Physicians & Surgeons

Professional liability insurance (malpractice) for physicians and surgeons, either MDs or DOs, is customarily written on either a claims-made or occurrence basis. Basic liability limits are usually $1 million per incident, with a $3 million policy aggregate (the maximum amount the policy will pay during the policy period). 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 its own set of criteria. Here are a few of the ways insurance underwriters classify medical professionals.

Nature of Your Practice

Some medical specialties carry a far greater litigation risk, so are priced significantly higher than others. For instance, a general practitioner will pay a far lower premium than a general surgeon, who in turn will pay a lower premium than a neurosurgeon. Some insurance companies are more comfortable with certain practice profiles than others.

Location of Your Practice

Where a physician practices impacts his or her premium significantly. Depending on jurisdiction, courts and juries frequently deliver vastly different verdicts. For instance, in New York, doctors who practice in Nassau or Suffolk Counties pay higher premiums than those in Manhattan, New York County, or Queens County. Upstate practitioners pay even less.

Board Certification

Physicians who have achieved board certification in their specialty stand in high regard with underwriters. The higher the risk profile of the specialty, the more important certification becomes. While there are a number of organizations conferring post-graduate certifications, underwriters commonly look to the American Board of Medical Specialties.

Full Time versus 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; under 20 hours is considered part time.

Teaching Credits

Some insurance carriers provide discounts to physicians who spend a significant portion of their time teaching.

Continuing Education

While these requirements vary from state to state, most insurers provide discounts to physicians who attend specific continuing education or loss control courses. Many insurance companies sponsor these courses for their policyholders.

Consent to Settle Clauses

Most physicians prefer to maintain their right to consent to any settlement. Insurance companies will sometimes offer discounts to physicians who waive their right to decide when and if to settle claims.

Claims-Free Discounts

Many carriers offer discounts to physicians who have been without claims for a certain period of time, usually five years or more.

Recent Graduate/New Practitioner

Most insurance companies offer substantial discounts to physicians just beginning their practice. These discounts usually disappear after a few years.

Claims History

Claims history is a critical factor in the underwriting decision. Underwriters understand the increasingly litigious environment in the United States. They realize that many doctors have had some degree of claims experience. An underwriter will review "frequency" and "severity." Frequency is how many claims you have had; severity is how much was paid to both defend and/or settle the claim. Depending upon specialty, there may be a frequency issue, though most actions should ultimately be either dismissed without payment or settled for nominal amounts. However, frequent claims can also serve as a red flag to an underwriter. High-value claims are looked at very carefully, and are often analyzed by the carrier’s claims department before a decision to insure is made. For a more in-depth discussion of non-standard medical malpractice insurance for "hard-to-place" professionals, please click here.

Medical professional liability is a complex subject. The right policy for you may not be the right policy for the doctor practicing down the hall. We would be happy to discuss your particular situation with you. Click here and complete a brief inquiry form, which allows us to call you. Or, you can call us at 866-759-0102. We return calls promptly.

As a physician or surgeon, your professional reputation and your assets are at stake. The professional relationships we have built with our insurance carriers can help protect you in an increasingly litigious environment.