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Monthly Archives: August 2013

How can a physician or surgeon reduce his medical malpractice insurance premium?

All of the top medical malpractice insurance companies prefer to insure those healthcare professionals least likely to have claims. So, most of them offer incentives to place your insurance with them. Generally, medical malpractice insurance rates are based on specialty, location, limits of liability, and actuarial data.

Premium credits are available, and should be mentioned by your agent. These are:

  • Five Year Claims-free discounts – These discounts can be significant. Usually a company requires that a physician be claims-free for five years to receive any discount. The longer you remain claims-free, generally the greater the credit. A doctor just getting out of residency may receive a new-to-practice credit, but is usually not eligible for a claims-free discount because he has not had enough experience. Even if you have had a claim, you will probably be eligible for a credit as time goes by and you remain claims-free.
  • Board Certification – A board certified physician can often receive discounts. The more board certifications, the greater the discount.
  • Society Memberships – Membership in National, Regional, or State Medical Societies can often result in a discount, depending on the insurance company.
  • Large Group Discount – A large group is appealing to an insurance company, especially if the group is relatively claims-free. Credits can be negotiated by the agent.
  • Shop the Market – A good agent will constantly monitor the very fluid malpractice marketplace for you, getting quotes from various companies well prior to your renewal. He will balance the need to reduce premium with the need to be insured by a quality company with a proven track record of claims defense.

The medical malpractice insurance market is “soft” right now, meaning that credits are available. You should not have to ask for them. They should be offered to you.

John Gracey Backer, CPA

John Gracey Backer, CPA, is the Treasurer of Gracey-Backer, Inc., an Insurance Agency in Delray Beach, Florida specializing in All Lines of Malpractice, Professional and Personal Insurance for the Healthcare Provider. He can be contacted at 800-272-6055 ext 128, or at

How Can a Dentist or Oral Surgeon Reduce His Dental Malpractice Insurance Premium?

All of the major dental malpractice insurance companies for dental professionals offer ways to reduce premium, as a way to attract and keep good dentists. Generally, a premium is based on your specialty, location, limits of liability, and actuarial data.

The following are ways you can reduce your premium:

  • Risk Management – Most dental malpractice insurance companies offer a Risk Management Course, either live or on-line. Successful completion of the course generally reduces your premium by 5%, and, hopefully, reduces your likelihood of having a claim.
  • Loss-Free Discount – If you have been with a company for five or more years, and have remained claims-free, you may be eligible for a discount. The size of the discount varies by company, and range from 1% to 20%. Discounts can be reduced or eliminated if you have had a claim which was successfully defended, but for which defense costs were incurred.
  • New-To-Practice Credits – A new dentist just out of residency may qualify for a credit of up to 50% for the first year, gradually coming down to no credit in the fifth year, at which time the dentist is eligible for the claims-free credit.
  • Part-Time Credit – Available for a dentist who works 20 or less hours per week. Some companies have a minimum age requirement, usually age 55.
  • Temporary Suspension of Coverage – If you need to take a break from your practice, because of illness, military service, or maternity, some companies will allow you to suspend your policy and pay a minimal premium, generally 15%. Your policy must generally remain in a suspended status for a minimum of 3 months.
  • Society Credit – Some carriers give a credit for being a member of a National, State or Specialty Society. Some companies require such membership to apply for coverage.

The dental malpractice insurance marketplace is “soft” now, meaning there is competition among carriers and rates are relatively low. The marketplace is cyclical, however, and we have been in this cycle for about seven years. A turn in claims frequency or severity could impact rates in the future. As always, you want to balance premium with quality, as a strong defense culture trumps all if you have a claim.

John Gracey Backer, CPA

John Gracey Backer, CPA, is the Treasurer of Gracey-Backer, Inc., an Insurance Agency in Delray Beach, Florida specializing in All Lines of Malpractice, Professional and Personal Insurance for the Healthcare Provider. He can be contacted at 800-272-6055 ext 128, or at

Medical Malpractice Insurance in Florida: Claims-made vs. Occurrence

What is Claims-Made Coverage?

You are insured under a claims-made policy, meaning that the policy in force at the time the claim is made against you is the one that responds. (This is just the reverse of auto insurance, where the policy responding is the one in effect at the time of the incident, regardless of when a claim is brought against you.) The incident must happen after the retroactive date to be covered.
Under the claims-made form of insurance, the premium increases every year over a five year period and then levels off and is only affected by overall rate increases or decreases for everyone. Sometimes, there are credits for being a new-to-practice doctor and risk management credits which further reduce the premium in the early years.

