Do You Understand Your Malpractice
Insurance Policy?

Patrice F. Hirning, M.D.
Medical Director, UMIA

As a physician are you fully aware of what is and is not covered by your malpractice insurance policy? This is critical to understanding what activities you perform which might be outside the coverage of your policy.

By law, UMIA can only cover medicine practiced in states where UMIA is licensed to provide insurance. Those states are Utah, Montana, Wyoming, Nevada and Idaho. A physician who practices in a state outside of these is not covered by his/her UMIA policy. For example, a physician who prescribes medications over the Internet may have problems. If a physician prescribes Chantix over the Internet to a patient in California and is sued when the patient commits suicide, this would not be covered by his/her UMIA policy.

Another example is a physician performing contract work outside of his usual practice setting. If the care occurs in a state where UMIA is licensed to write, then the physician’s UMIA policy might have to cover any suits even if the physician believed that the contract company was covering the work being provided. It is critical that a physician understand that UMIA might be called in to provide coverage for actions that the physician believed were being covered by another policy. UMIA or the physician’s attorney can assist in understanding which policy will cover which acts by the physician.

Are you a radiologist providing Teleradiology services? The American College of Radiology recommends that a radiologist interpreting a scan from a facility off site be licensed in the state where the film is taken, have privileges at the facility where the scan is taken, and have appropriate medical professional liability coverage. UMIA Underwriting Guidelines require that the radiologist be licensed in the state in which he/she interprets images and also have appropriate coverage (that is, be reading scans in a state where UMIA is licensed to provide insurance). Be sure that you understand whether you are covered for films that you are reading.

Are you aware whether your policy is covering the procedures that you are currently performing? If you have added procedures to your practice, contact UMIA to be sure that you have been assigned to the correct risk class based on the procedures that you perform. For example, if a general internist begins to do aesthetic procedures such as laser hair removal or “Smartlipo,” these activities are not included in the standard Internal Medicine policy. The physician should notify UMIA and be placed in the appropriate risk classification. Insurance rates are based on the losses of individual risk classes. In order to be fair to all insureds, it is important to be sure that you are placed in the appropriate risk class for the procedures that you perform and that you are paying appropriate premiums. Performing procedures that are outside of your risk classification could lead to adverse underwriting actions.

As a physician it is your responsibility to understand your malpractice insurance policy and what is covered. If you have not obtained a copy of your policy and read the policy, please contact UMIA and one will be provided for you. It is the goal of UMIA, as a physician-managed insurance company, to have informed policy holders who are actively engaged in understanding and managing their risk.