November 12, 2024 by matray

PIB Group Ltd (‘PIB’ or ‘the Group’), a specialist insurance intermediary, has entered the French market with the strategic acquisition of a prominent French medical malpractice insurance business BEA Group and its subsidiaries.

This investment marks a significant milestone in PIB Group’s ongoing European expansion and establishes a strong platform for further growth in France and beyond.

BEA Group is a French group founded in 2009 by CEO Marco Favale. It operates in the brokerage and claim management sector, focusing on medical malpractice and public market players. BEA Group has nine offices in three locations and also operates in the Italian market, through the 2023 acquisition of Capanna. The deal will see PIB Group providing investment and support to the BEA Group team, allowing them to continue growth across France and Italy.

The French market presents a substantial opportunity for PIB Group to enhance its European presence and offer specialized insurance solutions to a broader clientele. The newly acquired business, renowned for its expertise in medical malpractice, is well positioned to capitalize on the increasing demand for such insurance products across the continent.

With backing from world-leading private equity firms, Apax Funds and The Carlyle Group, this investment is a crucial step in realizing the strategy for PIB Group, consolidating specialist insurance distribution across major European markets.

Brendan McManus, CEO of PIB Group, stated, "Our deal with BEA Group is a significant achievement for the whole PIB Group, marking our 100th investment. France has long been a key missing link in our European growth strategy and I’m proud that we’ve been able to secure such a strong foothold in this critically important market. BEA Group is an entrepreneurial company, with exceptional people who have built an incredible brand and loyal customer base across France and Italy.

"I want to give a very warm welcome to Marco and Alexandre and everyone at BEA Group. Together, we’ll ensure our new colleagues settle well into the PIB family and work closely to ensure that we respect the nuances of the French and Italian markets. Our goal is to blend our international expertise with their deep local knowledge to create a thriving business that benefits everyone.”

Onno Jansen, CEO for PIB Group Europe, commented: “Our investment with BEA Group is one of the most exciting and important deals we’ve done to date. It not only strengthens our position in Europe but also sets the stage for future growth and innovation - much of which will occur in France and Italy. As we continue to pursue our strategy of consolidation and expansion across Europe, this deal is a testament to the team’s commitment to delivering specialised insurance solutions that meet the evolving needs of clients.”

Marco Favale, CEO and founder BEA, commented: “We’ve seen considerable growth at BEA Group over the past few years as we’ve worked to become a leading player in the medical malpractice space. Joining PIB Group for us marks the next stage of our journey, taking all that we’ve built so far and accelerating that growth using PIB Group’s resources and investment. It’s an incredibly exciting time for our team and clients, and we’re looking forward to a bright future ahead in France and Italy.”

November 7, 2024 by matray

by Margaret Surowka, Esq.
Being disciplined by a state medical board is one of the most daunting experiences a physician can face, with far-reaching consequences such as the loss of insurance plan participation, credentialing issues and even the revocation of board certification. The complexity of such disciplinary actions is heightened when physicians hold licenses in multiple states. Even if a physician's license in a particular state is inactive and they haven't practiced there for years, that state may still impose disciplinary actions based on findings from another jurisdiction. Since professional discipline is governed individually by each state, physicians with licenses in multiple states must remain aware of the potential issues and know how best to defend both themselves and their licenses.

The New York State Office of Profes-sional Medical Conduct, for example, considers any discipline or criminal conviction in another state as grounds for its own disciplinary action. Moving out of state does not necessarily mean escaping New York’s jurisdiction. If a physician holds a New York license — even if inactive — a disciplinary action in another state could result in the revocation or suspension of their New York medical license, regardless of where they currently practice.

Under New York Education Law §6539(9)(d), if a physician faces disciplinary action, license revocation or suspension in another state for conduct that would qualify as professional misconduct in New York, they risk losing or having their New York license suspended, even if it’s inactive.

It is critical for physicians to take prompt steps to avoid disciplinary action in New York, even if they no longer live or practice there. While New York typically initiates charges only when a violation is reported or discovered, physicians should remain vigilant about monitoring their status to prevent potential repercussions. Even if the disciplinary action in another state is relatively minor — such as a requirment to attend continuing medical education classes or pay fines — physicians could face more severe penalties in New York, especially if they fail to respond promptly.

