The practicing physician or organization is generally the name insured.

Coverage under the physician and surgeon professional liability policy assumes that a policy is in force and that the claim comes within the scope of the policy. It also assumes that the claim is reported in a timely fashion and that there is no other coverage.

Coverage on the Physician and Surgeon professional liability (medical malpractice insurance) insurance policy is similar to other general liability policies:

• It promises to indemnify the insured physician or surgeon for damages for which he is found legally liable, including the payment of a judgment negotiated by the insurance company, up to the limits of liability stated on the policy.
• It pays legal defense and mediation costs incurred by the insured physician or surgeon. The malpractice insurance company generally has the right to choose the attorney and run the defense. This right includes the decision to settle or litigate the case. Some professional liability (malpractice) policies have a “consent to settle” provision, which allows the insured some say in the decision to settle. In any case, the insured physician has an obligation to cooperate with the insurance company in the conduct of his defense.

Generally, professional liability is not covered by the commercial general liability policy. In rare cases, it is added by endorsement; however, it is better to have a standalone policy.

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A $1,000,000/$3,000,000 limit of medical professional liability insurance means that the most that the medical professional liability insurance company will pay for any one claim against a physician or surgeon in a year is $1,000,000. The most the medical malpractice insurance company will pay for any amount of professional liability claims against the physician or surgeon in one year is $3,000,000.

Many of our physician and surgeon clients ask how much professional liability coverage they need. At the risk of being vague, the answer really depends on a number of factors, including the physician or surgeon’s annual income, his assets, and medical professional liability insurance premium costs. We at Gracey-Backer, Inc. will consult with a physician or surgeon and tailor a policy for his or her particular needs.

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Every Claims-Made Professional Liability Insurance Policy has a retro-active date. For a new oral surgeon or dentist just beginning practice it should be your first day of practice. Experienced dentists may have a different retro-active date depending on their insurance history.

In most cases, a Dental Malpractice retro-active date determines how far back a bodily injury or professional injury caused by dental care will be covered by the policy. For example, a new dentist, Jane Doe, DMD begins practicing on July 1st 2012 and purchases her Dental Professional Liability policy effective July 1, 2012 to July 1, 2013 with a retro-active date of July 1, 2012. On August 1st 2012 she receives an incidence notice from an attorney for dental care she performed on a patient July 3rd, 2012. This would be a covered claim under the policy – since it is within her policy period July 1, 2012 and July 1, 2013 and is after her retro-active date. However, if this Dentist had waited until July 5th to place her coverage into effect, the claim would NOT be covered because the claim would have occurred prior to her retro-active date and effective date.

Now, let’s say Jane joins a group on March 1st, 2013 and wants to cancel her current policy and go with the new group’s insurance. She has two options to make sure her dental care work from July 1st to March 1st is covered. She can either purchase an Extended Reporting “Tail” Endorsement which will cover her or her estate for that specific time period indefinitely or she can write the new policy with an effective date of March 1st, 2013, but with a retro-active date of July 1st, 2012. Either way she will be covered for her prior acts back to July 1st, 2012. However, if she does not pursue these options, she will be solely responsible, “out of pocket”, for both legal defense and/or any claim payments, for the period of July 1st 2012 to March 1st, 2013.

Experienced dentists may wonder why they are keeping their original retro-active when there is a statute of limitations on Dental Malpractice claims. Although the statute is important to know, it is not to be considered in determining the retro-active date as the statute may change and often varies depending on the type of circumstances or patient seen, for example the date of discovery, children and the mentally challenged.

In conclusion, the retro-active date is extremely important and should be maintained unless an Extended Reporting “TAIL” Endorsement is purchased.

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• Businessowners – Protects a professional organization or an individual who owns or leases a business office from loss related to covered property damage or general liability (slip and fall). Hired and Non-Owned Auto coverage is also often recommended and offered under this type of policy.
• Umbrella Liability – Extended Liability for your office.
• Cyber Liability – Protects against computer hacks, breach, or patient privacy.
• Medical Defense Liability – Defends claims against insurance and Medicare/Medicaid fraud.
• Directors’ and Officers’ Liability – Protects against liability for decisions made while serving on a board as a director or officer.
• Workers’ Compensation Liability – Protects the employer against employment related injury or accident. Required by the State of Florida in most cases.
• Employment Practices Liability Insurance “EPLI” – Protects the employer against employment –related suits from employees.

In addition to Professional Liability, what other insurance do YOU need? In today’s litigious climate, understanding the importance of this question and it’s impact on a doctor’s financial future is crucial. It is important to select an Independent Agent that has the expertise required to assist the doctor in determining his or her needs.

As leaders in the Professional Liability Insurance marketplace, Gracey-Backer Insurance, Inc. , understands the needs of our Oral Surgeons and Dentists. We are committed to our job which is to protect our clients from financial loss with insurance products designed to meet their individual needs.

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