CNA Appoints Bruce Dmytrow to Senior Vice President, Healthcare

CNA announced the appointment of Bruce Dmytrow to senior vice president, Healthcare. In this role, Dmytrow is responsible for the overall strategic leadership and direction of CNA’s Healthcare underwriting unit. He reports to Kevin Smith, president and chief operating officer, CNA Specialty.  

Dmytrow joined CNA in 1995, most recently serving as vice president for Aging Services and National Programs. Throughout his career at CNA, he has had oversight for CNA’s enterprise-wide risk control strategic direction for Healthcare, Professional Services and Financial Institutions Customer Segments in the U.S., Canada and Europe. 

“Bruce is a trusted leader and is well-known for his breadth and depth across the continuum of care, with expertise that extends from the traditional hospital/physician model to new and emerging healthcare delivery systems,” Smith said. “Bruce’s extensive knowledge and leadership capabilities, combined with CNA’s more than 50 years of experience as a top underwriter of insurance solutions and services for healthcare companies, will enable us to better serve our more than one million healthcare customers.”

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Cooperative of American Physicians to Present at 2018 Southern California Association for Healthcare Risk Management Conference

The Cooperative of American Physicians, Inc. (CAP) recently announced that vice president for practice optimization, Carole Lambert, MPA, RN, will speak at the Southern California Association for Healthcare Risk Management (SCAHRM) 38th Annual Educational Conference in Rancho Mirage, Calif., on Thursday, May 3 at 10:05 a.m. PDT.

According to the company, CAP is dedicated to providing doctors and hospitals with the tools to offer patients a seamless experience while mitigating the risk inherent with providing care. It specializes in evaluating office systems and documentation, including both paper and electronic health records, to help healthcare practitioners reduce risk.

Joining Lambert will be co-presenter Randie Minovitz, BSN, RN, director, ambulatory risk management at PIH Health Whittier, a nonprofit regional health network serving Southern California. Their presentation, entitled “These Boots Are Made for Walkin’: Risk Management in Ambulatory Care,” will outline key takeaways for medical risk management professionals as they navigate and continue to develop their strategies for effective practice administration specifically as it relates to ambulatory care. Attendees will take away the following key lessons:

• The evolution to complex patient care in the ambulatory setting;

• Behaviors that multiply risk in ambulatory care delivery;

• Strategies for responding to historic and emerging risk issues in the ambulatory setting.

“While there is a growing emphasis on ambulatory procedures in favor of costly and unnecessary hospital stays, there has not yet been an increased acknowledgement of risk issues in the ambulatory care setting,” Lambert said.

“This presentation considers sources of risk along the continuum of ambulatory care and outlines strategies for effective responses to the sources of risk, providing a vital resource for healthcare professionals and practices,” Minovitz added.

Last year, CAP released a comprehensive guide called the Risk Management Self-Assessment Kit, in order to provide a resource and a practical checklist for healthcare providers to help ensure that they are meeting mandated requirements and recommended guidelines to serve as a benchmark for excellence in their risk management. 

Lambert is a member of the CAP Speakers Bureau, a group of experts and thought leaders in medical risk management, practice management, legal and public affairs.

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CMIC Group’s A- (Excellent) Rating Affirmed by A.M. Best; Outlook Revised to Negative

CMIC Group, a mutual medical professional liability insurance provider, was recently notified that A.M. Best has affirmed the Company’s financial strength rating of A- (Excellent), and the Long-Term Issuer Credit Ratings of “A-” of Connecticut Medical Insurance Company (CMIC) (Glastonbury, CT) and CMIC Risk Retention Group (District of Columbia). However, the outlook has been revised from stable to negative. 

The revised outlook reflects the negative trend in underwriting performance and the challenges CMIC faces to improve results in the near term given the ongoing soft market conditions. Underwriting results have suffered in 2016 and 2017 due to increased severity following several years of consistently positive underwriting results and corresponding surplus growth.  As well in 2017, CMIC booked a “one-time reserve adjustment” of $8 million to account for previously unidentified retro-dated coverage predominantly within the risk retention group’s modified claims-made book of business. 

Despite the reserve strengthening, CMIC’s surplus increased by $10.0 million to $309.5 million as of Dec. 31, 2017, due primarily to unrealized gains.  In terms of financial strength and stability, A.M. Best stated that the Company’s Balance Sheet has received the strongest level of risk-adjusted capitalization rating (BCAR).  They also commented that CMIC’s investments are conservative and liquid, while underwriting leverage continues to remain low. 

“Despite these recent developments, our company continues to be very strong financially and the Board of Directors, Management Team, and staff are working diligently to improve our financial performance during this difficult market cycle,” said Stephen J. Gallant, CEO of CMIC Group. “Likewise, we are reviewing our product offerings to ensure they continue to meet the evolving needs of the marketplace, and we appreciate the continued loyalty and support of our esteemed member physicians and valued distribution partners as we remain committed to the long-term success of the company.”

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The Doctors Company Names New Senior Vice President of Claims

The Doctors Company has promoted Catherine Shutack to the position of senior vice president of claims. In her new role, Shutack oversees the claims function throughout all 50 states for The Doctors Company. She reports directly to Bill Fleming, chief operating officer.