A recent example, published on the New York Department of Health website, involved a doctor disciplined by the New Mexico Medical Board. The physician was required to complete a controlled substances course, submit a summary to the board and undergo a psychological evaluation but was allowed to retain his license. However, when the New York board attempted to notify him of the disciplinary action, they were unable to reach him. As a result, he missed the opportunity to defend himself, and the New York board ultimately revoked his license.

This case underscores the importance of staying proactive and responsive. While physicians may be able to negotiate less severe disciplinary actions in other states — such as by completing educational courses or evaluations — failure to address the matter in New York can lead to severe consequences. A license revocation in New York can negatively impact medical liability insurance costs and will be publicly listed in the National Practitioner Data Bank, damaging a physician’s reputation and professional opportunities. Therefore, it is essential for physicians to remain reachable and responsive to avoid such outcomes.

This example is not an isolated incident. In fact, four out of the last 10 published decisions on the New York Department of Health website resulted from disciplinary actions originating outside of New York.

Physicians licensed in New York should also be aware that while they have the right to a hearing in cases of disciplinary action, the scope of that hearing is limited. Physicians cannot relitigate the underlying issues that led to the initial disciplinary action in the originating state. Instead, the hearing in New York typically focuses solely on determining the appropriate penalty. This limitation can make the defense process more challenging, as the original misconduct will not be reconsidered even if the penalties in New York could be severe.

Furthermore, New York often imposes onerous conditions if an agreement from a consent order is reached before any hearing. These conditions may include requiring the physician to reactivate their license, thereby preventing them from placing their license in inactive status. This would also require biennial registration fees from doctors who no longer practice in the state.

In summary, if you hold medical licenses in multiple states, it is essential to understand how each state you have been licensed in may take action against you for discipline imposed by the state where you actively practice. Ensure your contact information is updated in all states where you hold — or have held — a license, and always be responsive to notices from other states. Lastly, engage experienced legal counsel in the disciplining state to advise and defend you should the need arise.

Margaret Surowka is an attorney at Barclay Damon LLP, where she serves as co-leader of the firm’s Health & Human Services Providers Team. Her practice includes representing agencies, facilities and individual providers in compliance matters as well as licensure, disciplinary and ethics proceedings.

November 7, 2024 by matray

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

Pennsylvania Lawmakers Respond to Medical Liability Crisis
Medical liability tort reform advocates applauded Pennsylvania lawmakers last month when they introduced a package of tort reform bills aimed at addressing the commonwealth’s lawsuit crisis. The Pennsylvania court system consistently ranks among the most plaintiff-friendly, and the Supreme Court of Pennsylvania and Philadelphia Court of Common Pleas were declared the nation’s worst Judicial Hellholes for 2023/2024 by the American Tort Reform Foundation (ATRF) …

Artificial Intelligence Enabled Cameras Prevent Medication Errors
A team of researchers has developed the first wearable camera system that detects potential errors in medication delivery via artificial intelligence (AI) technology. In a test reported in npj Digital Medicine last month, the camera system recognized and identified which medications were being drawn in busy clinical settings with high proficiency. The AI technology achieved 99.6% sensitivity and 98.8% specificity at detecting vial-swap errors …

Colorado Supreme Court to Investigate How Damage Cap Can Be Pierced
The Colorado Supreme Court recently agreed to review a medical liability case involving an almost $40 million judgment against Banner Health, specifically to investigate the legal standard for determining damages when the trial court determines the state's $1 million cap on total medical malpractice damages can be exceeded. Colorado’s Health Care Availability Act currently enforces a $1 million total cap on combined economic and noneconomic damages for medical liability lawsuits. However, the total cap can be pierced when, “upon good cause shown,” the court “determines that the present value of past and future economic damages would exceed such limitation and that the application of such limitation would be unfair”…

Think Tank Prescribes Medical Malpractice Act Revisions to Solve New Mexico’s Healthcare Worker Shortage
Think New Mexico, a 501(c)(3) think tank committed to improving the lives of New Mexicans, published a policy report last month making a series of recommendations to alleviate the state’s healthcare worker shortage. To address the high cost of medical liability insurance coverage that “discourages providers from locating [to New Mexico], and drives others away,” the Think New Mexico policy report recommends six reforms to the state’s Medical Malpractice Act …

