April 9, 2024 by matray

Below are some headlines and article synopses from the April 2024 issue of Medical Liability Monitor. To read the articles in their entirety, please subscribe today.

Does AI Help or Hurt Radiologists’ Performance? It Depends on the Doctor
One of the most touted promises of medical artificial intelligence (AI) tools is their ability to augment human clinicians’ performance by helping them interpret images, such as X-rays and CT scans, with greater precision to make more accurate diagnoses. But the benefits of using AI tools for image interpretation appear to vary from clinician to clinician, according to new research led by investigators at Harvard Medical School, working with colleagues at Stanford University and the Massachusetts Institute of Technology (MIT) Sloan School of Management. The study’s findings suggest that individual clinician differences shape the interaction between human and machine in critical ways that researchers do not yet fully understand …

Investment Performance Helps Sustain Underwriting Stalemate for the MPL Industry: 2023 Year-End Financial Results for Medical Professional Liability Specialty Writers
After-tax net income for our composite of MPL insurers increased from slightly more than $400 million in 2022 to approximately $720 million in 2023, an increase of almost 75%. While underwriting results remained relatively flat in 2023, the composite’s investment income was buoyed by interest rate hikes implemented by the Federal Reserve, which increased to nearly $1 billion and was the highest level of investment income since 2010. While inflation remains near the top of everyone’s mind, for our composite, inflation’s impact to date has resulted in a larger increase in investment gains than underwriting expenses …

Florida Bills to End ‘Free Kill’ Law, Institute Noneconomic Damage Cap Die in Committees
Florida lawmakers filed five bills during the 2024 legislative session that would have ended a law denying recoverable damages for certain wrongful death medical liability claims (see MLM, January 2024). None of the bills passed before the session ended on March 8. Only Senate Bill (SB) 248 advanced out of its originating committee. The bill would have eliminated the law limiting noneconomic damages in wrongful death medical liability lawsuits to spouses and minor children and imposed a $500,000 total noneconomic damage cap on claims against healthcare providers, regardless of the number of providers who are liable; a $750,000 noneconomic damage cap for hospitals and other “non-practitioners”; and a $150,000 noneconomic damage cap for providers in emergency cases …

AM Best P/C Downgrades Outpace Upgrades in 2023: MPL Insurers Receive 7 Upgrades, No Downgrades
AM best downgraded more issuer credit ratings for the property/casualty (P/C) insurance industry than it upgraded in 2023, according to a new special report from the ratings agency, but medical professional liability (MPL) insurers bucked the trend with seven rating upgrades and no downgrades …

Feds Launch Probe Into Private Equity’s Increasing Role in Healthcare
The Justice Department, Federal Trade Commission and Department of Health & Human Services recently launched a joint, cross-government public inquiry into private-equity’s increasing control over the U.S. healthcare delivery system …

No More ‘Bare’ Brazilian Butt Lift Surgeries in Florida
Florida surgeons who perform gluteal fat grafting procedures, commonly referred to as Brazilian butt lift surgery, will be required to either secure medical professional liability insurance coverage or maintain an irrevocable letter of credit should Gov. Ron DeSantis sign the recently passed House Bill (HB) 1561. No other physician or surgical specialty is required by Florida law to have indemnity coverage. About 20% of the state’s plastic surgeons practice without malpractice insurance, an action referred to as “practicing bare” by insurance professionals …

Americans Unaware of Litigation Funding’s Impact on Legal System
Results from a new survey conducted by the American Property Casualty Insurance Association (APCIA) and Munich Reinsurance America indicate the American public at large is not aware of the negative impact of plaintiff lawyers’ tactics, e.g., predatory advertising and the use of third-party litigation funding, on their day-to-day household costs. And upon learning of these externalities, an overwhelming majority of survey respondents want state and federal laws changed to address these abuses of the legal system …

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April 8, 2024 by matray

Coverys hired Brian J. Farrell Jr., JD, to be its new senior vice president of claims, effective as of March 25, 2024.

Reporting to Coverys chief operating officer Catherine Donahue, Farrell will lead the Coverys claims team and oversee management across the enterprise providing quality claims services for policyholders.

Farrell most recently served as vice president of claims at Chubb, where he was responsible for differentiating the claims experience and solution management for the company’s largest and most complex clients. Prior to his 20-year tenure at Chubb, he was managing attorney for AIG, where he launched the organization’s workers’ compensation practice.

