Topics will include:
• Do you know the difference between Occurrence vs. Claims Made policies?
• Sexual Molestation/Abuse Coverage...Are you protected?
• HIPAA notices and Board Complaints...How to navigate
1. K N O W Y O U R P R O F E S S I O N A L I N S U R A N C E
C O V E R A G E
H O W A R E Y O U P R O T E C T E D ?
H O W W O U L D Y O U R P O L I C Y R E S P O N D I N T H E
E V E N T O F A C L A I M ?
1
Become an Educated Insurance
Buyer
3. 3
Thomas Van Wagner, founder of the Van Wagner Group, always had strong ties to the addiction treatment field. He
was in recovery starting in 1968 and was an advocate to the field in many ways.
He was a founder of the Friends of Long Island Council on Alcoholism; has served as president of the New York State
Council on Alcoholism and was a board member of the National Council on Alcoholism and Drug Dependence.
He continued to organize and participate in many fund raising activities for the field until his retirement in 2004.
Tom’s insurance background began in lower Manhattan. He is proud that he was able to combine his vocation and
avocation into an agency that helps people who are in the business of helping others.
Although Tom is retired and is no longer working with The Van Wagner Group, he leaves the Professional Liability
insurance program he helped to create and refine for over 20 years as his legacy. The program provides
comprehensive professional liability insurance to all mental health professionals, including students, peer recovery
specials and individual drug and alcohol counselors all at an affordable cost.
The Van Wagner Group was acquired by SterlingRisk in 2004. SterlingRisk is a top national insurance brokerage that
has helped the Van Wagner Group expand its ability to serve the needs of the addiction treatment industry.
5. 5
A Company You Can Count On
For 35 years, Great American Insurance Group has provided insurance solutions to the human and social service marketplace.
Over the years, they have expanded coverage and services to ensure that they are experts who can meet the evolving needs of this
marketplace.
Great American Insurance Group’s roots go back to 1872 with the founding of its flagship company, Great American Insurance Company.
Based in Cincinnati, Ohio, the operations of Great American Insurance Group are engaged primarily in property and casualty insurance,
focusing on specialty commercial products for businesses, and in the sale of traditional fixed and indexed annuities.
Great American Insurance Company is currently rated “A+” (Superior) by A.M. Best, and has received an “A” (Excellent) or higher
rating from the A.M. Best Company for more than 100 years.
The members of the Great American Insurance Group are subsidiaries of American Financial Group, Inc. AFG’s common stock is listed
and traded on the New York Stock Exchange under the symbol AFG.
A.M. Best rating affirmed March 20, 2015.
Why make the switch?
6. 6
Three Separate Coverage Parts and Limits in One Policy
1. Professional Liability Insurance
2. Commercial General Liability
3. Abuse or Molestation Coverage
Avoids any erosion of primary limits by
maintaining three separate silos of coverage
7. 7
Broad Definition of “Professional Services”
• Professional Services includes any service that involves specialized
education, knowledge, labor, judgment and skill that is
predominately mental or intellectual
• Our coverage is not limited to professionals who achieve a cap and
gown
• Before a loss occurs, our coverage form is explicit about who is
covered and who is not
8. 8
Professional Liability
Is the policy “Occurrence” or “Claims Made”
This is probably the most important coverage feature to understand.
Occurrence coverage
• With this coverage it does not matter when a claim or suit is reported, the policy will apply as
long as the injury or damage sustained was during the policy period.
• The premium will typically not vary year by year on an occurrence form policy.
Claims-Made Policy
• This coverage will only cover claims reported while the policy is in effect provided the injury or
damage occurred after the retroactive date.
• If a claim is reported after the expiration date of a policy there would need to be a “tail coverage”
in place in order for that claim to be covered.
• Claims-Made policy premiums vary over the first five years.
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What is Tail Coverage, or an Extended Reporting Period, and why is this necessary?
“Tail Coverage” extends the amount of time insureds can report a claim after
the expiration date and can typically cost up to 175% of premium.
The extended reporting period extends the amount of time you can report a
claim that occurred back during your claims made coverage dates.
You would need to purchase the extended reporting period if you choose not
to renew your coverage, retire, or your coverage will lapse.
There is a real need for tail coverage in the event your carrier decides to non-
renew your coverage due to claims history or decides to non-renew the
program entirely.
What is a retroactive date? Does my policy have one?
Policies written on a Claims-Made basis contain a specific date on which
coverage begins (commonly known as the “retroactive date”) and provides no
coverage for claims arising out of occurrences that take place prior to this
date.
