March 20, 2020 by matray

The Medical Professional Liability Association (MPL Association) president and CEO Brian K. Atchinson issued the following statement about (H.R. 6283), the Good Samaritan Health Professionals Act that was introduced by Representatives Raul Ruiz, MD (D-CA) and Larry Bucshon, MD (R-IN):

“During this time of pandemic and in other times of catastrophe, it is vital for patients to have access to quality, timely medical care. Unfortunately, healthcare professionals who cross state lines to volunteer their medical services during disasters are not adequately protected by federal law. Additionally, the current patchwork of state laws designed to encourage medical volunteerism compound the problem by being ambiguous and inconsistent, especially when applied to large-scale disasters. This could mean that vital medical volunteers are deterred from helping, turned away, or forced to limit their services at a time when their help is most needed.

We commend Representative Ruiz and Representative Bucshon for introducing The Good Samaritan Health Professionals Act, a measure that, while important for any future catastrophe, is particularly relevant now as it would provide civil liability protections to licensed health care professionals who volunteer their time and skills to treat coronavirus patients. The bill also would preserve a victim’s access to compensation if an injury is the result of willful or criminal misconduct, gross negligence, reckless misconduct, or a conscious flagrant indifference to the rights or safety of the patient.

The MPL Association will continue to build bipartisan support in Congress in order to pave a path forward for the enactment of this measure.”

March 18, 2020 by matray

Statement from the Medical Professional Liability Association:

The MPL Association has been actively monitoring evolving developments related to the coronavirus. Based on new guidance from the Centers for Disease Control and Prevention (CDC) and the District of Columbia government, the MPL Association Leadership Forum and Annual Conference scheduled for May 6-8 in Washington, D.C., is cancelled.

At this time, all other Association meetings scheduled for the autumn will continue as planned. We will continue to monitor guidance from the CDC and state and local health agencies as it relates to the coronavirus and will take necessary precautions based on local recommendations in each city where a meeting would be taking place. If conditions and travel guidance change, we will make decisions based on the best interest of our members, affiliate partners, sponsors, and staff.

March 18, 2020 by matray

NJ PURE announced a partnership reinsurance contract with General Reinsurance Corp., a member of the Berkshire Hathaway family of companies. Gen Re has an A++ (Superior) rating from A.M. Best Co. and has over $17.75 billion in assets.

"All of our policyholders may now take added comfort in knowing that NJ PURE has the financial support of Gen Re and the billions of dollars in assets behind it," said Eric S. Poe, a principal of NJ PURE's management company and chief litigation officer of NJ PURE. "By backing NJ PURE up to 70% of our future exposures up to our policy limits, we believe Gen Re's commitment to us is a testament to our long-term business model and its viability into the future."

March 12, 2020 by matray

MagMutual Insurance Company today announced it will be returning a 7% dividend to its PolicyOwners.

This marks the thirteenth consecutive year that the company has paid dividends. Since its inception, the company has returned more than $293M in financial rewards to its PolicyOwners, according to MagMutual.

“MagMutual is owned by our policyholders – that’s why we call them ‘PolicyOwners’ – and we want to make sure they profit from their company’s success,” said Joe Wilson, MD, executive chairman of MagMutual. “Our core business precepts are always putting PolicyOwners interests first and optimally managing their company. Paying dividends is a reflection of our commitment to them.”

“Our ability to continue paying some of the highest dividends in the industry, whilst maintaining positive operations and growing our significant financial strength, is a testament to the whole team,” said Neil Morrell, CEO of MagMutual. “I am thrilled for our policyholders and proud of my colleagues.”

March 12, 2020 by matray

Official statement from the Medical Professional Liability Association on coronavirus and its upcoming, May 6-8, Conference in Washington, D.C.

"The MPL Association has been having extensive discussions and consultations with Association members and leadership and other valued sources of information as well as actively monitoring developments related to the coronavirus. At this time, the MPL Association Conference in May will continue as planned. However, the Association remains very mindful of the health and safety of our members, affiliate partners, sponsors, and staff, and we will continue to closely monitor guidance from the CDC and state and local health agencies."

March 2, 2020 by matray

Berxi, part of Berkshire Hathaway Specialty Insurance, recently announced that it has entered into a strategic alliance with Vizient Insurance Services, LLC, a subsidiary of Vizient, Inc., to offer medical malpractice insurance products to Vizient member allied health professionals through an enhanced digital experience. The agreement with Vizient, a member-driven healthcare performance improvement company, became effective Jan 1.

