“7 Biggest Mistakes MD’s Make in their Medical Malpractice Insurance Coverage” contains many tips on what to avoid, information on choosing Risk Retention Groups, how to deal with insurance brokers, and industry insurance terms that doctors should know.

1. 7 Biggest mistakes MD’s make Withtheir Medical Malpractice Insurance including assuming cosmetic procedures are Covered Presented By : William D. Dyer, President HCP National Insurance Services, Inc. “We are the Health Care Industry’s Insurance Broker” www.hcpnational.com

2. THE 7 BIGGEST MED MAL MISTAKES Performing procedures that you are not covered for, and/or neglecting to state the procedures you are performing in the Medical Malpractice application procedure list. The insurer may deny or cancel your coverage for the false statement.

3. THE 7 BIGGEST MED MAL MISTAKES To avoid the denial of coverage or cancellation, take your time and read every line on the form. The procedure(s) that you mark are the only procedure(s) that the insurer is covering.

4. THE 7 BIGGEST MED MAL MISTAKES Do NOT deviate unless you contact your insurer prior to doing the new procedure(s), and obtain writtenconfirmation that it is now covering you. Never assume anything. If you have any questions—ask!

5. THE 7 BIGGEST MED MAL MISTAKES Beware of Surgical Brokers, who are professional marketers on the Web hustling to attract patients for cosmetic procedures. The patient assumes the surgical broker’s site is a real doctor’s site and will correspond with the surgical broker telling him/her what he/she wants done. The surgeon is now exposed to vicarious liability, where you are sued since a patient can logically assume that you are related businesses,and thus part responsible for anything the surgical broker says or does.

6. THE 7 BIGGEST MED MAL MISTAKES 3. You are your Brother’s Keeper. Think carefully about renting space to another MD., or hiring one. Having separate names on the door and business cards does not protect you from the public assuming that you have related entities. This is called vicarious liability.

7. THE 7 BIGGEST MED MAL MISTAKES Example

8. THE 7 BIGGEST MED MAL MISTAKES 4. Not maintaining your retro date when changing insurers or not buying tail . . . gaps cost more in the long run. Most medical malpractice insurance is claims made, which means the coverage has to be made on, or after the retroactive date and while the policy is current.

11. THE 7 BIGGEST MED MAL MISTAKES Result: His coverage is denied for something that happened on 11/06/05 involving the birth of a child, since he dropped his retro date. A year later he tries to apply to the Standard malpractice market to save money. The Standard Market is comprised of Medical Malpractice insurance companies that are regulated by the government and offer the lowest prices insuring only MD’s with favorable risk profiles and have normal practice patterns. (i.e. TDC, Med Pro and Norcal in California). When the Standard Insurer sees that he has dropped his 09/07/05 retro date they decline to insure him.

13. THE 7 BIGGEST MED MAL MISTAKES The following things are what you should communicate and expect from your broker: Beware of doing business with an unscrupulous broker who preys on your “got to have the cheapest deal syndrome.” He will cut your coverage to provide the cheapest deal. You will not know this until you have an uncovered claim or worse. Hire one broker. More brokers do not help, they hurt you since one broker will say one thing about your risk to an insurer and another will saysomething else. Ask for quotes or decline letters from all the malpractice insurers. We submit our Non Standard malpractice clients to the Standard market every year and sometimes they get in within the 1st try or the 6th try. Regardless of however many tries, it is worth it when they do get in. We met an FP OB paying 147k a year in the Non Standard market. We got him accepted by a Standard Insurer for 45k. His broker did not even submit him to the standard market.

14. If you are in the Standard market, ask your broker each year if any of the other Standard Insurers have lowered their rates. Otherwise, stay put! You have the best deal. Note: Standard insurance companies rarely change their rates. THE 7 BIGGEST MED MAL MISTAKES Ask your broker to give you a list of insurers that he/she will shop for you. 5 or 6 should be fine. If he/she is a pro then he/she will know the best deals for your specialty and risk profile. If you are in the non Standard market, ask your broker to shop for all the Standard Insurers till you are accepted by one.

16. A’s only A-, A, A+, A++

17. Never B category or lower, they tend to go out of business, not worth the risk

20. Insureds or policyholders who have banded together to form a federally chartered insurance company to share risk with each other.

21. Regulated by the federal government and are exempt from state regulation.

22. Federal law requires that they be licensed in one state (state of domicile).

24. Each policyholder has joint and several liability for the risks assumed and the losses developed by the RRG.

25. If premiums collected are inadequate to pay claims, each member is assessed.

26. i.e. If the RRG is short 10 million dollars and you are one of the 500 members of the RRG, you must pay on demand $20,000 on top of the premiums you already paid. This is made explicit under Federal law, and the amount of assessment is unlimited.

27. Groups may say that they are not assessable, but this is not accurate. If the premium is inadequate to pay losses:

28. Members may pay “voluntary assessments” to offset premium shortfall or

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