Policyholder Services



Are refractive surgeons charged a higher premium than physicians who do not perform refractive surgery?

Refractive surgeons are currently rated under the standard Surgery Class 3 coverage classification. OMIC’s claims experience for refractive surgery does not justify a premium surcharge at this time. Although more than one-fourth of OMIC’s insureds perform at least one type of refractive surgery, refractive surgery claims account for less than 4% of all open active claims. In addition, most refractive surgery claims ultimately resolve in the surgeon’s favor. The “severity” of refractive surgery cases also compares favorably to that of other claims. The average indemnity payment for claims involving refractive surgery is $156,779 for the 5-year period from 2010 through 2014; OMIC’s average indemnity payment for ophthalmology in general is $164,315 since the company’s inception and $202,728 for the five-year period from 2010 through 2014.

Although OMIC does not impose a premium surcharge for coverage of refractive surgery, coverage of intraocular refractive surgery procedures (e.g., refractive lens exchange and phakic implants) is not automatically included under the policy. Instead, coverage is extended by endorsement following review and approval of a supplemental questionnaire and is conditional upon adherence to the company’s underwriting requirements.

Updated 12/11/2015

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