50 percent of diagnosis-related claims. The next highest categories are infections (19%), cardiac/vascular (16%), and myocardial infarction-related injuries (11%). The top missed cancer diagnoses are colorectal (20%), lung (19%), prostate (11%), bladder (9%) and breast (8%).
  • Treatment-related claims are the second-most common malpractice allegation against primary care physicians. These claims are frequently associated with cardiac treatments, pain management, wound care and blood administration. They also can be related to allegations of unnecessary treatments or scenarios involving the wrong patient. The top medical treatment allegations are management of treatment (accounting for more than 60 percent of the claims), failure to treat and delay in treatment.
  • Medication-related malpractice claims against primary care physicians often result in high-severity adverse outcomes. Approx-imately 45 percent of the medication-related claims, and more than half of the indemnity dollars paid, are directly related to allegations of inattentive monitoring and management of medication. Medication ordering is the second most frequent claim allegation, constituting approximately one-third of the medication-related claims and 38 percent of the indemnity dollars.
  • Transitions in care can be fraught with fragmented instructions and inconsistencies if not managed correctly. The top claim associated with transitions of care involves a delay or failure to obtain a specialty consult when clinically indicated (38%). Other fraught areas include failure to coordinate follow-up care, communication breakdowns among multiple physicians who may be providing care to a single patient, not working as a cohesive clinical team and a failure or delay in transferring to an alternative facility.
  • Primary care physicians need a strategy to address and monitor their risks. Coverys recommends improving diagnostic accuracy and treatment by regularly performing a complete age-appropriate history and physical exam on every patient that includes cancer screening; closing the referral loop by implementing a system to track, review, document and communicate all test results to patients; implementing a process for obtaining informed consent when high-risk medications are prescribed; and ensuring safe care transitions takes place by offering care coordination as well as follow-up appointments for patients with complex medical needs.

This article provided by Medical Liability Monitor.

2019 MPL Association Conference to Convene in Portland, Oregon, May 15-17

The MPL Association, the organization representing the medical professional liability (MPL) insurance community, issued a reminder that its annual Conference will take place May 15-17 at the Marriott Portland Waterfront Hotel in Portland, Ore. The Conference is open to both MPL Association members and non-members. The Association also noted that advance registration for the 2019 MPL Association Conference will expire on April 12. Attendees who register before April 12 can save $100.

“This event convenes hundreds of professionals who work in insurance and alternative risk transfer, all looking to gain new insights on the global and day-to-day issues facing medical liability companies, risk retention groups, captives, trusts and other entities,” said Brian K. Atchinson, president and CEO of the MPL Association. “We have secured high-profile speakers and panels with decades of experience in medical professional liability. No matter what your role in the industry, we believe that you will learn some surprising perspectives by attending this conference. This unique event will help attendees find pragmatic solutions for optimizing performance in these changing and challenging times.”

The keynote speaker for the Conference this year is Kevin M. Kennedy, principal, ECG Management Consultants, who will explore disruptive forces in healthcare. Kennedy will share his perspective on what these changes might mean, lessons from other industries and how physicians as well as hospitals should respond. His discussion lays the foundation needed to answer a critical question for MPL professionals: How do these changes impact MPL insurers? This question, and more, will be explored in a follow-up panel discussion featuring Kennedy and several MPL executives. These two thought-provoking sessions will produce critical insights about healthcare and the ever-evolving environment for MPL insurers.

Chad C. Karls, FCAS, MAAA, principal and consulting actuary, Milliman Inc., will brief attendees on the industry’s historic and current financial results, offering insight into the major drivers of those results. In addition, he will provide perspective on the profitability of the business and the financial strength of writers of MPL coverage.

“This session will offer attendees a fuller understanding of the underlying drivers of the industry’s financial condition,” Atchinson said. “If you are interested in the performance of the MPL industry, these are the particular metrics that are important to watch closely.”

Wendy Chung, MD, Kennedy Family Professor of Pediatrics and Medicine at Columbia University, will discuss the MPL implications of precision medicine. With genetic and personalized therapies becoming more widely available, the average physician may be overwhelmed and challenged by the expectations of an ever-expanding knowledge base. Chung will help insurers understand and prepare for the necessary clinician and patient education, best practices and protocols to deal with potential exposures related to precision medicine.

There will be a panel discussion on the lessons learned from high-profile, catastrophic MPL cases. The expert panel will explore the impact of high-profile cases and the ramifications of such cases for MPL carriers, offering examples that illustrate the consequences of these cases. In addition, panelists will deconstruct the key elements in these lawsuits, from their individual perspective, and offer suggestions for minimizing exposure from such cases in the future.

