June 13, 2023 by matray

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

AM Best: U.S. Medical Professional Liability Insurers Make Underwriting, Net Income Gains Despite Difficult Environment
Despite improved underwriting results and a positive net income, AM Best is maintaining its negative outlook for the medical professional liability (MPL) insurance segment in 2023. The ratings agency justified the outlook on the segment’s negative returns and an overall decline in policyholders’ surplus due primarily to unrealized losses stemming from volatility in the capital markets …

New Leapfrog Report Reveals COVID-Related Increase in Healthcare-Associated Infections
The latest data from The Leapfrog Group’s spring 2023 Hospital Safety Grade indicates that the average risk of three healthcare-associated infections (HAIs) reached a five-year high in hospitals during the COVID-19 pandemic and remains elevated. These infections include Methicillin-resistant Staphylococcus aureus (MRSA), central line-associated bloodstream infections (CLABSI) and catheter-associated urinary tract infections (CAUTI). The report also reveals a continuous decline in patient experience measures, which are self-reported by patients and have a correlation with patient outcomes …

Inaugural MPL Association Report on State of the Market Reveals Industry’s Slowing Financial Progress
A new report published by the Medical Professional Liability Association indicates the medical professional liability (MPL) insurance sector posted a 5.9-percentage-point improvement in its combined ratio last year — down from 108.1% in 2021 to 102.2% in 2022 — demonstrating its best performance since 2017 when the industry reported a combined ratio of 101.7%. The industry still has not generated an underwriting profit since 2013 …

Florida Gives Providers, Payors Right to Refuse Care Due to Conscience
Florida Gov. Ron DeSantis recently signed SB 1580, or the “Protections of Medical Conscience” bill, which permits healthcare providers in the state to refuse services on the grounds that it violates their “sincerely held religious, moral or ethical belief.” The bill similarly applies to healthcare insurers, health plans and “any other entity that pays for, or arranges for payment of, any healthcare service.” The bill specifies that it does not preempt the federal Emergency Medical Treatment & Active Labor Act, which requires hospitals to stabilize any patient with an emergency condition. It further clarifies that the legislation cannot be used to deny care based on a patient’s race, color, religion, sex or national origin. There are no protections for gender identity or sexuality. The law takes effect July 1 ...

Medical Professional Liability Industry Convenes in New Orleans to Address Unique Challenges, Emerging Trends
The Medical Professional Liability (MPL) Association hosted its Annual Conference at the Roosevelt Hotel in New Orleans from May 17 - 19. Meeting in person for only the second time since the COVID-19 pandemic began, the conference carried an optimistic tone as the industry gathered to learn, network and share insights into the most pressing challenges currently facing the industry …

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June 5, 2023 by matray

The Doctors Company today announced the appointment of Christa Steele to its board of governors. Steele is a financial and governance executive with decades of corporate leadership experience across a wide range of industries.

Steele currently serves on the board of Tanimura & Antle and is vice chair of the National Association of Corporate Directors (NACD), Northern California Chapter.

“We are pleased to welcome Christa Steele to our Board of Governors,” said Richard E. Anderson, MD, FACP, chairman and CEO of The Doctors Company and TDC Group. “Her leadership experience in both public and private companies, combined with her skills in digital technologies and environmental, social, and governance strategies, will strengthen our ability to serve the entire medical profession.”

Steele is the former CEO of Balco Holdings, Inc., and previously served as president, CEO and board director of Mechanics Bank. Her prior board experience includes Recology as board chair, BrainChip Holdings, OFG Bancorp, Sasser Family Holdings and FIG Partners.

“I am excited to join this group of outstanding leaders from the healthcare and business communities in support of the management team at The Doctors Company and TDC Group,” Steel said. “As a former technology and bank CEO, I believe I am well positioned to assist The Doctors Company and TDC Group as healthcare continues to evolve, and larger technological partners enter the space.”

Steele earned an MBA from the Marshall School of Business at the University of Southern California and holds a Bachelor of Arts degree from California State University, Sacramento. She is an NACD Board Leadership Fellow with Governance Certification. Steele is a Member of the Audit and the Finance & Risk Committees at The Doctors Company.  

