Brian J. Spero Is Appointed to Coverys’ Board of Directors

June 21, 2019 by matray

Coverys announced the appointment of Brian J. Spero to the Medical Professional Mutual Insurance Company board of directors.

Spero has more than 30 years of proven expertise as a senior executive in insurance operations, legal, regulatory and administrative leadership roles. Spero currently serves as the president and CEO of The Beacon Mutual Insurance Company. In this role, he leads the organization’s strategic corporate vision, ensuring Beacon’s fiscal strength, including investment strategy, preservation of assets, reinsurance programs and claim reserve requirements. Spero previously served as executive vice president, chief operating officer and general counsel of Beacon.

“Brian is a great addition to the board and brings a wealth of experience developing and maintaining strategic alliances to coordinate the delivery of comprehensive, high-quality, and cost-effective insurance programs,” said Brenda E. Richardson, MD, chair of the board of directors. “The board and management look forward to working with him in the coming years.”

Prior to joining The Beacon Mutual Insurance Company, Spero was a founding partner of Partridge Snow & Hahn LLP, a partner and associate at Tillinghast, Collins & Graham in Providence, R.I., and law clerk to the Honorable Francis J. Boyle, United States District Court, District of Rhode Island.

Spero serves on the Rhode Island Governor’s Insurance Council, the Greater Providence Chamber of Commerce Board of Directors, the Rhode Island Public Expenditures Council, and the Meeting Street School Audit and Finance Committee. He also serves as a Bank of Newport corporator, an American Association of State Compensation Insurance Funds vice president & executive committee member, and is a member of the Association of Corporate Counsel, the Rhode Island Bar Association, and the Massachusetts Bar Association. He is admitted to practice of law in Rhode Island and Massachusetts. Spero obtained a Juris Doctor from Boston College Law School and a Bachelor of Arts from Colgate University.

Posted in Appointments and Promotions, Coverys, Medical Malpractice News | Leave a comment
NY DFS Approves Acquisition of Hospital Insurance Company by The Doctors Company

June 20, 2019 by matray

Acting New York Financial Services Superintendent Linda A. Lacewell today announced that the Department of Financial Services (DFS) has approved the application of The Doctors Company (TDC) to purchase Hospitals Insurance Company (HIC) from Maimonides Health Resources, Inc., Montefiore Medicine Academic Health System, Inc. and Mount Sinai Health System, Inc., for $638 million. TDC will also purchase the assets and liabilities of HIC’s current manager, FOJP Service Corp., from the sellers for $12 million.

“Taking into consideration the importance and current status of New York’s medical malpractice market, DFS carefully reviewed this acquisition to protect HIC policyholders,” said Acting Superintendent Lacewell. “The measured expansion of competition in the medical malpractice market by a DFS-regulated insurer is positive for doctors, and ultimately good for consumers.”

“We are pleased the New York Department of Financial Services has given final approval for this important transaction. This enables us to deliver on our commitment to New York physicians and hospitals to provide expanded coverage options from a strong admitted carrier, and to build a mission-based platform to serve the medical professions. We look forward to the transaction closing on July 31, 2019,” said Richard E. Anderson, MD, FACP, chairman and CEO of The Doctors Company.

Posted in Acquisitions and Mergers, Medical Malpractice News, The Doctors Company | Leave a comment
Center For Justice & Democracy Releases New Briefing Book — Medical Malpractice: By The Numbers

June 20, 2019 by matray

The Center for Justice & Democracy at New York Law School (CJ&D) today released the 12th update to its MedicalMalpractice: By The Numbers briefing book. The fully-sourced, 172-page volume includes the latest statistics and research on issues related to medical malpractice, including more than 500 footnotes linking to original sources. The briefing book’s release coincides with renewed attention to the topic of medical negligence, namely this Sunday’s premiere of “License to Kill,” a new Oxygen television series that focuses on medical malpractice.

“Viewers of the new series, and indeed anyone interested in learning more about the extent of avoidable patient injuries in this country, should turn to the briefing book as a resource,” said principal briefing book author, CJ&D’s Deputy Director for Law & Policy, Emily Gottlieb.

As in prior editions, topics include: medical malpractice litigation, healthcare costs and “defensive medicine,” physician supply and access to healthcare, medical malpractice insurance, patient safety and special problems for vets and military families. In addition, there are several new sections, including sexual assault by doctors, misdiagnoses (the most prevalent and costly type of medical error), childbirth negligence, plastic surgery, how physician stress and burnout leading to errors and the real cause of insurance spikes for doctors. Among the many new research findings since CJ&D’s December 2019 update are:

• Between 2007-2016, the number (frequency) of medical malpractice cases dropped more than 25%. For ob/gyns, the drop was 44%.

