Question for doctors about malpractice policy cancellation

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scorp_pccorp
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Question for doctors about malpractice policy cancellation

Post by scorp_pccorp »

Hi all,

I have a question for medical folks on here. I have read a bit about claims-made vs occurrence based malpractice policies and about what are the applicable situations for claims made after the policy is canceled by the insured doctor. I understand that with claims-made policies, the policy must be
currently in effect to cover claims made for services provided earlier (or if not, that a tail must be purchased when canceling the policy so that such claims are covered). This is different from occurrence based policies in which claims for services provided anytime during active policy period will be covered at any time in the future even if the policy had long been canceled and no longer in effect.

However I have a different sort of question on occurrence based policy cancellation: what happens if there is an open active claim (being defended by the insurance company) when this policy comes up for renewal and the doctor does not want to renew but wants to switch to a new company? Will there be a negative impact on the defense (in terms of resources, effort, advice, etc..) provided by the insurance company if the policy is not renewed? Is it better/advisable for the doctor to renew and stay with the policy in this case so that they can be assured that the best defense will be provided (even if just a psychological effect)? If the doctor had already applied prior for another policy which would have become active at the expiry of the current one, should they cancel the other policy? or keep both policies active until resolution of the claim and then decide which one to keep? Will there be any repercussions of canceling the other policy if they want to reapply for it in the future? Any other thoughts?
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LadyGeek
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Re: Question for doctors about malpractice policy cancellation

Post by LadyGeek »

This thread is now in the Personal Finance (Not Investing) forum (insurance).
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simplextableau
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Re: Question for doctors about malpractice policy cancellation

Post by simplextableau »

No one cares. You're not dealing with the sales agents in that circumstance. It's extremely common for insurers (of all kinds) to be defending an insured who isn't an actively renewing customer. The claims manager doesn't care, the lawyers don't care, etc.
JPM
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Re: Question for doctors about malpractice policy cancellation

Post by JPM »

OP's question implies lack of much personal experience with med Mal litigation. This might be a good question for White Coat Investor site. ER docs generally get a lot of med Mal experience over their careers because of the nature of their work. They may work under more than one policy if working in multiple states or for multiple employers during the same time period and they often change employers and/or locations a few times over a career. OP could ask one or more experienced local ER physicians. In our area, an ER doc generally averages once med mal case per year and most of those are settled for nuisance value, defeated, or withdrawn.

Some inexperienced physicians or employed physicians engage their own attorneys to protect their interest when it does not necessarily coincide with that of the insurer or the employer.
billaster
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Re: Question for doctors about malpractice policy cancellation

Post by billaster »

JPM wrote: Sat Aug 20, 2022 4:50 pm In our area, an ER doc generally averages once med mal case per year and most of those are settled for nuisance value, defeated, or withdrawn.
Do you mean individual ER docs are sued each year or one out of a collective group of ER docs in your area is sued each year?

According to an American Medical Association survey, only half of ER docs have ever been sued and only 3% of ER docs are sued each year.
MedSaver
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Re: Question for doctors about malpractice policy cancellation

Post by MedSaver »

These questions might better be answered by the insurance companies themselves. However, if it were me, I would absolutely renew and/or get tail.
MedSaver
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Re: Question for doctors about malpractice policy cancellation

Post by MedSaver »

billaster wrote: Sat Aug 20, 2022 11:41 pm
JPM wrote: Sat Aug 20, 2022 4:50 pm In our area, an ER doc generally averages once med mal case per year and most of those are settled for nuisance value, defeated, or withdrawn.
Do you mean individual ER docs are sued each year or one out of a collective group of ER docs in your area is sued each year?

According to an American Medical Association survey, only half of ER docs have ever been sued and only 3% of ER docs are sued each year.
Holy cow, Batman! Your ER docs are all getting sued once per year? That seems really high. Med mail must be expensive.
JPM
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Re: Question for doctors about malpractice policy cancellation

Post by JPM »

Yes pretty much our ER docs always have a case going around here. Most of our ER docs work part time or most of the time in a prosperous part of Illinois. Wisconsin is pretty doctor-friendly in regard to med mal but Illinois is the opposite.
billaster
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Re: Question for doctors about malpractice policy cancellation

Post by billaster »

JPM wrote: Sun Aug 21, 2022 11:53 am Yes pretty much our ER docs always have a case going around here. Most of our ER docs work part time or most of the time in a prosperous part of Illinois. Wisconsin is pretty doctor-friendly in regard to med mal but Illinois is the opposite.
Data from the Illinois Department of Insurance indicates there are about 70 cases for ER docs per year. There are about 3000 ER docs in Illinois so that is about 2.2% per year, which is a little below the national average. Now, when you say "have a case going", some cases can take take a couple of years to resolve, so you might double those numbers, but still a tiny fraction of every ER docs involved in malpractice cases at any one time.
Doctor Rhythm
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Re: Question for doctors about malpractice policy cancellation

Post by Doctor Rhythm »

:annoyed u
JPM wrote: Sun Aug 21, 2022 11:53 am Yes pretty much our ER docs always have a case going around here. Most of our ER docs work part time or most of the time in a prosperous part of Illinois. Wisconsin is pretty doctor-friendly in regard to med mal but Illinois is the opposite.
Are you in a position where you actually have reliable data - like in risk management, quality improvement, or departmental leadership? If it’s one case per year for the whole EM department with dozens of providers, that’s in line with national trends. However, it seems like an extremely high incidence and a real problem (as in “Houston, we have a problem”) if you mean one case per EM provider per year.

The stats billaster cited are from tables at the end of a 2017 AMA study. Illinois data is in a much denser report from 2021.
JPM
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Re: Question for doctors about malpractice policy cancellation

Post by JPM »

I must have bad info, be wrong.
obgraham
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Re: Question for doctors about malpractice policy cancellation

Post by obgraham »

The answer to OP's original question is likely:
If it is in the "occurrence" environment, then there's no question that the policy in effect at the time of the "occurrence" will cover the defense.
Similarly, of it is in the "claims made" environment, there is wording in the policies that dictates that once a claim is made under a claims policy which is in effect, that policy defends it, even if the policy expires. At least there was in mine.
Docs switch insurance companies all the time. It's not really an issue.
JPM
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Re: Question for doctors about malpractice policy cancellation

Post by JPM »

My reading of the Illinois.gov site compilation for 2021 reports defense counsel payments for 325 med mal cases that year for emergency medicine.
Doctor Rhythm
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Re: Question for doctors about malpractice policy cancellation

Post by Doctor Rhythm »

JPM wrote: Sun Aug 21, 2022 2:41 pm My reading of the Illinois.gov site compilation for 2021 reports defense counsel payments for 325 med mal cases that year for emergency medicine.
I believe the 2021 report I cited compiled data from 2014-19, so the 325 cases happened over 5 or 6 years rather than a single year.
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