Other topics to be explored during the two-day event will be the changing face of MPL claims, including new tactics that serve to inflate the potential value of a claim through higher life-care expense payouts; enterprise risk management and the tools that drive performance and mitigate risk; an interactive session on healthcare quality ratings and how they impact the MPL industry; and much more.

The MPL Association is well known for its comprehensive collection of MPL insurance, patient safety and risk management as well as other healthcare-related information and its ability to provide valuable services to a broad diversity of entities, Atchinson said.

By attending this one Conference, individuals who work in the MPL field gain an unparalleled intelligence on the essential developments for 2019 and a clear vision of the road ahead, and as at every MPL Association Conference, unique opportunities for one-on-one networking with their peers, Atchinson further said.

For more information about the 2019 MPL Association Conference, or to register online, visit www.MPLassociation.org.

This conference information is brought to you by Cunningham Group, the medical malpractice insurance specialists.

MLMIC Completes Demutualization, Acquisition by Berkshire Hathaway

MLMIC Insurance Co. announced last month the completion of its conversion from a property-and-casualty mutual insurance company to a property-and-casualty stock insurance company and the finalization of its $2.5 billion acquisition by National Indemnity Co., a subsidiary of Berkshire Hathaway Inc.

The conversion and acquisition followed a September 6 approval by the Superintendent of the New York State Department of Financial Services and a September 14 vote of MLMIC policyholders with policies in effect on July 14, 2016. The cash consideration resulting from the conversion will be paid out to eligible policyholders — policyholders with policies in effect from July 15, 2013, through July 14, 2016 — or their designees as promptly as practicable, according to the company.

As a subsidiary of Berkshire Hathaway, MLMIC will have enhanced capacity and financial strength to continue serving New York State physicians, hospitals and dentists. MLMIC remains the largest underwriter of medical professional liability insurance in New York and continues to be a New York‐focused medical malpractice writer regulated by New York State. The same Board of Directors and staff that have served the market for several decades will operate it.

“No one will see any difference [in day-to-day operations],” said Berkshire Hathaway chief executive Warren Buffett, during a livestreamed conversation between himself and James Reed, MD, MLMIC chairman of the board, from Berkshire Hathaway’s Omaha, Neb., headquarters on October 17. “The one thing that we will do is manage [MLMIC’s] investments.”

Reed highlighted how Berkshire Hathaway’s deep resources position MLMIC to address the challenging risks of the New York market as well as the hyper-evolving American healthcare delivery system.

“The tremendous financial resources of Berkshire Hathaway [lets us] assure physicians in New York that if they’re insured with MLMIC, there’s nothing that could come at us that we wouldn’t have the resources to deal with,” he said. “And the resources will allow us to be much more innovative in the way we approach malpractice insurance in the future.”

Reed pointed to the consolidation within the healthcare delivery system as one of the particularly pressing challenges currently facing the medical professional liability insurance industry that MLMIC wants to proactively address.

“At MLMIC, we know we’re going to have to be innovative with the consolidation that’s occurring — physicians coming together to form larger groups, health systems coming together, large groups coming together with health systems,” Reed said. “We need to be more innovative on the medical malpractice insurance side, and that’s exactly what we want to do as part of Berkshire Hathaway with those resources. We have a number of innovative ideas [for working] with some of these larger groups [that] we just couldn’t do in the past.”

In addition to National Indemnity Co. and MLMIC, Berkshire Hathaway also owns MedPro Group, which provides medical professional liability coverage in New York through its subsidiary risk retention group, MedPro RRG. And both Buffett and Reed view the intra-company competition as a benefit.

“We like the competition,” Buffett said. “For example, in workers compensation insurance, we have three different [companies] that have somewhat different areas of expertise. We have totally independent organizations that are out there calling on the same firms, trying to get their worker’s compensation business. Competition is fine.”

“We’re also hoping to be able to collaborate [with other Berkshire Hathaway companies operating in medical liability] because one option to consolidation in healthcare is collaboration,” Reed said. “The difficulty in doing that is always a legal one, but by being part of a single company like Berkshire Hathaway, we think particularly in the areas of working on patient safety, analytics and so forth, we can collaborate some. While each company pursues its own direction, some of those things that are common across the malpractice insurers within Berkshire Hathaway, we will be able to bring together and leverage that kind of capability to improve patient safety and, therefore, better outcomes from the malpractice standpoint.”

This information provided by Michael Matray of the Medical Liability Monitor.