May 23, 2023 by matray

AM Best has affirmed the Financial Strength Rating (FSR) of A (Excellent) and the Long-Term Issuer Credit Ratings (Long-Term ICRs) of “a+” (Excellent) of the core members of ProAssurance Group. Concurrently, AM Best has upgraded the FSR to A (Excellent) from A- (Excellent) and the Long-Term ICRs to “a+” (Excellent) from “a-” (Excellent) of NORCAL Insurance Company (NORCAL) (San Francisco, CA) and its subsidiaries, which are now part of ProAssurance Group. At the same time, AM Best has affirmed the Long-Term ICR of “bbb+” (Good) and all existing Long-Term Issue Credit Ratings (Long-Term IR) of ProAssurance Corporation (PRA) (headquartered in Birmingham, AL). All companies are indirect subsidiaries of PRA. The outlook of these Credit Ratings (ratings) is stable. (See below for a detailed listing of the companies’ ratings.)

The ratings of ProAssurance Group reflect its balance sheet strength, which AM Best assesses as strongest, as well as its adequate operating performance, favorable business profile and appropriate enterprise risk management (ERM).

The group’s balance sheet strength assessment continues to reflect the strongest level of risk-adjusted capitalization, as measured by Best’s Capital Adequacy Ratio (BCAR), as well as the strength of its reserves and quality of investments. The ratings also consider ProAssurance Group’s operating performance, which continues to be adequate as results benefited from the complete reunderwriting of its book of business and its strong rate gains, although loss costs in its medical professional liability (MPL) book of business remain pressured by the impacts of social inflation and the increasing frequency of excess verdicts, as seen in the first quarter of 2023. The ratings also consider the group’s market position as one of the leading MPL insurers in the United States, as well as its diversification across multiple disciplines, geographic areas and in its other lines of business. These ratings also acknowledge the depth and breadth of the group’s ERM programs and policies.

The rating upgrades of NORCAL and its subsidiaries reflect their status as members of ProAssurance Group due to the implicit and explicit support provided by the group following management’s integration efforts since its acquisition of NORCAL in 2021. Also considered is NORCAL and its subsidiaries’ strategic importance to the group, common management, and significant earnings contributions.

The ratings also benefit from the financial flexibility provided by PRA, the ultimate parent. PRA’s financial leverage is modest, with strong interest coverage, and holds a significant amount of cash and short-term investments outside of the insurance operating companies that are available for use without regulatory approval or other restriction. Nevertheless, the group has reported limited surplus growth over the most recent five-year period due to significant payments of dividends to PRA, which the parent has utilized for company stock repurchases and payment of shareholders’ dividends. Management remains committed to maintaining capital at its rated entities at levels commensurate with their ratings.

The stable outlooks for the Long-Term ICRs of ProAssurance Group members reflect the group’s continued strongest level balance sheet strength assessment, supported by effective capital management and financial flexibility afforded by it parent, while ongoing insurance operating initiatives implemented by management are expected to maintain its stable operating performance.

The FSR of A (Excellent) and the Long-Term ICRs of “a+” (Excellent) have been affirmed, with stable outlooks for the following members of ProAssurance Group:

• ProAssurance Casualty Company


• ProAssurance Indemnity Company, Inc.


• ProAssurance Specialty Insurance Company


• Medmarc Casualty Insurance Company


• ProAssurance Insurance Company of America


• ProAssurance American Mutual, A Risk Retention Group


• Allied Eastern Indemnity Company


• Eastern Advantage Assurance Company


• Eastern Alliance Insurance Company

The FSR has been upgraded to A (Excellent) from A- (Excellent) and the Long-Term ICRs to “a+” (Excellent) from “a-” (Excellent) with stable outlooks for the following new members of ProAssurance Group:

• NORCAL Insurance Company


• NORCAL Specialty Insurance Company


• Medicus Insurance Company


• FD Insurance Company


• Preferred Physicians Medical Risk Retention Group, a Mutual Insurance Company

The following Long-Term IRs have been affirmed with stable outlooks:

ProAssurance Corporation— --“bbb+” (Good) on $250 million 5.30% 10-year senior unsecured notes, due 2023

The following indicative Long-Term IRs under the shelf registration have been affirmed with stable outlooks:

ProAssurance Corporation—
-- “bbb+” (Good) on senior unsecured debt
-- “bbb” (Good) on senior subordinated debt
-- “bbb-” (Good) on preferred stock

May 8, 2023 by matray

The Medical Professional Liability (MPL) Association has announced that the American Tort Reform Association (ATRA) will receive the 2023 Award of Excellence in Public Policy. ATRA is being honored for its role in bringing greater fairness, predictability, and efficiency to America’s civil justice system. The MPL Association is the leading international organization representing the medical professional liability insurance community.

