olivia giaquinta 01/11/2014 resident symposium follow us on twitter: @medprodental
TRANSCRIPT
What is Malpractice?Professional negligence by act
or omission by a health care provider in which care provided
deviates from accepted standards of practice in the
dental community and causes injury or death to the patient.
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When do you need coverage?
ResidentMoonlighting
Private PracticeWorking Interview;Individual Coverage
MilitaryMoonlighting
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SPolicy Types: Occurrence & Claims-made
Policy Limits: $2 million / $4 million
Consent to Settle: Pure Consent
Risk Management & Claims Team: Dental Specific
Occurrence CoverageResponds to
claims based on when the dental
treatment occurred.
Responds to claims based on when the claim is filed against you.
Claims-made Coverage
Dental treatment 2012
Claim is filed 2014
2013
Residency Become a specialist after practicing for 4 years.
Leave of Absence Raise a family, poor health, medical mission trip, etc.
Claims Activity High claims activity, required to enter into
Excess and Surplus.
Relocation Move to a state where the carrier is not licensed.
Trends Join/leave a chain or franchise that provides coverage.
Faculty Leave private practice and work for a university. T
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Occurrence coverage
Claims-made
coverage
Certainty & Simplicity
x
Portability x
Tail Coverage Included
x
Multiple Limits x
Cost x x
2M/4M
2M/4M2M/4M
2M/4M
2M/4M
2M/4M
2M/4M
2M/4M
2M/4M
Occurrence Coverage
2M/4M2M/4M
Claims-made Coverage
*Limits available after 10 yearsP
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LIM
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Follow us on Twitter: @MedProDental
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Follow us on Twitter: @MedProDental
Defendant • 48 year old dentist in Pennsylvania• Substance abuse problem• Voluntarily enters rehabilitation for a period of 120 days• Patients seek care in other offices during his absence
Allegation• Effects of practicing while impaired become evident• 8 Malpractice lawsuits are filed in one year
Concern• Limts: $500,000/ $1,500,000 • Exceeds aggregate limit? • Defense tries to keep settlements within policy limits, to
protect doctors assets
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S$2 million / $4 million$5 million / $7 million
$250k / $750k (Indiana)$100k / $300k (Louisiana)
Occurrence Limit / Annual Aggregate Limit
Considerations:• Type of practice• Specialty vs. General• Venue of practice• Comfort zone of doctor• Years in practice, and
accumulated wealth • Tort environment and
trends
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Pure Consent
“will not compromi
se any claim
hereunder without
the consent of
the Insured.”
Common Exceptions Unreasonable
“Hammer”
Binding Arbitration
Board Approval
No Longer Insured by the Company
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#1a
Insured:
Patient:
Procedur
e:
Allegatio
n:
Result:
General Dentist
28 year-old female
Third Molar Extraction
Improper surgical technique; lack of informed
consent; failure to refer to an oral surgeon
Alleged permanent disability due to left lingual
nerve injury and chronic pain.
Paintiff Seeking:
• $120K Past medical expenses
• $250K Future medical expenses
• $750K Past and future lost income
• $500K General damages (pain,
suffering, disability, alleged inability
to have children)
• Willing to Settle for $100KCA
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Sett
lem
en
t:
Wh
at’
s t
he b
ig
deal?
Fulton County
Jury Verdict:
• General Dentist cleared of negligence charges
What is Risk Management?
Resources (courses and people) to help keep you out of the
courtroom and in your office working, where you belong.TH
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What is Claims Defense?
A team of defense attorneys (dental specific) and expert witnesses
committed to protecting your reputation, license, and assets.TH
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• We are the company who started it all in 1899.
• Berkshire Hathaway - Warren Buffett
• We offer the broadest coverage- Occurrence- Claims-made- Convertible claims-made
• Industry’s highest financial ratingsA++ from A.M. Best
Wh
o is
Med
Pro
?
• We offer PURE consent to settle.
• We have specialized Risk Management and Claims Teams.
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95 %How often MedPro wins when a claim goes to trial.
80%Dental cases filed against MedPro insured
that closed with no loss payment.99%
MedPro insureds are pleased with our claims service after we’ve defended them.
400k +Malpractice claims MedPro has managed since 1899.
25Average number of years MedPro claims managers
have in the healthcare liability industry.0
Exceptions to our consent to settle provision.1899
Malpractice insurance was inventedby the same physicians who founded MedPro.
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Policy Types: Occurrence & Claims-made
Policy Limits: $2 million / $4 million
Consent to Settle: Pure Consent
Risk Management & Claims Team: Dental SpecificK
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Student Video Submissions
Malpractice 101
You
Tub
e
Sausha Toghranegar (D4 @ Nova) submitted this YouTube video last year which was purchased by
MedPro.
VIDEO