The Cooperative of American Physicians Tops the 13,000 Member Mark, Reaching a New Milestone

September 5, 2023 by matray

The Cooperative of American Physicians, Inc. (CAP) recently announced that its membership has grown to exceed 13,000 California physicians, its largest member count in its 48-year history. The organization’s growth is further contributing to its already strong fiscal position and outlook.

“Independent physicians have endured more than their share of challenges over the past 15 years, marked most recently by the COVID-19 pandemic and the undermining of decades-old tort reforms contained in MICRA,” said CAP Vice President of Membership Development Dan Cavanaugh. “It’s not surprising that more physicians than ever are choosing CAP’s valuable resources, expertise, and unparalleled services to help them maintain their independence and operate safe and successful medical practices.”

To complement the medical professional liability coverage provided through the Mutual Protection Trust (MPT), CAP offers its members a wide range of value-added programs, including a risk management hotline, online risk reduction training, human resources support, practice management consultation, a group purchasing program, business and personal insurance coverages, and many other free or deeply discounted benefits.

“CAP’s membership milestone comes after MPT earned its 16th consecutive A+ (Superior) rating from A.M. Best earlier this year,” said CAP CEO Sarah E. Scher. “These two recent achievements exemplify CAP’s superior financial stability and long-term standing as a formidable leader in the California medical malpractice coverage arena.”

The enterprise began with approximately 500 physician members. Now, with more than 13,000 physician members, MPT is the second-largest provider of medical professional liability coverage in California. CAP credits its robust internal processes, disciplined underwriting and claims management practices, and dedicated risk management programs for its sustained growth and solid financial record.

AM Best Upgrades Credit Ratings of Hospitals Insurance Company, Inc.; Affirms Credit Ratings of Doctors Company Insurance Group’s Members

August 31, 2023 by matray

AM Best  upgraded the Financial Strength Rating (FSR) to A (Excellent) from A- (Excellent) and the Long-Term Issuer Credit Rating (Long-Term ICR) to “a” (Excellent) from “a-” (Excellent) of Hospitals Insurance Company, Inc. (HIC). Concurrently, AM Best has affirmed the FSR of A (Excellent) and the Long-Term ICR of “a+” (Excellent) of the members of Doctors Company Insurance Group. The outlook of these Credit Ratings is stable. (See below for a list of TDC’s companies.)

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

The ratings upgrade for HIC reflects the implicit support from its parent organization, TDC. HIC has been fully integrated into the group’s operations and is viewed as one of TDC’s four strategic business units. The company is critical to the group’s strategy and is a material contributor to the group’s premiums and earnings. Furthermore, the parent has indicated its willingness to provide explicit support if needed.

The ratings of TDC reflect the group’s balance sheet strength, which AM Best assesses as strongest, as well as its adequate operating performance, neutral business profile and appropriate ERM. TDC’s balance sheet strength continues to be supported by the strongest level of risk-adjusted capitalization, as measured by Best’s Capital Adequacy Ratio (BCAR). In addition, the group benefits from consistently favorable loss reserve development and a solid liquidity position. The group’s underwriting performance has shown improvement in recent years, with rate actions taken amid hardening market conditions within the medical professional liability (MPL) insurance segment. TDC maintains a strong market position as the second largest MPL writer in the United States, based on 2022 direct premiums written. Further, an appropriate ERM program is in place with a well-defined framework and risk management capabilities that are closely aligned with the group’s risk profile.

The FSR of A (Excellent) and the Long-Term ICRs of “a+” (Excellent) have been affirmed for the following members of the Doctors Company Insurance Group:

• 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

   

NOW Insurance Receives Funding from Arch Capital Group Ltd. to Accelerate Growth

August 22, 2023 by matray

NOW Insurance, a full-stack, AI-enabled commercial insurance platform specializing in medical professional liability coverage, announced today an investment from a subsidiary of Arch Capital Group Ltd. and a managing general agent partnership with Arch Insurance North America.

Proceeds from the latest capital raise will be used for launching its new suite of medical malpractice products, scaling their platform, and expanding distribution networks. Chief among these is the introduction of a new portal for brokers. Brokers will soon be able to submit and bind medical malpractice coverage online for physicians.

