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Frequently Asked Questions

I am covered by a group long-term disability policy. Is there one particular thing I should look for with regard to the extent of coverage?

Many physicians perform a sub-specialty within their specialty. For example, you may be a gastroenterologist within the specialty of internal medicine. Make sure your sub-specialty is covered. If your group long-term disability coverage protects your general specialty, but not your sub-specialty, you could be at risk.

I am employed by and insured by a group practice. How does the group’s financial condition affect my professional liability coverage?

When employers face financial difficulty, they may purchase less insurance or set aside less money to pay claims if self-insured. If you are a physician covered by an employer’s professional liability policy or self-insurance program, be sure to monitor what protections your employer is providing.

I’m feeling confident about the insurance coverages I have. What else do I need to think about?

There are three things you need to manage with regard to all of your professional liability and business coverage:

  • Maintain copies of each year’s policy indefinitely. Good recordkeeping is vital. At some point, you may need to establish exactly what coverage was in place many years prior.
  • Ensure you do not have any gaps in medical malpractice, professional liability or business insurance coverage. Regularly review your coverages with your agent to identify any areas where you are not protected. A Britton Agent can show you how to fill certain gaps in coverage before an uncovered claim arises.
  • Notify the carrier with practice changes. Keep your carrier informed about practice changes. Depending upon the specifics of your policy, if you do not inform your carrier about a change, the company may deny a claim if something occurs. Inform your carrier about changes to your name, your practice name, the structure of your practice, a change of address or addition of an address to your practice.

Should I make sure my medical malpractice insurance has a consent-to-settle clause?

You should have a consent-to-settle provision in your policy. This important provision precludes your insurance carrier from settling a case without your permission. But you should thoroughly read your policy to look for that clause. Make sure you have a pure consent-to-settle provision. Instead of a pure consent- to-settle provision, you may find exceptions that give settlement authority back to the insurance company.

What are the typical exceptions to consent-to-settle clauses?

It’s important to understand how the policy defines consent. Common exceptions to a consent-to-settle provision include:

  • If you refuse to consent to a settlement and elect to contest or continue to contest a claim, the company’s liability for loss shall not exceed the amount for which they could have settled such claim had you consented, plus claim expenses incurred after the time the company made such recommendation. This is called a “hammer clause.”
  • You have consent authority, unless the insurance company deems you unreasonable in withholding your consent.
  • You have consent authority as long as the company’s review panel or board agrees with you that your performance met the standard of care. If they disagree, the board assumes consent authority on your behalf.
  • You have consent authority unless the company disagrees, at which time they submit your refusal to consent to binding arbitration.
  • You have consent authority unless you are no longer insured by the company at the time settlement or trial occurs.
  • You have consent authority unless the company cannot locate you or you are otherwise unavailable at the time of settlement or jury trial.
  • You have consent authority unless your professional license has been suspended, revoked, or surrendered at any time during the claim process.
  • You have consent authority unless you are deceased or deemed incompetent.

Why Choose World Insurance Associates?

Advocacy: Our fully licensed agents act as your advocate—at no charge—for claims or premium disputes.

Free Professional Advisement: We are fully qualified to advise about all healthcare business insurance products, claims, and risk magement.

Time SavingsWe do the comparison shopping that saves you time and money.

Cost Savings: We make sure you receive all discounts available and offer payment plan options designed to fit your budget.

Expert Insight: We are thoroughly informed about professional liability policy provisions, exclusions, and coverages, which can vary widely.

Deep Resources: We work with the finest insurance carriers in the industry. That means we can bring you multiple coverage options with affordable rates specifically designed for your needs, even when those needs change over time.

If you have any questions or would like to learn more, give us a call at 800-462-3401.

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