Healthcare · Medical Professional Liability
Most malpractice problems don't surface at renewal
They surface two years later, when a claim arrives and the policy that was in force on the date of care is no longer the policy answering the phone.
Medical professional liability is its own market, with different carriers, different policy forms, and a reporting trigger that behaves nothing like the general liability policy sitting next to it in your file. We built a healthcare practice around that difference.
Scope
What the policy answers for, and where it stops.
Medical professional liability responds when a patient alleges that a negligent act, error, or omission in rendering care, or failing to render it, caused harm. It pays to defend the allegation and the damages you're found to owe, up to your limits. Two structural points matter more than most physicians are told, and what the form does not reach is worth its own look, next.
Why structure matters
The coverage form, defense cost treatment, and limit structure change what's actually available when a claim is made. Those details are easy to overlook until they become the only ones that matter.
Defense Costs
In most admitted physician policies, defense is paid in addition to your limits. In some surplus lines forms, defense erodes the limit instead.
On a claim that takes four years and two expert witnesses to defend, that distinction alone can be worth more than the annual premium.
Limit Structure
A $1M per claim / $3M aggregate program is common in Georgia.
Whether the entity shares those limits with its physicians, or carries separate limits of its own, changes what's actually available when one event names the practice and the treating physician together.
Generally covered
✓Negligent acts, errors, and omissions in rendering care
✓Defense costs against covered allegations, typically to final judgment
✓Damages you become legally obligated to pay, up to policy limits
✓Defense against intentional-conduct allegations, until final adjudication or admission
Coverage boundaries
What medical malpractice insurance does not cover
Malpractice policies exclude intentional wrongdoing, criminal acts, and fraud. That's accurate, but incomplete, and the incomplete version is what gets physicians into trouble.
Most forms still defend you against an allegation of intentional conduct until there is a final adjudication or an admission. Defense is often afforded even where indemnity is not. Allegations of sexual misconduct are usually not excluded outright, but sublimited well below the policy limit, sometimes with defense costs counting inside that sublimit.
The exposures that most often fall outside a malpractice policy are the ones nobody thought to ask about:
✓Billing and coding allegations
✓Stark and Anti-Kickback matters
✓Licensing board investigations
✓HIPAA and cyber events
✓Medical directorship duties
✓Clinical trial work
✓Telemedicine across state lines
✓Moonlighting or locum tenens assignments
Each has a coverage answer. None of it is automatic.
The right question isn't just whether you have malpractice insurance. It's whether the program around it accounts for how your practice actually delivers care.
The most consequential choice
Claims-made vs. occurrence, and the retroactive date
An occurrence policy responds to incidents during the policy period, whenever the claim is later reported, using that year's limits. It stays attached to that policy year permanently, but it's become harder to find in physician malpractice and generally costs more.
A claims-made policy responds to claims first reported during the policy period, provided the act occurred on or after the retroactive date. The incident does not have to happen during the policy period. That's the opposite of how it's commonly described, and physicians who believe the common version make poor decisions at transition.
What the retroactive date actually protects
The retroactive date is the earliest date of patient care your current policy reaches back to cover. Reset it to inception when you change carriers, and years of prior care become uninsured without anyone noticing.
Retroactive date
First day continuously insured on a claims-made basis. Care before this line is uninsured if reset.
Today
Current policy period. A claim reported now is covered back to the retroactive date.
We check the retroactive date on every claims-made policy we review. It's one line on a declarations page, and it's the most common serious error we find.
Two solutions to one problem
Tail coverage and prior acts coverage
When a claims-made policy ends, the reporting window closes with it. Incidents that already happened stay exposed. There are two ways to close that gap, and most summaries mention only one.
From the carrier you're leaving
Tail coverage
An extended reporting period endorsement that holds the reporting window open for incidents that occurred before the policy ended. An unlimited reporting period is materially better than a time-limited one.
Pricing generally runs ~250% of the mature claims-made premium, not whatever a physician still moving up the step-rating schedule happens to be paying today.
Many carriers waive the charge entirely on death, disability, or retirement once a physician satisfies an age and tenure test, a provision few physicians know exists until they need it.
From the carrier you're joining
Prior acts coverage
Also called nose coverage. The incoming carrier accepts your existing retroactive date and assumes the prior exposure, rather than resetting it at inception.
It's frequently the better and less expensive answer, and available more often than physicians expect.
Which route makes sense depends on the carriers involved, your years of maturity, and where you sit on the step-rating schedule. We work that math before the decision, not after it.
Solvency
Not all carrier paper carries the same backstop
Financial strength ratings are the starting point, not the finish. Coverage written by an admitted carrier sits behind state guaranty fund protection if that carrier fails. Coverage written by a surplus lines insurer or a risk retention group generally does not.
For a physician whose claim may not be reported for years, the solvency of the paper is part of the coverage analysis. We say so out loud, including when the non-admitted option is the right one.
Who we serve
Malpractice exposure looks different across healthcare
Hospitals and integrated health systems
Physician group practices and hospital-based specialty groups
Senior living, long-term care, home health, and hospice
Physician and allied health staffing organizations
Behavioral health providers
Ambulatory surgery centers and rehabilitation providers
Managed care organizations, where the exposure is managed care E&O rather than clinical malpractice
Ongoing
What happens after the policy is bound
Placement is the beginning of the engagement. On a malpractice program, the years between placements are where the relationship either proves out or doesn't.
Claims advocacy
Advocacy and monitoring for the life of every open claim.
Risk management
Loss prevention support built around your actual exposures.
Contract review
Contract and coverage review as your agreements change.
Regular contact
Check-ins that don't wait for renewal season to happen.
Request a program review
Send your current declarations page, or just tell us what's ahead.
We'll tell you where your retroactive date sits, whether your defense costs are inside or outside your limits, what your tail obligation would cost today, and whether your limits still match your exposure. If your current program is sound, we'll say that too.
