Insurance Update - RISKY BUSINESS - Practicing with Uninsured Physicians

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RISKY BUSINESS - Practicing with Uninsured Physicians

By Cliff Rapp, LHRM, Vice President Risk Management

A growing concern of many physicians and hospitals, especially in South Florida, is the exposure many specialists face while handling Emergency Room calls. Many high-risk specialists are refusing to treat patients in the Emergency Room.

Physicians are generally unaware that ER call exposure is included in the rates at FPIC and likely with other carriers as well. When rates are developed, there is consideration for the typical emergency room call exposure to risk. Since it is impossible to truly measure actuarially how much of the rate by percentage is a reflection of ER claims pressure, it is impossible for a carrier to offer discounting off of the rates if a doctor refuses to do ER. Traditionally, all physicians will have to offer some ER call, particularly if they intend to maintain admitting privileges. One way hospitals are dealing with the lack of specialists in the ER is to form a captive insurance company. The captive is being formed to initially only cover the exposure in the emergency room, but ultimately the captive will also cover the primary professional liability exposure, therefore eliminating the need for traditional insurers. The captive will be created as a single cell arrangement for each hospital involved. To the hospitals, this is an attractive option because they are already paying exorbitant premiums for liability coverage for their trauma physicians and will not be affected by the exposure of other hospitals or physicians.

Information in this article does not establish a standard of care, nor is it a substitute for legal advice. The information and suggestions contained here are generalized and may not apply to all practice situations. FPIC recommends you obtain legal advice from a qualified attorney for a more specific application to your practice. This information should be used as a reference guide only.