26
Olivia GiaQuinta 01/11/2014 Resident Symposium Follow us on Twitter: @MedProDental

Olivia GiaQuinta 01/11/2014 Resident Symposium Follow us on Twitter: @MedProDental

Embed Size (px)

Citation preview

Olivia GiaQuinta01/11/2014

ResidentSymposium

Follow us on Twitter: @MedProDental

What is Malpractice?Professional negligence by act

or omission by a health care provider in which care provided

deviates from accepted standards of practice in the

dental community and causes injury or death to the patient.

TH

E B

AS

ICS

DEN

TIS

TS

GET

SU

ED

?POLL

When do you need coverage?

ResidentMoonlighting

Private PracticeWorking Interview;Individual Coverage

MilitaryMoonlighting

KEY

TA

KEA

WAY

SPolicy Types: Occurrence & Claims-made

Policy Limits: $2 million / $4 million

Consent to Settle: Pure Consent

Risk Management & Claims Team: Dental Specific

Occurrence CoverageResponds to

claims based on when the dental

treatment occurred.

Responds to claims based on when the claim is filed against you.

Claims-made Coverage

Dental treatment 2012

Claim is filed 2014

2013

Residency Become a specialist after practicing for 4 years.

Leave of Absence Raise a family, poor health, medical mission trip, etc.

Claims Activity High claims activity, required to enter into

Excess and Surplus.

Relocation Move to a state where the carrier is not licensed.

Trends Join/leave a chain or franchise that provides coverage.

Faculty Leave private practice and work for a university. T

AIL

CO

VER

AG

EC

OM

MO

N

REA

SO

NS

LET’S

CO

MPA

RE

Occurrence coverage

Claims-made

coverage

Certainty & Simplicity

x

Portability x

Tail Coverage Included

x

Multiple Limits x

Cost x x

2M/4M

2M/4M2M/4M

2M/4M

2M/4M

2M/4M

2M/4M

2M/4M

2M/4M

Occurrence Coverage

2M/4M2M/4M

Claims-made Coverage

*Limits available after 10 yearsP

OLIC

Y

LIM

ITS

Follow us on Twitter: @MedProDental

CA

SE S

TU

DY

Follow us on Twitter: @MedProDental

Defendant • 48 year old dentist in Pennsylvania• Substance abuse problem• Voluntarily enters rehabilitation for a period of 120 days• Patients seek care in other offices during his absence

Allegation• Effects of practicing while impaired become evident• 8 Malpractice lawsuits are filed in one year

Concern• Limts: $500,000/ $1,500,000 • Exceeds aggregate limit? • Defense tries to keep settlements within policy limits, to

protect doctors assets

PO

LIC

Y L

IMIT

S$2 million / $4 million$5 million / $7 million

$250k / $750k (Indiana)$100k / $300k (Louisiana)

Occurrence Limit / Annual Aggregate Limit

Considerations:• Type of practice• Specialty vs. General• Venue of practice• Comfort zone of doctor• Years in practice, and

accumulated wealth • Tort environment and

trends

PO

LIC

Y

LIM

ITS

CO

NS

EN

T T

O S

ET

TLE

Pure Consent

“will not compromi

se any claim

hereunder without

the consent of

the Insured.”

Common Exceptions Unreasonable

“Hammer”

Binding Arbitration

Board Approval

No Longer Insured by the Company

CO

NS

EN

T T

O S

ET

TLE

CA

SE E

XA

MP

LE

#1a

Insured:

Patient:

Procedur

e:

Allegatio

n:

Result:

General Dentist

28 year-old female

Third Molar Extraction

Improper surgical technique; lack of informed

consent; failure to refer to an oral surgeon

Alleged permanent disability due to left lingual

nerve injury and chronic pain.

Paintiff Seeking:

• $120K Past medical expenses

• $250K Future medical expenses

• $750K Past and future lost income

• $500K General damages (pain,

suffering, disability, alleged inability

to have children)

• Willing to Settle for $100KCA

SE E

XA

MP

LE

Sett

lem

en

t:

Wh

at’

s t

he b

ig

deal?

Fulton County

Jury Verdict:

• General Dentist cleared of negligence charges

What is Risk Management?

Resources (courses and people) to help keep you out of the

courtroom and in your office working, where you belong.TH

E

BA

SIC

S

What is Claims Defense?

A team of defense attorneys (dental specific) and expert witnesses

committed to protecting your reputation, license, and assets.TH

E

BA

SIC

S

• We are the company who started it all in 1899.

• Berkshire Hathaway - Warren Buffett

• We offer the broadest coverage- Occurrence- Claims-made- Convertible claims-made

• Industry’s highest financial ratingsA++ from A.M. Best

Wh

o is

Med

Pro

?

• We offer PURE consent to settle.

• We have specialized Risk Management and Claims Teams.

NU

MB

ER

S

95 %How often MedPro wins when a claim goes to trial.

80%Dental cases filed against MedPro insured

that closed with no loss payment.99%

MedPro insureds are pleased with our claims service after we’ve defended them.

400k +Malpractice claims MedPro has managed since 1899.

25Average number of years MedPro claims managers

have in the healthcare liability industry.0

Exceptions to our consent to settle provision.1899

Malpractice insurance was inventedby the same physicians who founded MedPro.

TH

AT M

AT

TER

Policy Types: Occurrence & Claims-made

Policy Limits: $2 million / $4 million

Consent to Settle: Pure Consent

Risk Management & Claims Team: Dental SpecificK

EY

TA

KEA

WAY

S

THANK YOU!Follow us on

Twitter:@[email protected]

260.442.1806

Student Video Submissions

Malpractice 101

You

Tub

e

Sausha Toghranegar (D4 @ Nova) submitted this YouTube video last year which was purchased by

MedPro.

VIDEO