Medical Liability Monitor September 2023 issue highlights

September 11, 2023 by matray

Below are some headlines and article synopses from the September 2023 issue of Medical Liability Monitor. To read the articles in entirety, please subscribe today.

Connecticut Supreme Court Narrows Scope of COVID Immunity for Medical Liability Claims
The Connecticut Supreme Court last month determined that Gov. Ned Lamont’s pandemic-era executive order, which granted healthcare professionals and healthcare facilities immunity from civil liabilities resulting from care delivered in support of the state’s COVID-19 response during the public health emergency, did not apply in two medical malpractice cases …

Who Pays the Liability Bills When Artificial Intelligence Kills?
Modern AI systems are based on statistical methods. As providers increasingly rely on AI to make critical decisions, its statistical nature guarantees that certain AI systems will not perform as intended on some occasions, leading to more and more AI-related disputes. So, the question of who pays when something goes wrong dominates much of the debate surrounding AI in medicine as well as in other industries. The concept of “wrong” ranges from physical harm to privacy violations to biases that can be more easily perpetuated by AI on social media platforms …

Rate of ‘Serious Discipline’ of Physicians by State Medical Boards Drops from Previous Benchmark
A new analysis of disciplinary actions taken by state medical boards between 2019 and 2021 determined that Michigan disciplined physician misconduct at a higher rate than any other state, but the analysis also indicates an overall decline in the rate of serious disciplinary actions when compared to the rate between 2017 and 2019 …

Indemnity Payments Swell During Second Quarter for MPL Specialty Writers
Indemnity payments for the MPL industry have continued to rise through the second quarter 2023. A composite of MPL writers experienced a prolonged slowdown in indemnity payments for about 18 months from the second quarter 2020 through the third quarter 2021. In the last three quarters, the composite has seen the three largest quarterly indemnity payments on record, with the second quarter 2023 coming in at nearly $775 million. Based on the depth of the decline in indemnity payments after the pandemic started and general severity concerns in the industry, the composite may expect these sizable levels of indemnity payments to persist as the industry tries to dig out of the hole created by the court slowdown that the COVID-19 pandemic caused …

US Senator Questions Google About its AI Healthcare Chatbot Technology
U.S. Sen. Mark Warner, chairman of the Senate Select Committee on Intelligence, urged Google chief executive officer Sundar Pichai to provide greater clarity into his company’s deployment of Med-PaLM 2, an artificial intelligence (AI) chatbot currently being tested in healthcare settings. In a letter sent last month to the multinational technology company, Sen. Warner expressed his concern about reports of inaccuracies in the technology, calling on Google to increase transparency, protect patient privacy and ensure ethical guardrails ...

Is Artificial Intelligence Ready For Healthcare Applications?
What use could healthcare have for someone who makes things up, can’t keep a secret, doesn’t really know anything, and, when speaking, simply fills in the next word based on what’s come before? Lots, if that individual is the newest form of artificial intelligence, according to some of the biggest companies out there. Companies pushing the latest AI technology — known as “generative AI” — are piling on. Google and Microsoft want to bring types of so-called large language models to healthcare. Big firms that are familiar to folks in white coats — but maybe less so to your average Joe and Jane — are equally enthusiastic. Electronic medical records giants Epic and Oracle Cerner aren’t far behind. The space is crowded with start-ups, too …

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AM Best Affirms A (Excellent) Rating of Mutual Insurance Company of Arizona

September 6, 2023 by matray

Mutual Insurance Co. of Arizona MICA) announced that AM Best has affirmed its Financial Strength Rating (FSR) of A (Excellent) and its Issuer Credit Rating (ICR) of a+ (Excellent) — both with a stable outlook. MICA Risk Retention Group, Inc. also received a rating of A (Excellent), a+ (Excellent) with a stable outlook.

“MICA is proud of its continued financial excellence as exemplified by our approach to business and the ongoing recognition by AM Best,” said Ed Markey, MICA president and CEO. “MICA’s commitment to the independent physicians, advanced healthcare professionals and group practices we cover remains stronger than ever. The people at MICA live our mission every day, and we are committed to bringing value to our members.”