How Does Claims-Made Insurance Work?

In the first year, the policy covers claims reported during the first year based on work also performed in the first year. The premium is relatively low. In the second year, the policy covers claims reported during the second year based on work performed during the first and second years. In the third year, the policy covers claims reported during the third year based on work performed during the first, second, and third years. The same holds true for the fourth and fifth years. The fifth year claims made policy is called a “mature” policy.

What is an “Extended Reporting Endorsement” or “Tail” Coverage?

Because a policy needs to be in place for coverage to occur, an issue arises when you discontinue coverage and wish to be protected for claims reported after the date of termination of coverage. You have the option of purchasing a “tail” policy, which provides protection for claims which are reported during the tail period based on incidents occurring while coverage was in effect.

Customarily, the company provides a free “tail” policy if any of the following occur during the policy period:

  • Death
  • Disability
  • Retirement from your designated practice provided you have been with the company for five consecutive years.

If you do not purchase a tail policy, or are not eligible for a free tail, there is no coverage for claims reported after cancellation of your policy.

How Much Does Prior Acts Coverage Cost

Under the claims-made form of insurance, it is simple to switch from one carrier to another and not have a gap in coverage. The new carrier simply sets the new retroactive date the same as the one on your old policy. There is no need to purchase a costly tail policy from the old carrier (unless required by your employer). You will still be covered for your prior acts. The new carrier will require proof of prior coverage with your retroactive date along with a loss run.

What if I change my Limits of Liability on the Claims-Made Policy?

An advantage of the claims-made policy is that you can change your limits any year at renewal. The new limits will apply back to the retroactive date. Many doctors increase their limits as time goes on as they have more to lose in a lawsuit. The new, higher limits, will apply all the way back to the beginning of their practice, if that is when the retroactive date was set.

Barbara Gracey Backer

Barbara Gracey Backer is the Vice-President of Gracey-Backer, Inc., an Insurance Agency in Delray Beach, Florida specializing in All Lines of Professional and Personal Insurance. She may be contacted at 800-272-6055 X118 or at

Employment Practices Liability Insurance (EPLI)

We all hope to never be involved in a lawsuit with an employee, but the fact is that it happens. Ensure that you are protected by learning about Employment Practices Liability Insurance, or EPLI. Click on the video below to watch Gracey-Backer’s Vice President, Barbara Backer, explain the benefits of having EPLI.

Sleep Apnea and Dental Malpractice Insurance

More and more dentists are being trained in the use of oral appliances for obstructive sleep apnea and in the area of dental anesthesia. While these procedures provide a wonderful service for the patient and additional revenue for the dentist, they do not come without additional exposure to dental malpractice insurance claims.

Obstructive sleep apnea (OSA) is defined as sleep-disordered breathing. This condition causes the person to experience a decreased or paused air flow during sleep when airways become blocked, floppy or narrowed which often produces loud snoring.

If a dentist suspects a patient may have sleep apnea then he or she should work together with a physician or dental sleep specialist to diagnose the disorder. If an oral appliance is recommended, the dentist providing this treatment should be properly trained and aware of licensing limitations regarding this appliance as serious injury or death could occur while patients are being treated with an oral device.

Dental malpractice insurance (also known as dental professional liability insurance) claims are on the rise with some attorneys specializing in the field. With dental anesthesia arguably being the number one claim, a patient with sleep apnea should be given special attention as they may be at a higher risk for complications when undergoing anesthesia. In normal sleep, a person with sleep apnea will usually waken when their breathing stops, however if they are under anesthesia and placed into a deep sleep they may be unable to awaken when they stop breathing.

To provide the best patient care and possibly avoid a dental malpractice insurance claim, a dentist should be aggressive in their risk management. The dentist should obtain complete health history, signed informed consent forms, keep complete treatment and ongoing care documentation including notes concerning physician consultations, and take appropriate precautions for patients who are suspected of having sleep apnea prior to any treatment. In addition, communication between all parties – the primary dentist, treating dentist, specialists, physicians, and the patient is vital in making sure that there is care consistency.

Regina Walker

Regina Walker is an Agent at Gracey-Backer, Inc., an Insurance Agency in Delray Beach, Florida specializing in All Lines of Professional and Personal Insurance for the Healthcare Provider. Regina is an Account Executive in the Dental/Oral Surgery Department. She can be contacted at 800-272-6055 ext 111, or at

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