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Still have questions? Call us at (800) 611-0793 or
send us a note.
Will using L&J Insurance Services increase the cost of my
insurance?
No. L&J has a long-standing policy of not adding any additional
fees or charges for our services. We are compensated by the
insurance companies based on brokerage agreements that have been in
place for many years, in most cases. L&J Insurance Services has
always believed that doing the right thing for you, the client, will
naturally be the right thing for us. Even if you elect to utilize
another broker's services, it is prudent to verify any additional
fees that may be charged right upfront.
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I have been declined or informally advised to withdraw my
application from an insurance company. Does that mean I am unable to
be insured?
No. Often, a company will decline coverage because they are not a
good match for your practice or specialty. Other companies will be
eager to insure you, in most cases. Very rarely is a physician or
practice "uninsurable". We can help you work with the right
companies to obtain options for coverage.
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Will I be able to go back to the standard insurance market someday?
In most cases, it is possible to return in a few years. However,
it is not reasonable to offer this blanket assurance without some
important considerations being addressed: Severity of claims, number
of claims, scope of practice and disciplinary actions are all
factors that will greatly influence "WHEN" such a change can be
realistically expected.
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What about the "Statute of Limitations"?
A practical response here is best: If the Statute of Limitations
on malpractice suits were stable and absolute, insurance companies
would only sell policies for one year and no "tail" would be needed.
As this is not the case, it is a safe assumption that the Statute of
Limitations is not effectively barring all suits and claims
that do not strictly adhere to the timelines it delineates.
If the
insurers aren't relying wholly on the Statute of Limitations, it is
prudent to follow their example. Of course, any legal advice should
be obtained from an attorney.
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What law says I need to carry malpractice?
It is necessary to obtain legal counsel on this matter to assure
compliance with the law. Realistically,
most physicians are required to maintain and provide evidence of
insurance coverage to participate in HMO/PPO contracts and have
staff privileges at medical facilities.
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What if I just establish a bank account to pay any claims that may
arise? Can't I just "self-insure"?
By failing to maintain adequate insurance, you are "self insured"
by default. Naturally, you will be fully responsible for any claims
filed against you and the legal costs and awards that may result
from a claim.
Large
companies and hospital systems will often insure some portion of
their risk themselves via complex trusts, captive insurance
companies and reinsurance plans. The sheer scope and financial
commitment demanded by this approach is often prohibitive for the
small group and much more so for the individual physician.
The largest
problem with "Self Insurance" is that it won't be accepted by any
Credentialing Department, Staff Office, HMO, Medicare, MediCal or
similar institution. The guidelines for insurance are very specific
and almost universally preclude a self-funded insurance approach.
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What about "Tail" coverage?
In a "Claims Made" policy, coverage is limited to claims reported
during the policy period.
There is no
coverage for claims reported after the policy expiration date (last
day of the policy), even if the incident occurred during the policy
period, unless you buy an "Extended Reporting Period Endorsement",
commonly referred to as "tail" coverage. Tail coverage insures you
for incidents that took place while your policy was in force, but
where no claim was made until after the policy expired.
"Tail"
coverage can be very confusing and is elemental to having complete
coverage. It may be best to call us and discuss your circumstances
specifically.
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What is the difference between "Admitted" and "Non-Admitted"
companies?
Admitted companies have been authorized to transact insurance in
the state by the Department of Insurance. They will be subject to
the regulations of that state and must comply with the governance of
the DOI.
Non-Admitted
companies have elected not to be authorized by the state DOI. Often
mistakenly perceived as being "shaky" or questionable companies,
these carriers will opt not to be admitted to allow more leeway in
pricing and coverage scope for policies they will write. Admitted
companies may be unable to insure risks due to limitations on
premium increases imposed by the DOI, where Non-Admitted companies
can be very flexible. This flexibility will often result in a
customized coverage solution for complex policy placements.
It is
important to note that transacting business with Non-Admitted
companies can be very complicated. It is critical to understand the
full implications of the offered terms and conditions and know the
status and standing of any insurer being considered for coverage.
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I've never had a deductible before. Why do I have one now?
Insurers will often place a deductible on alternative market
policies to afford themselves some additional protection. Many
claims are resolved very quickly with little expense. To avoid
multiple small expenditures, the responsibility for the initial
expenses will be borne by the insured. Some small premium reduction
can be achieved by accepting an increased deductible. Common
deductible levels are $5,000 to $15,000 per claim.
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Why is my "Claims Made" policy increasing every year?
Generally, claims made premiums increase over a five-year time
period from the first date of coverage. In the fifth year of
continuous coverage with the same company, a "mature" rate is
reached. Mature rates will only increase due to: additional claims
experience, a significant change in practice or an overall carrier
rate increase.
The largest
increase is typically seen from Year 1 to Year 2, with the smallest
increase being from Year 4 to Year 5.
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