A feature of the agreement is Berxi’s ability to provide Vizient members with fast, efficient digital access to affordable high-quality medical malpractice insurance. Members can choose from a range of limits and take advantage of noteworthy coverage features, such as defense costs that are paid in addition to the insurance limits. Quotes are available online in minutes at berxi.com/vizient.


“We look forward to supporting Vizient member health professionals in their insurance needs through this agreement,” said Adam Yasan, managing director of Berxi. “Many healthcare professionals are looking for more insurance protection and the Berxi digital sign-up experience provides ease of access, speed and choice in coverage to meet these needs.”

Vizient provides solutions and services that improve the delivery of high-value care by aligning cost, quality and market performance for more than 50 percent of the nation’s acute care providers, which includes 95 percent of the nation’s academic medical centers, pediatric facilities, community hospitals, integrated health delivery networks and more than 20 percent of ambulatory providers.

February 28, 2020 by matray

The promise and potential risks of machine learning and other technology will be examined by experts at the 29th Healthcare Risk Management / Patient Safety Conference on Wednesday, March 11, at the New York Marriott Marquis.

2020 Healthcare Technology—Friend or Foe is hosted by Healthcare Risk Advisors (HRA), a business unit of The Doctors Company Group that provides third-party comprehensive insurance and risk management advisory services to New York hospitals. Several hundred healthcare leaders and providers from throughout New York City are expected to attend the conference, and complimentary registrations are still being accepted.

Keynote speaker Robert M. Wachter, MD, will speak on "Healthcare's Digital Revolution: (Finally) A Time for Optimism." Dr. Wachter is professor and chair of the Department of Medicine at the University of California, San Francisco; thought leader in organization of care, quality, patient safety, and digital health; and best-selling author of The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine's Computer Age. Additionally, Dr. Wachter serves on the Board of Governors of The Doctors Company.

Dr. Wachter will also moderate a point-counterpoint debate on whether handheld devices are a patient care aid or a dangerous distraction. Adam Levine, MD, anesthesiologist with Mount Sinai Health System, will take the pro side. Kerin Torpey Bashaw, MPH, BSN, RN, senior vice president of patient safety and risk management with The Doctors Company, will present the cons.

Other healthcare experts speaking at the conference are:

Bryan Sexton, PhD, director of the Duke Center for Healthcare Safety and Quality at the Duke University Health System. Dr. Sexton will address "Workforce Well-Being as Quality of Care: Evidence-Based Burnout Busters (Mobile Friendly)." Hardeep Singh, MD, MPH, chief of health policy, quality and informatics at the VA Innovation Center, Baylor College of Medicine, in Houston, Texas. Dr. Singh will talk on "Relationship of Diagnostic Errors and Health Information Technology: It's Complicated." Zachary Lockerman, MD, MBA, FACG, CPE, chief medical informatics officer / patient safety officer at Maimonides Medical Center; Peter Shamamian, MD, vice president and chief quality officer at Montefiore Medical Center; and Robbie Freeman, MBA, MSN, BS, vice president of clinical innovation at Mount Sinai Health System. They will provide an update on how their hospitals are using technology to improve patient outcomes.

"We are exceedingly proud to attract some of the most preeminent experts in healthcare technology to our conference," said David L. Feldman, MD, MBA, FACS, senior vice president of HRA and chief medical officer for HRA and The Doctors Company Group. "Our speakers will explore the latest technological advances in healthcare and examine the benefits, as well as potential underlying risks, to providers and patients."

About Healthcare Risk Advisors Healthcare Risk Advisors ( healthcareriskadvisors.com ), formerly FOJP Service Corporation, provides comprehensive insurance and risk management advisory services to leading academic hospitals, long-term care facilities, and social services agencies in the metropolitan New York area. Healthcare Risk Advisors is part of The Doctors Company Group.    

February 26, 2020 by matray

AM Best has downgraded the Financial Strength Rating (FSR) to A (Excellent) from A+ (Superior) and the Long-Term Issuer Credit Ratings (Long-Term ICR) to “a+” from “aa-” for the members of ProAssurance Group. The outlook of the FSR has been revised to stable from negative whilst the outlook for the Long-Term ICR remains negative. Concurrently, AM Best has downgraded the Long-Term ICR to “bbb+” from “a-” of ProAssurance Corporation (PRA) (headquartered in Birmingham, AL), as well as all associated Long-Term Issue Credit Ratings (Long-Term IRs). The outlook of these Credit Ratings (ratings) remain negative. All companies are indirect subsidiaries of PRA. (See below for a detailed listing of the companies’ ratings.)