• Ninety-percent of doctors with at least five medical malpractice claims are still in practice.

• There is no “quality of care” information available for 75% of doctors treating Medicare patients.

• The federal government doesn’t require hospitals to tell the public how often mothers die or suffer from childbirth complications.

• After Texas enacted severe “tort reform” measures in 2003, access to medical care grew by “close to zero.”

• When a state caps damages, rates for cardiac stress tests and other imaging tests, Medicare Part B lab and radiology spending, all rise.

• When it comes to preventing deaths from medical errors, out of 195 countries in the world, the U.S. ranks below the top 50.

“Organized medicine continues to push laws that would reduce the accountability of unsafe hospitals and incompetent physicians,” said CJ&D Executive Director Joanne Doroshow, who edited the briefing book.

“Yet hundreds of thousands of patients die each year due to preventable medical errors at the same time insurance claims and lawsuits are dropping.

“We have an enormous patient safety problem in this nation. Even sexual misconduct by physicians is going largely unchecked. The last thing we should do is try to solve these problems by increasing the obstacles harmed patients face in the already difficult process of bringing a case against the person or institution that harmed them.”

A copy of the full briefing book can be found here: http://centerjd.org/content/briefing-book-medical-malpractice-numbers

Posted in Uncategorized | Leave a comment
Denise M. Condron promoted to Vice President of Loss Prevention and Kevin M. Bresnahan, JD, promoted to Vice President of Claims at CMIC Group

June 19, 2019 by matray

CMIC Group announced that Denise M. Condron, previously the Director of Loss Prevention, has been promoted to the role of Vice President of Loss Prevention. Additionally, Kevin M. Bresnahan, JD, the prior Director of Claims, has been promoted to the role of Vice President of Claims.

Condron has more than 20 years of healthcare experience in both clinical and administrative roles. In 2017, under her leadership, the company’s CME Program received Accreditation with Commendation from the Connecticut State Medical Society, and more recently, she led the CMIC’s return to the MPL Association Data Sharing Project. She has worked to expand the CMIC Loss Prevention Education Program to include additional enduring materials, live events and most recently, the inclusion of webinars.

“Denise has been instrumental in providing high-quality programs and support services to our physicians and their practices,” said Stephen J. Gallant, Chief Executive Officer of CMIC Group. “Her ongoing efforts and expertise have become a valuable resource to our members.”

Bresnahan has more than 25 years of experience as both a defense trial attorney and an insurance claims executive. In addition to leading the Claims Department, he has played a major role in defending policyholders while protecting the overall interest of the company. His responsibilities have recently expanded to include lobbying and governmental affairs.

“Kevin’s extensive litigation and claims management experience have proven to be an asset for policyholders as they navigate the claim process,” Gallant said. “His contributions continue to produce positive changes beyond the Claims Department.”

Posted in Appointments and Promotions, CMIC, Medical Malpractice News | Leave a comment
MIEC to Host ‘Summit for Insurance Defense’ on June 20

June 12, 2019 by matray

MIEC announced its inaugural MIEC Summit for Insurance Defense will take place in Boise, Idaho, on June 20, 2019. The Summit for Insurance Defense is a new annual regional seminar series. Each year it will be hosted in one of MIEC’s territories. The goal of this seminar series is to bring together physicians, practice managers and legal professionals to learn and network.

The event will take place at Boise’s Riverside Hotel where attendees can pick one of two educational seminar tracks focusing on either Idaho Law or Patient Safety & Risk Management. Each track features two, one-hour sessions with communal breaks in between. Attendees will learn proactive methods of protecting a practice from potential liabilities and how best to defend clients, with the opportunity to earn CLE credits for those eligible.

The legal track speaker panel features staples of the Boise legal community: Raymond Powers, Esq., of Powers Farley PC; Keely Duke, Esq., of Duke Scanlan & Hall, and Andrew Brassey, Esq., of Brassey Crawford & Howell, PLLC.

During the second legal session, attendees will learn effective strategies to address jury selection in cases involving hospital and independent providers, effective voir dire strategies and latest jury selection trends. Furthermore, attendees will gain insight into being able to successfully navigate the challenges of presenting evidence in an abbreviated trial schedule, prepare and present witnesses in theses challenged schedules, and develop tactics to keep jurors engaged through disruptive trial schedules.