“I am very excited to further strengthen our partnership with Arch. As an innovative company and leader in the Insurtech space, they understand the potential of our platform and have shown their commitment in helping it succeed,” said Philip Cabaud, CEO of NOW Insurance.

“NOW Insurance’s innovative approach to the medical malpractice market aligns with Arch’s commitment to using analytics and AI to deliver an exceptional broker experience,” said Jay Rajendra, chief strategy and innovation officer for Arch Capital Group Ltd. “We’re looking forward to bringing NOW’s platform to our broker partners and working closely with NOW to further develop their analytics capabilities.”

Integris Group Announces National Accreditation for CME Program by ACCME

August 11, 2023 by matray

Integris Group recently announced that the Accreditation Council for Continuing Medical Education (ACCME) has awarded the company’s Continuing Medical Education (CME) program with accreditation through July 31, 2027.

The decision came after a rigorous application process, which spanned nearly two years, from the preparation of the submission documentation, to an interview with ACCME officials, to the final result, according to Integris.

“Congratulations to Integris and the risk management team for receiving this important and valuable accreditation,” said Victoria Reyes, MD, Integris Board Member and Chair of the Risk Management Committee. “This was no small feat and will be a valuable benefit to our policyholders.”

The accreditation by the ACCME was timely, given a new reporting requirement recently released by the American Board of Surgery (ABS). Going forward, ABS-certified providers can no longer self-report the 150 hours of Maintenance of Certificate (MOC) eligible CME courses needed to maintain their license. Instead, the MOC credits must be reported through an ACCME accredited provider.

Now nationally accredited through the ACCME, Integris Group has added this reporting capability to the services and benefits they offer their policyholders.

“At Integris, we pride ourselves on delivering exceptional educational content to our membership,” said Denise Condron, Integris vice president of risk management. “The national accreditation by the ACCME demonstrates this commitment and also enables us to enhance the service we provide our members by allowing us to report these courses on their behalf to the ABS.”

Medical Liability Monitor August 2023 issue highlights

August 10, 2023 by matray

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

Florida Supreme Court Changes Appellate Rules So Challenges to Expert Witness Qualifications Can Be Immediately Appealed
The Florida Supreme Court last month amended the state’s rules of appellate procedure “to provide for interlocutory review of nonfinal orders that deny a motion dismiss on the basis of the qualifications of a corroborating witness.” Prior to the rule change, medical malpractice defendants had to wait until the conclusion of their trial before appealing any denied motions to dismiss based on the qualifications of the plaintiff’s expert witness. Since the July 6 rule change, hospitals and healthcare providers can immediately appeal an order denying a motion to dismiss based on grounds that the plaintiff’s medical expert witness isn’t adequately qualified to testify against the defendant …

Share of Physicians Working in Private Practice Dropped by 13 points During Past Decade
A new Policy Research Perspective from the American Medical Association (AMA) indicates the share of physicians working in a practice wholly owned by physicians dropped by 13 percentage points during the past decade — from 61.4% in 2012 to 46.7% in 2022. In contrast, the share of physicians directly employed by — or contracted directly with — a hospital during that period increased from 5.6% to 9.6%, and the number working in a hospital-owned practice jumped from 23.4% to 31.3% …

New Report Estimates Diagnostic Error Contributes to 795,000 Permanent Disabilities, Deaths Across Care Settings Annually
The U.S. National Academy of Medicine first declared the improvement of diagnosis in healthcare “a moral, professional and public health imperative” in 2015. However, current estimates of the full scope of harms related to medical misdiagnosis still vary widely. Using novel methods, a team from the Johns Hopkins Armstrong Institute Center for Diagnostic Excellence and partners from the Risk Management Foundation of the Harvard Medical Institutions recently published what they believe to be the first rigorous national estimate of permanent disability and death resulting from diagnostic error …

