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.

September 10, 2024 by matray

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

Michigan Wrongful Death Act Precludes Recovery of Future Earnings
The Michigan Supreme Court determined last month that families are not eligible to sue for recovery of a loved one’s future earning capacity in wrongful death lawsuits. The ruling overturns precedent and reaffirms that the state’s Wrongful Death Act does not permit an estate’s recovery of lost future earnings …

Study Chronicles Adverse Events in The Outpatient Setting
A new study examining the prevalence of patient harm in outpatient settings — like primary care visits, specialty care appointments, day surgeries, visits to the emergency room and other settings where patients receive most of their care — discovered that 7% of patients who received treatment at 11 outpatient care facilities in 2018 experienced at least one adverse event and 1.9% experienced at least one preventable adverse event …

MPL Association Analysis of Loss Reserving Finds Continued Redundancy
The medical professional liability industry has historically experienced favorable loss reserve development. According to the MPL Association report, cumulative favorable development exceeded $17 billion between 2004 and 2018. However, this positive trend has experienced a significant decline as of late, with total favorable development amounting to less than $2 billion between 2019 and 2023. Despite this contraction, the report’s findings suggest that the industry’s reserves remain largely redundant …

Direct Written Premium Continues Rising, Easing Expense and Indemnity Payment Pressures for MPL Specialty Writers
Mirroring the first quarter of 2024, MPL premiums during the second quarter continued to grow. The composite’s direct written premium increased by 1.4% relative to the second quarter of 2023. Although this marks the composite’s seventh consecutive year of premium growth, its second-quarter 2024 was a bit muted when compared to the previous three years. Yet while this year’s second-quarter premiums fall short of the mid-year peak in 2005, they do represent the third-highest premiums in the data’s 20-year history …

ATRA Designates Five States Lawsuit Infernos Due to Expanding Liability
The American Tort Reform Association (ATRA) last month designated Colorado, Maryland, Missouri, New Hampshire and New York “Lawsuit Infernos” in its latest Legislative HeatCheck report, citing the pursuit of liability-expanding laws by those states’ legislatures as reason for continued scrutiny. The ATRA’s Legislative HeatCheck report evaluates a select group of states’ progress — or lack thereof — in enacting meaningful tort reform measures during their most recent legislative sessions …

California Bill Aims to Regulate Private Equity in Healthcare
A bill pending in California’s legislature to ratchet up oversight of private equity investments in healthcare is receiving enthusiastic backing from consumer advocates, labor unions and the California Medical Association but drawing heavy fire from hospitals concerned about losing a potential funding source. …

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

September 9, 2024 by matray

Coverys announced today the appointment of Nico Santini, CFA, to be the organization’s first chief investment officer (CIO). Santini will report to president and chief executive Joseph G. Murphy.

With more than 20 years of investment experience, the company reports that Santini will play a pivotal role in setting and achieving long-term goals that support the Coverys’s insurance business. He will also lead Coverys’ investment policy, asset allocation, portfolio and risk management, and investment accounting functions.

Santini is expected to strengthen strategic planning initiatives by bringing investment policy and insights into the investment markets and insurance environment. He has deep expertise on the buy-and-sell side of insurance asset management, strategic and tactical asset allocation, risk and asset liability management, and business planning.

“Our Coverys investment portfolio is a valuable asset in supporting our policyholders, agents and brokers, and our organization to maximize our financial strength and growth opportunities,” Murphy said. “The creation of the chief investment officer role is a recognition of our commitment to our policyholders and our agents and brokers and is an important step in our evolution as an organization with international reach. Nico’s extensive experience building out investment structures will strengthen Coverys’ strategic approach to managing and growing its portfolio, enabling us to better support our ambitious growth goals and capital decision-making processes.

“Coverys has steadily served the needs of its customers as a result of its dedication to strong financial performance and its stable investment philosophy. I’m honored to help set the vision, strategy, and pathways for this next chapter of company growth and join a new team of colleagues committed to excellence.”

Most recently, Santini served as CIO at Coaction Specialty Insurance, leading the investment group through the acquisition of publicly traded ProSight Global, where he also served as CIO. During Santini’s tenure at the two organizations, he grew the investment group’s capabilities and established investment policies and procedures that ultimately supported the investment portfolio. Prior to that, Santini was senior portfolio manager for New England Asset Management.  

