Ken Hawkins Joins Pinnacle Actuarial Resources as Consulting Actuary

August 20, 2019 by matray

Pinnacle Actuarial Resources announced that Ken Hawkins, ACAS, MAAA, has joined Pinnacle as a consulting actuary in the firm’s Bloomington, Ill., home office.

Hawkins returns to Pinnacle after three years of leading pricing and rate implementation for a regional property/casualty insurer’s commercial lines products.

“We are very pleased to welcome Ken back to Pinnacle,” managing principal Joe Herbers said. “Ken has tremendous breadth and depth of experience and will bring a highly relevant, customer-focused approach to the work he does for our clients.”

Hawkins has more than 13 years of experience in the property/casualty practice area. His expertise includes loss reserving, funding studies, cost-allocation mechanisms, loss-cost projections, captive-feasibility studies, commercial-lines ratemaking, financial analysis of insurance companies, deductible analysis and simulation methods. He has extensive experience developing simulations that utilize company-specific data to calculate risk margins.

Hawkins holds Associate of the Casualty Actuarial Society (ACAS) and Member of the American Academy of Actuaries (MAAA) credentials and received his Bachelor of Science degree in actuarial science from the University of Illinois, Urbana-Champaign.

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Internists, Leading Physician & Public Health Organizations Urge Immediate Action to Prevent Firearm-related Injury, Death

August 8, 2019 by matray


The American College of Physicians (ACP) and the nation’s leading physician and public health organizations called for policies to reduce firearms-related injuries and deaths in the U.S. in a new call-to-action, “Firearm-Related Injury and Death in the United States: A Call to Action from the Nation’s Leading Physician and Public Health Professional Organizations,” published today in the Annals of Internal Medicine.

“We are living in a world where gun violence is becoming increasingly common, and as physicians, we have a responsibility to address this public health crisis and to keep our patients safe and healthy,” said Robert McLean, MD, FACP, president, ACP.

ACP, together with the American Academy of Family Physicians, American Academy of Pediatrics, American College of Surgeons, American Medical Association, American Psychiatric Association, and the American Public Health Association, delineate the following in a new policy paper:

• Comprehensive criminal background checks for all firearm purchases, including sales by gun dealers, sales at gun shows, private sales and transfers between individuals with limited exceptions should be required.

• Research into the causes and consequences of firearm violence and unintentional injuries and deaths to help identify, test, and implement strategies to reduce these unnecessary injuries and deaths is urgently needed.

• Currently, federal laws prohibiting domestic abusers from accessing firearms apply only to spouses and not dating partners— this loophole in the background check system must be closed. Offenders who have been found guilty of a crime of violence against a family member or intimate partner, including dating partners, cohabitants, stalkers, and those who victimize a family member other than a partner or child should be reported to the National Instant Criminal Background Check System and be prohibited from purchasing or possessing firearms.

• Storing firearms safely and securely is essential to reducing the risk of unintentional or intentional injuries or deaths from firearms, particularly in homes with children, adolescents, people with dementia, people with substance use disorders, and the small subset of people with serious mental illnesses that are associated with greater risk of harming themselves and others.

• The great majority of those with a mental illness or substance use disorder are not violent; however, screening, access and treatment for mental health disorders play a critical role in reducing self-harm and interpersonal violence. The organizations represented in this paper support improved access to mental health care and caution against broadly including all individuals with a mental health or substance use disorder in a category of individuals prohibited from purchasing firearms.

• Extreme risk protection order (ERPO) laws, which allow families and law enforcement to petition a judge to temporarily remove firearms from individuals at imminent risk of using them to harm themselves or others, should be enacted in a manner consistent with due process.

• Physicians can and must be able to advise their patients on issues that affect their health, including counseling at-risk patients about mitigating the risks associated with firearms in the home and firearm safety.

• The magnitude and frequency of mass attacks are unacceptable to our organizations. A common-sense approach to reducing casualties in mass shooting situations must effectively address high-capacity magazines and firearms with features designed to increase their rapid and extended killing capacity.