April 1, 2024 by matray

AM Best has removed from under review with developing implications and affirmed the Financial Strength Rating (FSR) of A (Excellent) and the Long-Term Issuer Credit Ratings (Long-Term ICRs) of “a” (Excellent) of certain members of Curi Insurance Group (Curi). Concurrently, AM Best has removed from under review with developing implications and downgraded the Long-Term ICRs to “a” (Excellent) from “a+” (Excellent) and affirmed the FSRs of A (Excellent) of Medical Mutual Insurance Company of North Carolina and its wholly owned subsidiary, Medical Security Insurance Company. Both companies are domiciled in Raleigh, NC and also members of Curi. The outlook assigned to all of these Credit Ratings (ratings) is stable. (Please see below for the list of Curi members and ratings.)

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

These ratings were previously placed under review with developing implications in February 2023, following the announcement that Curi Holdings, Inc. and Constellation, Inc. (Constellation) had entered a definitive merger agreement. Effective Oct. 1, 2023, the merger closed, with Curi Holdings, Inc. as the surviving entity. Following the merger, the subsidiary members that comprised Constellation Insurance Group and Curi Holdings Group are now viewed as one AM Best rating unit, Curi Insurance Group.

The group’s balance sheet strength assessment is supported by its risk-adjusted capitalization being at the strongest level, as measured by Best’s Capital Adequacy Ratio (BCAR), which reflects the group’s moderate underwriting leverage, high quality of capital, conservative investment portfolio and adequate loss reserve position. The balance sheet strength assessment is further bolstered by adequate liquidity and a reinsurance program supported by highly rated participants to help protect the group’s surplus and earnings. Additionally, some financial flexibility exists as members of the group are also members of both the Federal Home Loan Bank of Des Moines and Atlanta. The ultimate parent, Curi Holdings, Inc., has a neutral rating impact on the ratings of the merged insurance companies with more than $2 billion of consolidated assets and generating nearly $400 million in revenue, serving more than 50,000 physicians, healthcare providers and organizations across the United States as of year-end 2023.

The group’s operating performance remains in line with its peer group composite. Despite some deterioration in underwriting results in recent years, results remain profitable, bolstered by investment income, which is a significant contributor to earnings. Consolidated underwriting results have lagged the industry composite in more recent years due to several large problematic accounts and unfavorable reserve development, which has been impacted in part by delayed settlement of COVID-19 period claims. Non-renewal of problematic accounts and re-underwriting of higher risks, as well as pricing adjustments and synergies expected throughout 2024, are projected to lead to improved underwriting results. AM Best expects the group’s prospective operating performance to benefit from the enhanced scale and geographic diversification following the merger. The ratings are also supported by the group’s adequate ERM as governance and oversight have been merged across all insurance operations for the combined organization.

The stable outlooks reflect AM Best’s expectation that the ongoing strategic initiatives implemented by management will drive stable operating performance over the intermediate term, while the group maintains the strongest balance sheet strength assessment and risk-adjusted capitalization.

The FSR of A (Excellent) and the Long-Term ICRs of “a” (Excellent) have been removed from under review with developing implications and affirmed with a stable outlook assigned for the following members of Curi Insurance Group:

• UMIA Insurance, Inc.


• MMIC Insurance, Inc.


• Arkansas Mutual Insurance Company


• MMIC Risk Retention Group, Inc.

The Long-Term ICRs have been downgraded to “a” (Excellent) from “a+” (Excellent) and the FSRs of A (Excellent) affirmed and removed from under review with developing implications with a stable outlook assigned for the following members of Curi Insurance Group:

• Medical Mutual Insurance Company of North Carolina


• Medical Security Insurance Company

April 1, 2024 by matray

The Doctors Company approved a 2024 premium dividend of approximately $14.7 million, bringing the company’s total of declared dividends to date to $470 million.

“We are pleased to reward members once again with earned dividends,” said Richard E. Anderson, MD, FACP, chairman and CEO of The Doctors Company and TDC Group. “Dividends are an important part of our mission to advance, protect, and reward the practice of good medicine.”

Dividends of up to 10% were approved by The Doctors Company Board of Governors for eligible members in the following states: Florida, Idaho, Illinois, Maryland, Massachusetts, Michigan, Montana, North Carolina, Ohio, Texas, Virginia, Washington and Wyoming. Members of the American Academy of Otolaryngology—Head and Neck Surgery and the American Society of Plastic Surgeons may also receive a dividend, depending on their eligibility.

