Claims-made insurance coverage for physicians and surgeons.
Physician » Insurance » Policy Features
Medical Mutual writes the majority of its insurance coverage on a claims-made basis, which means you will have protection for claims which arise out of covered professional services you provide following your initial effective date (retroactive date) of coverage. So, any claims filed against you today are covered by current policy limits, even though your limits may have been lower at the time of the incident in question.
Consent to Settle It’s up to you.
Medical Mutual will not settle any claim or suit on your individual policy without your consent, an important feature that clearly protects your interests by giving you ultimate control over whether or not a claim is settled on your behalf.
Save with Prior Acts ("Nose") Coverage
You may be eligible for prior acts ("nose") coverage if you are transferring from a claims-made policy with another carrier. Nose coverage provides protection against claims which are unknown to you at the time coverage is issued and which arise from covered services rendered prior to the initial effective date of your policy with Medical Mutual. The retroactive date of your previous policy becomes the retroactive date of your policy with Medical Mutual Insurance Company of Maine. This eliminates the necessity of purchasing "Tail" coverage from your previous carrier in order to switch to Medical Mutual. If your current coverage is "occurrence" coverage, you do not need prior acts coverage.
Reporting Endorsement ("Tail") Coverage:
It is important to note that when a claims-made policy cancels or is not renewed for whatever reason, beginning 30 days after the termination of the policy there is no longer any coverage in force for any unreported incidents or claims. To preserve coverage on a canceled claims-made policy for future claims arising out of professional services provided prior to the termination of the policy, a tail or extended reporting endorsement is offered at the time of the cancellation.
You have the right to purchase this endorsement for up to 30 days after the policy is canceled. If you do not exercise this right and have not obtained prior acts ("nose") coverage from your new insurer, you will not have protection for future claims arising out of care provided while your policy was in force.
When “Tail” Coverage is Free
The premium for tail endorsements will be waived if the following requirements are met:
- You are age 55 or older, are completely and permanently retiring from the practice of medicine and,
- You have been insured with MMIC for at least five years.
The premium is also waived at any time for death or total permanent disability. Under these circumstances and unlike most other carriers the Medical Mutual tail extends indefinitely and automatically, without any time limit.
If you notify Medical Mutual prior to a planned absence, protection may be available while your practice is covered by another health care provider.
Premium discounts are offered for:
- Loss-Free Experience you can earn a 1% discount per year of loss-free experience while insured by Medical Mutual; this discount is capped at 15%
- Longevity you can earn a 1% discount per year of continuous membership with Medical Mutual; this discount is capped at 10%
- Part-Time Practice health care providers in part-time practice
- New Doctor residents entering private practice for the first time may be eligible
- Leaves of Absence
- Other Factors which mitigate the risk of loss or facilitate administration.
You cannot be assessed back-charges if prior years’ rates are proven to have been inadequate.
Physician’s Administrative Defense Coverage
Physician Administrative Defense (PAD) is a feature of your medical professional liability insurance policy you can take advantage of should you be the subject of a disciplinary proceeding in front of a government licensing board, a hospital board, or any other organization that can curtail, suspend or revoke your ability to practice. Like most carriers, Medical Mutual provides coverage, subject to limits, for legal consultation and defense costs related to administrative disciplinary proceedings. Again, differences arise, however, in how Medical Mutual and other carriers treat such situations.