For more than two decades, ACP has advocated for the urgent need for impactful legislation that would reduce firearms-related injuries and deaths, and our policy paper sparked the “This Is Our Lane” movement of physicians speaking out on gun violence prevention. Additionally, in light of last weekend’s shootings in El Paso, Texas and Dayton, Ohio, ACP released a statement expressing our frustration and sadness.

“We need to protect our patients, their families, and our communities across the country from needless injuries and deaths, it’s time for the U.S. to put firearms violence prevention at the forefront of the health care conversation,” said Dr. McLean. “We are committed to working with all stakeholders, and continuing to speak out, to address this public health threat.”

All firearms-related health policy content published in Annals of Internal Medicine is free to the public at

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The Doctors Company Completes Acquisition of Hospital Insurance Co., FOJP Service Corp. in New York

August 1, 2019 by matray

The Doctors Company has completed the purchase of Hospitals Insurance Company (HIC), a New York State admitted and licensed insurance company, and FOJP Service Corp., a New York service organization that provides third-party comprehensive insurance and risk management advisory services to HIC-insured hospitals. The purchase price is $650 million, subject to closing adjustments.

"We are excited to bring our mission to advance, protect, and reward the practice of good medicine to an even greater number of healthcare providers in New York," said Richard E. Anderson, MD, FACP, chairman and CEO of The Doctors Company. "Our mission is beautifully aligned with the great work of HIC and FOJP."

Proceeds from the transaction will be returned to the not-for-profit hospitals that owned and founded HIC and FOJP more than 30 years ago — The Mount Sinai Hospital and Beth Israel Medical Center (Mount Sinai), Montefiore Health System (Montefiore) and Maimonides Medical Center (Maimonides).

"Mount Sinai, Montefiore and Maimonides are indispensable anchors of New York's healthcare system, and this transaction will not only strengthen their ability to provide high-quality care to their communities, but also make capital improvements that will benefit millions of New Yorkers," said Greater New York Hospital Association president Kenneth E. Raske.

The close of this transaction is also the inception of Healthcare Risk Advisors (HRA), a new business unit within the TDC Group, which will succeed FOJP and focus on third-party comprehensive insurance and risk management advisory services, including management of the self-insured programs of large healthcare organizations in New York and beyond.

HIC will continue to exist as an admitted New York-domiciled insurer providing coverage for hospitals, physicians affiliated with HIC's insured hospitals, and long-term care facilities and social services agencies. HIC and FOJP employees will become part of HRA and continue to provide the same outstanding services to HIC, the member hospitals, longterm care facilities and social services agencies as prior to the transaction.

HRA and HIC will be led by Noeleen Doelger as chief operating and financial officer and Robert A. Kauffman as president. Walter Harris, who served as president and CEO of HIC and FOJP prior to the transaction, will assume a consulting role with the TDC Group and report to Dr. Anderson.

"This transaction provides a platform on which to expand our self-insured programs to additional physicians, hospitals, and healthcare systems," said Kauffman. "At the same time, we remain steadfast in our commitment to provide our founding hospitals with the excellent service that supports what they do best — providing quality healthcare to their communities."

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ISMIE Mutual Partners with Kentucky DOs

July 31, 2019 by matray

ISMIE Mutual Insurance Co. announced a new affinity program partnership with the Kentucky Osteopathic Medical Association (KOMA). Through the program, KOMA members will receive access to ISMIE’s risk management services, premium discounts and other. Physicians coming out of residency are eligible for special discounts.

“We look forward serving the members of KOMA through this exciting new affinity partnership,” said ISMIE Chairman Paul H. DeHaan, MD. “KOMA joins the Indiana, Iowa, Ohio and Pennsylvania state osteopathic associations as ISMIE affinity partners. We find that ISMIE’s comprehensive approach to providing medical professional liability coverage aligns nicely with how DOs approach patient care.”

Kentucky osteopathic physicians who are members of KOMA can access the ISMIE affinity program through all ISMIE-appointed brokers. KOMA members can access more information and request a quote at

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ProAssurance Named a Ward’s 50 Company for the Thirteenth Consecutive Year

July 17, 2019 by matray

ProAssurance Corp. has been named to the Ward’s 50 for 2019. This is the thirteenth-consecutive year the Ward Group has recognized ProAssurance as one of America’s fifty top performing property-casualty insurance companies.

