Question 1

How do I confirm the amount due, the payment date, or whether a payment was applied?

Accepted Answer

Use the current carrier invoice or billing statement, not an old quote or prior payment, to confirm the amount due and the payment date. Match its policy number and term to your declarations. For a payment, credit, refund, or receipt, ask for the carrier ledger or written confirmation and check the amount and effective date. Payment schedules, processing times, and accepted methods vary by carrier and billing arrangement.

Question 2

Which payment method or installment option can I use?

Accepted Answer

Use only a payment channel authorized on the current invoice or by the carrier. Before paying, confirm the policy number, amount, due date, installment terms, or premium financing, which is a loan used to pay the premium. Ask whether a fee applies and when the carrier will treat the payment as received. Keep the confirmation. Do not send account or card details through a general email or website form, and do not assume that a prior method remains available.

Question 3

What should I do after a cancellation, nonrenewal, lapse, or reinstatement notice?

Accepted Answer

Read the notice now. Identify the policy, effective date, stated reason, required payment or information, and every response deadline. Nonrenewal ordinarily means the carrier will not continue coverage after the current policy expires. Cancellation or lapse can end the current term earlier. Do not assume that a late payment or reinstatement request restores continuous coverage. Obtain written confirmation of the status and effective dates.

Question 4

Is a certificate of insurance proof that the requested coverage exists?

Accepted Answer

A certificate summarizes policy information and does not create, extend, or change coverage. The declarations, policy form, endorsements, and any valid binder control. Check the insured name, policy dates, limits, and requested wording. If the request requires a coverage change, obtain an endorsement, binder, or other confirmation from a party with authority to bind the insurer before a revised certificate reflects that change.

Question 5

What is the difference between the declarations, policy, endorsement, and certificate?

Accepted Answer

The declarations identify the insured, policy period, limits, and other policy-specific facts. The policy form states the coverage terms, conditions, and exclusions. An endorsement adds, removes, or changes a term. A certificate summarizes selected policy information for a third party but does not amend coverage. Read these documents together, and keep every endorsement with the policy term to which it applies.

Question 6

What information is needed to issue or revise a certificate?

Accepted Answer

Send the exact name and address of the certificate holder, the delivery email, the contract or credentialing requirement, and the date needed. Identify the physician, practice entity, and location involved. Do not paraphrase requested wording if you have the original requirement. Your agent can then separate a routine certificate request from a request that needs carrier approval or a policy endorsement.

Question 7

How do I know whether a requested policy change took effect?

Accepted Answer

Confirm the change with a carrier-issued endorsement, revised declarations, or a valid binder from a party with authority to bind the insurer. A request, certificate, invoice, or informal email does not by itself amend the policy. Compare the issued document with the insured name, clinician, location, service, limit, and effective date you requested. Also confirm any premium change and outstanding conditions.

Question 8

How do I request current loss runs?

Accepted Answer

Ask the current and prior carriers for loss runs covering the years the new carrier or credentialing organization requests. The carrier may require a signed authorization and specific identifying information. Review the report when it arrives and resolve errors before submitting it. A loss run reports the carrier's recorded claim history; it does not replace your duty to report a new incident under the policy.

Question 9

What is needed to obtain or complete a malpractice insurance quote?

Accepted Answer

Provide a complete, signed application when required, current declarations, policy and endorsements, recent loss runs, and any renewal or nonrenewal notice. Describe every physician, entity, location, procedure, state, work schedule, and outside role. Answer follow-up questions and correct errors before you ask the carrier to put coverage in force. To check status, ask which items remain open and whether the terms are still subject to underwriting. A quote cannot be compared fairly when it uses incomplete or different facts.

Question 10

What should I compare besides premium?

Accepted Answer

Compare the coverage form, retroactive date, limits, whether limits are shared, defense-cost treatment, consent-to-settle terms, exclusions, endorsements, tail options, and carrier status. Confirm that each quote uses the same physicians, procedures, locations, and prior-care dates. Then compare premium and payment terms. The cheapest quote is not an equivalent option when a material coverage term or exposure assumption is different.

Question 11

Why can my premium change even when the base rate did not?

