Understanding Medical Malpractice Insurance WAPA 32318 Insurance Basics

Understanding Medical Malpractice Insurance WAPA 3/23/18

Insurance Basics • Claims Made • Occurrence

Claims Made • Claim must be made during the policy period (or extended reporting period) arising out of acts occurring on or after the retroactive date. • Limit of Liability applies for the year that the claim is reported as long as the act giving rise to the claim occurred on or after the retroactive date • Watch the retroactive dates • Extended reporting period (or Tail) coverage

Occurrence • The policy that was in effect at the time that the alleged occurrence took place responds regardless of when the claim is brought. • Limits of Liability remain in place forever

Modified claims Made • A claims made policy that has the extended already incorporated.

• Duty to Defend vs. Reimbursement • Limit of Liability Per claim/ Aggregate • Retention vs Deductible • Admitted Carrier vs Non-admitted Carrier • Additional Insureds (employees, students, volunteers, locum tenens) except for intern, extern, resident, fellow, medical, dental, osteopathic or chiropractic doctor)

Additional coverages • Licensing Board Actions Defense • Sexual Misconduct Defense • Regulatory Actions • Cyber

Employed vs Independent vs Moonlighting • Employed • By a healthcare provider or other entity

Wisconsin Statutes • Ch 655 Wisconsin Statutes • Mandatory Insurance • A physician or CRNA practicing in WI 240 hrs or more per year • A partnership, corporation or any organization or enterprise organized and operated in WI for the primary purpose of providing the medical services of physicians or CRNAs • Ambulatory Surgery Center • A hospital • An entity that is an affiliate of a hospital that provides diagnosis or treatment of, or care for, patients of the hospital • A nursing home whose operations are combined as a single entity with a hospital

• The fund shall provide coverage for claims against the healthcare provider or the employee of the healthcare provider due to the acts or omissions of the employees acting within the scope of his or her employment and providing healthcare services

Injured Patients and Families Compensation Fund • Mandatory participation • Provides unlimited excess coverage over approved primary coverage

• Independent • Individual policy • Limits available are those indicated on the policy

• Moonlighting

• Carla Borda • R&R Insurance Services • 262 -502 -3843 • Carla. Borda@rrins. com • www. myknowledgebroker. com