Medical Malpractice Insurance
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Who is Required To Have Medical Malpractice Insurance?
Medical Malpractice Insurance may be required by your licensing authority. You should contact your licensing authority to determine if Medical Malpractice Insurance is mandatory and if certain minimum coverage is required.

Can a company offer different coverage limits within the same category of healthcare provider?
No, due to the Division’s interpretation of the “take all comers” statute, every insurer that offers such coverage would also have to offer the same limits to each healthcare provider within the same category.

Can premiums vary?
A medical malpractice insurer is not prohibited from establishing reasonable classifications of risks and premium charges based upon the relative risk associated with practice in a particular specialty.

Can an insurer cancel/nonrenew my policy?
Acceptable reasons for cancellation or nonrenewal of medical malpractice policies have been:

  • nonpayment of premiums
  • mutual consent of the parties to the contract of insurance
  • fraud or material misrepresentation in the application for insurance or renewal thereof
  • the insured’s license or registration has been subject to a restriction, suspension or revocation during the policy period
  • discovery of willful, reckless or illegal acts or omissions by the insured that increase the hazard insured against
  • determination by the Commissioner of Insurance that continuation of the policy would violate or place the insurer in violation of the law.

There are certain exceptions to this provision. For example, an insurer may cancel/nonrenew a physician policy, if they no longer write physicians policies. Any other insurer who writes physicians is required to offer a physician policy.

What is the difference between a claims-made policy and an occurrence policy?
In many cases, a claims-made policy provides liability coverage only if a written claim is made and in many cases reported to the insurer during the policy period or any applicable extended reporting period. An occurrence policy provides liability coverage for injury or damage that occurs during the policy period, regardless of when the claim is actually made.

What is an extended reporting period?
Generally, an extended reporting period allows an insured to make a claim after the expiration of a claims-made liability policy. The extended reporting period, also known as a “tail”, should be specified in your policy.

What happens when I decide to retire or if I die or I am disabled and have claims-made coverage?
A number of insurers provide, some as optional coverage, 100% premium waiver for “tail” coverage. The 100% premium waiver of “tail” coverage, in many instances, is contingent upon having continuous coverage with the same insurer for a certain number of years (i.e., 3-5 years). Some insurers also offer discounted retirement “tail” coverage if you have less than the required number of years of such coverage for the 100% premium waiver. You should check with your agent or insurer for the availability, premium and specific policy provisions.

What should I do if I am called up for military service?
You may be able to avoid having to pay policy premiums and/or purchase “tail” coverage while in the military, provided you return to the insurer as a regular policyholder when such military service is completed. You should check with your agent or insurer for any allowances made for military service.

What is a retroactive date?
Generally, the retroactive date is the date in a claims-made liability policy, which triggers the beginning period of insurance coverage. If such date is shown on your policy, any claim made during the policy period will not be covered if the loss occurred before the retroactive date.

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