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Coverage Questions to Ask

Malpractice policies are not all the same. Some are more notable for what they don’t cover than for what they do. It is extremely important that you read your policy carefully. Ask your broker or agent the following questions about your coverage, then you will understand the "PULIC Advantage." Remember, you obtain insurance to help protect your assets.

 

Does the company have the experience and expertise I need?

Industry-specific experience and expertise are extremely important. For your insurance needs, look for a company with experience and financial strength. Ask how long the company has been writing medical malpractice insurance for health care providers who have difficulty obtaining coverage. It takes many years of experience to fully understand this market.

Our company has more than 20 years of experience, expertise, and financial stability, which has been validated by solid ratings from A.M. Best and Fitch Ratings since our inception.


 

Is the company domiciled in the United States?

An insurance company that is domiciled in the United States is subject to regulation by its state of domicile. This generally means that the carrier must meet certain financial and market conduct standards. Companies domiciled in the U.S. are generally audited by their state of domicile. If a complaint should arise, it can be submitted to the carrier’s state of domicile for resolution. If a carrier is not domiciled in the U.S., it is not subject to the laws of the United States. This also means that there may not be any recourse for the insured with a complaint against the insurer. These companies are often called off-shore carriers. Because of the risks involved, some hospitals and other health care organizations will not allow medical staff members to be insured with off-shore companies.

Our company is domiciled in the United States.


 

Do I have some input in any proposed settlement or can the company simply settle claims as it sees fit?

Some companies simply settle claims in the least costly manner—whether or not the insured agrees to the settlement. You may have more difficulty getting back into the standard market if your insurer continues to pay claims against you. A consent-to-settle provision means that claims cannot be settled without the insured's involvement.

Our Broad Form Policy includes a pure consent-to-settle provision. Our S800 Policy Form also includes a consent-to-settle provision, but it is more limited and restrictive.


 

Are legal expenses covered in addition to the limits of liability?

Some policies include legal expenses within policy limits. This means that there may be less, or even no, money available for potential indemnity payments because legal expenses have “eaten into” the limits. A policy that includes legal expenses in addition to the limits offers more protection. This is especially true if you purchase lower limits of liability.

Our Broad Form covers legal expenses in addition to the limits of liability. Our S800 Policy Form allows insureds to choose whether they want the legal expenses inside or outside the policy limits of liability. As a general rule, we offer expenses outside the limits of liability on policies with low limits of liability to give better protection to the insured.


 

Does the policy offer a generous extended reporting coverage (tail) option when I terminate coverage?

Extended reporting (tail) coverage provides additional time in which claims may be reported to the insurance company. Some policies strictly limit the availability of tail coverage to 12 months. The fact is, many claims and suits are filed several years after the alleged error. With only a 12-month tail option, the insured may have great personal exposure for claims that are made later.

In nearly all states, PULIC offers, on our Broad Form, a one-year, five-year, and 10-year tail option, thereby providing significantly more and longer protection. Our S800 Policy Form provides a one-year tail option, but the policy can be modified to provide a five-year and 10-year option.


 

Do I need a broker or an agent?

It is extremely important that you have an expert on your side who will ask the important questions. A broker represents the insured. A broker will often have access to several different markets, and can help you find the best option based on your individual needs. An agent generally represents the insurance company and may not have access to different markets.

PULIC only works with brokers, thus ensuring that you are properly represented by a qualified insurance professional.


 

How do I get a Business Associate Agreement from Professional Underwriters Liability Insurance Company?

Each Professional Underwriters Liability Insurance Company insurance policy includes a Business Associate Agreement Endorsement.

If you would like another copy of the endorsement, please contact us, and we will send it to you.

Please provide a copy of this Business Associate Endorsement to your HIPAA Compliance Officer, and let us know if you need further assistance.

PULIC
1888 Century Park East., Suite 850
Los Angeles, California 90067-1737
(800) 537-7362
Fax: (866) 344-6029
E-mail: info@pulic.com