Policyholder Services

Explanation of Application Process

Updated 8/22/2019

Q. Must I be a member of the Academy to apply?
Yes. Because OMIC was created and is exclusively sponsored by the Academy, we require that ophthalmologists be a member of the Academy to be eligible for coverage with OMIC. As an Academy member, you are also eligible for many other valuable benefits.

Q. Do I need to send payment with my application?
A. No. In fact, you should not submit payment until you receive our quote letter, review it, and decide to become an OMIC insured.

Q. How long will it take to process my application?
A. We recommend that you forward your completed application to us at least 30 days prior to your requested effective date of coverage to allow us ample review time. If you need us to expedite your application review, please notify us and we will do our best to accommodate your needs.

Applications are usually processed based upon the order received and the requested effective date. Review times will vary depending upon the completeness of the application, the level of review required, and the volume of applications received, among other factors. Processing time may take longer if the application is incomplete, if the applicant has prior claims history, or if special review by members of our physician-staffed Underwriting Committee is necessary.

Q. What does OMIC look for when reviewing my application?
A. We consider a variety of factors that have an impact on your liability exposure, including your training, previous practice experience, claims history, and scope of practice, to verify that your exposure is reasonable based on guidelines established by OMIC’s Board of Directors, composed of practicing ophthalmologists like yourself. By doing so, we are able to keep our coverage reasonably priced; your premiums will not be used to subsidize high risk physicians.

Q. Will OMIC consider me if I have had any claims?
A. Yes. One of the advantages of being insured through OMIC is that we have a committee of experienced, practicing ophthalmologists who review each claim. We know that claims sometimes are simply an unavoidable result of practice in today’s litigious environment. While OMIC does consider claims frequency and severity, we also look beyond the “numbers” when evaluating the quality of care rendered and when determining your eligibility for insurance.

Q. Will I have to complete this detailed application every year?
A. You will be asked to complete an abbreviated version of the general application once every three years to provide OMIC with current information regarding your practice activities. We do ask, however, that you notify us promptly if changes in your practice or liability exposure occur to make sure that you are properly insured. For examples of the kinds of changes you should advise us of, click here.

You may also need to complete other short-form questionnaires if you perform refractive surgery or other procedures that require special underwriting.

Q. When should I cancel my current policy?
A. You should never cancel your current coverage or allow it to lapse until we have advised you in writing that your application has been approved. Although most applicants are ultimately approved for coverage, occasionally an application may not meet OMIC’s conservative underwriting guidelines and may be denied as a result.

Q. What happens if an application is denied?
A.The applicant will have two choices. When the company determines it is not in a position to offer coverage, we will notify the applicant of our intent to decline the application and advise the doctor why we are considering this decision. The applicant will have the opportunity to request reconsideration by our Underwriting Committee by sending us additional or clarifying information within the time period specified in our notice. Or, the physician may withdraw his/her application and seek coverage elsewhere.

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Six reasons OMIC is the best choice for ophthalmologists in America.

Best at defending claims.

An ophthalmologist pays nearly half a million dollars in premiums over the course of a career. Premium paid is directly related to a carrier’s claims experience. OMIC has a higher win rate taking tough cases to trial, full consent to settle (no hammer) clause, and access to the best experts. OMIC pays 25% less per claim than other carriers. As a result, OMIC has consistently maintained lower base rates than multispecialty carriers in the U.S.