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Resident Symposium. Olivia GiaQuinta 01/11/2014. Follow us on Twitter : @ MedProDental. What is M alpractice ?.
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ResidentSymposium Olivia GiaQuinta 01/11/2014 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. THE BASICS
POLL DENTISTS GET SUED?
When do you need coverage? Private Practice Working Interview; Individual Coverage Resident Moonlighting Military Moonlighting
Policy Types: Occurrence & Claims-made Policy Limits: $2 million / $4 million Consent to Settle: Pure Consent Risk Management & Claims Team: Dental Specific KEY TAKEAWAYS
Dental treatment 2012 Claim is filed 2014 2013 Occurrence Coverage Claims-made Coverage Responds to claims based on when the dental treatment occurred. Responds to claims based on when the claim is filed against you.
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. TAIL COVERAGE COMMON REASONS
*Limits available after 10 years 2M/4M 2M/4M 2M/4M 2M/4M 2M/4M 2M/4M 2M/4M POLICY LIMITS 2M/4M 2M/4M 2M/4M 2M/4M Occurrence Coverage Claims-made Coverage 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 CASE STUDY Follow us on Twitter: @MedProDental
$2 million / $4 million $5 million / $7 million $250k / $750k (Indiana) $100k / $300k (Louisiana) POLICY LIMITS 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 POLICY LIMITS
Pure Consent “will not compromise any claim hereunder without the consent of the Insured.” CONSENT TO SETTLE
Common Exceptions Unreasonable “Hammer” Binding Arbitration Board Approval No Longer Insured by the Company CONSENT TO SETTLE
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. • Insured: • Patient: • Procedure: • Allegation: • Result: CASE EXAMPLE #1a
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 $100K CASE EXAMPLE
Fulton County Jury Verdict: Settlement: What’s the big deal? • General Dentist cleared of negligence charges
What isRisk Management? Resources (courses and people) to help keep you out of the courtroom and in your officeworking, where you belong. THE BASICS
What isClaims Defense? A team of defense attorneys (dental specific) and expert witnesses committed to protecting your reputation, license, and assets. THE BASICS
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 Who is MedPro? • We offer PURE consent to settle. • Industry’s highest financial ratings • A++ from A.M. Best • We have specialized Risk Management and Claims Teams.
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. 25 Average number of years MedPro claims managers have in the healthcare liability industry. 0 Exceptions to our consent to settle provision. 1899 Malpractice insurance was invented by the same physicians who founded MedPro. THAT MATTER NUMBERS
Policy Types: Occurrence & Claims-made Policy Limits: $2 million / $4 million Consent to Settle: Pure Consent Risk Management & Claims Team: Dental Specific KEY TAKEAWAYS
THANK YOU! Follow us on Twitter: @MedProDental 260.442.1806 Olivia.GiaQuinta@medpro.com
Malpractice 101 YouTube Student Video Submissions SaushaToghranegar (D4 @ Nova) submitted this YouTube video last year which was purchased by MedPro. VIDEO