To be included in the Ward’s 50, companies are subject to a rigorous evaluation process that includes financial performance, asset quality and capital position, revenue growth, underwriting results, financial returns and operational excellence.

“Being named to the Ward’s 50 for the thirteenth consecutive year is an accomplishment that highlights the success of our long-term strategy, emphasizing the unrivaled protection and security we offer our customers," said Ned Rand, ProAssurance’s president and chief executive officer. "It is a testament to our employees and distribution partners that we have extended our Ward’s run despite the challenging insurance marketplace in which we operate, made possible by their unyielding dedication to our promise of ‘Treated Fairly’.”

“We recognize ProAssurance for outstanding financial results in the areas of safety, consistency and performance over a five-year period,” said Jeff Rieder, partner and head of Ward Group. “In selecting the Ward’s 50, we analyze the financial performance of nearly 3,000 property-casualty insurance companies, identifying the 50 companies that pass financial stability requirements and demonstrate the ability to grow while maintaining strong capital positions and underwriting results.”

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A.M. Best Affirms Credit Ratings of Members of MedPro Group

July 11, 2019 by matray

A.M. Best has affirmed the Financial Strength Rating of A++ (Superior) and the Long-TermIssuer Credit Ratings of “aa+” of the members of MedPro Group (MedPro) (headquartered in Fort Wayne, IN). These Credit Ratings (ratings) apply to The Medical Protective Company (Fort Wayne, IN), 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 A.M. Best categorizes as strongest, as well as its strong operating performance, favorable business profile and appropriate enterprise risk management.

The ratings also acknowledge MedPro’s robust capitalization, long-term operating performance and the significant 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 maintaining a margin of safety. Furthermore, the ratings benefit from the explicit and implicit financial support provided by the ultimate parent, Berkshire Hathaway Inc., which includes reinsurance programs, investment opportunities and capital support.

Partially offsetting these positive rating factors are the inherent challenges associated with being a predominately monoline MPL insurer, particularly as they relate 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, broad premium base and jurisdictional diversity that mitigate these concerns.

Downward rating pressure may result from a significant decrease in risk-adjusted capitalization from an adverse earnings trend due to underwriting or investment losses. Downward rating pressure also may result should the group’s relationship with Berkshire Hathaway Inc. or National Indemnity Company change, which also would result in a diminution of the business profile.

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July 1, 2019 by matray

AMA Abortion Lawsuit Puts Doctors In The Thick Of Debate

The American Medical Association is suing North Dakota to block two abortion-related laws, the latest signal the doctors’ group is shifting to a more aggressive stance as the Trump administration and state conservatives ratchet up efforts to eliminate legal abortion.

The group, which represents all types of physicians, has tended to stay on the sidelines of many controversial political issues, and until recently has done so concerning abortion and contraception. Instead, it has focused on legislation that affects the practice and finances of large swaths of its membership.

But, said AMA President Patrice Harris in an interview, the organization felt it had to take a stand because new laws forced the small number of doctors who perform abortions to lie to patients, putting “physicians in a place where we are required by law to commit an ethical violation.”

One of the laws, set to take effect Aug. 1, requires physicians to tell patients that medication abortions — a procedure involving two drugs taken at different times — can be reversed. The AMA said that is “a patently false and unproven claim unsupported by scientific evidence.” North Dakota is one of several states to pass such a measure.

The AMA, along with the last remaining abortion clinic in the state, is also challenging an existing North Dakota law that requires doctors to tell pregnant women that an abortion terminates “the life of a whole, separate, unique, living human being.” The AMA said that law “unconstitutionally forces physicians to act as the mouthpiece of the state.”

It’s the second time this year the AMA has taken legal action on an abortion-related issue. In March, the group filed a lawsuit in Oregon in response to the Trump administration’s new rules for the federal family planning program. Those rules would, among other things, ban doctors and other health professionals from referring pregnant patients for abortions.

“The Administration is putting physicians in an untenable situation, prohibiting us from having open, frank conversations with our patients about all their health care options — a violation of patients’ rights under the [AMA] Code of Medical Ethics,” wrote then-AMA President Barbara McAneny.