Eligible members will receive this year’s dividend on their annual premium for policy renewals between July 1, 2024, and June 30, 2025.

“As a member-owned company, we are committed to sharing the results of our financial success with the healthcare professionals we insure,” said Deepika Srivastava, chief operating officer of The Doctors Company. “Our multiyear dividend program recognizes the outstanding outcomes achieved by our members.”  

March 7, 2024 by matray

Below are some headlines and article synopses from the March 2024 issue of Medical Liability Monitor. To read the articles in their entirety, please subscribe today.

Study Finds Use of Generative Artificial Intelligence in Healthcare Delivery Hampered by Trust, Training, Liability Fears
A new study discovered that despite broad optimism among healthcare professionals about the potential benefits of generative artificial intelligence (Gen AI) engagement in healthcare delivery, those on the front lines of medicine maintain grave concerns about the technology’s implementation. The report, titled ClinicAI Companions, reveals significant gaps between how clinicians use Gen AI in their personal lives, what they believe the benefits are for their practice, their concerns about implementation and their confidence in management/leadership to get implementation right. Two-thirds of survey respondents said they don’t trust their hospital/clinic leaders to effectively deploy Gen AI, and four out of five believe the technology will place them at a greater risk of medical liability claims …

Patient Frustration with U.S. Healthcare Surges
The complexity of navigating long waits for brief appointments, impersonalized care and perplexing insurance bills is causing a spike in frustration with the U.S. healthcare delivery system. According to a survey of more than 1,000 patients, 61% of respondents find the U.S. healthcare system to be a “hassle,” with 53% feeling it “treats patients more like a number than a person” …

More Than 134,000 Cancer Cases Undiagnosed During Start of COVID
More than 134,000 cancer cases went undiagnosed during the first 10 months of the COVID-19 pandemic, according to a new study. Thirty-four percent of medical malpractice claims involving death or permanent disability are associated with an inaccurate or delayed diagnosis, and the medical professional liability industry has been anxious that the frequency of diagnosis-related claims could spike post-pandemic …

Philadelphia Medical Liability Filings Up 33% Since Venue Rule Change
Philadelphia experienced a large jump in the number of medical liability lawsuits filed in its court system last year, the first since the Supreme Court of Pennsylvania widened its venue rule for medical liability lawsuits. The updated venue rule took effect Jan. 1, 2023. Plaintiff attorneys filed 544 medical liability cases last year, a 33% increase from the average annual caseload during the three years prior to the pandemic, according to the Philadelphia Common Pleas Court’s trial division …

States Where Physician Assistants Have Wider Scope of Practice Experience Fewer Malpractice Payments
A recent 10-year study found no significant increase in medical malpractice payment reports (MMPRs) in states with permissive laws regulating the scope of practice for physician assistants (PAs), challenging longstanding concerns about patient safety. The study analyzed data from the National Practitioner Data Bank alongside state laws and regulations governing PA practice. Concerns have been raised by some in the medical community that permissive regulations could compromise patient safety and lead to an increase in medical liability claims. However, the findings of this study suggest otherwise. During the 10-year period from 2010 to 2019, states with permissive PA practice laws did not encounter a higher incidence of MMPRs when compared to states with more restrictive regulations. In fact, states permitting PAs to practice independently experienced a notable 58.3% reduction in PA MMPRs …

Filed Ballot Initiatives Ask Colorado Voters To Decide MedMal Litigation Rules
Plaintiff attorneys and healthcare/business leaders in Colorado recently filed competing ballot initiatives that will ask the state’s voters to decide in November the amount of recoverable damages in catastrophic injury and wrongful death lawsuits, whether certain records are accessible in medical malpractice litigation, whether to cap attorney fees at 25% of recovered damages, and whether to mandate that plaintiff attorneys disclose up front the expected litigation expenses their clients are responsible for paying and cap those costs at no more than 10% above the estimate. …

Subscribe today to get this issue (as well as the 2023 Annual Rate Survey at no additional cost).

February 29, 2024 by matray

MLMIC Insurance Co. launched its new podcast series, “The Verdict,” yesterday.

The Verdict podcast focuses on a wide variety of subjects that relate to medical and dental professional liability within New York State.

