New Yorks Changing Malpractice Insurance Marketplace Presented by Gabrielle Lamb, Vice President of Business Development at PriMed Consulting.

New York’s Changing

Malpractice Insurance

MarketplacePresented by Gabrielle Lamb, Vice President

of Business Development at PriMed Consulting

Standard Market

• MLMIC

• PRI

• MMIP

• HIC

• Academic

MLMIC

• Medical Liability Mutual Insurance Company (MLMIC): MLMIC is the oldest and largest carrier in the State. MLMIC is an admitted carrier, hence physicians insured through MLMIC have the State Guaranty Fund to protect them in case of insolvency of the carrier. In addition, MLMIC insured physicians may be eligible for the Section 18 Excess Insurance program for $1/3 Million in coverage that is provided at no cost to physicians.

PRI

Physicians Reciprocal Insurers is the 2nd largest medical malpractice insurance carrier in the state of New York. Like MLMIC, they offer the security of the guarantee fund and free excess to those who qualify

HIC

• Hospitals Insurance Company, Inc. has a long standing relationship with the FOJP hospitals and will provide their attendings with coverage.

Standard Market Carriers

• Pros

• Free excess coverage

• Guarantee fund protection

• Cons

• Slot rating

• No flexibility on premiums/discounts

RRG

What is a Risk Retention Group?

A Risk Retention Group (RRG) operates under the auspices of the Federal Risk Retention Act (RRA) of 1986. Please keep in mind that the coverage being offered is through a risk retention group, which is not subject to all of the insurance laws and regulations of your state and as such is considered an un-admitted carrier.

Pros & Cons

Pros

• Significant savings for groups and hospitals

• Hands on and customized risk management solutions

• Aggressive claims handling

Pros & Cons

Cons

• No guarantee fund ★ Financial Stability is key

• Excess limits must be purchased

• Hospital acceptance

Carriers

• MedPro RRG

• AMS

• Oceanus

• Doctors & Surgeons

• Care

• Fairway

AMS

Applied Medico-Legal Solutions:Since 2003, AMS RRG has been providing medical liability insurance to a growing number of physicians across a broad range of specialties, and today we are one of the nation’s premier physician risk retention groups.

Our stable, flexible, cost-effective medical liability insurance options now protect over 2,500 members.

The risk retention group model ensures our physician-owner interests are aligned with the company’s

AMS RRG’s continued financial strength rewards shareholders with tangible benefits

Our physician-led underwriting process delivers more accurate risk assessments and customized insurance programs

All member claims assistance and defense is provided by a staff of attorney adjusters

MedPro RRG

• Jonathan Lazar MBA, CPCU Marketing Manager

• Overview of the Medical Protective RRG

MedPro

Medical Protective

• Reinsurer of MedPro RRG

• The nation’s oldest and strongest healthcare in malpractice

• Currently insures more than 120,000 healthcare providers nationwide

• Rated A++ (Superior) by A.M. Best

• Owned by Berkshire Hathaway

• www.MedPro.com

Princeton Insurance (NJ)

• Service provider to MedPro RRG NY hospitals and physicians

• Rated A++ (Superior) by A.M. Best

• Owned by Berkshire/Medical Protective

• Previously owned by MLMIC

• 9,000+ physicians, 29 hospitals/health systems

• Known for personalized customer service and customized risk programs

MedPro RRG Risk Retention Group

• Rated A++ (Superior) by A.M. Best

• No capitalization costs

• No possibility of premium assessments

• Full consent-to-settle provisions

• Expert local defense counsel specializing in New York healthcare malpractice claims

Benefits of this approach

• The right structure for New York, allowing risk-specific pricing and tailored coverage alternatives

• The national expertise of Medical Protective, backed by Berkshire Hathaway’s unparalleled financial strength

• The local support of Princeton Insurance, with past New York affiliation and knowledge of medical professional liability in our founding “DNA”

Claims

Over 400,000 claims resolved

Supplementing local defense lawyers with national reach and expertise for experts and other resources

Past decade:

1. 90% trial win rate

2. 80% closed without payment

3. 99% overall customer satisfaction

Underwriting.

•First Dollar Coverage

• Excess Coverage

• Deductibles and Self-Insured Retentions (SIRs)

• Reinsurance

• Performance-Based Risk Sharing

• Loss Portfolio Transfers (LPTs)

• Employed Physician Programs

Risk Management

• Risk management philosophy: To recognize hospitals and health systems as their own first and best risk manager and to come alongside them as a seasoned expert, a resource and trusted partner in order to improve patient outcomes and reduce loss.

• MedPro offers a data-driven, collaborative risk management services

Why PriMed

• PriMed is an independent medical malpractice insurance agency. We work with all NY carriers and help our clients to find the best fit for their needs; along with those of their group and hospital.

Summary

• Market is changing to meet the needs of the changing healthcare industry.

• More options than in the past

Q&A

• Questions???

Thank you NYSAMSS!

Gabrielle Lamb

PriMed Consulting

www.primedconsulting.com