ATRA is a nationwide network of state-based legal reform coalition organizations backed by 142,000 grassroots supporters with a strong track record of enacting and defending civil justice reforms. The organization was founded in 1986 by the American Council of Engineering Companies and has attracted a diverse membership of nonprofits, small and large businesses, and state and national trade, business, and professional associations. It is the nation’s first organization dedicated exclusively to tort reform and liability reform through public education and the enactment of legislation.

“All of us at ATRA appreciate very much this recognition for the work we do to reform the nation’s civil justice system,” said Tiger Joyce, ATRA president. “Abuses of the legal system reduce access to lifesaving healthcare, increase its costs unnecessarily, and hinders the overall economy. ATRA is committed to addressing these issues in the legislatures, in the courts, and through broader public education about the impacts of lawsuit abuse. We appreciate greatly our partnership with the MPL Association and look forward to continuing it this year and beyond.”

“The Association is pleased to honor ATRA with this award, especially given the surge in large verdicts and erosion of laws protecting healthcare providers across the country. It is vital that the MPL community comes together in support of the defense bar,” said John H. Mize, MPL Association Board Chair and SVMIC president and chief executive officer. “We applaud ATRA and its commitment to promoting equity and justice in the U.S. legal system.”

The MPL Association Award of Excellence in Public Policy is given to organizations, government officials, or private citizens who have undertaken exemplary efforts to recognize and advance the public policy needs of the MPL community. The award will be presented at the 2023 MPL Association Conference on May 18 in New Orleans.  

May 8, 2023 by matray

The Medical Professional Liability (MPL) Association has announced that the Society to Improve Diagnosis in Medicine (SIDM) will receive its 2023 Award of Excellence in Patient Safety. SIDM is being honored for its role as a leading force in the medical community in addressing patient safety. The MPL Association is the leading international organization representing the medical professional liability insurance community.

SIDM catalyzes and leads change to improve diagnosis and eliminate harm from diagnostic error. The organization works in partnership with patients, their families, the healthcare community, and every interested stakeholder. SIDM is the only organization focused solely on the problem of diagnostic error and improving the accuracy and timeliness of diagnosis.

In 2015, SIDM established the Coalition to Improve Diagnosis to increase awareness and actions that improve diagnosis. Members of the Coalition represent hundreds of thousands of healthcare providers and patients, and the leading health organizations and government agencies involved in patient care. Together, stakeholders work to find solutions that enhance diagnostic safety and quality, reduce harm, and ultimately, ensure better health outcomes for patients.

“SIDM is pleased and honored to receive your recognition of our efforts towards reducing patient harm through this award! As the only organization whose sole focus is to foster and support efforts and policies aimed at reducing patient harm, we believe that every person will be a patient at some time, and therefore deserves equitable access to safe care,” said Jennie Ward-Robinson, SIDM chief executive officer. “We remain steadfast and dedicated to achieving our goal and your recognition strengthens our resolve to continue collaborating with patients, healthcare professionals, and organizations within the healthcare ecosystem to identify and address patient safety gaps that will reduce harm. Only together we can ensure that patients receive the care they deserve with the best possible outcomes."

“We applaud the leadership and accomplishments of SIDM to develop innovative solutions to reduce medical errors arising from misdiagnosis, delayed diagnosis, or missed diagnosis,” said John H. Mize, MPL Association Board Chair and SVMIC president and chief executive officer. “On behalf of the MPL Association Board and its members, I am pleased to honor SIDM with this award.”

The MPL Association Award of Excellence in Patient Safety is presented to individuals or organizations that have demonstrated a commitment to enhancing patient safety and improving healthcare through systemic improvements. The award will be presented at the 2023 MPL Association Conference on May 18 in New Orleans.  