The podcast aims to provide insights on standard of care, legal issues and risk management. It will also, from time to time, interview thought leaders throughout the medical professional liability industry.

During the first episode of The Verdict, MLMIC’s content marketing manager Tammie Smeltz, sits down with MLMIC chief executive officer Michael Schoppmann, to discuss the organization's history and the status of medical professional liability in New York.

During this podcast, Schoppmann offers advice to both new-to-practice physicians and experienced providers about medical professional liability insurance, including the benefits of belonging to your local and state medical societies.

To listen to the inaugural episode of The Verdict, please click here.

February 15, 2024 by matray

Pinnacle Actuarial Resources, , a property and casualty actuarial consulting firm, today announced principal Roosevelt Mosley will become the firm’s new managing principal effective April 9. Outgoing managing principal Joe Herbers will return to his role as firm principal.

“Over the last two decades, Pinnacle has grown into the leading independent property and casualty actuarial consulting firm in the U.S.,” Mosley said. “Our position in the industry has been largely due to the successful execution of our established business strategy. Collaborating with the firm’s principals, Joe has done an exceptional job of driving that strategy and helping to build Pinnacle’s widening reputation for quality, accuracy and innovation.”

The managing principal plays an important and highly collaborative role at Pinnacle and works with Pinnacle’s principals to set strategy and determine organizational goals. The managing principal also coordinates the implementation of policies and procedures, monitors day-to-day business operations and supports oversight of the firm’s functional areas. The role is also essential to communicating to all key stakeholders, including clients, on all important matters.

“The word growth does not appear in Pinnacle’s strategic plan, as set by the firm’s principals,” Herbers said. “Instead, our plan is focused on our commitment to our clients, empathetic customer service and outstanding communications. Those pillars have played a key role in Pinnacle’s success and are values to which Roosevelt has dedicated his career. He is particularly well-qualified for this role and will excel in growing and developing Pinnacle’s prominence and eminence in the property and casualty industry.”

Mosley has over 30 years of experience in the insurance industry and has worked for Pinnacle since 1999. He has been a principal at Pinnacle since 2006 and has led several of the firm’s functions including IT and strategic partnerships. Mosley’s practice is focused on predictive analytics and he is very widely known and respected for his leadership in the property and casualty industry.

He has been heavily involved in the profession and has volunteered with a number of important professional organizations. He is currently the immediate past president of the Casualty Actuarial Society (CAS) and served as president of the organization from 2022 to 2023. He has also volunteered with many industry organizations over the years, including the CAS, the American Academy of Actuaries, the Actuarial Foundation and the International Association of Black Actuaries (IABA).

Herbers has served as Pinnacle’s managing principal for almost 16 years. He is one of the firm’s founding principals and has worked to advance the actuarial profession. He is a sought-after speaker and is the author of numerous thought leadership pieces on actuarial matters. In addition to his long track record of serving hundreds of clients, he has dedicated himself to developing Pinnacle’s culture, and its scores of talented professionals.

He will continue to work at Pinnacle as a principal and consulting actuary, focusing on employee development and management of a designated functional department, or key management area (KMA).

“On behalf of all the firm’s principals, I thank Joe for his many years of service as Pinnacle’s managing principal. I am looking forward to continuing his legacy as managing principal,” Mosley added.

February 8, 2024 by matray

Below are some headlines and article synopses from the February 2024 issue of Medical Liability Monitor. To read the articles in entirety, please subscribe today.

Florida Looks to Impose Noneconomic Damage Caps, End ‘Free Kill’ Law
A bill that would end a Florida law denying recoverable damages for certain wrongful death medical liability claims and impose noneconomic damage caps on medical malpractice awards cleared a key hurdle last month when it was approved by the state’s Senate Judiciary Committee …

New York Gov. Hochul Vetoes Bill Expanding Recoverable Wrongful Death Damages
New York Gov. Kathy Hochul vetoed for a second time the Grieving Families Act, a bill that would have expanded recoverable damages in wrongful death claims to include noneconomic damages. Under the current 177-year-old law, compensable damages in wrongful death actions are limited to economic loss only. New York and Alabama are the only two states that currently restrict family members from seeking recovery for their emotional suffering by limiting recoverable damages to the deceased’s earning potential …