Accepted Answer

A renewal premium can change even when one base rate stays the same. The carrier may have updated your practice details, discounts, surcharges, claims history, coverage limits, or the development step of a claims-made policy. Ask for a written comparison with the prior term. It should separate changes in your practice from changes in the carrier's rates or rating rules.

Question 12

When should renewal work begin?

Accepted Answer

Start when the carrier requests renewal information, and allow enough time to correct errors before the policy expires. Begin earlier if you added clinicians, locations, procedures, states, entities, or claims, or if the carrier issued a nonrenewal notice. Work backward from the expiration date and allow time for loss runs, applications, signatures, underwriting questions, payment, and written confirmation that coverage is in force.

Question 13

Does a quote, application, or payment request prove that coverage is active?

Accepted Answer

No. A quote states proposed terms, an application supplies underwriting information, and a payment request addresses billing. None alone proves that coverage was bound. Obtain a binder or written confirmation from the insurer or a producer with authority to bind it. Confirm the insured name, effective date, policy period, limits, retroactive date, and outstanding conditions. Then review the issued declarations and endorsements.

Question 14

When should I report a new physician, nurse practitioner, physician assistant, or other clinician?

Accepted Answer

Report the clinician before the requested coverage start date. Provide the full legal name, license information, specialty, procedures, work locations, expected hours, employment or contractor status, and prior coverage history. The carrier may need an application and underwriting review. Do not assume the clinician is covered because an offer was accepted, payroll started, or a certificate was requested.

Question 15

When should I report a new entity, location, service, or procedure?

Accepted Answer

Report the change before it begins. Give the carrier enough detail to decide whether it fits the current policy, changes the rating, needs an endorsement, or requires another policy. Include ownership, services, staffing, procedures, patient setting, address, and start date. A business registration, lease, credentialing approval, or certificate request does not add the exposure to a malpractice policy.

Question 16

Should I report a change in clinical hours or practice status?

Accepted Answer

Yes. Report a move to part-time work, a leave, return to practice, major schedule change, or end of clinical work before the change takes effect. State the hours, dates, services, locations, and whether any administrative or supervisory work continues. The carrier decides whether the change affects classification, premium, coverage, or tail eligibility. Keep the written endorsement or status confirmation; a payroll or employment change does not update the policy.

Question 17

Does employer coverage include moonlighting, locums, telehealth, or medical-director work?

Accepted Answer

Do not assume employer coverage follows you to outside work. The employer's policy, declarations, schedules, and endorsements determine whether the work is insured. The employment agreement can state who must arrange or pay for coverage and tail coverage, but it cannot create insurance coverage. Confirm the insured physician and entity, covered services and locations, dates, retroactive date, limits, and treatment of outside work before the work begins.

Question 18

What changes when I practice in another state?

Accepted Answer

Confirm licensing and clinical rules first, then ask the carrier to approve the state, services, setting, and effective date. Coverage territory language alone may not mean the carrier has accepted an ongoing practice in that state. Telehealth also involves the patient's location. Keep written carrier confirmation with the policy, and check whether the move changes premium, defense arrangements, limits, or the need for a separate policy.

Question 19

How do I change carriers without losing coverage for prior care?

Accepted Answer

Map the old and new coverage dates before canceling or replacing anything. For claims-made coverage, preserve the retroactive date through approved prior-acts coverage or buy an extended reporting endorsement, often called tail coverage, from the old carrier. Confirm the new policy's effective date and retroactive date in writing. Report known incidents as the old policy requires; prior-acts coverage is not a way to move a known claim silently.

Question 20

What is the difference between claims-made and occurrence coverage?

Accepted Answer

Occurrence coverage generally ties coverage to when the covered professional incident happened, even if the claim is made later. A claims-made policy generally requires the claim to be first made during the policy period or an applicable extended reporting period, and some forms also require reporting within a stated period. The professional services must also fall on or after the retroactive date. Read the actual claim, reporting, retroactive-date, and extended-reporting provisions because the trigger varies by form.

Question 21

How do tail coverage, prior-acts coverage, and the retroactive date work together?