The patient safety risk management track features nationally recognized practice management specialists Debra Phairas, president of Practice & Liability Consultants, LLC, and Kim Stanger of Holland & Hart, LLP. Their sessions will center around minimizing practice liability. Focusing on aging, impaired or otherwise disruptive physicians in a practice, as well as addressing ways to minimize risk when employing non-physicians in your practice.

Following the educational seminars, both tracks will come together for a joint keynote presentation from Justin Skeesuck and Patrick Gray. Justin and Patrick have had a unique friendship that spans over 42 years. Despite the many challenges of a progressive neuromuscular disease robbing Justin of the use of his arms and legs, the two seek to live life without reservation. Justin and Patrick use their life/work experiences and their adventures as the backdrop to which they explore concepts such as leadership, teamwork, relationship and the power of the human collective.

Finally, the seminar will close out with a social cocktail hour, allowing attendees to meet, socialize and network among fellow medical and liability professionals.

To learn more and to register for FREE, please visit the Summit for Insurance Defense page by clicking HERE.

Posted in Medical Malpractice, Medical Malpractice News, Medical Professional Liability Insurance, MIEC | Leave a comment
Webinar: The Growing Cost of Defending Medical Malpractice Claims and How to Reverse the Trend for Doctors, Hospitals and Insurance Companies

June 12, 2019 by matray

During the past fifteen years, the number of malpractice claims filed has dropped significantly (as much as 27% according to the CRICO 2018 CBS Benchmarking Report). That's good news for insurance companies, doctors and hospitals.

But while the frequency of claims went down, the cost of defending a malpractice lawsuit rose materially (3.5% for all claims and 5% for those without indemnity, according to the CRICO 2018 CBS Benchmarking Report) during that same period, with annual trend rates ranging in the mid to upper single digits for some segments.

The reduction in the frequency of claims has masked the problem of increased defense costs. And this increase is having an industrywide impact. Before claims costs get any higher, now is the perfect time to take a serious look at what your organization is doing to handle these claims and, based on your findings, how to reduce these rising costs.

So what's behind the increased costs of defending a claim? What processes are likely to have the biggest impact on them? Do you have confidence that the data you're collecting will support your claims strategies going forward? And are you open to some nontraditional strategies that could help you better control costs?

Get answers to these questions and more when you register to attend "The Growing Cost of Defending Medical Malpractice Claims and How to Reverse the Trend for Doctors, Hospitals, and Insurance Companies" on Thursday, June 27, 2019. We've put together a panel of experts who will provide you with a medical malpractice insurance industry status report and a picture of where things are headed. You'll learn how and why costs are increasing and what you can do to reduce them.

Click Here to Register

Experts Make Sense of It All
Listen as Mark Reynolds of CRICO reviews the results of its most recent study Medical Malpractice in America: A 10-Year Assessment with Insights. Find out some of the reasons that claims-and even the time to process those claims-are down. You'll learn why the number of cases with multiple defendants has increased by about 20% and how that can affect your costs. And why the largest increase in those costs is from cases with no indemnity payment at all.

Next, you'll hear from Chad Karls. His company, Milliman Inc., has collected significant data on the cost of defending a claim. He'll share some of what Milliman has learned from this data and provide you with insights and examples of how, in some cases, nontraditional thinking is challenging the way claims are managed to better control costs.

And finally, Tim Smith from the NORCAL Group will show you how to analyze data and put it to practical use within your organization to enhance the value proposition for your customers. You'll learn what NORCAL did to uncover outdated strategies and how they were able to eliminate waste and drive efficiency in a coordinated and collaborative manner.

You'll come away with insights that will help you develop actionable strategies that you start working on as soon as you log off your computer at the end of the webinar.

Who Should Attend?
Whether you're a medical liability insurance professional, hospital or healthcare executive, or risk manager-anyone who needs to get a better handle on the rising cost of defending malpractice claims and ways to reverse this trend — this is one webinar you can't afford to miss.

Register today to guarantee your place at this essential learning session. And remember that your entire team in one location can participate with you when you register.

Medical Liability Monitor Webinar at a Glance
DATE: Thursday, June 27, 2019 TIME: 2 p.m. EDT; 1 p.m. CDT; 12 p.m. MDT; 11 a.m. PDT
PLACE: Your computer
COST: $147 per site (unlimited attendance at one location) through 6/14/19, $197 thereafter
TO REGISTER: Click here or email leslie@medicalliabilitymonitor.com

Here is just some of what you'll learn during this in-depth 90-minute conference:
• Why the cost of defending medical malpractice claims is going up — and what you can do to reverse the trend.

• How to determine which of your defense firms is best for specific types of claims.