MMIC Responds to One-Sided Accusations of Bad Faith in Iowa Capital Dispatch Article
The nonprofit news organization Iowa Capital Dispatch last month published an article outlining allegations that MMIC Insurance Inc. engineered a record-setting $97.4 million jury verdict against one of its insured clinics last year in an attempt to persuade Iowa lawmakers to pass the noneconomic damage cap legislation that Gov. Kim Reynolds signed into law on February 16 of this year. The article makes no attempt to verify the allegations or explore counterarguments independently. It does not include any real overview of the underlying medical liability case or historical context for the noneconomic damage cap legislation and lacks any input from legal experts, healthcare professionals or relevant authorities who could provide insight into the legal filings. Medical Liability Monitor contacted MMIC for comment. Following is its written response to the allegations outlined in the Iowa Capital Dispatch article …

Why Doctors Aren’t Prepared for Medicine’s AI Transformation
As artificial intelligence systems like ChatGPT increasingly find their way into everyday use, physicians will similarly begin incorporating these tools into their clinical decision making, diagnoses and treatment of common medical conditions. These tools, called clinical decision support (CDS) algorithms, can be enormously helpful in guiding healthcare providers in determining, for example, which antibiotics to prescribe or whether to recommend a risky heart surgery. The success of these new technologies, however, depends largely on how physicians interpret and act upon a tool’s risk predictions — and that requires a unique set of skills that many are currently lacking ...

Report Recommends Policy Steps to Slow Private Equity’s Role in Medicine
A new report, Monetizing Medicine: Private Equity and Competition in Physician Practice Markets, examines private equity’s voracious acquisition of physician practices during the last several years. The analysis evaluates market penetration across 10 physician practice specialties, the impact on market shares and concentration, and on prices and expenditures. The authors ultimately frame policy steps that would strengthen FTC competition enforcement …

Malpractice Lawsuits Over Denied Abortion Care May Be on the Horizon
A year after the overturning of Roe v. Wade, many physicians and hospitals in the states that have restricted abortion are reportedly refusing to end the pregnancies of women facing health-threatening complications out of fear they might face criminal prosecution or loss of their medical license. Some experts predict those providers could soon face a new legal threat: medical malpractice lawsuits alleging they harmed patients by failing to provide timely, necessary abortion care …

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Fitch Ratings Affirms ‘A’ Ratings, ‘Stable’ Outlook for The Doctors Company

July 17, 2023 by matray

Fitch Ratings affirmed its “A” (Strong) Insurer Financial Strength ratings for The Doctors Company, part of TDC Group. The outlook of these ratings is “Stable.”

Fitch noted that the ratings are based on a very strong statutory capital position and sufficient loss reserve levels. Fitch further stated that The Doctors Company has a strong business profile as the nation’s number-two writer in medical professional liability insurance.

Fitch commented that The Doctors Company’s capital position is “very strong.” The “A” with “Stable Outlook” ratings include:

• The Doctors Company, an Interinsurance Exchange


• The Doctors Company Risk Retention Group, a Reciprocal Exchange


• TDC National Assurance Company


• TDC Specialty Insurance Company

“These ratings from Fitch reflect the strength and stability of The Doctors Company,” said Marco Vanderlaan, The Doctors Company and TDC Group chief financial officer. “This financial strength gives us the capability and resources necessary to protect our members today and for many years to come as we advance, protect and reward the practice of good medicine.”  

AM Best Affirms Superior Credit Ratings of Members of MedPro Group

July 13, 2023 by matray

AM Best has affirmed the Financial Strength Rating of A++ (Superior) and the Long-Term Issuer Credit Ratings of “aa+” (Superior) of the members of MedPro Group (MedPro). These Credit Ratings (ratings) apply to The Medical Protective Company (Fort Wayne, IN) and its affiliates: Princeton Insurance Company (Princeton, NJ); PLICO, Inc. (Oklahoma City, OK); Wellfleet Insurance Company (Fort Wayne, IN); and Wellfleet New York Insurance Company (Flushing, NY); as well as MedPro’s two reinsured affiliates, MedPro RRG Risk Retention Group and AttPro RRG Reciprocal Risk Retention Group (both domiciled in the District of Columbia). The outlook of these ratings is stable.

