Policyholder Services



Will OMIC cover me if I am sued for reporting another physician to the licensing board or hospital?

Yes. Subject to standard policy exclusions, Coverage Agreement D: Professional Committee Activities Coverage for Ophthalmologists extends coverage for claims arising out of professional services rendered by the Insured as a member of, or participant in, a formal accreditation, utilization review, or similar professional board or committee of a state licensed health care facility or clinic or a professional society.

In addition, most states have statutes that provide immunity from suits brought by a physician who is the subject of professional review. To be protected by these statutes, the witness or participant must act in good faith within the scope of such professional review committee process. Members of the committee usually must not only act in good faith but also must make a reasonable effort to obtain the facts of the matter and act in the reasonable belief that the actions taken were warranted by those facts. As long as the peer review was conducted in good faith for the purpose of promoting quality patient care and proper procedures were followed, there should be no liability.

If peer review functions are performed carelessly or are undertaken for anti-competitive purposes, any legal challenge brought may be successful. Intentional actions, including restraint of trade, anti-trust, slander, libel, and defamation of character, are generally excluded under all types of insurance policies.

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

#1. Consistent return of premium.

Publicly-traded insurance companies exist to make profits for shareholders while physician-owned carriers often return profits to their policyholders. Don’t underestimate this benefit; it can add up to tens of thousands of dollars over the course of your career. OMIC has one of the most generous dividend programs for ophthalmologists and has returned more than $20 Million to our members through dividends.

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