• How to find and fix some of the problem areas within your organization.

• Where to find data you can use to streamline processes, create strategies, and cut costs.

• How to turn your data into usable, actionable information to effectively manage legal costs.

• How to switch from "the way it's always been done" to thinking outside the box, and the potential benefits of trying something new.

• The data you need and how to use it to support your claims strategies going forward.

• The increased use of "disclosure and apology" and whether or not it reduces the likelihood of a lawsuit... and much more!

Distinguished Presenters
Chad C. Karls, FCAS, MAAA, has been a principal and consulting actuary with Milliman since 1993. His areas of expertise include property and casualty insurance, particularly ratemaking, loss reserve analysis, and financial planning. Mr. Karls also has an understanding of defense costs and has developed an advanced analytics platform that extracts the intelligence from attorney invoices.

Mr. Karls has published 50 articles on medical professional liability issues in Best’s ReviewMedical Liability MonitorNational UnderwriterBureau of National Affairs – Health Care Policy Report, and Inside Medical Liability and has been quoted in The Wall Street JournalBest WeekU.S. InsurerAmerican Medical News, and Medscape Medical News. In addition, Mr. Karls has spoken more than 100 times at various industry conferences, including those sponsored by the Casualty Actuarial Society, the Medical Professional Liability Association, A.M. Best Company, and others.

Mr. Karls has a B.S. in actuarial science from the University of Wisconsin and is a Fellow of the Casualty Actuarial Society and a member of the American Academy of Actuaries.

Mark E. Reynolds is President and CEO of the Risk Management Foundation of the Harvard Medical Institutions Incorporated (CRICO). CRICO insures 25 hospitals, nearly 13,000 physicians, and more than 200 other health care organizations for professional liability. The CRICO program also insures 100,000+ employees, including nurses, physician assistants, and clinical support staff. In addition, CRICO is a leader in patient safety, simulation and team training, and risk management.

Mr. Reynolds has 20 years of experience in the healthcare and insurance industries, most recently as CEO of Neighborhood Health Plan of RI, where his outcome-driven approach resulted in it being rated among the nation’s top 10 Medicaid health plans.

Timothy Smith is the Chief Claims Officer of the NORCAL Group. With more than 30 years of experience in the legal and insurance industries, he has held claims leadership positions at various national and local companies.

Prior to working in the insurance industry, Mr. Smith practiced law in California and Illinois, specializing in medical malpractice, products, and general liability.

Mr. Smith received his Bachelor of Science in commerce/accounting from DePaul University in Chicago and his Juris Doctor from the McGeorge School of Law in California.

Click Here to Register  

Posted in Medical Liability Monitor, Medical Malpractice, Medical Malpractice News, Medical Professional Liability Insurance, Uncategorized, webinar | Leave a comment
Physicians’ Reciprocal Insurers to Present Webinar “How to Respond to Document Requests, Audits and Overpayment Demands”

June 10, 2019 by matray

Physicians' Reciprocal Insurers (PRI) announced an upcoming, June 25, webinar on "How to Respond to Document Requests, Audits and Overpayment Demands."

Presented in partnership with Frier Levitt, a national healthcare law firm, this webinar will provide valuable information for both physicians and practices on how to mitigate the risk of, and respond to audit notices, document requests, and overpayment demands. Knowing what to expect and understanding the best course of action can help protect your professional license, save money, and avoid litigation.

The webinar will be hosted by Guillermo J. Beades, Esq., senior counsel for Frier Levitt's Healthcare Litigation Department. Beades has extensive litigation experience within the healthcare field including litigating before state licensing authorities, federal healthcare agencies and state healthcare agencies.

According to PRI, this webinar will take you through the process of what to do when receiving a request or demand from a government agency or private payor, which will include:

• How to identify if a document request is problematic

• Current audit trends with a focus on the codes, modifiers, and procedures that are a substantial risk for triggering an audit

• How to formulate an action plan to respond to audits and document demands

• How physicians and practices can protect themselves and low lower the risk of adverse audit findings

• Identifying common pitfalls and how to avoid them

This free webinar will take place on Tuesday, June 25, from 2-3 p.m. To register for this event please use this Registration Link.

For additional information, please contact Katherine Guglielmo at KGuglielmo@frierlevitt.com.

