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Professional liability ("malpractice") insurance for physicians and surgeons (both MD's and DO's) has customarily been written on either a claims-made or occurrence basis, with basic liability limits of $1 Million per incident, with a $3 Million policy aggregate.  Excess limits are generally available, either on an individual basis or through a healthcare facility, such as a hospital.

Underwriting is based upon a number of different factors, and each insurance company has their own set of criteria:

bulletNATURE OF PRACTICE: Obviously, some medical specialties carry a far greater litigation risk, and are thus going to be priced significantly higher than others.  For instance, a general practitioner is going to pay a far lower premium than a general surgeon, who in turn is going to pay a lower premium than, say, a neuro-surgeon.  Premium costs aside, certain insurance companies are simply more comfortable with certain practice profiles than others.
bulletLOCATION: Where a physician practices can have a significant impact on his/her premium.  Underwriters are keenly aware that courts and juries in different jurisdictions often come up with vastly different verdicts.  For instance, in my home state of New York, doctors who practice in Nassau or Suffolk Counties will pay a higher premium than, say, one who practices in Manhattan (New York County) or Queens County.  Upstate practitioners will pay even less.
bulletBOARD CERTIFICATION: Most underwriters like to see that a physician has achieved board certification in his or her specialty.  The higher the risk profile of the specialty, the more important that this becomes.  While there are a number of organizations conferring post-graduate certifications, it is most common for underwriters to look to the American Board of Medical Specialties.
bulletFULL TIME /  PART TIME: How many hours a physician practices each week is also a factor in pricing the policy.  Generally, 20 or more hours per week is considered "full time" and under 20 hours is considered "part time."
bulletTEACHING CREDITS: Some insurance carriers provide discounts to physicians who spend a significant portion of their time teaching.
bulletCONTINUING EDUCATION: While the requirements vary from state to state, most insurers provide discounts to physicians who attend certain continuing education or loss control courses.  Many insurance companies sponsor these courses for their policyholders.
bulletCONSENT TO SETTLE CLAUSES: Insurance companies will sometimes offer discounts to physicians who agree to allow the insurer to decide when and if to settle claims.  It is my experience, however, that most doctors prefer to maintain their right to consent to a settlement.
bulletCLAIMS FREE DISCOUNTS: A number of carriers offer a discount to those physicians who have been without claims for, say, five years or more.
bulletRECENT GRADUATE / NEW PRACTITIONER: Most insurance companies offer substantial discounts to physicians who are just beginning their practice.  These discounts are usually graded, and disappear after 2 or 3 years.
bulletCLAIMS HISTORY: Obviously, this is a critical factor.  While every underwriter appreciates the fact that in the increasingly litigious environment in the United States, many doctors have had some degree of claims experience, an underwriter will look carefully at the twin issues of "frequency" and "severity."  Depending upon the physician's specialty, it might be expected that there will be a "frequency" issue, though most actions should ultimately be either dismissed without payment or settled for nominal amounts.  On the other hand, a "frequency" issue might also serve as a "red flag" to an underwriter.  "Severe" claims are looked at very carefully, and are often analyzed by the underwriter's own claims department before a decision is made.  For a more in-depth discussion of non-standard medical malpractice insurance for "hard-to-place" professionals, please click here .

Without a doubt, the subject of professional liability insurance for physicians and surgeons is complex.  The "best" policy for you, may not be the "best" policy for the doctor down the hall!

I would be happy to discuss your particular situation in greater detail. You can click here and complete a brief inquiry form, which will allow me to get back to you. Or, if you would prefer to, give me a call at 877-320-4061. This number is available 24-hours a day, and it will automatically try to find me, and will connect you to me if I am available. If I cannot take your call, you will have an opportunity to leave a private voicemail message, and will get back to you promptly. Of course, I can always be reached via e-mail at, insurance@insurance4docs.com.

Thank you for your time . . . I look forward to speaking with you.

Bruce R. Swicker

Copyright 2002, Bruce R. Swicker, "The professional's insurance professional!"  All rights reserved.