If you make these changes, you can obtain lower premiums

It’s possible to obtain lower premiums for professional liability coverage, but “to put yourself in that position, you have to outperform the average in your state or community,” advises Jonathan Katz, president of Oros Risk Solutions, an Orlando, FL-based insurance and consulting agency specializing in selling medical professional liability insurance.

“How, in a malpractice arena, can physicians modify their behavior to put themselves in a better position? One way is to avoid risky behavior,” he says.

Katz notes that rates have greatly improved since the medical malpractice crisis a decade ago, in part due to the fact that physicians with poor loss ratios were pushed to nonstandard types of insurance arrangements. There were penalties for risky behavior, so practices stopped doing some of the things that were leading to claims, and physicians embraced the patient safety movement. “They didn’t want to pay double everyone else and have worse coverage,” Katz says. “They wanted to get back to the standard market, with quality coverage at reasonable rates.”

“The insurance market is soft right now, but that is going to change,” warns Katz. He says physicians can do these things to put themselves in a better position before the market turns:

• Avoid performing procedures without adequate training.

Katz says insurers are seeing a trend in claims involving this scenario, the most egregious instance involving an ophthalmologist performing full plastic surgery procedures such as breast augmentation and liposuction.

“Doctors are looking for ways to make money outside their normal practice. One of the big trends is doctors getting certified over the weekend to do procedures,” he says. “When doctors [provide care that is] outside their training, they are more apt to make errors in that area.”

The fact that the procedure wasn’t within the physician’s training or scope of practice will make a claim less defensible, adds Katz.

• Take advantage of free patient safety services offered by your insurer.

Most physicians and medical groups don’t take advantage of services such as surveys, education, and file reviews offered by insurers, reports Katz. “You can get a lot of good consulting and advice for free,” he says.

• Look closely at the circumstances involving claims before judging a provider.

Just because a provider was named in several claims isn’t necessarily an indication he or she is not practicing good medicine. “Don’t make harsh decisions without digging deeper,” says Katz.

On the other hand, Katz also has heard from claims managers that although a particular case was won at trial, the physician named in the lawsuit was practicing poor medicine. If after looking closely at a claim, you conclude a physician is not practicing good medicine, “you may want to exit that bad actor from the group,” he says.

• Identify and act upon claim trends.

If claims involve misdiagnosis in a certain area, this misdiagnosis is an indication that education for everyone involved is warranted, advises Katz. Claims might involve a certain type of procedure done infrequently. If an orthopedic surgeon is experiencing major losses from claims involving rarely performed spinal surgery, for example, “the provider should seriously consider discontinuing the procedure,” says Katz.


Jonathan Katz, President, Oros Risk Solutions, Orlando, FL. Phone: (407) 745-2892. Email: jkatz@orosrisk.com.