In its rating report, AM Best recognized that MICA maintains the strongest level of risk-adjusted capitalization while maintaining a strong record of distributing policyholder dividends. MICA continues to deliver strong operating results that outperform the medical professional liability composite and the overall property/casualty industry. AM Best also recognized MICA’s significant market knowledge and expertise and its ability to appropriately assess and manage risk.

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Positive Physicians Insurance Co. Appoints Shelly Ursini Senior Vice President of Insurance Services

September 6, 2023 by matray

Positive Physicians Insurance Company announced the strategic appointment of Shelly Ursini as the senior vice president of insurance services, effective immediately. Shelly joins the team with a rich portfolio of experience in insurance services, marketing, underwriting and business development.

Shelly Ursini has more than 18 years of experience in the Medical Professional Liability (MPL) arena. She has served in various capacities on both the broker and carrier sides of the industry. Most recently, she held the position of vice president of marketing and business development at Integris Group where her leadership extended to both business development and underwriting teams, showcasing her versatility and comprehensive understanding of the industry.

Ursini will spearhead Positive's expansion initiatives in the New England region as part of the company's strategic plan to extend its national footprint. Beyond geographical expansion, she will be instrumental in diversifying the portfolio of products and services offered to our insureds, thereby enhancing customer value.

"Shelly is an extraordinary addition to our Senior Leadership Team," said Michael G. Roque, president and CEO of Positive Physicians Insurance Co. "Her extensive leadership and national experience in the MPL industry will be pivotal in executing Positive's strategic vision. We're excited to have Shelly's expertise as we make our forthcoming expansion into the New England territory and the introduction of new, region-specific products and services."

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I-PASS Institute, Coverys Collaborate to Bring Patient Safety Solution to Hospitals Nationwide

September 6, 2023 by matray

I-PASS Patient Safety Institute (I-PASS), an authority on highly reliable clinical handoffs, announced it is working with Coverys to offer a structured communication tool to hospitals nationwide. For more than 15 years, I-PASS has provided hundreds of healthcare institutions with the methodology, platform and training to implement best-in-class clinical handoffs that capture critical patient information, prevent communication breakdowns, and significantly improve patient safety. I-PASS will now be offered to select hospitals at no cost. The funds for this program have been made available through the Coverys Community Healthcare Foundation, Inc., through its Transitions in Care grant program.

Of the hospitals that applied to the grant’s call for nominations, up to three recipients will be selected to participate in the pilot program. The program will offer access to the full I-PASS handoff bundle, hands-on training and EHR integration to help these institutions reduce medical errors that occur due to miscommunication and poor patient handoffs. The grant recipients will be announced in fall of 2023.

A recent analysis by the Joint Commission identified communication breakdowns as the leading cause of sentinel events, which have increased by 78% from 2020 to 2022. With communication breakdowns, handoffs are a particularly vulnerable time for communication failures and can lead to serious or fatal medical errors. Further, hospitals and medical professional liability (MPL) organizations are seeing a steady rise in claims severity and medical malpractice nuclear verdicts. A 2022 study published in the Journal of Patient Safety shows that nearly half of all medical malpractice cases involve miscommunication, 77% of which could be prevented with a proper handoff tool.

“We recognize that in this challenging time in healthcare, proactive strategies are what’s going to drive meaningful change in patient safety,” said Dana Siegal, vice president of risk management and analytics at Coverys. “The Coverys team is committed to being part of this positive progress and bringing highly reliable handoff communications to hospitals to improve care delivery and experience. We’re looking forward to collaborating with I-PASS to bring world-class solutions to our providers.”

“I-PASS and Coverys are deeply aligned on the importance of advancing patient safety and mitigating risk through structured communication,” said William Floyd, CEO of I-PASS. “Seeing all sides of the ecosystem collaborating towards the same mission is heartening. When we implement solutions that are proven to address the root cause of harmful events, we create a higher standard of care and a system where everyone wins.”

The I-PASS handoff method was first established by the I-PASS Study Group – a team of clinicians determined to create a blueprint for safer handoffs that captured often-missed patient information. The I-PASS handoff bundle is a direct result of their cumulative experience and research. The bundle offers a universal structure that enables caregivers across clinical settings to communicate patient information reliably and uniformly. Today, I-PASS Institute coaches and clinical leaders work with hospitals to help them adopt the I-PASS methodology through planning, implementation, training, and ultimately, sustained behavior and positive culture change. The cumulative effect is a more positive care experience for all parties and the opportunity to significantly reduce preventable adverse events.

