WGA InsureBlog

Most healthcare providers look at their insurance policies more as a costly expense, a nuisance and a necessity for their licensing rather than a legally binding contract. However, that is a oversimplification. A medical malpractice insurance policy IS a contract and must be treated as such. The terms and conditions of the contract can vary from company to company and even among different policies issued by the same company.

Few contract items demonstrate this more clearly than the wording surrounding the issue of “triggers”. For simplification purposes, we will assume coverage is on a claims-made coverage from. Claims made policies exclude coverage for incidents that were reported to previous insurance companies. Read more…

In an age of ever-increasing dependence on electronic records and cyber-security, it should come as little surprise that there is a steady diet of new examples of data breaches and the loss of private data. This is especially true in the case of healthcare institutions and providers. Read more…

There was an article in the New York Times recently focused on one aspect of national reform, the push for more graduates to become primary care physicians. Pete Reilly of WGA’s Healthcare Practice takes a look down the road to the potential impact this will have on insurance rates for healthcare providers and the influence it could have on the increased use of electronic medical records.

The Health Information Technology for Economic and Clinical Health Act (known as the “HITECH” Act), enacted as part of the American Recovery and Reinvestment Act of 2009, substantial expands the HIPAA privacy and security rules. A recent survey conducted with the readers of Modern Healthcare found that privacy is a big concern with several key changes in healthcare information privacy laws of the act. This installment of “Ask the Experts” takes a look at risk management issues regarding this issue within healthcare operations.

The recent merger of the iconic Physicians’ Desk Reference (PDR®) found in every physician’s office, clinic and hospital, with the Health Care Notification Network (HCNN), the only network that delivers FDA-required drug Alerts to physicians and other prescribers online, has created a new combined service that provides FDA-required Alerts, monthly specialty-specific clinical updates and a copy of the 64th edition of the PDR with regular insert updates to all to medical providers. This effort to minimize “information errors” is a crucial step for prescribers of medicines across the healthcare spectrum. Read more…

CNA HealthPro Insurance just announced the results of their latest annual survey titled Reducing Risk in a Changing Industry: CNA HealthPro Aging Services Claims Analysis 2004-2008. One interesting aspect of this study is CNA’s ability to break down claims information between the for-profit and the not-for-profit health care sectors. Some of the results make sense but some are quite surprising. So, it is not very surprising that claim frequency overall is lower in the not-for-profit sector. But, why, for example, are patient falls (the greatest source of claims at nursing homes) almost 20% more likely in not-for-profit settings? Are there some risk management techniques that the for-profit sector can teach the not-for-profit sector here? This study certainly confirms some historical trends and highlights the need to sound fundamental risk management strategies.

Medical liability insurance premiums have eased nationwide for the fourth consecutive year, according to the annual Medical Liability Monitor survey. 58% of premiums had no change, up from 50% in 2008, another 36% of premiums fell, down from 43% last year. This is a continuation of the positive trend that we have seen over the past few years. There is still enough capacity in the market to foster price competition. For the coming year, we do not see this changing dramatically. While these trends are encouraging Read more…