May 7, 2024 by matray

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

Colorado Considers Raising Noneconomic Damage Cap To Save It
The Colorado Senate Judiciary Committee last month approved by a four-to-one vote Senate Bill 24-130 (SB-130), legislation that would incrementally increase the state’s $300,000 cap on noneconomic damages to $500,000 over the course of five years. The bill must now clear the full Senate and the House before the legislative session concludes on May 8. Supported by the Colorado Medical Society, the state’s largest insurer of physician liability COPIC Insurance Co., and other key physician and patient advocates, SB-130 is similar to the approach taken by California in 2022 when an initiative to remove the state’s medical liability noneconomic damage cap qualified for the electoral ballot. In response, legislators brokered a compromise between healthcare, legal and consumer advocates to increase the state’s noneconomic damage cap legislatively and incrementally from $250,000 to $500,000 …

Congress Likely to Kick the Can on Covid-Era Telehealth Policies
Federal lawmakers face a year-end deadline to solidify or scuttle an array of COVID-era payment changes for telehealth services that include allowing people to stay in their homes to see a doctor or therapist. Most of the proposals focus on how Medicare covers telehealth services. But the rules affect patients on all types of insurance plans because typically private insurers and some government programs follow Medicare’s example. Without congressional action, virtual healthcare services like audio-only calls or online meetings with specialty doctors — such as an occupational therapist — could end. The bills would also continue to allow rural health clinics and other health centers to offer telehealth services while waiving a requirement for in-person mental health visits …

New Kentucky law Protects Healthcare Workers from Criminal Prosecution of Medical Mistakes
Kentucky recently passed a law shielding healthcare providers from criminal liability for any “harm or damages” alleged to have occurred from “an act or omission relating to the provision of health services.” House Bill (HB) 159 — which received unanimous support from the commonwealth’s House and Senate — protects physicians, nurses and other medical staff from criminal prosecution for medical mistakes made in good faith as they navigate patient care situations. The bill was signed by Gov. Andy Beshear on March 26 …

Physicians Fight to Keep Practices Afloat After ‘Change’ Cyberattack
The American Medical Association (AMA) last month published results from an informal survey that illuminates the ongoing, devastating impact of the February 21 cyberattack against Change Healthcare — a unit of UnitedHealthcare Group (UHG) — on physician practices across the country. And according to survey respondents, the fallout has serious implications for the survival of independent medical practices and patient care …

Study Challenges Common Assumption on Rising Maternal Mortality, AMA Lobbies for Changes
The U.S. maternal mortality rate is accelerating at an alarming rate, according to a new study from Northwestern Medicine. And it’s not because Americans are getting pregnant at older ages. The study discovered that maternal mortality increased among every age group — with the greatest relative increases among pregnant people aged 25-29 and 30-34 years old …

Senate Investigating Whether Emergency Care Harmed by Private Equity
U.S. Senator Gary Peters, chairman of the Homeland Security & Governmental Affairs Committee, last month requested information from four emergency department staffing firms — and the three private equity companies that own them — about their business practices and how those practices impact patient care. In letters to Blackstone, KKR and Apollo Global Management and their respective staffing firms TeamHealth, Envision Healthcare, US Acute Care Solutions and Lifepoint Health, Peters requested information about business operations, staffing decisions, and patient care and safety at several emergency departments across the country …

Patients’ Health at Risk as Insurers Deny, Delay Vital Treatments
To curb healthcare costs and block unnecessary services, insurers have long required doctors to obtain their approval before they’ll pay for certain drugs, treatments and procedures. But in recent years, insurers have ratcheted up their use of prior authorization, causing delays and denials of care that are harming or even killing people, many doctors and patients say …

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April 26, 2024 by matray

The Medical Professional Liability (MPL) Association has announced that the Federation of State Physician Health Programs, Inc. (FSPHP) will receive the 2024 Award of Excellence in Physician Wellness. FSPHP is being honored for its role as a leader in the medical community, specifically to improve the health and well-being of medical professionals. The MPL Association is the leading international organization representing the medical professional liability insurance community.

FSPHP is a national association of Physician and Health Professional Programs (PHPs). The programs provide confidential assessment, referral to treatment, resources, and monitoring for physicians and healthcare professionals, and those in training who may be at risk of impairment from mental illness, substance use disorders, and other health conditions. In addition to working with participants, PHPs provide education, outreach, and advocacy to their medical communities in support of physician health and well-being.