May 4, 2023 by matray

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

New Hampshire Attorney General’s Report on State Medical Board Calls for Greater Transparency, Legislature Considers Public Advocate
A new report published by the attorney general of New Hampshire calls on the state’s board of medicine to implement reforms that would provide the public with more information about potentially unsafe doctors. The attorney general’s office has recommended posting malpractice complaints and settlements, as well as publicly posting the names of physicians who receive “letters of concern,” which are currently kept confidential …

AM Best Maintains Negative Outlook for Medical Professional Liability Segment
AM Best is maintaining its negative outlook for the medical professional liability segment of insurance in 2023. According to the credit rating service’s Market Segment Outlook, published on March 31, the drivers behind the industry’s negative outlook include rising claim severity, social inflation, the potential for indirect pandemic-related claims, the ongoing pressures of a depressed demand in the physician market and diminishing reserve redundancies …

AMA Analysis of Medical Liability Monitor Annual Rate Survey Data Notes Rate Increases Unseen in Two Decades
A protracted period of upward volatility in medical liability premiums has extended into a fourth consecutive year and suggests a hard insurance market has spread across many states, making it difficult for physicians to find affordable coverage, according to a new Policy Research Perspectives report in which the American Medical Association (AMA) analyzed Medical Liability Monitor’s 2022 Annual Rate Survey data. The prevalence of year-to-year increases in medical liability premiums between 2019 and 2022 has not been observed in two decades …

Colorado Supreme Court Agrees to Hear Damage Cap Challenge
The Colorado Supreme Court agreed last month to hear an appeal over whether a more than $9 million medical liability jury verdict against two physicians and Sky Ridge Medical Center should be reduced to $1 million, in-line with the medical liability damage cap parameters of the state’s Health Care Availability Act ...

HHS Proposes Bolstering Confidentiality Around Reproductive Care
The U.S. Department of Health & Human Services (HHS), through its Office for Civil Rights, issued a Notice of Proposed Rulemaking (NPRM) last month to strengthen Health Insurance Portability & Accountability Act (HIPAA) Privacy Rule protections by prohibiting the use or disclosure of protected health information to investigate or prosecute patients, providers and others involved in the provision of legal reproductive healthcare, including abortion care. According to HHS, it has heard from patients, providers and organizations representing thousands of individuals that this change is needed to protect patient-provider confidentiality and prevent private medical records from being used against people for seeking, obtaining, providing or facilitating lawful reproductive healthcare …

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May 3, 2023 by matray

Hudson Insurance Group (Hudson) today announced the appointment of Jennifer Schoenthal as head of Digital Health for HudsonPro. In this newly created position, Schoenthal will spearhead the development of Hudson’s new Digital Health modular product offering, which includes Medical Professional Liability, Cyber and Technology Errors & Omissions coverage components. HudsonPro was introduced in 2021 as a rebrand of Hudson’s Management Liability, Financial Institutions, Cyber, E&O and MPL lines of business.

“We are thrilled to have Jennifer join our team at Hudson,” said Trevor Howard, executive vice president and head of HudsonPro. “She brings over 25 years of experience in underwriting and product development, and is a nationally recognized speaker and writer, frequently attending industry events and serving on various panels.”

Prior to Hudson, Schoenthal was global product leader for Beazley’s Virtual Care product and has also served as the director of underwriting for a Lloyds of London coverholder, where she developed programs for Allied Health, Products Liability and Medical Spas.

She is based in Atlanta and reports to Michelle Langen, Medical Professional Liability director of HudsonPro.

May 1, 2023 by matray

The Medical Professional Liability (MPL) Association has awarded its 2023 MPL Industry Defender Award to Alan K. Breaud, Peter T. Dazzio, JD, Anne M. Oldenburg, JD, Gordon Slemko, LLB, and Jeffrey R. Street. This award is presented to defense attorneys in recognition for their exceptional and outstanding lifelong contributions to defending physicians, other healthcare professionals, and institutions while supporting medical professional liability insurers.

Alan K. Breaud

Breaud is an attorney at Breaud & Meyers in Lafayette, Louisiana, and has served as a defense counsel for LAMMICO for more than thirty years. He devotes a large part of his practice to the defense of medical malpractice claims, having defended approximately 320 LAMMICO claims before Medical Review Panels and winning 90% of those claims. Breaud practiced for a short time in public finance and thereafter joined the staff of the District Attorney’s Office in New Orleans. Since 1981 he has practiced primarily in the litigation field. In addition, Breaud has served on the Louisiana Attorney Disciplinary Board, which is tasked with the responsibility of investigating all allegations of lawyer misconduct.

Peter T. Dazzio, JD

Dazzio is a partner at the Baton Rouge, Louisiana, law firm Watson, Blanche, Wilson and Posner. He has represented physicians, hospitals, and other healthcare providers to the highest level of excellence in his 50 years of practice. His areas of practice include medical malpractice defense, hospital general liability defense, insurance defense, hospital regulatory, staff privileges, medical executive committee hearings, and hospital policies. Dazzio was instrumental in creating the Louisiana Hospital Association Self-Insurance Medical Malpractice Trust Fund and the Louisiana Physicians Trust. He was also a long-term member of the Louisiana Attorney Disciplinary Board.

