Med-Mal 100 : Questions to Ask When Selecting a Malpractice Insurance Carrier

Research your options and ask the right questions to prospective insurance providers.

If a claim is filed against you, how will the insurer defend you?

Few things in a doctor’s professional life generate more stress and disruption than an allegation of medical malpractice— so it’s important that physicians know what to expect when they are sued and how to navigate the legal process to ensure success. The litigation process can be long and drawn out. The process typically lasts two to five years, with claims being filed a year to two years after a negative event or the date of discovery of an injury—depending on state laws. Effective claims management starts with the prompt review of a claim by an experienced claims specialist.

What is the carrier’s financial strength?

It’s essential that the medical malpractice insurer has sufficient financial resources to pay all current and future claims against policyholders. Consider the following when evaluating a carrier’s financial strength against its competitors:

  • A.M. Best Company and Fitch Ratings.
  • Assets.
  • Surplus.

What additional tools and resources are offered by the insurer?

Select an insurer that offers the tools and resources you need to help reduce risk and keep your practice safe. Your coverage should include access to CMEs, online disclosure resources, and health literacy tools, as well as personalized risk management services and patient safety programs. An insurer with deep expertise in this area could help you make sustainable improvements to your practice by using data to help you reduce adverse events, and by helping you focus on claims analysis, practice risk and safety culture, patient communication, team building, and more.

Does the insurer provide coverage solutions that meet your needs?

In today’s changing healthcare environment, it’s important to choose an insurer that knows the business risks inherent in medical practices and provides innovative solutions to protect you from emerging exposures, including:

  • Cyberattacks and data breaches.
  • HIPAA violations and Medicare reviews.

Does the insurer offer dividend and loyalty programs to its members?

An insurer owned by policyholders, e.g., a mutual or reciprocal, may pay dividends or loyalty rewards to those policyholders. Some provide both. A stock insurance company focuses solely on building wealth for its stockholders.

Is the insurer committed to being your strategic partner?

Navigating today’s complex healthcare environment requires an insurer that does more than pay claims. A strong, effective business partner will also:

  • Provide data that reveals liability trends in your medical specialty and helps improve safety in your practice environment.
  • Successfully support medical liability reform and vigorously advocate in defense of the practice of good medicine.

Does the insurance provider have local expertise?

A strong national reach provides the scope and resources to identify emerging risks and respond with innovative solutions for all specialties, while local experts lend unique regional insights. An insurer that has an established multistate presence may have a portable policy that will allow you to be covered wherever you practice.

The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each healthcare provider in light of all circumstances prevailing in the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.

The Doctors Insurance Agency
215 S. Highway 101, Suite 117
Solana Beach, CA 92075
(858) 345-1370
(800) 464-2986