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

The ratings also acknowledge MedPro’s risk-adjusted capitalization being at the strongest level, as measured by Best’s Capital Adequacy Ratio (BCAR), long-term profitable operating performance and the leading market position it maintains in the medical professional liability (MPL) sector. Additionally, the ratings consider the group’s substantial distribution capabilities, prudent claims-handling philosophy and culture of holistic risk management. The group consistently outperforms peers by most metrics, illustrated by substantial historical returns on equity, low operating ratios and solid net underwriting income. Furthermore, the ratings benefit from the explicit and implicit financial support provided by its affiliate, National Indemnity Company, and MedPro’s ultimate parent, Berkshire Hathaway Inc. [NYSE: BRK A and BRK B], which includes reinsurance programs, investment opportunities and capital support.

Partially offsetting these positive rating factors are the inherent challenges associated with the MPL line of business, particularly as it relates to price competition, changing market dynamics, potential changes in legislation (i.e., tort reform), increasing loss cost trends and regulatory risk. At the same time, AM Best recognizes the organization’s strong management team, diversified premium base and jurisdictional diversity, which have contributed to MedPro outperforming its peers over the longer term.

The group’s large allocation to common stocks exposes it to significant volatility during periods when the equity markets experience sharp declines. The group has historically demonstrated its ability to absorb this volatility and maintain the strongest level of risk-adjusted capitalization due to its low underwriting leverage, driven by its affiliated reinsurance agreement with National Indemnity Company and MedPro’s substantial capital position, and the investment managers’ historical trend of success in turbulent markets.

Medical Liability Monitor July 2023 issue highlights

July 6, 2023 by matray

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

MPL Insurance Market Recovery at Risk of Stalling, Positive Pricing Window Finite
The U.S. medical professional liability insurance (MPLI) market staged a significant recovery in 2022 with a 102.5% combined ratio, compared to an average of 109% during the previous four years. Positive pricing actions and a more favorable prior underwriting period reserve experience are key factors behind the recent improvement. While this shift is encouraging, a near-term return to consistent underwriting profits remains unlikely. The level of premium rate increases shows signs of moderating, creating questions about whether premium volume can keep pace with loss-cost patterns influenced by inherently volatile claims litigation and settlement activity, persistent higher inflation and a weaker economy …

EmPRO Posts Impressive Second-Year Results, Signals Regional Expansion
EmPRO Insurance Co. recently marked its second year writing business as the third-largest admitted medical professional liability insurer in New York State. A wholly owned subsidiary of Physicians’ Reciprocal Insurers (PRI), EmPRO was capitalized in 2020 by its parent, while assuming all of PRI’s active New York business. For the year ended Dec. 31, 2022, EmPRO recorded another year of improved financial performance, reporting admitted assets of $395.8 million, liabilities of $283.7 million, reserves of $176.9 million, surplus of $112.1 million, gross written premium of $178.4 million, net income of $12.1 million and a combined ratio of 82.7% …

Indemnity Payments Impact First-Quarter financial Results for MPL Specialty Insurers
Perhaps the most interesting storyline this quarter was the resurgence of indemnity payments during the fourth quarter of 2022 and the first quarter of 2023. MPL specialty writers experienced an 18-month slowdown in indemnity payments that started in the second quarter of 2020. This includes the four quarters with the fewest indemnity payments made in the last 10 years. Beginning in the fourth quarter of 2021, it appeared as though payments had stabilized, but the hole created between the second quarter of 2020 and the third quarter of 2021 had not been filled. Now, during the last two quarters, the composite has had its two largest quarters of indemnity payments on record …

New York Lawmakers Again Vote to Update Wrongful Death Statute
New York lawmakers have again overwhelmingly passed a bill to overhaul the state’s 176-year-old wrongful death statute. A similar bill was vetoed by Gov. Kathy Hochul on Jan. 30 due to her concerns it could result in “significant costs for many sectors of our economy, particularly hospitals that are still recovering from the pandemic and struggling to stay afloat“ …

Nevada More Than Doubles its Noneconomic Damage Cap
Following heated debate over a bill proposing to significantly raise Nevada’s $350,000 noneconomic damage cap for medical liability lawsuits, healthcare provider and trial lawyer interests presented lawmakers with a deal last month to establish a new cap of $750,000. The previous cap was created via ballot initiative in 2004. The legislation also increases the statute of limitations to initiate a medical malpractice lawsuit from one year to two years from when the plaintiff should have been able to recognize a complication or three years from the date the alleged malpractice incident occurred ...