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Markel promotes Sal Pollaro to Executive Underwriting Officer for Professional Liability

September 5, 2023 by matray

Markel, the insurance operations within the Markel Group, recently announced that Sal Pollaro has been named executive underwriting officer, professional liability for Markel Specialty, a division within the Markel insurance business. In his new role, Pollaro will lead the professional liability team to generate profitable growth, including establishing underwriting strategies, driving product development, and enhancing technical and analytical capabilities.

“Sal is a proven leader and brings extensive profit and loss management experience, including profitable growth, maximizing marketplace solutions, and ensuring relevant value propositions,” said Jane Peterson, chief underwriting officer for Markel Specialty. “He also places a special emphasis on talent development, which is critical in this business. We look forward to having him lead our professional liability team.”

Pollaro has more 25 years of experience in the insurance industry. He joined Markel in 2009 and most recently served as managing director of management and professional liability for Markel Specialty. He replaces Jim Gray, who retired at the end of May.

“We’re grateful for Jim’s dedication and industry expertise at Markel over the past 25 years,” said Peterson. “His innovation and customer focus are unparalleled. During his time here, Jim made lasting contributions to the professional liability team, mentoring underwriters, and recruiting countless others in the field.”

Pollaro will report to Peterson and is based out of Markel’s New York City office.  

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The Cooperative of American Physicians Tops the 13,000 Member Mark, Reaching a New Milestone

September 5, 2023 by matray

The Cooperative of American Physicians, Inc. (CAP) recently announced that its membership has grown to exceed 13,000 California physicians, its largest member count in its 48-year history. The organization’s growth is further contributing to its already strong fiscal position and outlook.

“Independent physicians have endured more than their share of challenges over the past 15 years, marked most recently by the COVID-19 pandemic and the undermining of decades-old tort reforms contained in MICRA,” said CAP Vice President of Membership Development Dan Cavanaugh. “It’s not surprising that more physicians than ever are choosing CAP’s valuable resources, expertise, and unparalleled services to help them maintain their independence and operate safe and successful medical practices.”

To complement the medical professional liability coverage provided through the Mutual Protection Trust (MPT), CAP offers its members a wide range of value-added programs, including a risk management hotline, online risk reduction training, human resources support, practice management consultation, a group purchasing program, business and personal insurance coverages, and many other free or deeply discounted benefits.

“CAP’s membership milestone comes after MPT earned its 16th consecutive A+ (Superior) rating from A.M. Best earlier this year,” said CAP CEO Sarah E. Scher. “These two recent achievements exemplify CAP’s superior financial stability and long-term standing as a formidable leader in the California medical malpractice coverage arena.”

The enterprise began with approximately 500 physician members. Now, with more than 13,000 physician members, MPT is the second-largest provider of medical professional liability coverage in California. CAP credits its robust internal processes, disciplined underwriting and claims management practices, and dedicated risk management programs for its sustained growth and solid financial record.

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AM Best Upgrades Credit Ratings of Hospitals Insurance Company, Inc.; Affirms Credit Ratings of Doctors Company Insurance Group’s Members

August 31, 2023 by matray

AM Best  upgraded the Financial Strength Rating (FSR) to A (Excellent) from A- (Excellent) and the Long-Term Issuer Credit Rating (Long-Term ICR) to “a” (Excellent) from “a-” (Excellent) of Hospitals Insurance Company, Inc. (HIC). Concurrently, AM Best has affirmed the FSR of A (Excellent) and the Long-Term ICR of “a+” (Excellent) of the members of Doctors Company Insurance Group. The outlook of these Credit Ratings is stable. (See below for a list of TDC’s companies.)

The ratings reflect HIC’s balance sheet strength, which AM Best assesses as strongest, as well as its adequate operating performance, limited business profile and appropriate enterprise risk management (ERM).

