Lesson 202 - Coverage Overview for Healthcare Providers

In this section, we will be talking specifically about Medical Professional Liability insurance and the different ways of placing coverage and the impacts it may have toward your future plans and liabilities. Understanding the differences in how the structure of your insurance is setup is vital in the success of your business.

Individual Coverage

Physicians, Advanced Practitioners, and Allied Providers are all eligible to get individual coverage that protects them and their businesses if they have one. As discussed in the previous lesson, getting individual coverage has some ramifications if you obtain a claims-made policy. Once you are in a claims-made policy, you’ll want to maintain it for a lifetime, as some carriers offer free Death, Disability & Reitreimentn Tail Coverage so that you don’t have to pay for extended reporting period coverage.

Facilities & Entity Coverage

Healthcare providers can cover their practice by obtaining Entity Coverage, which will first cover the business and, in most cases, the providers who work for the healthcare practice. Advanced providers are typically automatically included in these policies, and only physicians need to be scheduled. Most of these policies are written on a claims-made basis, so tail coverage will need to be kept in mind for each provider; however, most carriers offer Rolling IBNR coverage as long as the policy is kept in force. This option is most flexible for those who are operating a business with multiple providers who may come and go.

Group Coverage

Group coverage is typically for physicians and advanced providers practicing the same medicine specialty. A policy, depending on the insurance company, can be written to provide separate limits of coverage for each provider, all under one policy/contract. This provides the most flexibility for physicians within the same specialty working at the same locations, hospitals, or IPA’s. Group coverage can also be written separately, so that in cases where there is a physician insured that has a claims history, they can be separate in terms of billing.

Updated 4/20/2023