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Q: What does DiederichHealthcare do for me? A: Discover why so many physicians look to DiederichHealthcare for their professional liability insurance solutions. DiederichHealthcare has been a leading provider of professional liability insurance for physicians for more than thirty years. Our goal is to deliver cost effective, quality insurance protection to our physician clients. The highly acclaimed staff of DiederichHealthcare understands the difficulties physicians are experiencing. Moreover, they work diligently for physicians to develop solutions. It is important for you as a prospective physician client to understand exactly what we can do for you. DiederichHealthcare provides consultation on which coverage from any
carrier which offers professional liability insurance to physicians.
This allows us to focus on developing a program which bests suits your
individual needs as compared to only offering one carrier. This eliminates
many of your hassles by providing you the opportunity to explore all
options by using us as a single source. DiederichHealthcare, prior to each policy renewal, and more frequently based on market/situational changes, reviews each account and policy by conducting a thorough analysis of the physician client’s policy(s) to determine options for renewal coverage. These options are then presented to the physician with our recommendation. This is accomplished prior to renewal in order to avert last minute decision making.
Q: Are all medical malpractice policies essentially the same? A: No, there can be significant differences in coverage, i.e., coverage availability for ancillary personnel, sexual misconduct, defense for Medicare/Medicaid fraud, etc.
Q: What are Missouri 383’s and similar programs in other states? A: In general, some states have legislation that allows small groups of physicians to create insuring entities to provide coverage to physicians, and, in some cases, other healthcare professionals. In Missouri this legislation is known as Chapter 383 of the Missouri Statutes. DiederichHealthcare closely monitors such developments. As an example, DiederichHealthcare disseminated information to physicians in Missouri alerting them to issues and concerns. This was a vital service to these physicians. Careful review by all physicians is encouraged as these types of programs are being marketed under various names in a number of venues. This has created alarming concern regarding the long term viability and stability of these insuring entities. Tremendous potential implications exist for physicians who elect coverage with these entities and are later left to seek alternative coverage. To view a copy of the communication disseminated to the physicians of Missouri which includes a legal review by the in-house Chief General Counsel of DiederichHealthcare click here: www.diederichhealthcare.com/pages/383.
Q: What's the difference between occurrence and claims-made coverage? A: Occurrence policies cover claims on the basis of when they are incurred regardless of when they are reported. For example, an occurrence policy written for 1997 covers only claims arising out of incidents which occur in 1997 irrespective of when the claim is actually made. Claims-made policies cover claims on the basis of when they are reported. For example, a claim that is incurred in 1997 but is not reported until 1999 will be covered under the claims-made policy issued for 1999 (assuming the policy is continuously in force with a prior acts date of 1997 or previous).
Q: What is prior acts coverage? A: Provides coverage for claims which arose from the prior acts of the policyholder while insured with the previous claims-made carrier and eliminates the need to purchase a reporting endorsement (tail coverage) upon cancellation of claims-made coverage with another company. Do not purchase tail coverage in order to transfer from one company to another without first contacting DiederichHealthcare to determine if it is required and/or the most cost-effective method of providing continuous coverage.
Q: What is reporting endorsement or "tail" coverage? A: This coverage, if purchased or obtained at no charge for death, disability, or retirement, permits you to continue reporting claims for the years you were insured. For example, if you had claims-made coverage in 1996, but canceled it in 1997, then in 1998 a claim is made against you for an incident that occurred in 1996 you would be protected for this claim by your past policy only if tail coverage was obtained.
Q: What information does a malpractice insurance company report to the National Practitioner Data Bank? A: Each entity that makes a payment on behalf of a physician, dentist or other health practitioner in settlement of, or in satisfaction in whole or in part of a claim or judgment against that practitioner, must report the payment to the Data Bank. Medical malpractice payments are limited to exchanges of money and must be the result of a written complaint or claim demanding monetary payment for damages.
Q: How do some company's premiums seem much lower than others? A: In
most cases large differences in premiums exist because the physician
simply does not have coverage with the right carrier for their specialty.
Various companies prefer different specialties as a result of their
success in defending claims for those particular specialties. When
a physician elects coverage with the company best suited for that physician’s
specialty and geographical location, it results in very competitive
premiums. DiederichHealthcare matches each physician to the company
that best meets this criteria, from among those companies that are
established in your area. This sometimes means there are companies
that we will not recommend even when their premiums are lower. You
will find that upon receipt of a proposal if this has occurred the
listing of company premiums will include companies with premiums lower
than that recommended. A complete explanation will be included. In
the event you wish to obtain coverage with a company, notwithstanding
our recommendation, we can always provide coverage. Q: What is Medical Malpractice? A: Malpractice is another word for “negligence” which means that a health care provider did not measure up to the standard of care expected of reputable and careful health care providers under similar circumstances. If the malpractice caused harm, a lawsuit or claim may be filed to recover damages for the harm that was suffered. Q: Who are Health Care Providers? A: Health Care Providers are the people and institutions involved in the “healing arts.” Included in the definition are medical doctors, podiatrists, chiropractors, nurses, physician assistants, midwives, optometrists, dentists, psychologists, pharmacists, physical therapists, hospitals, clinics, and health maintenance organizations (HMOs). Q: What is the Medical Standard of Care? A: Health care providers are required to use that degree of learning and skill ordinarily used under similar circumstances by reputable and careful members of the profession. If, for example, a surgeons actions are questioned, another surgeon must testify that the doctor being sued failed to do something that he should have done, or did something which he should not have done. Q: Why are Expert Witnesses necessary? A: If the subject matter is not commonly understood by ordinary people, then evidence may be offered by someone with specialized knowledge and experience. This person is called an “expert witness.” In most medical malpractice cases, the plaintiff cannot prove the case unless an “expert” testifies regarding the issues of “standard of care” and “causation.” A: Causation means that the incorrect actions of the health care provider probably led to or contributed to the injuries and damages suffered. For example, if an emergency room doctor did not quickly examine a patient, it could be a life-or-death situation. However, if the patient would have died, regardless of anything a doctor might have done, then there would be no “causation,” even if the doctor delayed his examination. Another example of “no causation” would be a person who receives an incorrect prescription from the pharmacist and realizes the mistake before she takes the medicine. However, if the medicine were actually taken, and harm resulted, there is “causation.” Q: Why does Causation have to be proven be a Probability and not a Possibility? A: To prove a medical malpractice case, it must be probable that the incorrect treatment caused the harm. In this context, “probability” means that it is “more likely than not” that the treatment caused the harm. The plaintiff must prove that there was more than a 50% Q: What damages can be recovered in Medical Malpractice Cases? A: Damages are divided into two categories: economic and non-economic. Economic damages include out-of-pocket losses that have ascertainable monetary value, such as lost earnings and medical bills. If the loss can be replaced with money, it is “economic.” Noneconomic damages are typically known as “pain and suffering” damages. It is compensation for physical impairment or disability, or the diminished enjoyment of life caused by the malpractice. If the malpractice resulted in a patient’s death, the damages include compensation for the lost financial support that the spouse and family would have received, and compensation for the loss of the decedents care, comfort and love. |
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