August 29, 2024 by matray

LAMMICO was recently named the No. 2 "Top Workplace" for 2024 by The Times-Picayune and The New Orleans Advocate. The medical liability insurer also received special awards for "Communication" and being named a "Top Workplace" for 10 consecutive years, while earning the No. 1 spot in 2021 and 2023. The "Top Workplace" honor is based solely on employee feedback gathered through a confidential, third-party survey that uniquely measures the employee experience and its component themes, including whether employees feel respected and supported, enabled to grow and empowered to execute, among others.

August 28, 2024 by matray

MagMutual Insurance Co. named Tanner Colegrove, MD, its new chief medical officer. A board-certified OB/Gyn, Colegrove received her medical degree from the University of Iowa and completed her residency at University of Arizona College of Medicine. She has 18 years of  experience as an OB/Gyn and was most recently the medical director of maternity services at Northwestern Medicine Lake Forest Hospital (NLFH).

During her time at NLFH, Colegrove was integral to patient safety efforts and provided physician-level oversight of quality, safety and operations in the maternity unit. Her notable accomplishments include founding the OB/Gyn Hospitalist program at NLFH, helping the department earn a U.S. News and World Report designation of “High Performing Maternity Unit” in 2023 by reducing cesarean section rates from 28.2% in 2022 to 26.7%; helping to reduce C-section decision-to-incision times by implementing a standardized team response to labor emergencies; and being named “NLFH Patient Safety Champion” in 2022.

Colegrove also served as regional medical director for the Northwestern Medicine Academy for Quality & Safety Improvement (AQSI), a professional development program that equips clinicians with knowledge and skills to lead meaningful change. Through this work, Colegrove contributed to quality improvement efforts across various specialties and clinical settings.

As MagMutual’s chief medical officer, Colegrove will lead MagMutual's clinical risk mitigation initiatives and direct the development of educational resources and strategies to help policyholders improve patient outcomes and avoid claims.

“Dr. Colegrove’s dedication to keeping patients safe and focusing on actionable clinical strategies makes her a great fit for this role and aligns with MagMutual’s commitment to reducing risk and optimizing outcomes for policy owners and their patients,” said Bill Kanich, MD, JD, MagMutual executive chairperson. “We’re pleased she is joining our team and I’m excited for what she’ll be able to accomplish.”  

August 15, 2024 by matray

AM Best has upgraded the Long-Term Issuer Credit Rating to “a+” (Excellent) from “a” (Excellent) and affirmed the Financial Strength Rating of A (Excellent) of Medical Mutual Insurance Co. of Maine (MMIC). The outlook of these Credit Ratings (ratings) is stable.

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

These rating actions are the result of MMIC’s disciplined underwriting strategy, which has resulted in profitable underwriting income in recent years despite challenging market conditions. In addition, despite the decline in the magnitude of MMIC’s favorable reserve development on prior accident years, the company has achieved solid organic surplus growth. MMIC’s balance sheet strength also has benefited from strong liquidity measures and favorable leverage during this time. As a result, the company’s balance sheet strength has compared favorably to AM Best’s medical professional liability (MPL) composite. Furthermore, the ratings reflect the cycle management programs and review processes put into place to reduce volatility should the MPL market deteriorate in MMIC’s key jurisdictions. These positive rating factors are offset partially by the inherent market risks associated with the MPL sector as it relates to price competition, loss cost trends, regulatory challenges and changes in the overall U.S. healthcare system.

The stable outlooks are based on AM Best’s expectation that the company’s rating fundamentals for balance sheet strength, operating performance, business profile and ERM will be maintained over the medium term.

August 13, 2024 by matray

ProAssurance recently received a provisional accreditation from the Accreditation Council for Continuing Medical Education (ACCME). ProAssurance achieved this accreditation by using current educational activities that demonstrate compliance in the areas reviewed by the ACCME. Risk Management will revise available programs and publications carrying continuing medical education (CME) credits to reflect the updated ACCME accreditation statement identifying ProAssurance as the accrediting body. The accreditation statement must appear on all CME activity materials and brochures distributed by ProAssurance.

Previously, ProAssurance Indemnity Company, Inc. was ACCME accredited from 1995 to August 2021. NORCAL Insurance Company officially joined the ProAssurance Group of companies in May 2021, and in July 2021, NORCAL received ACCME Accreditation with Commendation. Due to the timing of program expirations and reaccreditations, the two companies came together in August 2021 to provide accredited CME through joint providership with the NORCAL Accreditation with Commendation achievement. As integration continued, it was decided that now was the time to begin the 12-month process of returning to a ProAssurance ACCME accredited education program. This provisional accreditation is current from 7/22/2024 to 7/31/2026, at which time ProAssurance will apply for full accreditation.