It’s an unusually assertive stance for a group that has taken multiple positions on abortion-related issues over the years.

Mary Ziegler, a law professor at Florida State University who has written several books about abortion, said that the AMA’s history on abortion is complicated. In general, she said, the AMA “didn’t want to get into the [abortion] issue because of the political fallout and because historically there have been doctors in the AMA on both sides of the issue.”

In recent years, the AMA has taken mostly a back seat on abortion issues, even ones that directly addressed physician autonomy, leaving the policy lead to specialty groups like the American College of Obstetricians and Gynecologists, which has consistently defended doctors’ rights to practice medicine as they see fit when it comes to abortion issues.

Ziegler said it is not entirely clear why the AMA has suddenly become more outspoken on women’s reproductive issues. One reason could be that the organization’s membership is skewing younger and less conservative. Also, this year, for the first time, the AMA’s top elected officials are all women.

In its earliest days, the AMA led the fight to outlaw abortion in the late 1800s, as doctors wanted to assert their professionalism and clear the field of “untrained” practitioners like midwives.

Abortion was not an issue for the group in the first half of the 20th century. The AMA became best known for successful fights to fend off a national health insurance system.

Leading up to Roe v. Wade, the 1973 Supreme Court decision that legalized abortion nationwide, the AMA softened its opposition. In 1970, the AMA board called for abortion decisions to be between “a woman and her doctor.” But the organization declined to submit a friend-of-the-court brief to the high court during its consideration of Roe.

In 1997, the AMA, in a surprise move, endorsed a GOP-backed measure to ban what opponents called “partial-birth abortions,” a little-used procedure that anti-abortion forces likened to infanticide. A year later, however, an audit of the AMA’s leadership found its trustees had “blundered” in endorsing the bill and had contradicted long-standing AMA policy.

One reason the organization may be moving on the issue now could be the shifting parameters of the abortion debate itself. In 1997, the abortion procedure ban that the AMA endorsed “polled well and allowed abortion opponents to paint the other side as extremist,” Ziegler said.

Exactly the opposite is true today, she said, as states pass abortion bans more sweeping than those seen at any time since Roe v. Wade. Yet most public opinion polls show a majority of Americans want abortion to remain legal in many or most cases.

“As abortion opponents take more extreme positions, the AMA is probably a little more comfortable intervening” Ziegler added.

Molly Duane, a lawyer from the Center for Reproductive Rights who is arguing the case for the AMA and North Dakota’s sole remaining abortion clinic, said the laws being challenged are “something all doctors should be alarmed by. … This is an unprecedented act of invading the physician-patient relationship and forcing words into the mouths of physicians.”

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.

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Brian J. Spero Is Appointed to Coverys’ Board of Directors

June 21, 2019 by matray

Coverys announced the appointment of Brian J. Spero to the Medical Professional Mutual Insurance Company board of directors.

Spero has more than 30 years of proven expertise as a senior executive in insurance operations, legal, regulatory and administrative leadership roles. Spero currently serves as the president and CEO of The Beacon Mutual Insurance Company. In this role, he leads the organization’s strategic corporate vision, ensuring Beacon’s fiscal strength, including investment strategy, preservation of assets, reinsurance programs and claim reserve requirements. Spero previously served as executive vice president, chief operating officer and general counsel of Beacon.

“Brian is a great addition to the board and brings a wealth of experience developing and maintaining strategic alliances to coordinate the delivery of comprehensive, high-quality, and cost-effective insurance programs,” said Brenda E. Richardson, MD, chair of the board of directors. “The board and management look forward to working with him in the coming years.”

Prior to joining The Beacon Mutual Insurance Company, Spero was a founding partner of Partridge Snow & Hahn LLP, a partner and associate at Tillinghast, Collins & Graham in Providence, R.I., and law clerk to the Honorable Francis J. Boyle, United States District Court, District of Rhode Island.

Spero serves on the Rhode Island Governor’s Insurance Council, the Greater Providence Chamber of Commerce Board of Directors, the Rhode Island Public Expenditures Council, and the Meeting Street School Audit and Finance Committee. He also serves as a Bank of Newport corporator, an American Association of State Compensation Insurance Funds vice president & executive committee member, and is a member of the Association of Corporate Counsel, the Rhode Island Bar Association, and the Massachusetts Bar Association. He is admitted to practice of law in Rhode Island and Massachusetts. Spero obtained a Juris Doctor from Boston College Law School and a Bachelor of Arts from Colgate University.

