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Strengths and Weaknesses of Claims Made & Occurrence Policies

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So which of the policies

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between occurrence claims made

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and claims paid policies do most radiologists have?

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Most radiologists have claims made policy in part

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because the occurrence policy,

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because it lasts forever, is more expensive.

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At least initially the claims made policy is less expensive.

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But when you add in tails

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and noses, if you're required to do that

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because you're changing carriers,

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then it eventually evens out with the occurrence.

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But for most people in most practices, group practices,

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for example, it's a claims made policy.

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What are the issues with an occurrence policy?

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Well, the occurrence policy assumes that

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that medical malpractice company is gonna be around forever

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to cover your issues

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that occurred while you had that policy.

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So you have to go with a company that is reliable

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and isn't gonna go bankrupt

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and not be available with money to pay your pay, your, your,

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your malpractice, uh, payouts after you've left them.

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So you know, will it really cover 20 years later.

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And that can occur with minors.

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So if you know that the statute

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of limitations in your particular state

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with minors is seven years, or 14 years,

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or even 20 years,

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depending upon when the person no longer is a minor, um,

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you need an occurrence coverage company that's gonna be

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around for those longs.

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So, um, the other thing is inflation.

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So let's say you buy a policy for that has a million dollars

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of coverage, uh, 20 years from now.

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Um, it may be that,

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but the cost of living as it is, that might not be enough

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that you have 20, 20 years from now.

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So, um, keep, keep your policies, keep your copies

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of your old policies, particularly when you're dealing

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with an occurrence PO policy with the claims made policy.

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We talked about the issues that the cost varies

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as you start out because of more cases accumulating.

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The cost will vary with your noses and your tails.

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If there's a policy wraps, you need to get coverage

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and the tails may be limited to five years in duration,

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and they are relatively expensive.

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Fortunately, the likelihood that you'll be sued

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for something that occurred five years ago

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is relatively low,

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and some states have a statute of limitations with regard to

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how soon you are allowed to sue a physician

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after an error is discovered.

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So, um, you have to keep current with the limits on the,

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in, on the damages.

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You can top off your prior policies

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by adjusting retroactive dates.

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Remember that you can go backwards in time actually

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with the nose, for example.

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And, um, understanding those issues

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with claims made policies are important.

Report

Faculty

David M Yousem, MD, MBA

Professor of Radiology, Vice Chairman and Associate Dean

Johns Hopkins University

Michael A. Bruno, MD, FACR, MS

Professor of Radiology & Medicine, Vice Chair for Quality and Chief of Emergency Radiology

Penn State University

Tags

Non-Clinical