10. 10
1. No need to buy the costly Tail Coverage or an Extended Reporting Endorsement
2. Premiums will not increase year by year for the “first five years”
3. You have built up experience with Van Wagner
11. 11
A former client alleged a professional misconduct three years ago.
* With a Claims Made form the policy must be in force when the claim is filed and the
retro date must go back further than the date of the incident. With an Occurrence form
all you need is to have a policy in force.*
12. 12
$-
$100
$200
$300
$400
$500
$600
Year 1 Year 2 Year 3 Year 4 Year 5 Tail
Occurrence
Claims Made
Premium Occurrence Claims Made
Year 1 $300 $180
Year 2 $300 $230
Year 3 $300 $260
Year 4 $300 $290
Year 5 $300 $300
Tail $- $500
Total Premium $1,500 $1,760
Occurrence vs Claims Made
13. 13
Professional Liability Loss Scenarios
a. Your patient has a relapse and her
parents claim that it’s your fault.
b. Your patient loses their job after you
advised them to “stand up” to their boss
c. A patient alleges that you touched them
inappropriately during your session.
14. 14
Abuse or Molestation
Individuals and corporate counselors often provide care and other services to vulnerable
clients, such as children, elderly adults and the developmentally challenged.
These clients and the agencies that serve them need to have insurance protection
regarding damages from any form of abuse, not just sexual abuse or vicarious liability.
Our Abuse or Molestation coverage limits are provided separately from the
Professional and Commercial General Liability coverage parts. This is an important
feature because other insurance industry abuse coverage forms often reduce the amount
of insurance limits available to pay for Professional or General Liability losses.
In addition, our Abuse or Molestation form provides claim and legal defense
expenses outside the coverage limits. This feature is significant because abuse or
molestation related claims may require the hiring of experts and specialized legal
representation which can be very costly.
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The Moment of Truth: Abuse and Molestation
The moment of truth for an insured happens when a claim occurs.
You ask yourself, “Did I purchase the right coverages for my self and/or organization’s
abuse exposure, and did I purchase insurance from a sound and reliable insurance
company?”
Abuse and Molestation is an often misunderstood coverage and frequently purchased with
minimal coverage limits.
For social services and health care, especially those working with children or vulnerable
adults, this can be one of the most needed coverages.
In an abuse claim, your reputation is at stake as well as your financial stability.
Abuse claims can be very costly when it comes to defending the claims and paying any
damages or settlements.
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Van Wagner Product Offerings:
Professional Liability with a broad definition of professional services
• The policy also covers those with specialized knowledge, not just degree professionals.
• Professional Liability is available for full-time counselors and students as well as at a
discounted rate for those working part-time.
• Limits are offered at $1 million each incident / $3 million annual aggregate and up to $2
million per incident / $7 million annual aggregate when required by state, contract, or for
those who just want higher limits. (Cost: $25)
A Signature General Liability Broadening Endorsement with:
• Increased medical payments and property damage extension or coverage for damage to
premises rented to you.
• Personal and Advertising Injury included.
Abuse or Molestation with limits of $100,000 each act of abuse / $100,000 aggregate. Defense
expense outside limits.
Additional Insured – Automatic status when required by contract (Example: Landlord)
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Van Wagner Product Offerings
continued:
Allied Health Professional Plus Endorsement
• Peer Review
• $25,000 / $50,000 Administrative Defense of HIPAA Notification Cost.
• Our definition of a complaint is audit, investigation, ADM proceedings, arbitration, claim, civil
lawsuit or legal action brought against you by any person, entity, or federal, state or local
agency.
• Also covers complaint brought by health care insurance company to determine if fees you have
charged as resolvable and proper.
LLC, PC, Inc., S. Corp
• This applies to sole owners/members of a Corporation or LLC when the owner/member is the
only person providing services and there are no employees or any other individuals providing
services on behalf of the Corporation or LLC.
• If you don’t have employees then this coverage is important for you.
• If you carry only an individual policy and your corporation is named in a claim or suit, you
will not have protection for the action against your corporation.
• This is covered at no additional premium, provided you are the sole owner and sole
employee.
18. 18
Van Wagner Product Offerings
continued:
Education Programs such as:
• Abuse Prevention
• Slip and Fall Elimination Program
• Social Networking Safety
Newsletter and Brochure
Our easy automatic renewal and pay on-line access
E Learning webinars such as today’s. Let us know suggestions for future topics!
Van Wagner Website:
www.vanwagnergroup.com
or
www.insure-addictioncounselor.com
1(800) 735-1588