Accepted Answer

These terms protect different parts of claims-made continuity. The retroactive date marks the earliest professional services that may qualify, subject to the policy. Prior-acts coverage places eligible earlier services under a new claims-made policy. Tail coverage, or an extended reporting endorsement, allows certain claims arising from services covered by the old policy to be first made or reported after that policy ends. Verify the dates, election deadline, duration, limits, and exclusions in the issued documents.

Question 22

Who pays for tail coverage when a physician leaves?

Accepted Answer

The employment agreement usually allocates tail cost between the physician and employer. The carrier's terms determine whether tail coverage is available, who is eligible, the price, the election deadline, and what the endorsement covers. Review both before departure. Obtain the carrier's written quote or eligibility decision, identify the contractual payer, and do not let a payment dispute cause the election deadline to pass.

Question 23

Is tail coverage free when I retire?

Accepted Answer

The Doctors Company provides free tail coverage on retirement, disability, or death. Some claims-made policies offer a no-cost retirement tail only when the insured meets stated age, continuous-coverage, disability, or full-retirement conditions. The conditions vary by carrier and policy edition. Ask for written eligibility confirmation before setting the retirement date or canceling coverage. Also confirm how the endorsement treats part-time work, volunteer care, and later return to practice.

Question 24

What does a limit such as $1 million/$3 million mean?

Accepted Answer

A $1 million/$3 million limit commonly means up to $1 million for one covered claim or occurrence and up to $3 million in the aggregate for the stated policy period. The policy's definitions control both numbers. Confirm whether the trigger is a claim or occurrence, which insureds share the limits, whether separate aggregates apply, and whether defense expenses reduce any limit.

Question 25

Can physicians and the practice share one limit?

Accepted Answer

Yes, some policy structures share a limit or aggregate among physicians, the entity, or both. Other structures provide separate limits. Shared limits can reduce what remains for another insured or claim after one loss. Ask the carrier or agent to diagram which insureds share each per-claim and aggregate limit, then confirm the answer in the declarations, endorsements, and policy definitions.

Question 26

Do defense costs reduce the liability limit?

Accepted Answer

The policy decides. Some forms pay covered defense expenses outside the liability limit; others reduce the limit, use a separate defense limit, or apply different rules to certain proceedings. Read the defense and limits provisions together and check endorsements. Ask how fees, expert costs, appeal bonds, licensing matters, and other expenses are treated. Do not infer the answer from the limit shown on a certificate.

Question 27

When should I report an incident before a formal claim?

Accepted Answer

Report it when the policy's incident or potential-claim language tells you to report, even if no lawsuit or demand has arrived. Triggers can include an adverse outcome, a complaint, a request for compensation, an attorney contact, or facts that may reasonably lead to a claim. Use the policy's reporting channel and include the required information. Early notice can protect coverage rights and allow the carrier to assist.

Question 28

What should I do with a demand, subpoena, summons, or attorney records request?

Accepted Answer

Preserve the document, record when and how it arrived, and identify every deadline. Report a summons, complaint, demand, subpoena, notice of intent, arbitration request, or attorney communication tied to an alleged injury through the channel required by your policy. A routine records request is not automatically a malpractice claim, but an allegation or demand may trigger reporting. Do not alter the medical record, discuss liability, or negotiate a response before receiving carrier or defense-counsel guidance.

Question 29

Does reporting an incident mean the carrier made a malpractice payment?

Accepted Answer

No. Reporting an incident gives the carrier notice; it does not mean that anyone admitted liability or that the carrier made a settlement or payment. The carrier may investigate, provide support, or close the matter without payment. Keep the reporting confirmation and respond to carrier requests. Any later reporting duty to a licensing board or the National Practitioner Data Bank depends on the facts and governing rules.

Question 30

Which policy responds after I leave a job or change carriers?

Accepted Answer

Coverage can depend on the incident date, the date the claim was first made, the reporting date, the retroactive date, and any tail or prior-acts endorsement. Review the notice provisions of every policy that could apply and give prompt notice through each required channel. If the policies overlap or their instructions conflict, notify the involved carriers and ask them to evaluate coverage rather than delaying notice while you try to allocate the claim yourself.

Medical malpractice insurance questions, answered.

Do you have a demand, summons, attorney request, or serious incident?

Your current policy, billing, and documents