Coverys Report Examines Drivers of Diagnostic Error in the ED
Coverys published its latest Dose of Insight report last month, providing a data-driven look at the drivers of diagnostic error. Diagnostic error contributed to 26% of all Coverys medical liability claims from 2019 through 2023 yet represented 41% of the total indemnity paid over the same period. These claims had an average indemnity of $627,000 per claim, almost 50% more expensive than the average indemnity for all other types of malpractice events …

Physicians With Multiple State Licenses Face Complex Disciplinary Risks
Being disciplined by a state medical board is one of the most daunting experiences a physician can face, with far-reaching consequences such as the loss of insurance plan participation, credentialing issues and even the revocation of board certification. The complexity of such disciplinary actions is heightened when physicians hold licenses in multiple states. Even if a physician’s license in a particular state is inactive and they haven't practiced there for years, that state may still impose disciplinary actions based on findings from another jurisdiction. Since professional discipline is governed individually by each state, physicians with licenses in multiple states must remain aware of the potential issues and know how best to defend both themselves and their licenses …

Subscribe today to get this issue (as well as the 2024 and 2025 Annual Rate Survey at no additional cost).

November 7, 2024 by matray

Positive Physicians Insurance Co. promoted Cobie Buchman to the senior vice president and chief claims officer. This promotion reflects Buchman’s significant contributions to the company and his commitment to enhancing Positive Physicians’ claims capabilities.

Buchman joined Positive Physicians in 2023 as senior vice president of claims and has been instrumental in elevating the performance and efficiency of the company’s claims team. With more than 24 years of national claims experience in medical professional liability, Buchman has played a key role in expanding Positive’s growth initiatives, transforming the company's reinsurance program, and refining and adding rigor to all aspects of the claims process, including claims committee, reserving, analysis and disposition of complex claims.

“Since joining Positive, Cobie has demonstrated exceptional leadership and a deep understanding of the medical professional liability industry,” said Michael G. Roque, Positive Physicians Insurance Co. chief executive officer. “His expertise has been critical in enhancing our claims operations and supporting our strategic objectives. We are confident that in his role as SVP & Chief Claims Officer, Cobie will continue to drive innovation and excellence within our claims department.”  

October 10, 2024 by matray

LAMMICO congratulates Lafayette Surgical Specialty Hospital in Lafayette, La., the recipient of the 9^th Annual LAMMICO Patient Safety Award and Grant. The 2023-2024 Patient Safety Award and Grant centered on falls prevention. Preventing patient falls is a top priority for patient safety, patient satisfaction, quality reputation and cost reduction. Patient falls may result in injuries such as lacerations, fractures, intracranial bleeding and death. Compared to patients who do not suffer falls, those with fall-induced injuries stay in the hospital longer and incur higher hospital costs. To decrease patient falls in the hospital or ambulatory surgery setting, a multifaceted approach with standardized and customized interventions is needed. Developing an evidence-based falls prevention program is essential. This grant program encouraged participating hospitals to tackle this challenge and reduce their patient fall rates.

Grant applicants completed falls prevention online courses in LAMMICO’s learning management system. These courses focused on information about falls, recommended interventions for falls prevention programs, and how staff can help prevent patient falls.

By demonstrating the best improvements (in policies, procedures, protocols and/or processes) related to a reduction in patient fall rates after completing this risk management and patient safety education, Lafayette Surgical Specialty Hospital (LSSH) was awarded:

• $10,000 grant for nursing professional development
• One-year Risk Manager membership to the American Society for Healthcare Risk Management (ASHRM)

One of the steps taken by the team at LSSH to prevent falls included staff helping all patients with dressing. A “Call Before You Fall” program was implemented throughout the hospital. It included educational patient signage. The staff placed all patients in a chair or on the side of the bed with the side rails up, rather than on the side of the bed, while a wheelchair was obtained for discharge. LSSH had a 40% decrease in patient falls for the three-month post-education period, as compared to the three-month pre-education period.