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

The ratings downgrade reflects AM Best’s view that ProAssurance Group’s medical professional liability (MPL) operating performance has deteriorated in recent accident years and calendar years with results more in line with industry averages. The company reported a $30.4 million adverse loss reserve development in the fourth quarter of 2019, driven by a single large national MPL account and a full-year 2019 combined ratio of 118.9%. Prospective results also are expected to be challenged in 2020 and again in 2021 with its planned acquisition of NORCAL Group (NORCAL). As ProAssurance Group continues to face challenges of declining MPL premium levels in competitive markets and increasing MPL loss severity, AM Best does not expect the group to materially out-perform the MPL industry in the near future.

While the group’s balance sheet strength continues to be assessed at strongest, the negative outlook reflects the decreasing trend of its capital adequacy, as measured by Best’s Capital Adequacy Ratio (BCAR), driven by lower underwriting profits and reduced embedded equity in loss reserves. The planned acquisition of NORCAL in 2020 is likely to place some additional strain on the group's consolidated risk-adjusted capitalization. The ratings also consider the ProAssurance 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. The planned NORCAL acquisition will likely increase the group’s operational scale and strengthen its market position in the long term. These ratings also acknowledge the depth and breadth of the group’s ERM programs and policies. In addressing challenges in a prolonged soft MPL market, management has leveraged its talent, knowledge base and market position to introduce innovative alternatives.

The FSR has been downgraded to A (Excellent) from A+ (Superior) and the outlook revised to stable from negative while the Long-Term ICRs have been downgraded to “a+” from “aa-” with that outlook remaining negative for the following members of the ProAssurance Group:

•ProAssurance Casualty Company
•ProAssurance Indemnity Company, Inc.
•ProAssurance Specialty Insurance Company, Inc.
•Medmarc Casualty Insurance Company
•Noetic Specialty Insurance Company
•Podiatry Insurance Company of America
•ProAssurance American Mutual, A Risk Retention Group
•Allied Eastern Indemnity Company
•Eastern Advantage Assurance Company
•Eastern Alliance Insurance Company
The following Long-Term IRs have been downgraded with the outlook remaining negative for:
ProAssurance Corporation:

--to “bbb+” from “a-” on $250.0 million 5.30% 10-year senior unsecured notes, due 2023
The following indicative Long-Term IRs under the shelf registration have been downgraded with the outlooks remaining negative:
ProAssurance Corporation:
--to “bbb+” from “a-” on senior unsecured debt
--to “bbb” from “bbb+” on senior subordinated debt
--to “bbb-” from “bbb” on preferred stock

February 26, 2020 by matray

AM Best has downgraded the Financial Strength Rating (FSR) to A- (Excellent) from A (Excellent) and the Long-Term Issuer Credit Ratings (Long-Term ICR) to “a-” from “a” for the members of NORCAL Group (NORCAL). Concurrently, AM Best has maintained the under review status on these Credit Ratings (ratings) and revised the implications to developing from negative. (See below for a detailed listing of the companies.)

The ratings reflect NORCAL’s balance sheet strength, which AM Best categorizes as very strong, as well as its adequate operating performance, neutral business profile and appropriate enterprise risk management.

These rating actions are a follow up to ones taken on Dec. 10, 2019, when the group was placed under review with negative implications after significant reserve strengthening was reported in third-quarter 2019, resulting in deterioration of capitalization and profitability. The rating downgrades reflect the adverse reserve development reported in fourth quarter, the additional net reserve leverage taken on by this charge and the potential for further adverse loss reserve development, which is considered in AM Best’s view of risk-adjusted capitalization. The size and breadth of the charge also raises questions as to risk awareness and the appropriateness of the group’s reserving and claims management practices, as well as loss-cost assumptions when setting pricing.  

The under review status takes into consideration the potential for additional reserve charges as well as the recently announced acquisition of the group by ProAssurance Corporation, one of the leading medical professional liability insurers in the United States. The value of the transaction involves a base consideration to policyholders of $450 million with a $150 million three-year earn-out on prior year reserves, following the demutualization of NORCAL. The transaction is expected to close in late fourth-quarter 2020 or in first-quarter 2021, pending demutualization and regulatory approval.  