The ratings upgrade for HIC reflects the implicit support from its parent organization, TDC. HIC has been fully integrated into the group’s operations and is viewed as one of TDC’s four strategic business units. The company is critical to the group’s strategy and is a material contributor to the group’s premiums and earnings. Furthermore, the parent has indicated its willingness to provide explicit support if needed.

The ratings of TDC reflect the group’s balance sheet strength, which AM Best assesses as strongest, as well as its adequate operating performance, neutral business profile and appropriate ERM. TDC’s balance sheet strength continues to be supported by the strongest level of risk-adjusted capitalization, as measured by Best’s Capital Adequacy Ratio (BCAR). In addition, the group benefits from consistently favorable loss reserve development and a solid liquidity position. The group’s underwriting performance has shown improvement in recent years, with rate actions taken amid hardening market conditions within the medical professional liability (MPL) insurance segment. TDC maintains a strong market position as the second largest MPL writer in the United States, based on 2022 direct premiums written. Further, an appropriate ERM program is in place with a well-defined framework and risk management capabilities that are closely aligned with the group’s risk profile.

The FSR of A (Excellent) and the Long-Term ICRs of “a+” (Excellent) have been affirmed for the following members of the Doctors Company Insurance Group:

  • The Doctors Company, An Interinsurance Exchange

  • TDC National Assurance Company

  • TDC Specialty Insurance Company

  • TDC Special Risks Insurance Company

  • The Doctors Company Risk Retention Group, a Reciprocal Exchange

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NOW Insurance Receives Funding from Arch Capital Group Ltd. to Accelerate Growth

August 22, 2023 by matray

NOW Insurance, a full-stack, AI-enabled commercial insurance platform specializing in medical professional liability coverage, announced today an investment from a subsidiary of Arch Capital Group Ltd. and a managing general agent partnership with Arch Insurance North America.

Proceeds from the latest capital raise will be used for launching its new suite of medical malpractice products, scaling their platform, and expanding distribution networks. Chief among these is the introduction of a new portal for brokers. Brokers will soon be able to submit and bind medical malpractice coverage online for physicians.

“I am very excited to further strengthen our partnership with Arch. As an innovative company and leader in the Insurtech space, they understand the potential of our platform and have shown their commitment in helping it succeed,” said Philip Cabaud, CEO of NOW Insurance.

“NOW Insurance’s innovative approach to the medical malpractice market aligns with Arch’s commitment to using analytics and AI to deliver an exceptional broker experience,” said Jay Rajendra, chief strategy and innovation officer for Arch Capital Group Ltd. “We’re looking forward to bringing NOW’s platform to our broker partners and working closely with NOW to further develop their analytics capabilities.”

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Integris Group Announces National Accreditation for CME Program by ACCME

August 11, 2023 by matray

Integris Group recently announced that the Accreditation Council for Continuing Medical Education (ACCME) has awarded the company’s Continuing Medical Education (CME) program with accreditation through July 31, 2027.

The decision came after a rigorous application process, which spanned nearly two years, from the preparation of the submission documentation, to an interview with ACCME officials, to the final result, according to Integris.

“Congratulations to Integris and the risk management team for receiving this important and valuable accreditation,” said Victoria Reyes, MD, Integris Board Member and Chair of the Risk Management Committee. “This was no small feat and will be a valuable benefit to our policyholders.”

The accreditation by the ACCME was timely, given a new reporting requirement recently released by the American Board of Surgery (ABS). Going forward, ABS-certified providers can no longer self-report the 150 hours of Maintenance of Certificate (MOC) eligible CME courses needed to maintain their license. Instead, the MOC credits must be reported through an ACCME accredited provider.

Now nationally accredited through the ACCME, Integris Group has added this reporting capability to the services and benefits they offer their policyholders.

“At Integris, we pride ourselves on delivering exceptional educational content to our membership,” said Denise Condron, Integris vice president of risk management. “The national accreditation by the ACCME demonstrates this commitment and also enables us to enhance the service we provide our members by allowing us to report these courses on their behalf to the ABS.”

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Medical Liability Monitor August 2023 issue highlights

August 10, 2023 by matray

Below are some headlines and article synopses from the August 2023 issue of Medical Liability Monitor. To read the articles in entirety, please subscribe today.