“Physician health programs provide hope for physicians and other healthcare providers suffering with substance use disorders, mental health conditions, and suicide. They also protect the public by ensuring healthcare providers under their charge are safe to practice by providing personalized, tailored support, treatment, monitoring, and accountability,” said Michael J. Baron, MD, MPD, DFASAM, president of the Federation of State Physician Health Programs and medical director of the Tennessee Physician Health Program. “PHPs facilitate the return of healers to practice with outcome data that far surpasses that for the general population facing similar disorders. Embracing these programs isn't just about healing individuals; it's about reducing professional liability risk, ensuring patient safety, and advancing a culture of empathy, accountability, and excellence in patient care.”

“We applaud the Federation of State Physician Health Programs and stand with them in the mission to support physician health programs to improve the health of medical professionals, thereby contributing to quality patient care,” said MPL Association Board Chair John H. Mize, president & CEO, SVMIC. “On behalf of the MPL Association Board and its members, I am pleased to honor FSPHP with this award.”

The MPL Association Award of Excellence in Physician Wellness will be presented at the 2024 MPL Association Conference on May 9 in Washington, D.C.

April 26, 2024 by matray

The Medical Professional Liability (MPL) Association has announced that James D. Hurley, ACAS, MAAA, consulting actuary with WTW, will receive the 2024 Award of Excellence in Lifetime Achievement. Hurley is being honored for his decades of unwavering commitment and significant contributions to the MPL industry. The MPL Association is the leading international organization representing the medical professional liability insurance community.

Regarded as a leading expert on medical professional liability insurance, Hurley’s commitment and contributions to the MPL industry are considerable and his professional accomplishments and resume are equally impressive. He has spoken at numerous MPL Association events across the years where his presentations on the financial state of the industry are always much anticipated and well received. In addition, Hurley has provided testimony on Capitol Hill and in state legislatures on MPL issues, authored many articles on actuarial and financial topics for the MPL Association, served on committees and sections including the Rating Agency Relations Committee, the Regulatory Affairs Committee, and Underwriting Section, and engaged in research and studies in evaluating medical liability reform and other key MPL stakeholder issues. He is an associate of the Casualty Actuarial Society, a member of the American Academy of Actuaries (AAA), and part of a WTW team dedicated to the MPL industry. He is a former chairperson and member of the AAA subcommittee on medical professional liability and also served as a member of the AAA Property/Casualty Risk Based Capital Working Group.

“Jim’s work in the actuarial field in support of the MPL Association and its members is extraordinary,” said MPL Association Board chair John H. Mize, president and CEO, SVMIC. “He has dedicated more than 40 years of his life to ensuring his clients’ success and to sharing his knowledge. The medical professional liability industry has benefited greatly from Jim’s wisdom, and we are pleased to honor him with this well-deserved award.”

The MPL Association Award of Excellence in Lifetime Achievement will be presented at the 2024 MPL Association Conference on May 9 in Washington, D.C.

April 23, 2024 by matray

The Medical Professional Liability (MPL) Association has awarded its 2024 MPL Industry Defender Award to John D. Cassidy, Tamura D. Coffey, R. Brent Cooper, Louis “Duke” DeHaas, and Selina Hunt. This award is presented annually to defense attorneys in recognition of their exceptional and outstanding lifelong contributions to defending physicians, other healthcare professionals, and institutions while supporting medical professional liability insurers.

John D. Cassidy

Cassidy is the managing partner in the Boston law firm of Ficksman & Conley, LLP. He has represented healthcare providers since 1980 and has successfully tried more than 200 major medical malpractice cases. He also represents physicians and dentists before the Boards of Registration in Medicine and Dentistry on disciplinary and licensing matters. He is a Fellow of the American College of Trial Lawyers. In addition, Cassidy has been invited to lecture to healthcare providers throughout Massachusetts, has served as a faculty member in programs designed to educate attorneys regarding malpractice actions, and has appeared on national public television to discuss malpractice cases.

Tamura D. Coffey

Coffey is the founder of the law firm of Coffey Law PLLC in North Carolina and is an experienced trial lawyer, specializing in the defense of complex medical malpractice litigation for more than 30 years, including birth trauma lawsuits that represent significant financial and reputational exposure. Additionally, she provides representation for matters of corporate negligence, both medical professional and physician liability, and licensing board matters. To date, Coffey has obtained a defense verdict in every case that she has litigated on behalf of Novant Health. This record has helped maintain North Carolina’s reputation as a reasonable venue for professional liability litigation. In addition, Coffey is an outstanding educator for the organizations she represents as well as the North Carolina Chapter of the American Society for Health Care Risk Managers.