PIAA 2017: Current Trends & Future Concerns

Amidst Healthcare Uncertainty, PIAA 2017 Medical Liability Conference Focused on Current Challenges, Future Concerns

Hosted at the Broadmoor Hotel in Colorado Springs, Colo., with the backdrop of a Republican plan to repeal and replace the Affordable Care Act stalled between the U.S. House and Senate, the 2017 PIAA Medical Liability Conference convened from May 17 – 19 to examine the many challenges currently facing the medical professional liability insurance industry.

“This is a time of significant uncertainty for PIAA, the medical profession and the professional liability community,” acknowledged Richard Anderson, MD, PIAA chair as well as chairman and chief executive of The Doctors Company, during the opening remarks to the conference. “The evolution in healthcare delivery is transforming healthcare financing, organization and regulation, while challenging traditional definitions of good medicine. … The consolidation of healthcare delivery is well into its second decade and will be only marginally affected by national politics. Eighteen-percent of the American economy is in play. This is a non-partisan process that is unlikely to be interrupted. PIAA is working to move the process of ‘repeal and replace’ toward reasonable solutions, if this is possible in Washington today.”

Following are some of the highlights from the educational sessions at this year’s Medical Liability Conference.

Healthcare in the Digital Age
Keynote speaker Robert M. Wachter, MD, professor and chair of the Department of Medicine at the University of California, San Francisco, launched the two-day Medical Liability Conference with a session titled, 21st Century Medicine: IT, New Practice Methods and More.

Wachter started by acknowledging, “the angst of the modern physician is the challenge to “deliver high-quality, safer, satisfying and more affordable care.”

The answer to that challenge is clearly tech-enabled, but the medical industry remains in its infancy stage regarding information technology. Wachter illustrated this point by citing statistics from the Office of the National Coordinator for Health IT that show only 9.4 percent of hospitals employed electronic health record technology in 2008, but that number jumped to 83.8 percent by 2015.

Drawing upon his professional experience and real-life case examples to explore some of the unforeseen consequences in healthcare’s adoption of data information technology, Wachter noted how the clerical burden of electronic health records has pushed physician burnout rates above 50 percent (up 9 percent in the last three years); how the intensive care unit at his hospital has an average of 2,558,760 audible alerts per month, which has created staff alert fatigue; and how digitization has threatened the doctor-nurse collaboration as well as the doctor-patient relationship.

Later that day — and in the wake of the previous week’s massive “Wanna Cry” ransomware attack that paralyzed many hospitals and physician offices in the United Kingdom — a chilling session titled The Data Privacy & Security Landscape: Today’s Threats & Risk Mitigation explored the many ways digital criminals are targeting the healthcare sector.

Panelist Gamelah Palagonia, Willis Towers Watson senior vice president, walked attendees through the increasing complexity and endless array of developing threats such as Ransomware, Distributed Denial of Service (DDoS) attacks and vulnerabilities associated with the “Internet of Things” (IoT) that has propelled the cyber risk landscape into uncharted territory.

“Healthcare is the most vulnerable industry in America,” Palagonia said, noting that the healthcare sector accounted for 22 percent of all hacking incidents by industry. The good news, she said, is that proper employee training can mitigate two-thirds of all cyber risks facing healthcare.

Emerging Trends
In a session titled Storm on the Horizon: Determining the Next Claims Hurricane, moderator Sarah Pacini, JD, chief executive of the Cooperative of American Physicians, led panelists through emerging trends in handling medical professional liability claims.

Panelist Matthew Nielsen, Esq., vice president of claims for OMS National Security Co. RRG, brought attendees’ attention to the relatively growing trend where medical liability plaintiff attorneys invest in litigation cost insurance, which covers expert fees, deposition transcripts, travel, trial exhibits, mediator expenses, copies, etc., in the event that the plaintiff loses at trial. Such coverage is currently available in 16 states. Nielsen opined that this insurance product carries the potential to spike the volume of medical liability claims filed, swell the number of cases that go to trial, increase indemnity and embolden plaintiff attorneys to spend more money on expert witnesses and the overall amount they are willing to spend on a medical malpractice trial.

Joel Hopkins, Esq., partner at Saul Ewing LLP, spent significant time exploring the inherent challenges presented by electronic health records and the discoverable metadata found in the technology’s audit trails. Not only does the available metadata raise issues of privilege and confidentiality, it can push an insurer’s loss adjustment expense into the five figures.

During the session Employment or Private Practice: Factors Influencing this Key Decision, moderator Mary Ursul, Coverys executive vice president, and panelists looked at the data indicating physician employment continues to increase as well as the factors leading to a doctor’s decision to remain in private or employed practice.