Anne M. Oldenburg, JD

Oldenburg, a partner at HeplerBroom LLC in Chicago, represents doctors, dentists, and other healthcare providers for several MPL insurance companies. She has devoted her career to the defense of medical professionals and has tried numerous cases to verdict and handled cases on appeal. She also represents professionals before state licensing boards. Oldenburg has a record of achieving numerous favorable outcomes, including defense verdicts and many dismissals. She serves on the Board of Directors of the Illinois Association of Defense Trial Attorneys and previously served as an Illinois State Representative for the Defense Research Institute.

Gordon Slemko, LLB

Slemko, General Counsel at HIROC (Healthcare Insurance Reciprocal of Canada), defends the organization’s subscribers and their employees in a variety of medical malpractice actions, up to and including trial. Slemko provides internal corporate advice and manages an internal legal department of nine lawyers, law clerks, and administrative assistants. He also liaises and co-leads negotiation of retainer arrangements with HIROC’s external legal providers. He is the chair of the Outreach Committee of the Medico-Legal Society of Toronto and is a member of the Advocate’s Society of Ontario, the Ontario Bar Association, and the Canadian Bar Association.

Jeffrey R. Street

Street is co-managing partner at Hodgkinson, Street, Mepham in Portland, Oregon, and specializes in the defense of physicians and healthcare professionals in Oregon and Washington. Throughout his career, Street has taken hundreds of cases to trial or arbitration. For Physician’s Insurance alone, he has taken 39 cases to trial including complex, high severity cases such as birth and neurological injury. Street is a Fellow in the American College of Trial Lawyers and has been recognized as an Advocate member in the American Board of Trial Advocates.

“These outstanding defense attorneys have served as important partners with medical professional liability organizations,” said Brian K. Atchinson, 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 is pleased to honor their work.”  

April 20, 2023 by matray

Coverys recently announced the hiring of Cathy Donahue to be its chief operating officer. Reporting to Joseph Murphy, Coverys president and chief executive officer, she will oversee a wide range of functions and business units within Coverys, including claims, human resources, risk management and analytics, information technology, enterprise risk management, and diversity, equity and inclusion. Donahue has more than two decades of experience in the insurance industry.

“Cathy has deep expertise in effecting change and innovation across organizations by listening and engaging others,” Murphy said. “As a result of this collaborative approach, she is adept at operational efficiency, mitigating risk, ensuring compliance and strengthening overall quality across organizations. Coupled with Cathy’s operational strengths is her passion and belief in cultivating a purpose-led culture. She is an exemplary role model who truly aligns with our Coverys core values.”

Donahue most recently served as assistant vice president and chief administrative officer at The Hartford, where she oversaw the diversity, equity and inclusion strategy for its claims and operations division. Prior to that, she held senior operations roles at Chubb & Son, including vice president and managing director of Worldwide Surety Operations and operations manager for North America.

“I am delighted to join Coverys, a company known for driving growth and innovation in the medical professional liability insurance market,” Donahue said. “I look forward to collaborating with the team to execute our long-term strategic plan to bring sophisticated technology, risk-mitigation strategies, data intelligence and evidence-based processes to liability protection."

April 17, 2023 by matray

Sompo International, a provider of commercial and consumer property and casualty (re)insurance, promoted Margaret Hyland to president of North America Reinsurance. Hyland now reports to Christopher Donelan, chief executive officer, Global Reinsurance, Sompo International Holdings Ltd.

“We are excited to see Maggie step into her new role given her wealth of leadership experience and strong relationships within the (re)insurance industry,” Donelan said. “Our ability to attract and develop the depth of talent on our team is one of our greatest strengths and we are confident Maggie has the reputation and expertise needed to take our business forward.”

Hyland previously served as the company’s executive vice president, head of North American Professional Liability Reinsurance at Sompo International. With more than 30 years of experience in the North American (re)insurance industry, she has held leadership positions with various companies including Allied World, CNA, Axis Capital and Willis Re. Hyland has a Master’s in Business Administration from the Gabelli School of Business at Fordham University and Bachelor of Arts in Literature and Speech from St. John’s University.