The developing implications reflect the potential for NORCAL’s ratings to be lowered in the event the transaction does not close and/or further reserve development is reported. There is also the potential for NORCAL’s ratings to be stabilized or enhanced if the ProAssurance transaction is consummated. However, concerns regarding rising loss costs (i.e., severity) in the medical professional liability segment and its impact on profitability remain.

The FSR was downgraded to A- (Excellent) from A (Excellent) and the Long-Term ICRs downgraded to “a-” from “a”, with the implications of the under review status revised to developing from negative for the following members of NORCAL Group:

· NORCAL Mutual Insurance Company

· NORCAL Specialty Insurance Company

· Medicus Insurance Company

· FD Insurance Company

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

February 20, 2020 by matray

ProAssurance Corp. and NORCAL Group announced today the signing of a definitive agreement under which NORCAL would become a part of ProAssurance in a $450 million transaction following the demutualization of NORCAL Mutual Insurance Company (NORCAL Mutual), NORCAL's ultimate controlling party. The demutualization and the acquisition agreement are mutually contingent, and are subject to required regulatory and policyholder approvals. Based on available estimates of premium, the combination of these companies is expected to create the nation's third largest specialty writer of liability insurance for healthcare professionals and facilities. The companies are targeting to close the transaction by the end of 2020, subject to required approvals.

This transaction is expected to deliver multiple strategic and financial benefits, including enhancements to scale and capabilities, access to the high-quality California physicians market at a time when the healthcare professional liability market is starting to harden, and an expected $18 million in pre-tax synergies. These synergies will consist of corporate and back-office expenses, staffing, and other cost areas such as technology and real-estate, along with consolidation of reinsurance and investments. We anticipate the transaction will be accretive to earnings in the second year of ownership, and generate highly attractive returns to shareholders over the longer term as well.

"Bringing together these two great organizations provides ProAssurance and NORCAL with a transformational opportunity to enhance the services we can deliver to our customers and distribution partners, while creating significant long-term value for ProAssurance shareholders," said Ned Rand, President and Chief Executive Officer of ProAssurance. "Much like ProAssurance's predecessors, NORCAL was founded by physicians in the 1970’s to serve the professional liability insurance needs of physicians. NORCAL's history and physician focused culture make it a perfect fit for the ProAssurance family."

Rand continued, "For over 40 years, ProAssurance and its predecessors have navigated the peaks and valleys of the long cycle characteristic of our businesses. This announcement serves as an example of what we have always believed: it is during the most challenging stages of the long cycle that the greatest opportunities arise."

Scott Diener, President and Chief Executive Officer of NORCAL, said, "We are thrilled to be partnering with ProAssurance. Given today’s challenging healthcare environment, both organizations will benefit significantly from the formation of this enhanced company. Combining with ProAssurance brings tremendous strategic value to NORCAL through increased financial strength, access to new and innovative products for policyholders, and the increased scale of our core services and data analytics. The completion of this transaction will enhance and expand NORCAL's ability to serve its customers in the highly competitive MPL industry as we strive to carry out our mission."

Mike Boguski, President of ProAssurance's Specialty Property & Casualty division, added, "This transaction is an exciting combination of healthcare professional liability industry leaders. Strategically, this combination provides us with a national platform, geographic diversification, deep penetration in the physician market, best in class talent, and access to high quality distribution partnerships. We look forward to working with the exceptional employees and distribution partners at NORCAL to create a premier organization to serve the evolving healthcare market on a national basis."

The Boards of Directors for both companies have unanimously approved the transaction, which now requires the approval of NORCAL Mutual policyholders and appropriate state and federal regulators. Eligible NORCAL Mutual policyholders will be asked to vote on the Plan of Conversion and at the same time will be asked to select how they will be compensated for their mutual company interest in NORCAL Mutual. Under the terms of the agreement, NORCAL Mutual's demutualization will be followed by a tender offer from ProAssurance to purchase the stock of the demutualized company. ProAssurance will pay a base consideration of $450 million in cash, with a contingent consideration of up to $150 million should ultimate loss estimates as of the acquisition date develop favorably. In addition, NORCAL will have the opportunity to nominate two individuals to new seats on the ProAssurance Board.