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NY DFS Approves Acquisition of Hospital Insurance Company by The Doctors Company

June 20, 2019 by matray

Acting New York Financial Services Superintendent Linda A. Lacewell today announced that the Department of Financial Services (DFS) has approved the application of The Doctors Company (TDC) to purchase Hospitals Insurance Company (HIC) from Maimonides Health Resources, Inc., Montefiore Medicine Academic Health System, Inc. and Mount Sinai Health System, Inc., for $638 million. TDC will also purchase the assets and liabilities of HIC’s current manager, FOJP Service Corp., from the sellers for $12 million.

“Taking into consideration the importance and current status of New York’s medical malpractice market, DFS carefully reviewed this acquisition to protect HIC policyholders,” said Acting Superintendent Lacewell. “The measured expansion of competition in the medical malpractice market by a DFS-regulated insurer is positive for doctors, and ultimately good for consumers.”

“We are pleased the New York Department of Financial Services has given final approval for this important transaction. This enables us to deliver on our commitment to New York physicians and hospitals to provide expanded coverage options from a strong admitted carrier, and to build a mission-based platform to serve the medical professions. We look forward to the transaction closing on July 31, 2019,” said Richard E. Anderson, MD, FACP, chairman and CEO of The Doctors Company.

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Center For Justice & Democracy Releases New Briefing Book — Medical Malpractice: By The Numbers

June 20, 2019 by matray

The Center for Justice & Democracy at New York Law School (CJ&D) today released the 12th update to its MedicalMalpractice: By The Numbers briefing book. The fully-sourced, 172-page volume includes the latest statistics and research on issues related to medical malpractice, including more than 500 footnotes linking to original sources. The briefing book’s release coincides with renewed attention to the topic of medical negligence, namely this Sunday’s premiere of “License to Kill,” a new Oxygen television series that focuses on medical malpractice.

“Viewers of the new series, and indeed anyone interested in learning more about the extent of avoidable patient injuries in this country, should turn to the briefing book as a resource,” said principal briefing book author, CJ&D’s Deputy Director for Law & Policy, Emily Gottlieb.

As in prior editions, topics include: medical malpractice litigation, healthcare costs and “defensive medicine,” physician supply and access to healthcare, medical malpractice insurance, patient safety and special problems for vets and military families. In addition, there are several new sections, including sexual assault by doctors, misdiagnoses (the most prevalent and costly type of medical error), childbirth negligence, plastic surgery, how physician stress and burnout leading to errors and the real cause of insurance spikes for doctors. Among the many new research findings since CJ&D’s December 2019 update are:

• Between 2007-2016, the number (frequency) of medical malpractice cases dropped more than 25%. For ob/gyns, the drop was 44%.

• Ninety-percent of doctors with at least five medical malpractice claims are still in practice.

• There is no “quality of care” information available for 75% of doctors treating Medicare patients.

• The federal government doesn’t require hospitals to tell the public how often mothers die or suffer from childbirth complications.

• After Texas enacted severe “tort reform” measures in 2003, access to medical care grew by “close to zero.”

• When a state caps damages, rates for cardiac stress tests and other imaging tests, Medicare Part B lab and radiology spending, all rise.

• When it comes to preventing deaths from medical errors, out of 195 countries in the world, the U.S. ranks below the top 50.

“Organized medicine continues to push laws that would reduce the accountability of unsafe hospitals and incompetent physicians,” said CJ&D Executive Director Joanne Doroshow, who edited the briefing book.

“Yet hundreds of thousands of patients die each year due to preventable medical errors at the same time insurance claims and lawsuits are dropping.

“We have an enormous patient safety problem in this nation. Even sexual misconduct by physicians is going largely unchecked. The last thing we should do is try to solve these problems by increasing the obstacles harmed patients face in the already difficult process of bringing a case against the person or institution that harmed them.”

A copy of the full briefing book can be found here:

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