Per-claim, aggregate, shared, and separate limits.

A $1 million/$3 million declaration does not show whether the physician, group, and entity share one pool or have separate limits. It also does not show what earlier claims or defense expenses have already consumed. Read the declarations, policy, and endorsements together.

Picture a group with a pending claim against one physician and a new claim against the practice entity. Before anyone says there is "$3 million available," identify the insureds, per-claim limit, aggregate, related-claims wording, defense-cost treatment, and all prior payments. The answer is policy- and fact-specific.

Read the two limit numbers

A malpractice policy often shows two numbers, such as $1 million per claim and $3 million aggregate. These numbers serve different purposes.

The per-claim limit is the maximum available for one covered claim, subject to the policy's defense-expense, deductible or self-insured-retention, related-claims, and endorsement terms. The aggregate limit is the maximum available for covered claims during the stated period, subject to the same terms.

Assume a policy has $1 million per claim and $3 million aggregate. One covered claim may have no more than $1 million available under that policy's terms. Several covered claims may draw on the $3 million aggregate together. An exhausted aggregate can leave no insurance available for later claims in the same period.

Policy definitions can change how related allegations count. Read the provision that combines or separates related claims.

Identify who uses each limit

The declarations page can identify insured people and entities. The definitions, schedules, and endorsements can then state or modify the applicable limit structure.

Separate limits give an insured a distinct limit. Shared limits apply one limit to several insureds.

Shared limits can include a physician, practice entity, nurse practitioner, physician assistant, or other clinician. One covered claim can reduce the amount left for everyone sharing that pool if the policy treats their work and the allegations as covered and within that shared limit.

A group policy can also use separate per-claim limits and one shared aggregate. Do not infer the structure from a certificate alone.

Follow a group claim through the limits

Assume a policy lists Dr. Garcia, a physician assistant, and Garcia Medical Corporation. A patient sues all three over one course of care.

If all three share one $1 million per-claim limit, adding defendants does not itself create $3 million for that claim.
If the physician and entity have separate limits, the policy still defines when allegations count as one related claim and how each limit applies.
If several claims involve different patients, the interrelated-acts provision can still treat them as one claim. Paid covered amounts reduce a shared aggregate only when the form charges them to it during the applicable period.
If defense costs sit inside the limits, defined charged expenses can shrink the available indemnity before any settlement or judgment.

The declarations page begins the answer. The limit endorsement, related-claims provision, defense clause, and entity endorsement finish it.

Review the entity coverage

A lawsuit can name both a clinician and the practice entity. Read the issued declarations, named-insured or additional-insured schedule, coverage grant, limits clause, and endorsements to see whether the entity has its own limit, shares a clinician's limit, or is not insured for the work at issue.

Vicarious liability is an entity's alleged responsibility for another person's conduct. The entity and related-claims provisions can matter, but so can the separation-of-insureds, claim or medical-incident definition, multiple-insured clause, exclusions, and allocation terms.

A management company, property company, or medical spa might not be an insured under the physician policy. Use an entity map to record whether it is an insured, covered under another policy, or has a consciously accepted uninsured exposure based on its actual role. A common brand, address, owner, certificate, or contract does not establish coverage.

Review clinicians and supervision

The clinician roster should record each physician and advanced practice clinician's actual coverage arrangement, including contractor or locums policies, and whether the group policy includes that person's services.

Test one actual supervision fact pattern against the policy's definitions, insured schedule, multiple-insured clause, entity terms, limits, and defense provisions. Do not assume the policy uses one universal approach to supervision allegations.

Do not assume one certificate proves coverage for the full group. California law says a certificate is not a policy and does not amend, extend, or alter coverage.

Record the limit structure in a table

Use a separate row for each person or entity. Record the legal insured name, capacity or role, document and page, claim trigger, per-claim or each-claim limit, aggregate scope, shared pool, defense-expense treatment, deductible or self-insured retention, related-claims or multiple-insured clause, excess layer, and contract requirement.

Ask these questions:

Who is named, scheduled, or qualifying as an insured?
Who has a separate limit, and who shares each per-claim and aggregate pool?
Does the entity have its own limit, share a limit, or fall outside the grant?
Do defined defense expenses reduce the per-claim limit, aggregate, both, neither, or a separate cap?
How does the policy combine related claims and multiple insureds?
What paid indemnity and charged expenses have already eroded the relevant limit? Keep reserves separate from paid amounts.
What contract sets a minimum limit? A contract sets a requirement, not a coverage grant or guaranteed available limit.

Add the minimum limits from employment agreements, facility contracts, and payer requirements to the same table.

Update the table after you add a clinician, entity, or location. Confirm whether the issued terms require an endorsement, and preserve the resulting document.

Preserve each historical policy. For occurrence coverage, start with the policy in force when the covered medical incident occurred. For claims-made coverage, identify the policy or extended reporting period that may respond, then read its prior-acts, related-claims, limits, and reporting terms. Compare claims-made and occurrence coverage.

Before binding or renewing, test one representative multi-defendant claim map and one multiple-claim-year map against the table. Resolve a mismatch in the issued documents before relying on a shared-limit structure.