by Al Anthony Mercado, Esq., managing attorney of the downstate region of the law firm Mercado May-Skinner (MMS) and an employee of MLMIC Insurance Company
As a healthcare provider, you work hard to maintain a successful practice and deliver excellent medical services to your patients. Unfortunately, in the litigious New York malpractice environment, there is a good possibility that you will eventually face a medical malpractice claim. Similarly, there are legislative attempts to expand the time to sue for malpractice and recoverable damages.
The best initial way to protect yourself against a medical malpractice award is to choose the right medical liability insurance carrier. Below are five basic qualities to look for when choosing a medical liability insurance carrier.
A medical liability insurance carrier’s presence and experience in New York State, and especially in your local area, is extremely important for handling malpractice claims. Knowledge of the litigious New York malpractice environment (including the laws, courts, judges, attorneys and damage values) is especially important to successfully defend a medical malpractice claim. Presence alone is not enough — look at how long an insurance carrier has been in the New York State insurance market and their claim results.
Financial Strength, Stability and AM Best Rating
Financial strength and stability are additional key considerations for choosing the right medical liability insurance carrier. You certainly do not want to learn of your insurance carrier’s financial instability while facing a claim of malpractice. Financial strength and stability can demonstrate an effective history in handling past claims as well as the ability to successfully defend future claims.
A key indicator of an insurance carrier’s financial strength in the market is its AM Best rating. AM Best is a global credit rating agency specializing in the insurance industry. When an insurance carrier has a superior AM Best rating of A+ or better, it is a strong indication of its stability and strength in the marketplace. Although it should not be the only factor when evaluating an insurance carrier’s financial strength and stability, it should be a primary consideration.
Insurance Policies, Discounts and Cost
The “Two C’s,” choice and cost, are important considerations when choosing an insurance carrier. Some specific considerations include:
- Availability of claims-made and occurrence policies
- An occur rence policy covers a physician for any incident that occurs during the poli cy period regardless of when the mal practice claim is filed. Accordingly, it will continue to provide coverage even after a policy ends.
- A claims-made policy, however, will only provide cov erage if both the alleged malpractice took place and the claim is filed during the policy period.
- Availability of consent and non-consent to settle policies
- Availability of coverage for professional entities and employees
- Availability of various discount programs like MGMA
You should keep two sayings in mind when considering cost: “penny wise, pound foolish” and “an educated consumer is the best customer.” Cost is an important consideration but should not be the only one. When comparing costs, make sure that you are getting the same protection and services.
Risk Management Education and Services
Malpractice claims begin during the treatment of a patient. Education and training on risk mitigation strategies have been shown to be an effective tool for healthcare providers to avoid claims and/or lower damages. In addition, the availability of an insurance carrier’s legal team (which is well-versed in New York law) can prove to be valuable in situations leading to potential malpractice claims — think unexpected or bad outcomes, dissatisfied or difficult patients, refunds and regulatory questions.
Fighting for the New York Medical Community
A final consideration in choosing the right medical liability insurance carrier is determining whether the carrier is invested in fighting for the interests of New York State healthcare providers.
- Is the carrier active in fighting legislation that would expand medical malpractice liability and damages?
- Does the carrier have a record of fighting for tort reform and supporting legislative efforts to lessen malpractice for the medical community?
- Has the carrier partnered and collaborated with organized medicine to lessen malpractice liability?
- Has the carrier regularly engaged in risk management education to help mitigate claims and/or liability?
Partnering with a carrier that supports the medical community makes you part of a team fighting for tort reform.
Choosing a medical liability insurance carrier is an important decision in your professional career. Selecting the right one based upon the considerations above will afford you support and guidance before claims occur, provide you with strategies to avoid malpractice claims and give you protection and peace of mind in the unfortunate event you are the subject of malpractice claim.