Specialists Hospital Shreveport in Shreveport, La., is the second place participant of the Patient Safety Award and Grant. A grant of $5,000 for nursing professional development and a one-year Risk Manager membership to ASHRM was presented to this hospital in recognition of this honor.

After participating in the grant program, Specialists Hospital Shreveport learned that one of the best falls prevention steps is to better educate staff. They updated their falls prevention policy and procedures. They also developed an educational presentation that is used during new staff orientation to teach falls prevention strategies.

LAMMICO commends these two hospitals and all others who submitted award applications, for their commitment to improving patient safety.

October 7, 2024 by matray

Preverity, a provider of clinical risk analytics and patient safety solutions, and Graves Gilbert Clinic, a  healthcare provider in South Central Kentucky, have announced a strategic partnership to enhance patient safety and risk mitigation efforts.

According to the companies, this collaboration marks a significant step forward in healthcare, combining Preverity's  data analytics capabilities with Graves Gilbert Clinic's commitment to delivering exceptional patient care.  Through this partnership, Graves Gilbert Clinic will leverage Preverity's analytics to gain deeper insights into patient safety outcomes and physician practice patterns.

"We are proud to partner with Graves Gilbert Clinic, an organization renowned for its dedication to patient care," said Gene Boerger, Preverity President & COO.  "Our combined expertise will empower Graves Gilbert Clinic with data-driven insights to optimize patient safety protocols and reinforce their commitment to providing exceptional healthcare."

Preverity's platform will provide Graves Gilbert Clinic with:

• Timely and accurate intelligence on clinical activities.


• Benchmarks against national, regional, and system standards.


• Insights into factors influencing physician risk.


• Tools to enhance patient safety protocols.

October 1, 2024 by matray

AM Best has affirmed The Doctors Company's financial strength rating (FSR) of A (Excellent) and its long-term issuer credit rating (ICR) of "a+". The outlook of these ratings is stable.

The FSR of A (Excellent) and the long-term ICR of "a+" (Excellent) have been affirmed for the following:

• 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

Additionally, AM Best has upgraded the long-term ICR of Hospitals Insurance Company (HIC) to "a+" (Excellent) from "a" (Excellent) and affirmed its FSR of "A" (Excellent). HIC is a subsidiary of The Doctors Company.

The FSR of A is assigned only to select companies with excellent ability to meet ongoing insurance obligations. The "a+" ICR is assigned to entities that have an excellent ability to meet their ongoing senior financial obligations.

"These ratings from AM Best reflect the strength and stability of our company and reinforce our vision to build the preeminent organization for service to healthcare," said Richard E. Anderson, MD, FACP, Chairman and CEO of The Doctors Company and TDC Group. "Our financial strength allows us to help healthcare professionals meet the challenges of a constantly shifting landscape and better serve our members."

October 1, 2024 by matray

LAMMICO announced a new strategic partnership with the Mississippi Hospital Association (MHA) as its endorsed medical professional liability carrier. The MHA is the statewide agency for healthcare representation and service to all hospitals and healthcare networks, as well as the patients and communities they serve. MHA is comprised of more than 100 hospitals, healthcare systems, networks, care providers and a pool of over 50,000 employees.

“The LAMMICO team is excited to enter this partnership and earn this endorsement from MHA,” said J. Michael Conerly, MD, LAMMICO president and chief executive. “With our experience in providing medical professional liability insurance for hospitals and other healthcare facilities in the South, this is a wonderful opportunity for us to work with those that provide care to the citizens of Mississippi. We look forward to upholding our purpose, ‘we protect those who care for others.’”

“LAMMICO’s commitment to patient safety and improving quality outcomes aligns with MHA’s mission and will greatly benefit hospitals and their patients. We look forward to introducing this new partner to our communities and we are pleased to welcome LAMMICO to the MHA family”, said Richard Roberson, Mississippi Hospital Association president and chief executive.

September 26, 2024 by matray

AM Best has revised the outlooks to negative from stable and affirmed the Financial Strength Rating (FSR) of A (Excellent) and the Long-Term Issuer Credit Ratings (Long-Term ICRs) of “a” (Excellent) of Medical Professional Mutual Insurance Co. and its rating unit members, collectively known as Coverys Companies. (See below for a detailed list of these subsidiaries and Credit Ratings.)