Healthcare Risk Retention Groups Drive Record RRG Premium Growth
Risk retention groups (RRGs) reported record premium growth in 2022. Premium increased by 12.9% to $4.9 billion, an increase of more than $558 million over the $4.3 billion reported in 2021, according to reporting by the Risk Retention Reporter. This marks the largest premium increase in dollar terms for the RRG industry, surpassing the premium growth of $527 million in 2003. Among RRGs reporting the largest premium gains, the healthcare sector led representation with six RRGs reporting premium gains of $10 million or more …

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NFP Acquires Presidio Financial Services Corp., Expands Its Specialized Medical Malpractice Insurance Expertise

June 29, 2023 by matray

NFP, a property and casualty broker, benefits consultant, wealth manager and retirement plan advisor, announced it has acquired Presidio Financial Services Corp. Based in Westlake Village, Calif., Presidio is an independent insurance brokerage that provides an extensive range of products and solutions tailored specifically for physicians, hospitals, healthcare facilities and healthcare professionals. The acquisition closed on April 7.

Gisela Plazas, Presidio's founder and CEO, will be joining NFP and working with Scott Foster, NFP’s Healthcare & Life Sciences Specialty practice leader. “We’re very excited to welcome Gisela to NFP,” said Foster. “She is a strong producer with an extensive network of relationships, and we look forward to introducing NFP’s breadth of solutions to her current and future clients.”

Founded in 2002, Presidio’s specialized insurance offerings include healthcare professional liability, business office coverage, errors and omissions, workers’ compensation, commercial general liability, directors and officers, cyber liability, employment practices liability and umbrella coverage.

“Adding Presidio is a great strategic move for our growing P&C presence in the Western US,” said Mike Schneider, president of NFP’s West region. “Gisela’s specialized expertise in medical malpractice will complement our existing capabilities and create new opportunities to deliver value to clients.”

"I’m thrilled to join NFP and begin contributing to the success of a growing, people-first organization,” said Plazas. “This is a great opportunity for me to integrate my medical malpractice knowledge across the organization and introduce additional solutions to our clients.”  

Integris RRG Elects Two Doctors to its Board of Directors at Recent Annual Meeting of Members

June 28, 2023 by matray

Integris Group announced the elections of Powen Hsu, MD, and Jeffrey Rind, MD, to the Integris RRG Board of Directors. The elections took place at the Integris RRG Annual Meeting of Members on June 9th.

“The addition of Dr. Hsu and Dr. Rind to our Board of Directors will deliver new insights and perspective to the Company,” said Stephen J. Gallant, Integris Group chief executive officer. “Both physicians bring a wealth of knowledge to our Board of Directors. We are confident their presence will enhance our progress towards our strategic goals, benefiting our policyholders. We look forward to working with them as we continue our mission of strategic growth and welcome their contributions.”

Powen Hsu, board certified in physical medicine and rehabilitation and addiction medicine, is the medical director at the Farnum Center, an addiction treatment center in Manchester, NH. He has also served as medical director at several other facilities, including Fusion Health Services, Encompass Health Concord, Blueprint/Bonfire Recovery Center and as the section chief of adult medicine at Catholic Medical Center. Hsu is a past member of Catholic Medical Center’s Board of Directors. Hsu received his medical degree from Tufts University and completed his postgraduate medical training at Salem Hospital, Sinai Hospital, and John Hopkins University Hospital.

A board certified neurologist, Rind is a founding member and managing partner of Derry Neurological Associates in Derry, NH. Rind has also served in a variety of hospital leadership roles, including chief of staff, chairman of the Board of Trustees, and chairman of the Credentials Committee at Parkland Medical Center. He is a past member of the Center for Life Management’s Board of Directors and Finance Committee. Rind received his undergraduate degree from State University of New York at New Paltz, his Ph.D. from City University of New York, his medical degree from New York Medical College and completed his postgraduate medical training at Mount Sinai Hospital.