26
Olivia GiaQuinta 01/11/2014 Resident Symposium Follow us on Twitter: @MedProDental
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 BA
SICS
DEN
TIST
S G
ET
SUED
?POLL
When do you need coverage?
ResidentMoonlighting
Private PracticeWorking Interview;Individual Coverage
MilitaryMoonlighting
KEY
TAKE
AWAY
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. TA
IL C
OVE
RAG
ECO
MM
ON
REA
SON
S
LET’
S CO
MPA
REOccurrence coverage
Claims-made
coverageCertainty &
Simplicityx
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 yearsPO
LICY
LI
MIT
S
Follow us on Twitter: @MedProDental
CASE
STU
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
POLI
CY 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
POLI
CY
LIM
ITS
CON
SEN
T TO
SET
TLE
Pure Consent“will not
compromise any claim
hereunder without
the consent of
the Insured.”
Common Exceptions Unreasonable
“Hammer”
Binding Arbitration
Board Approval
No Longer Insured by the Company
CON
SEN
T TO
SET
TLE
CASE
EXA
MPL
E #
1aInsured:
Patient:
Procedure:Allegation: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 $100KCASE
EXA
MPL
E
Sett
lem
ent:
W
hat’
s th
e bi
g de
al?
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
SICS
What is Claims Defense?A team of defense attorneys
(dental specific) and expert witnesses committed to protecting your
reputation, license, and assets.THE
BASI
CS
• 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
Who
is
Med
Pro?
• We offer PURE consent to settle.
• We have specialized Risk Management and Claims Teams.
NU
MBE
RS
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.
THAT
MAT
TER
Policy Types: Occurrence & Claims-made
Policy Limits: $2 million / $4 million
Consent to Settle: Pure Consent
Risk Management & Claims Team: Dental SpecificKE
Y TA
KEAW
AYS
Student Video Submissions
Malpractice 101
YouT
ube
Sausha Toghranegar (D4 @ Nova) submitted this YouTube video last year which was purchased by
MedPro.VIDEO
