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- What is the difference between a claims made policy and an occurrence policy?
Claims made vs. Occurrence.
- How can I get a copy of my certificate?
Feel free to call us at 1-800-318-9930. Our normal business hours are 9am - 5pm; Monday - Friday.
- How can I obtain loss runs or claims history from my carrier?
If you currently work with Professional Risk Associates, you can contact your agent at 1-800-318-9930 to obtain these or send us a request at salesdivision @profrisk.com.
- What is "tail" coverage?
Tail, or an "Extended Reporting Endorsement," is coverage that protects the physician against all claims arising from professional services performed while the claims-made policy was in effect but reported after termination of the policy. Some insurers offer this feature free of charge for retiring doctors who meet certain requirements.
- How do I obtain "prior acts" or "nose" coverage?
You can obtain prior acts coverage through your next carrier if you purchase a claims made policy. The carrier must approve this coverage. You should work with your agent to ensure that you have no gap in coverage.
- What is the difference between the standard market and the non-standard market?
There are several differences between the standard and non-standard market, including policy forms, premium, and taxes. If a physician or healthcare provider cannot find coverage in the standard market (because of claims, specialty, or other issues), coverage from the non-standard market is an option. However, these markets do not file rates with the state, and they do not participate in the Guaranty Fund. Premiums tend to be higher, and policy forms are more limited. In addition, there is a surplus lines tax that must be paid to the state where the physician is practicing (the amount of this tax varies from state to state).
- Do you have specific coverage programs for my specialty?
PRA works with several carriers on various programs; however, most are not specialty-specific. We do, however, currently represent certain companies that are endorsed by specialty associations, and we may be able to help you secure coverage through the company that is endorsed by your specialty.
- What is a gap in coverage?
You are considered to have a gap in coverage when you do not have coverage in force to cover a potential claim. This can result from several different scenarios, including:
- Leaving a claims made policy and not purchasing tail coverage OR prior acts (you would be personally responsible for any claims that could arise from that time period)
- Practicing without any coverage
- Doing procedures for which your carrier is not providing coverage
- Could having a gap in coverage affect my future insurability?
Yes. Many standard market carriers will not write coverage for a physician that has a gap in coverage, even if the gap is further back than the statute of limitations.
- What is "Retirement Tail" coverage and how does it differ from regular Tail coverage?
Retirement tail coverage is typically provided at no additional charge once you meet certain requirements of your carrier. Most carriers require that you retire completely from the practice of medicine in order to be eligible for a free retirement tail. Regular tail coverage is an endorsement that you can purchase to cover past exposure. When you purchase regular tail coverage, you may continue to practice medicine.
- Claim Triggers: Demand vs. Incident. What is the difference?
Demand Trigger: Will not respond to a claim without receipt by the insured of a demand for money or services and alleging a medical incident. This definition can vary from carrier to carrier, so be sure to check the specific policy.
Incident Trigger: In addition to the above, a policy with an incident trigger also responds to medical incidents that are reported to the company during the policy period which might result in a claim.
- Does my policy automatically include coverage for my non-physician employees?
No, this coverage may NOT be provided automatically for a group practice or a solo practice. Typically Nurse Practitioners, Physician Assistants, CRNAs, and Nurse Midwives will need separate limits of liability. Please check with your agent on this issue to make sure that all of your employees have coverage.
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