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What is the difference between a Claims Made and an Occurrence
policy?
Claims Made policies provide coverage for all claims made
during the period a policy is in force. A reporting endorsement
(or tail) is usually purchased (and recommended) to protect
the insured from all future claims arising from incidences
that occurred while covered by the carrier.
Occurrence policies protect the insured against all claims
that may result from services rendered while a policy is in
effect, without regard to the date an actual claim is discovered.
This form of professional liability insurance has sheltered
physicians since the inception of medical malpractice coverage.
Do Claims Made and Occurrence policies
provide coverage in all fifty states?
No. While Occurrence coverage is accepted in all fifty states,
some Claims Made policies may exclude the following states:
Alaska, Hawaii, Kansas, Massachusetts, New Mexico, New York,
Pennsylvania, Wisconsin, Indiana, Kansas, and Louisiana. It
is important to ask any locum tenens agency which offers Claims
Made coverage if they can provide services in every state..
Are agencies who provide Claims Made
coverage required to also provide Tail coverage?
No. While agencies that provide Claims Made coverage should
also accrue funds to purchase the tail coverage, they are
not required to do so. Likewise, agencies that do accrue the
necessary funds are not required to actually purchase the
tail coverage. As proof a tail is being fully funded, request
a letter from the insurance company itself, or from a financial
institution stating the tail is fully funded and they are
holding the funds for payment, if requested. Do not accept
a letter from the locum tenens agency or the insurance agent
or broker..
As a locum tenens provider, what changes
can I expect when working with an agency?
Depending on which agency a locum tenens provider works with,
there is the possibility of providing services under Claims
Made coverage; the possibility that the agency may not be
able to operate in all fifty states; and the possibility of
lower compensation rates in order to cover the increased cost
of the new coverage.
As a locum tenens physician, what questions should I ask
the agencies I work with?
Important questions to ask are:
- Who is you malpractice carrier?
- What form of coverage does the agency offer? If it's
Claims Made, is the agency fully accrued for the tail?
- Is the insurance carrier licensed and admitted in all
fifty states?
- Is the agency's malpractice policy written on a consent
to settle basis?
- If the carrier is not Medical Protective, St. Paul, or
Evanston, then who is the carrier, and what are they known
for writing (auto, homeowners, malpractice?)?
- Who was the agency's previous carrier? If it was Western
Indemnity/Galltney Group/H.I.S., then ask how they handled
the past acts of coverage.
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