Ohio Statute of Repose ‘Means What It Says,’ Applies to Wrongful Death
The Supreme Court of Ohio finally put to rest the issue of whether the state’s statute of repose for medical claims applies to wrongful death claims on Dec. 28, 2023, answering the long-discussed question in the affirmative …

Iowa Advances Bill to Pierce State’s Medical Malpractice Statute of Repose
Iowa lawmakers advanced a bill last month that would remove time requirements for filing a medical liability lawsuit against healthcare providers who conceal a cause of injury. Iowa law currently imposes a strict six-year statute of repose on medical liability claims, except those involving medical equipment left in a patient’s body post-surgery. If the bill becomes law, there will be no constraint for patients whose cause of injury or death was concealed by a healthcare provider …

Developing Safe Harbors to Address Malpractice Liability, Wasteful HealthCare Spending
With U.S. healthcare spending expected to exceed $7.2 trillion annually by 2031, the push to reduce healthcare resource utilization will only intensify in the coming years. Evidence suggests inpatient spending declines by about 5% — with no significant change in patient outcomes — when the threat of malpractice liability is removed. Current guidelines aimed at reducing waste do not account for the potential impact of medical liability and therefore may miss an opportunity to reduce spending without harming patients …

MPL Association Publishes Report on Industry’s 2023 Midyear Results
The Medical Professional Liability (MPL) Association recently published its Medical Professional Liability Insurance Sector Report: 2023 Midyear Financial Performance. This semiannual report provides insights into the MPL insurance market’s financial performance with commentary on the internal and external forces impacting insurer performance. Based on their review of the industry’s loss data, the report’s authors anticipate that frequency will likely remain flat at around 8,000 annual paid claims going forward, while average severity will continue its relentless climb …
Subscribe today to get this issue (as well as the 2023 Annual Rate Survey at no additional cost).

Subscribe today to get this issue (as well as the 2023 Annual Rate Survey at no additional cost).

February 6, 2024 by matray

Accomplished medical malpractice litigator Alyson J. Kirleis has joined Marshall Dennehey’s Pittsburgh office as a shareholder in the Health Care Department. Previously, she was a partner with Davies McFarland & Carroll.

Kirleis has more than 35 years of experience defending physicians, nurses and dentists, hospitals and long-term care facilities when claims and lawsuits are brought against them. An experienced litigator, she has successfully handled hundreds of matters which have included trials, mediations and appeals throughout western Pennsylvania in both state and federal courts. She additionally represents health care professionals before various licensing boards, from initial incident to proceedings before Hearing Examiners or Professional Licensing Boards.

“In the realm of medical malpractice defense in Pennsylvania, few attorneys match Alyson’s wealth of experience and track record of success,” said Robin B. Snyder, director of Marshall Dennehey’s Health Care Department. “Her enthusiasm for her cases  and extensive understanding of health care systems and operations set her apart when facing opponents in litigation. We are thrilled to welcome her to our bench of experienced medical malpractice trial attorneys.”

A leader within the greater Pittsburgh legal community, Kirleis is member of the Board of Governors of the Academy of Trial Lawyers of Allegheny County. She is also a member of the American Bar Association’s Tort Trial & Insurance Practice Section, and the Pennsylvania and Allegheny County Bar associations.

She is a graduate of Lehigh University and the University of Pittsburgh School of Law, and is admitted to practice in Pennsylvania.

February 5, 2024 by matray

The Cooperative of American Physicians, Inc. (CAP) announced that A.M. Best reaffirmed its A+ (Superior) rating for the Mutual Protection Trust (MPT). MPT has annually received this rating from A.M. Best since 2006.

A.M. Best once again recognized MPT for “maintaining the strongest level of risk-adjusted capitalization,” signifying its solid financial standing to withstand potential risks and uncertainties. The A+ rating exemplifies MPT’s ongoing ability to fulfill its financial obligations to its nearly 13,000 physician members.
v “We are proud to consistently earn this A+ (Superior) rating,” said CAP CEO Sarah Scher. “It reinforces CAP’s status as a leader in the California medical malpractice coverage market and further demonstrates our commitment to ensuring our members receive exceptional protection they can trust.”

A.M. Best also acknowledged the financial strength of Cooperative of American Physicians Insurance Company (CAPIC), which earned a rating of A- (Excellent). CAPIC is a wholly owned subsidiary of CAP and provides medical malpractice coverage tailored to large medical groups, reinsurance, and other benefits to its physician members.