Florida Supreme Court Changes Appellate Rules So Challenges to Expert Witness Qualifications Can Be Immediately Appealed
The Florida Supreme Court last month amended the state’s rules of appellate procedure “to provide for interlocutory review of nonfinal orders that deny a motion dismiss on the basis of the qualifications of a corroborating witness.” Prior to the rule change, medical malpractice defendants had to wait until the conclusion of their trial before appealing any denied motions to dismiss based on the qualifications of the plaintiff’s expert witness. Since the July 6 rule change, hospitals and healthcare providers can immediately appeal an order denying a motion to dismiss based on grounds that the plaintiff’s medical expert witness isn’t adequately qualified to testify against the defendant …

Share of Physicians Working in Private Practice Dropped by 13 points During Past Decade
A new Policy Research Perspective from the American Medical Association (AMA) indicates the share of physicians working in a practice wholly owned by physicians dropped by 13 percentage points during the past decade — from 61.4% in 2012 to 46.7% in 2022. In contrast, the share of physicians directly employed by — or contracted directly with — a hospital during that period increased from 5.6% to 9.6%, and the number working in a hospital-owned practice jumped from 23.4% to 31.3% …

New Report Estimates Diagnostic Error Contributes to 795,000 Permanent Disabilities, Deaths Across Care Settings Annually
The U.S. National Academy of Medicine first declared the improvement of diagnosis in healthcare “a moral, professional and public health imperative” in 2015. However, current estimates of the full scope of harms related to medical misdiagnosis still vary widely. Using novel methods, a team from the Johns Hopkins Armstrong Institute Center for Diagnostic Excellence and partners from the Risk Management Foundation of the Harvard Medical Institutions recently published what they believe to be the first rigorous national estimate of permanent disability and death resulting from diagnostic error …

MMIC Responds to One-Sided Accusations of Bad Faith in Iowa Capital Dispatch Article
The nonprofit news organization Iowa Capital Dispatch last month published an article outlining allegations that MMIC Insurance Inc. engineered a record-setting $97.4 million jury verdict against one of its insured clinics last year in an attempt to persuade Iowa lawmakers to pass the noneconomic damage cap legislation that Gov. Kim Reynolds signed into law on February 16 of this year. The article makes no attempt to verify the allegations or explore counterarguments independently. It does not include any real overview of the underlying medical liability case or historical context for the noneconomic damage cap legislation and lacks any input from legal experts, healthcare professionals or relevant authorities who could provide insight into the legal filings. Medical Liability Monitor contacted MMIC for comment. Following is its written response to the allegations outlined in the Iowa Capital Dispatch article …

Why Doctors Aren’t Prepared for Medicine’s AI Transformation
As artificial intelligence systems like ChatGPT increasingly find their way into everyday use, physicians will similarly begin incorporating these tools into their clinical decision making, diagnoses and treatment of common medical conditions. These tools, called clinical decision support (CDS) algorithms, can be enormously helpful in guiding healthcare providers in determining, for example, which antibiotics to prescribe or whether to recommend a risky heart surgery. The success of these new technologies, however, depends largely on how physicians interpret and act upon a tool’s risk predictions — and that requires a unique set of skills that many are currently lacking ...

Report Recommends Policy Steps to Slow Private Equity’s Role in Medicine
A new report, Monetizing Medicine: Private Equity and Competition in Physician Practice Markets, examines private equity’s voracious acquisition of physician practices during the last several years. The analysis evaluates market penetration across 10 physician practice specialties, the impact on market shares and concentration, and on prices and expenditures. The authors ultimately frame policy steps that would strengthen FTC competition enforcement …

Malpractice Lawsuits Over Denied Abortion Care May Be on the Horizon
A year after the overturning of Roe v. Wade, many physicians and hospitals in the states that have restricted abortion are reportedly refusing to end the pregnancies of women facing health-threatening complications out of fear they might face criminal prosecution or loss of their medical license. Some experts predict those providers could soon face a new legal threat: medical malpractice lawsuits alleging they harmed patients by failing to provide timely, necessary abortion care …

Subscribe today to get this issue (as well as the 2022 Annual Rate Survey at no additional cost).

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