The ratings reflect Coverys’ balance sheet strength, which AM Best assesses as strongest, as well as its marginal operating performance, neutral business profile and appropriate enterprise risk management.

The negative outlooks reflect pressure on Coverys’ balance sheet strength assessment from increased volatility in loss and loss adjustment expense reserves as the group continues to report modest adverse reserve development in the past few years, which is a clear departure from an earlier practice of more conservative reserving with consistently favorable reserve development. As of year-end 2023, accident years 2016-2019 continued to develop adversely, partially offset by large reserve releases in 2021-2022, which may be premature given the long-tailed nature of the medical professional liability (MPL) line of business. Due to the increased volatility of reserves, the assessment of the group’s balance sheet strength, while still at the strongest level currently, could be lowered potentially.

AM Best assesses Coverys’ operating performance as marginal, as its underwriting and return metrics lag its MPL peers and the broader property/casualty industry. In the past few years, the group’s calendar-year underwriting results showed some improvement from comprehensive operational overhauls by the new management team. However, due to the long-tailed nature of the MPL line and the more recent weakening of reserve strength, AM Best will have more confidence in these results when the years mature.

Negative rating action could occur if adverse reserve development materially impacts earnings and/or future capital formation. Negative rating action also could occur if the group’s risk-adjusted capitalization were to weaken materially, which could result from significant deterioration of operating performance, an increase in claims frequency or severity, or from adverse reserve development.

While unlikely in the near term, the ratings may be positively affected through sustained improvement in underwriting and overall operating performance providing support for the Coverys’ strongest level of balance sheet strength.

The FSR of A (Excellent) and the Long-Term ICRs of “a” (Excellent) have been affirmed with the outlooks revised to negative from stable for the following members of the Coverys Companies rating unit:

• Medical Professional Mutual Insurance Company


• ProSelect Insurance Company


• Preferred Professional Insurance Company


• Coverys Specialty Insurance Company


• Coverys Risk Retention Group, Inc.


• Coverys Limited


• Coverys International Insurance Company Designated Activity Company

September 12, 2024 by matray

EmPRO Insurance Co. was recently recognized by Top Workplaces USA, an employer recognition program.

EmPRO was honored as a Top Workplace on Long Island and received national recognition as a leading insurance company in the ‘Financial Services’ category as a Top Workplace earlier this year. This marks EmPRO’s debut on both nationwide lists, highlighting its commitment to creating an excellent work culture alongside impressive financial growth.

“Receiving these Top Workplaces awards highlight our collaborative environment at EmPRO, while also underscoring our core values,” said Bruce Shulan, EmPRO president and CEO. “It’s truly inspiring to see how much our efforts are appreciated by employees and to receive affirmation that we have successfully created a space where top talent can innovate, grow and excel. I extend my heartfelt thanks to all our employees for their invaluable contributions to this achievement.”

“The recognition is especially meaningful because it reflects the voices of our employees,” said Jocelyn Tobia, EmPRO vice president of human resources. “At EmPRO, we’re dedicated to creating a workplace where everyone feels valued and heard. Our focus on employee satisfaction and professional development is evident in our low turnover rate and the strong tenure of our experienced team members.”

The Top Workplace rankings are based on employee feedback results captured by the Energage Workplace Survey, which is built on data from millions of employees at tens of thousands of organizations during the past 18 years. In the survey, EmPRO employees awarded the company high marks in supporting its positive direction, showing appreciation for their contributions, fostering professional growth and development, and for genuinely caring about their concerns.

EmPRO’s ‘people-first’ approach is highlighted by several employee initiatives, including a generous tuition reimbursement program, which supports both undergraduate and graduate studies. The company also actively encourages its employees to participate in skill-building seminars. In addition, EmPRO recently introduced a comprehensive Management Training Series designed to assist supervisors and managers in advancing their careers and honing their leadership skills. The company has also invested in state-of-the-art conference rooms and collaborative workspaces, as well as adding an onsite café and a new Fitness Center.