Policyholder Services

Take An Active Role When Reviewing Your Professional Liability Application and Policy Documents

Be engaged when reviewing your insurance protection to avoid unpleasant surprises down the road. The average ophthalmologist will be sued two to three times during their career. Make sure you are comfortable with the company that is protecting you, the policy terms and conditions, and the process for maintaining your applications and policy forms. It’s understandable that you may not want to pay much attention to such these issues now, but you will be glad you did if/when a claim notice arrives in your inbox. Here are a couple of things to note.

Even if someone else is purchasing insurance coverage on your behalf, you are solely responsible for your professional liability.

You are responsible for defending yourself should a claim be filed against you. You cannot transfer this personal liability to another ophthalmologist, partnership, or corporate entity. You also cannot have another party initiate, modify, or terminate your coverage for you. Although your employer may have some additional vicarious, or assumed, liability as your employer, that liability is a completely different and separate issue from your own personal professional liability.

Avoid situations where a staff member simply completes all the insurance forms for you and says “sign here.” At the very least take some time to carefully review all forms if some of the form was completed on your behalf. If anything is unclear ask questions before signing a new (or renewal) application or any other document that may affect your coverage. Often physicians feel that the “business” side of the practice is better left to the staff whether it is handled by a credentialing person, office manager, administrator, or CEO or CFO. But your staff will not be the target of a malpractice claim should one be filed. You will be. You, as the physician, will be responsible for both you and the actions of your staff and your coverage could be affected if you signed a form that contains erroneous, misleading, or false information.

You have the right, and even a responsibility, to know the details about your insurance company and the policy covering you.

You may feel a little uncomfortable asking for details of the insurance coverage maintained by a prospective employer. Don’t be. As mentioned above, it is in your interest to know how your coverage works. You’ll want to know the limits of liability your policy provides, whether there is a deductible (also know as a self-insured retention), coverage restrictions or requirements, and additional benefits that would be available for you personally.

You should also do some research on the company including looking up the AM Best report to make sure that it is a reputable, highly rated, carrier. If you join a group practice who tells you “we’ll take care of all of that for you” you may want to politely thank them but also ask for either a short summary of the insurance coverage provided by the group or copies of the insurance documents such as the declarations page showing you listed along with your coverage details. Asking questions about your coverage with a sincere interest in learning about the insurance protection that is in place to protect you is in your best interest and should be looked at as a positive attribute by your employer. If they don’t know or are not interested in researching the answers to these or other questions, it may be a red flag.

Call OMIC’s sales department for answers to basic questions about insurance or visit the Insurance 101 page.