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Medical Liability Monitor August 2024 issue highlights

August 8, 2024 by matray

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

Georgia Supreme Court Rules COVID Orders Tolled Statute of Limitations
The Supreme Court of Georgia ruled last month that a statewide COVID-19 judicial emergency order issued in March 2020 can be applied to toll, or pause, the state’s five-year statute of repose for medical liability cases. The unanimous decision overturns a prior unanimous decision by the Georgia Court of Appeals that prevented a medical professional liability claim against Floyd Medical Center from proceeding …

Study Shows risks of Integrating AI Into Medical decision-making
Researchers at the National Institutes of Health (NIH) found that an artificial intelligence (AI) model solved medical quiz questions — designed to test health professionals’ ability to diagnose patients based on clinical images and a brief text summary — with high accuracy. However, physician-graders found the AI model made mistakes when describing images and explaining how its decision-making led to the correct answer. The findings, which shed light on AI’s potential in the clinical setting, were published in npj Digital Medicine. The study was led by researchers from NIH’s National Library of Medicine and Weill Cornell Medicine, New York City, N.Y. …

California Court of Appeal Affirms Medical Liability Plaintiff Attorneys Lacking Expert Testimony Open to Malicious Prosecution Claims
The California Court of Appeal for the Second District, Fourth Division last month affirmed that plaintiff attorneys who bring medical liability actions without expert testimony are open to malicious prosecution claims …

Michigan Supreme Court Expands Admissibility of Expert Testimony in Medical Liability Lawsuits
The Michigan Supreme Court issued two opinions last month that broaden the scope of admissible expert witness testimony in medical liability lawsuits. The first opinion involved expert testimony that lower courts determined inadmissible because the expert failed to cite any published medical literature or other authority to support their opinion that the defendants had breached the standard of care. The second opinion combined two medical liability cases where plaintiffs’ expert witnesses did not practice the same subspecialty as the defendant physician …

Louisiana Adds Transparency to Third-Party Litigation Financing
Louisiana Gov. Jeff Landry recently signed into law a bill that will contribute greater transparency about the involvement of third-party litigation funders in subsidizing civil litigation in the state. The new statute, Senate Bill 355, went into effect on August 1, and makes litigation financing contracts subject to discovery in civil liability lawsuits …

Coverys Expands London Insurance Platform with Regulatory Approval
Coverys announced last month that its dedicated London platform Coverys Ltd. received approval from the UK’s Prudential Regulatory Authority and Financial Conduct Authority to commence underwriting medical liability risk. The approvals enable the organization to expand its product offerings in the London market, supporting Coverys’ global growth and diversification strategy. Coverys Ltd. is part of Coverys’ dedicated London platform, which includes both an insurance company and managing general agent operations, collectively “Coverys London” …

Subscribe today to get this issue (as well as the 2023 and 2024 Annual Rate Survey at no additional cost).

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Ryan Specialty, MagMutual Form Exclusive Relationship for Healthcare Facility Business

August 1, 2024 by matray

Ryan Specialty, an international specialty insurance firm, announced that it is forming an exclusive relationship with MagMutual Insurance Co. This relationship is through Sapphire Blue, which specializes in developing sophisticated solutions to complex healthcare risks, and is a part of the firm’s underwriting specialty, Ryan Specialty Underwriting Managers.

Sapphire Blue underwrites senior living and allied healthcare liability and will become MagMutual’s exclusive underwriter for policyholders outside the traditional physician and hospital model, most significantly as related to senior living and allied healthcare facilities.

According to Ryan Specialty, the exclusive relationship will strengthen product innovation, customer service, and risk management.

“MagMutual is a leader in the physicians and hospital professional liability insurance market, and we are pleased to strategically align our healthcare practice with them,” said Patrick Ryan, founder, chairman and chief executive at Ryan Specialty. “We appreciate the collaboration of Neil Morrell and MagMutual’s talented team during this process, and we look forward to jointly bringing innovation and greater customer solutions to our clients and their insureds.”

“Bringing together the two most positively disruptive, fastest-growing and customer-focused organizations in healthcare liability insurance is an exciting prospect for our current and future agents and customers,” said Neil Morrell, MagMutual chief executive officer. “The synergies are not only self-evident, they are potentially transformative.”

"The collective experience, expertise and brand recognition of our two organizations is exceptional in the healthcare liability marketplace,” said Nancy McMahon, Saphire Blue chief executive officer. “Together we will expand our healthcare liability products and offerings to better serve those who care for others.”

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