“As service is the number one priority of the claims department, this new role provides me with an even greater opportunity to positively impact our members,” said Shutack. “I am proud to lead our claims department employees, who are committed to being the best partners for our members during the most trying times of their professional lives.”

Shutack noted The Doctors Company’s claims staff employees are some of the most experienced in the industry and share a passion to vigorously protect and defend members. “Being sued is a devastating, life-changing event for doctors,” said Shutack. “We’re there to support our members at every step, from the moment a claim is filed to when it’s closed.”

Shutack most recently served as vice president of claims for the company’s Northeast region.

“We are extremely pleased to promote Cathy to this national leadership position,” said Fleming. “Through her years with The Doctors Company, she has shown a passion for our members and for tirelessly defending the practice of good medicine. Under Cathy’s leadership, members can be assured they will continue to receive top-notch service throughout the life of their claim.”

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A.M. Best Revises Outlooks to Negative for Members of Connecticut Medical Insurance Group

A.M. Best has revised the outlooks to negative from stable and affirmed the Financial Strength Rating of A- (Excellent) and the Long-Term Issuer Credit Ratings of “a-” of Connecticut Medical Insurance Company (Glastonbury, Conn.) and its sponsored risk retention group company, CMIC Risk Retention Group (District of Columbia). These companies are collectively referred to as Connecticut Medical Insurance Group (the group).

These Credit Ratings (ratings) reflect the group’s balance sheet strength, which A.M. Best categorizes as strongest, as well as its adequate operating performance, limited business profile and appropriate enterprise risk management.

The revised outlooks reflect the negative trend in underwriting and operating performance and the challenges that the group faces to improve results in the near term given the ongoing competitive market conditions. Results have suffered in recent years due to an increase in severity as well as the emergence of adverse development on prior accident year loss reserves, which culminated in a $23.4 million underwriting loss in 2017. The group’s reserves historically developed very favorably, but have come under pressure in recent years as loss costs for the group have been increasing. In addition, a large reserve “one-time adjustment” was taken in order to recognize retro-dated features in the group’s modified claims made book of business, which had not been previously included in the third party actuarial consultant’s assumptions. Despite the strengthening, surplus increased $10 million from the previous year due to unrealized gains.

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A.M. Best Downgrades FSR, Credit Rating for MedMal Direct Insurance Co.; MPL Insurer Requests to No Longer Participate in Rating Process

A.M. Best has downgraded the Financial Strength Rating to B- (Fair) from B++ (Good) and the Long-Term Issuer Credit Rating to “bb-” from “bbb” of MedMal Direct Insurance Company (MedMal Direct) (Jacksonville, FL). The outlook of these Credit Ratings (ratings) has been revised to negative from stable. Concurrently, A.M. Best has withdrawn the ratings as the company has requested to no longer participate in A.M. Best’s interactive rating process.

The ratings reflect MedMal Direct’s balance sheet strength, which A.M. Best categorizes as adequate, as well as its marginal operating performance, limited business profile and marginal enterprise risk management (ERM).

These rating actions are related partly to MedMal Direct’s prospective balance sheet strength and A.M. Best’s concerns related to ultimate reserve adequacy, and the potential loss emergence and legal actions related to extra contractual obligations and excess of policy limits (as an event subsequently disclosed in the company’s year-end 2017 statutory annual statement). Unfavorable outcomes from each of these could potentially have a negative influence on the parent’s already high debt leverage and ability to cover its cost of capital. Concerns regarding reserve adequacy have increased following recent changes in claims management and changes in reserving practices added to the limitations on the company’s own data due to its relatively short time in operation, as well as adverse reserve development in calendar-year 2017 and each of the prior three accident years. The 2017 reserve increase contributed to a 20% decrease in policyholders’ surplus and significantly decreased capitalization.

The company’s operating performance has been below the medical professional liability (MPL) averages and trending negatively in recent years culminating in the significant loss reported in 2017. While claims frequency remains relatively flat, the MPL market is in a prolonged soft pricing cycle. Market dynamics continue to see private practice physicians leaving for employment opportunities with physician groups or hospitals, mergers among physician groups and health care systems, greater medical responsibilities being taken on by physician extenders that were performed previously by physicians, as well as other changes. The business profile is limited by MedMal Direct’s concentration of underwriting risk in MPL lines, mainly in Florida. In recent years, Florida has reversed certain tort reforms that would keep claims frequency and severity in check. However, the company has partially mitigated this by writing most policies at low limits.

Furthermore, in A.M. Best’s opinion, the company’s ERM is marginal. While the company has brought in seasoned leadership in key management positions in recent years, those changes have either followed material deficiencies in operations or precipitated corrective actions and contributed to the company’s marginal operating performance.

The outlooks have been revised to negative based on the challenges facing this company, as earnings and future capital formation may be constrained due to the potential for additional reserve strengthening in the near term and what could become of the legal actions related to the adverse excess of policy limits claims judgment in January 2018. Management is currently reviewing its options in this matter.