Panelists cited data from a 2015 Merritt Hawkins “Survey of Final-Year Medical Residents” that indicates 36 percent of today’s physicians finishing their residency or fellowship are open to a hospital-employed practice — up from just 3 percent in 2003. These young doctors most value free time, educational debt relief and a good income when determining how to practice. Panelists also noted medical liability as a “significant concern” to young physicians has dropped significantly since 2011.

During Leveraging Data to Change the Risk Mitigation Game, Rick Hammer, MD, senior vice president at SE Healthcare Quality Consulting, and James Saxton, Esq., chief executive at Saxton & Stump LLC, discussed how empowering doctors with their own data could serve as one of the foundational elements necessary for success. They noted that — when utilized in a very specific way — data could be a gateway to professional liability risk mitigation. To illustrate this point, the panelists looked at how the implementation of a data-driven obstetric patient safety program at the New York Weill Cornell Medical Center decreased its number of sentinel events from five in 2000 to none in 2008 and 2009; during the same period, the hospital’s obstetric department reduced its average annual compensation payments from $27,591,610 between 2003 and 2006 to $2,550,136 between 2008 and 2009.

The Financial State of MPLI
Diving deep into the financial health of the medical professional liability insurance industry, during the session MPL Insurance Industry Performance: What’s the Latest?, Chad Karls, principal and consulting actuary at Milliman Inc., examined the underlying drivers of the medical professional liability industry’s financial condition.

Karls began his presentation with the unsettling fact that the industry’s overall direct written premium decreased by 24 percent between 2006 and 2016. That number is an even bigger 32 percent when looking solely at the direct written premium from traditional physician liability insurance — as opposed to including hospitals, other facilities and other providers.

The most impressive news Karls shared was the extreme slide in claims frequency, which has fallen around 40 percent since 2001. “This is really big stuff,” he marveled. “It’s huge.” Karls later explained how the industry’s almost 40-percent drop (relative to 2000 – 2002 levels) in physician paid indemnity is “driven totally by the fall in claims frequency.”

While the decline in claims frequency and paid indemnity is a positive, Karls brought attention to “the fly in the ointment” — allocated loss adjustment expenses (ALAE) have ballooned by 6.3 percent between 2005 and 2015. Even more concerning, 38 percent of ALAE costs are spent on claims that are dropped, withdrawn or dismissed, and ALAE severity is outpacing indemnity severity. Obviously, defense costs are getting out of control.

Combined ratios inched above 100 percent for the first time since 2005, denoting an underwriting loss, but Karls noted medical professional liability insurers are buoyed by “incredibly strong balance sheets … the strongest balance sheets we’ve ever had.”


MPLI Executive Insights: Paul Greve, Executive Vice President, Willis Towers Watson Health Care Practice

On the latest episode of Healthcare Matters, we interview Paul Greve, Executive Vice President at Willis Towers Watson Health Care Practice for our segment, MPLI Executive Insights. We sat down with Greve during the 2017 Professional Liability Underwriting Society (PLUS) Medical Professional Liability Symposium, where he moderated the panel, “Hot Topics: Regulatory and Related Changes in Healthcare.” We spoke with Greve on many topics, including the effect that changing or replacing the Affordable Care Act could have on hospitals and physician liability and the possibility of including federal tort reform in future healthcare legislation. Greve addressed how measures like caps on noneconomic damages, affidavits of merit and safe harbor laws could impact the medical liability industry.

Greve spoke with us as part of our new segment, MPLI Executive Insights, where we talk with top medical liability industry executives on current trends in medical liability, where the industry may be headed in the future and the impact of politics and reform efforts on the medical liability industry.

MPLI Executive Insights: Andre Stewart, Chief Underwriting Officer – NORCAL Mutual

Join us for the first episode of our new Healthcare Matters segment, MPLI Executive Insights, where we interview top medical liability executives on current and future trends and developments in the industry. Today’s segment features Andre Stewart, Chief Underwriting Officer for NORCAL Mutual, who joined us during the 2017 Professional Liability Underwriting Society (PLUS) Medical Professional Liability Symposium. Stewart discussed several topics with us, including the importance of underwriting profits; how ‘shock losses’ can disturb the market, and the implications of repealing the Affordable Care Act on the medical liability industry.

Founded in 1975 in San Francisco, NORCAL Mutual Insurance Company has expanded from its West Coast origins to offer medical malpractice insurance in 35 states, including newly-added Colorado and Minnesota. NORCAL has maintained a rating of “A” or higher with A.M. Best throughout its history.