Posted in Medical Malpractice News, Physicians’ Reciprocal Insurers (PRI), Risk Management, webinar | Leave a comment
A.M. Best Places Credit Ratings of CMIC Group’s Members Under Review With Negative Implications

June 7, 2019 by matray

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

The under review status considers several strategic initiatives that management plans to execute during the third quarter of 2019 and the benefits these are expected to have on the group’s prospective operating results. These initiatives, combined with corrective underwriting actions introduced by management in the prior year, are expected to improve the group’s operating performance, which has suffered in recent years due to increased claims severity, diminishing reserve redundancies, and a declining premium base. A.M. Best views these initiatives being taken in the upcoming quarter as material and therefore, failure to execute on these plans is likely to result in negative ratings pressure, hence the negative rating implications. The ratings will remain under review pending further discussions with management and, more importantly, the execution of these new initiatives.

Posted in A.M. Best, CMIC | Leave a comment
Fitch Downgrades ProAssurance’s HoldCo Ratings; Affirms IFS Ratings at ‘A’

June 6, 2019 by matray

Fitch Ratings has affirmed ProAssurance Corporation’s (PRA) subsidiaries Insurer Financial Strength (IFS) ratings at 'A' (Strong). Fitch has downgraded PRA's senior unsecured debt to 'BBB' from 'BBB+' and its Issuer Default Rating (IDR) to 'BBB+' from 'A-'. The Rating Outlook is Stable. A full list of rating actions follows at the end of the release.

KEY RATING DRIVERS

The rating affirmation considers the company's very strong capital and profitability, low financial leverage, and favorable reserve experience. Partially offsetting these positives is the company's business profile.

Fitch's downgrade of the holding company ratings reflects a financial leverage and fixed-charge coverage ratio profile that is no longer consistent with narrow notching. In particular, narrow notching may be applied if a company maintains 15% or less financial leverage or has 12x or greater in fixed-charge coverage (FCC). As of YE 18, PRA had FLR of 16% and FCC of 5.5x respectively.

While financial leverage has increased, mainly from reductions in common equity from dividends and share repurchases, it was the decline in FCC below a 12x threshold that has led to the holding company ratings being downgraded. FCC declined, for the sixth consecutive year primarily due to the effect of lower prior year favorable reserve development on earnings.

Fitch views PRA's profitability as very strong but declining. The full year calendar year combined ratio for 2018 was 101.5%, up from the prior year's 95.4%. Calendar year combined ratios for the past several years have benefited from large favorable loss reserve development. Pre-tax operating income was $73 million for full year 2018 down 42% from the prior year and 71% from full year 2014.

PRA has a moderate business profile. Approximately 60% of overall premium relates to medical professional liability insurance (MPLI) a relatively volatile line of business. The MPLI market includes numerous monoline MPLI writers that have very strong capital positions and limited underwriting opportunities outside of MPLI, thus intensifying a soft market. The company does actively write workers' compensation but is exploring strategic alternatives for its Lloyd segment.

Overall, reserve adequacy is a positive to the rating. PRA is likely to continue to report significant but declining favorable prior period reserve development going forward. Fitch believes that current loss ratio estimates incorporate a reasonable but conservative view for future claims reserves.

RATING SENSITIVITIES

The following could lead to a downgrade of all ratings:

--An increase in financial leverage above 28% or decline in operating earnings-based coverage below 6x;

--Material adverse reserve development;

--An increase in the company's GAAP operating leverage of 1.0x or higher;

--A Prism capital model score below 'Strong' (currently 'Very Strong').

The following could lead to an upgrade:

--An improvement in business profile while maintaining profitability.

Posted in Fitch Ratings, ProAssurance Corp. | Leave a comment
ISMIE Mutual Admitted in Texas

June 6, 2019 by matray

Today, the ISMIE Mutual Insurance Company announced that Texas insurance regulators have approved the company’s rate and forms filing. According to the company, growing its foothold in Texas is a significant step for the medical professional liability carrier’s national expansion.

With this development, ISMIE is able to offer Texas physicians, health professionals and medical entities of all types its customized medical liability coverage. New policyholders will gain access to a wide range of ISMIE’s core products, which include risk management products, cyber liability protection and claims services.

“Obtaining approvals in Texas in 2019 was an important strategic goal for ISMIE,” said Paul H. DeHaan, MD, ISMIE chairman. “We previously established our presence in Texas through our subsidiary ISMIE Indemnity, so we benefit from having an understanding of the Texas market. Being an admitted carrier allows more coverage options for our current and future policyholders.

“Texas hosts a vibrant, innovative and growing medical community. ISMIE offers that community a broad range of risk management and medical liability products. We are working with top-tier, Texas-based distribution partners and expect significant interest to come from the Texas market.”

Posted in Expansion, ISMIE Indemnity, ISMIE Mutual, Medical Malpractice News, Medical Professional Liability Insurance | Leave a comment