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Healthcare Matters: 2018 Medical Professional Liability Market Update

Healthcare Matters launched new video segments from its “MPLI Executive Insights” series, where executives from companies involved with medical malpractice insurance are interviewed about trending topics and contemporary challenges facing the industry at large.

The two new segments of “MPLI Executive Insights” feature interviews from the 2018 Professional Liability Underwriting Society (PLUS) Healthcare and Medical PL Symposium in Chicago.

In the first video, Bill Burns, vice president of insurance research at the global investment management firm Conning, expertly discusses the state of the medical professional liability (medical malpractice) insurance industry. In this segment, Burns examines the challenges associated with operating in a soft market where medical malpractice insurance rates have not changed significantly in more than a decade, whether the market will eventually harden or accumulated surplus has created a new normal for MPL insurance pricing and the potential for a few large MPL insurance companies monopolizing the industry.

In the second video, Andrew Charron, head of healthcare for specialty insurance provider CapSpecialty, shares his insight into the miscellaneous facilities insurance market. In this segment, Charron discusses the booming home health market, challenges associated with a growing market but shrinking premium value and how underwriting speed can often determine who ultimately gets a potential insured’s business.

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CFC Expands Cyber Policies for U.S. Healthcare Providers

Specialty-insurance provider CFC Underwriting recently announced the newest version of its cyber insurance product for U.S. healthcare providers. With the latest policy, CFC enhances its combined cover for privacy and operational disruption with industry-specific features to help healthcare organizations prepare for and respond to cyber incidents as well as comply with industry regulations.

“While most healthcare providers are aware of their privacy and data breach exposures, they can easily overlook cover for operational disruption. The unprecedented increase in malware attacks has shown that operational exposures must be addressed – in fact, we’re now seeing the costs of operational disruption and rebuilding far exceed what a large-scale privacy breach might cost the same entity,” said CFC Cyber Product Leader, James Burns. “Our stand-alone cyber product for the U.S. healthcare sector is tailored to their unique risks, helping limit the impact of a cyber incident on their organization.”

According to CFC, its latest cyber insurance product addresses the exposures and regulatory requirements unique to U.S. healthcare organizations and ensures that core elements of cover are available each time a crisis strikes, even if a policyholder experiences multiple cyber incidents in the same policy period.

CFC’s cyber policies offer the provision of first party cover on an “each and every claim” basis and don’t restrict policyholders with policy aggregates. Additionally, CFC’s cyber offering for U.S. healthcare providers includes cover for HIPAA corrective action plans and cover for bodily injury resulting from a cyber attack alongside cover for the costs associated with improving risk management controls following a breach, system repair costs and incident response costs in addition to the limit.

“CFC offers a market-leading cyber insurance product backed by a global response capability which ensures our policyholders not only have comprehensive cover, but that they can recover quickly from cyber incidents,” Burns said.

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A.M. Best Affirms “A” (Excellent) Rating for NORCAL Mutual Insurance Company, Outlook Revised to Stable

A.M. Best has again affirmed a rating of “A” (Excellent) for NORCAL Mutual Insurance Company and its affiliates, in addition to revising the ratings outlook to “stable.” The revised outlooks are attributed to the improvements in underwriting and operating performance trends, along with A.M. Best’s expectation of sustaining positive trends moving forward.

“Our strategic efforts to fortify our financial stability have resulted in NORCAL being well positioned to receive a stable rating. Our 34-year A-rating track record is a testament to our prudent decision making and the ability to adapt as the landscape of healthcare continues to change,” said Mark Johnson, NORCAL Mutual chief financial officer.

NORCAL Mutual Insurance Company shares the A.M. Best rating with NORCAL Specialty Insurance Company, Medicus Insurance Company, FD Insurance Company and Preferred Physicians Medical Risk Retention Group, a Mutual Insurance Company.

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MagMutual Declares New Dividend, Owners Circle Options for 2018

MagMutual Insurance Co. announced a 10-percent premium return to policy owners as well as flexible options for its dividend and Owners Circle reward programs.

According to the insurer of medical liability, MagMutual policyholders have received over $215 million in dividends since inception.

“MagMutual continues to pay more than ever to our policyholders, even while our competitors continually give back less,” said Neil Morrell, president and chief executive of MagMutual. “Returning dividends is what a mutual should do, whenever possible. Thanks to our strong performance, we have paid out more dividends over the last seven years than in the entire history of our company.”

The MagMutual Board of Directors, in recognition that policyholders may prefer to receive an alternative dividend in lieu of the Owners Circle credit, is also offering an additional 3-percent dividend return. Policyholders who prefer this option will receive a 13-percent dividend.

The MagMutual Board of Directors also declared a 10-percent Owners Circle allocation to recognize policyholders’ ownership in a financially strong company. Those who do not want the alternative 3-percent dividend will receive their 10-percent Owners Circle credit.

“We at MagMutual constantly try to serve our policyholders,” said Joe Wilson, MD, executive chairman of MagMutual. “We do this by delivering the exceptional products, services and pricing and paying among the highest dividends in the industry. We have been pleased with the amount we’ve been able to give back in recent years, and hope our policyholders are pleased as well.”

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