Policy Coverage and Features

Medical Liability Protection and Coverage: The basic liability policy provides coverage for claims made, relating to medical care a covered physician provided or failed to provide, up to the individual and aggregate limits of the policy. Policy coverage can be modified to meet specific practice needs or because of underwriting sanctions.

Premises Liability Coverage: The basic physician’s liability policy includes coverage up to $50,000 for bodily damage and liability for an accident occurring on your office premises with an aggregate limit of $100,000 during any policy period.

Fraud and Abuse Coverage: This coverage is called Medefense and is included in the standard liability policy. The individual physician medical liability policy includes coverage up to a limit of $25,000 for payment of legal expenses incurred by the policy holder to defend against disciplinary actions taken by a health care entity for credentials, privileges, or membership; state licensing board for unprofessional conduct; actions by HHS for Medicare and Medicaid fraud and abuse; and for any actions taken for HIPAA violations.

Employers Practices Liability Coverage: This coverage is called EPL coverage and is included in the standard medical liability policy. This coverage provides payment of legal costs up to $25,000 incurred in defense of wrongful termination, workplace harassment, sexual harassment, discrimination, retaliation and workplace tort actions (defamation, invasion of privacy, wrongful discipline, deprivation of career opportunity) of a physician’s employees.

No Fault Coverage: On request medical costs up to the no fault limit of $5,000 incurred by a patient as a result of an injury resulting from an insured physician's treatment, failure to treat or as a result of an accident in the office can be paid up to one year after the event occurred.

Death, Disability, and Retirement: This coverage is included in all polices. Insured physicians who reach the age of 50 and have been insured at least one full year at a mature rate receive tail coverage without payment of additional premium upon retiring from medical practice. Should a covered physician die or become totally and permanently disabled and unable to practice medicine, tail coverage is provided without payment of additional premium.

Tail Coverage: Tail coverage is insurance purchased to cover any claims against a physician occurring after the termination of a claims-made policy. If the policy is terminated coverage is needed for any claims filed after the termination date of the policy. This coverage can be obtained by paying additional premium for an extended reporting endorsement, known as "tail coverage", or by purchasing insurance from another provider with "prior acts" coverage.

Prior Acts Coverage: Coverage for prior acts extends protection against claims filed against a physician for medicine practiced prior to the date the claims made policy is put in force. Prior acts coverage is available only to physicians who have practiced in the UMIA coverage area and have acceptable underwriting profiles. Each request for prior acts coverage is carefully underwritten. Physicians with significant claim histories, paid losses, or who have provided medical care outside of the UMIA coverage area will not qualify for prior acts coverage. If prior acts coverage is obtained, there is no need to buy tail coverage from the prior insurer.

Additional Entity Coverage Options and Additional Named Insureds

Corporation, LLC, or Partnership Coverage:
A physician who uses a professional corporation, limited liability company, or partnership as a practice entity may name the entity as an additional named insured on the individual physician policy. This provides protection for the entity against liability claims. The amount of coverage is included under the physician’s individual limit at no additional premium cost.

Employed Paraprofessional Coverage:
Other health care providers employed by the physician such as nurse anesthetists (CRNA’s), nurses (RN’s), physician assistants (PA’s), nurse practitioners (CNP’s), and nurse midwives (CNM’s) can be offered covered under the umbrella of an individual physician’s policy. Separate policy limits for each paraprofessional may be purchased if desired.