September 17, 2020

Protecting Your Practice: Beyond Medical Professional Liability (MPL) Insurance

From Physicians Insurance

Running a medical clinic is a complex business undertaking, requiring key tools to help you protect your practice interests, so you can focus on providing quality care. The following is a high-level overview of the range of protections beyond professional liability coverage that you should know about. While Physicians Insurance does not offer all these coverages, we are frequently asked about them, so we have compiled some useful guidance from our broker community. (Please note that some of the coverages discussed below may be included or may be available as an endorsement to your Physician Insurance medical professional liability policy.)

In setting up insurance protections, you should understand the scope of your coverage, its limits, your policy's definition of a claim, and each policy's notification timing requirements. When in doubt, contact your broker or insurance carrier to get clarity.

Employment practices liability coverage (EPLI)

Personnel issues include discrimination, harassment, and conflicts with and between staff related to pay, hours, work rules, and/or termination considerations. Standard EPLI policies exclude wage-and-hour claims, and if endorsed, the policies will cover defense at a typical sublimit of $100,000. EPLI claims have been on the rise, and juries are less tolerant than in the past, so it's important to understand whether your MPL coverage includes an endorsement for these risks, and whether your organization needs higher limits. (Claims related to employee benefits fall under Employee Benefits Liability, an endorsement under a general liability policy.)

General liability coverage

The liability around clinic property is a broad topic and includes instances of visitors injuring themselves while on your property—within the building, parking lot, or other common areas—such as tripping over an exposed cord or upturned rug, or sitting in a chair you didn't know was broken.

Cyber coverage

In recent years, health care has been a frequent target for cybercrime. Your medical professional liability policy may include an endorsement with some coverage to help offset costs related to data breaches, such as response costs, defense costs, damages, business-interruption expenses, or extortion expenses.

Property insurance

This coverage provides protection against most risks to property (e.g. buildings, contents, and equipment), such as that caused by fire, theft, vandalism, and weather damage. (Standard property policies do not cover damages from earthquakes or floods, but those coverages are available.) Additions to a property policy may include:

• Employee Dishonesty Endorsement—This endorsement covers employee theft or embezzlement, both of which happen much more commonly than people realize.
• Equipment Breakdown Endorsement—If, for instance, your computer system crashes and is inoperable for a few days, this coverage reimburses the clinic for costs, such as fees for emergency IT services or for the recovery of any lost data or patient records.

Business buyout coverage

If you find yourself needing to act upon your clinic's buyout agreement due to the sudden loss of a physician partner or other key employee, this coverage helps finalize negotiations with such a person's estate and/or survivors.

Regulatory/billing errors and omissions (E&O)

This policy covers things like defense costs, settlements, and civil fines and penalties, in association with a wide range of regulatory issues, such as:

• Medicare/Medicaid audits, including coverage for Recovery Audit Contractor (RAC) and Zone Program Integrity Contractor (ZPIC) audits
• HIPAA compliance violations
• Commercial-payor audits
• STARK violations
• EMTALA violations

The above provides a list of possible solutions to the risks you face. Every scenario is unique, but knowing what coverage is available will help you discuss your priorities with your broker or any insurance professional.

Physicians Insurance A Mutual Company is WSMA's exclusively endorsed professional liability insurance carrier. Visit the Physicians Insurance website or call 206.343.7300 for more information.