R. Brent Cooper

Cooper is a shareholder with Cooper Scully in Dallas and focuses his practice on commercial litigation, insurance litigation, and appellate practice. He has more than 100 trials in state and federal courts and has argued more than 250 appeals in the intermediate and supreme courts of various states. In his 44 years of practice, he has been at the forefront of appellate law. Perhaps the biggest impact Cooper has had on healthcare professionals has been through his work with Texas Alliance for Patient Access, which was instrumental in passing comprehensive tort reform in Texas in 2003. Cooper helped draft the legislation, assisted in getting it passed, and has continued working tirelessly to preserve the legislative reforms.

Louis “Duke” DeHaas

DeHass is president and senior trial attorney at La Follette, Johnson, DeHaas, Fesler & Ames in Los Angeles. He has defended physicians, allied health specialists, and hospitals. Specifically, DeHaas has tried in excess of 350 jury trials, including over 175 medical malpractice cases. He has also tried multiple administrative hearings representing physicians before the California Medical Board. His litigation exposure consists of jury trials, arbitration, and cases venued both in state and federal courts. He is a Fellow of the American College of Trial Lawyers and a Fellow of the International Academy of Trial Lawyers.

Selina Hunt

Hunt is the head of practice, Legal for Avant Law Pty Ltd in Queensland and South Australia. She has specialized in defendant insurance litigation throughout her career of over two decades and, since joining Avant more than 14 years ago, her area of expertise has been in health law—solely representing medical practitioners and their practices. She leads a team of experienced solicitors and administration staff to provide outstanding legal defence and support to Avant members throughout Queensland and South Australia. As well as personally representing members in civil claims, coronial investigations and inquests, and professional conduct matters, Hunt provides advice to Avant members as part of Avant’s Medico-legal Advisory Service.

“We are pleased to honor these outstanding defense attorneys who have served as important partners with medical professional liability organizations,” said Eric R. Anderson, interim president and CEO, MPL Association. “Their successful representation of healthcare professionals and institutions embodies excellence in the claims defense field. On behalf of our members and those they insure, the MPL Association thanks these individuals for their years of dedicated work.”

April 23, 2024 by matray

The Medical Professional Liability (MPL) Association announced that Carl T. Hook, MD, will receive the 2024 Award of Excellence in Honor of Peter Sweetland. Dr. Hook is being honored for his outstanding contributions and longtime dedication to the MPL insurance community, the MPL Association and healthcare professionals. The MPL Association is the leading international organization representing the medical professional liability insurance community.

Dr. Hook, a PLICO insured since the 1980s, joined the PLICO Board of Directors in 2001, while continuing to practice full-time as an ENT physician. In 2004, when it became evident that PLICO was in severe financial difficulty, Dr. Hook answered his Board's call to be CEO & President with the charge to help save the organization. He retired from medicine, dedicated himself to learning the business of medical professional liability insurance and restored PLICO to sound financial footing. Throughout these many decades, Dr. Hook was an exceptionally active participant in first the Physician Insurers Association of America (PIAA), and then the MPL Association, having served for many years on the Membership & By-laws Committee and on the Activities Committee.

Dr. Hook is a native Oklahoman and obtained all of his education and training in his home state. He holds an undergraduate degree from Southwestern Oklahoma State University, an MD degree from the University of Oklahoma, and received his Otorhinolaryngology training at Oklahoma University Health Sciences Center.

“Through grit, will, and commitment, Dr. Hook turned PLICO around and positioned it for long-term success,” said MedPro Group CEO Tim Kenesey. “Dr. Hook's passion for medicine, for his policyholders, for PLICO, and for his people make him not only a great leader, but well-deserving of this Award of Excellence. And I'd add that he is also a kind, good man—a friend to colleagues and competitors alike.”

MPL Association Board Chair John H. Mize, President & CEO, SVMIC, said, “Dr. Hook is truly an exemplary member of the medical profession and of the MPL community. We are very pleased to honor him for his extraordinary commitment to the physician community, the MPL industry, and this Association. We are grateful for his remarkable dedication of time and energy over the years to support this organization.”

The award will be presented to Dr. Hook on May 9 at the MPL Association Conference held in Washington, D.C.

The MPL Association Award of Excellence in Honor of Peter Sweetland, established in 1993 by the MPL Association’s Board of Directors, was created in honor of the late Peter Sweetland, one of the Association’s chief architects and most fervent supporters. The award recognizes an individual who has provided exemplary service to the industry and to

April 22, 2024 by matray

Inszone Insurance Services, a provider of commercial, personal and benefits insurance, recently announced its acquisition of Talerity, LLC, a specialized

Inszone Logo

insurance agency focusing on professional liability for medical providers.

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 …

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

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.”