Managed Care Director's & Officers and Professional Liability Protection

There are numerous types of entities formed by providers, healthcare institutions and corporations that become part of the delivery of medical services within the Managed Care system. Some of these entities are very complex. It is a daunting task trying to manage how each piece fits together and making sure each aspect of the delivery of the Managed Care Services are performed correctly.

Unfortunately, almost every participant of the Managed Care delivery system gets drawn into a liability claim when the system does not perform to the consumer's expectation.

Participants in the Managed Care delivery system have seen a significant increase in claims, insurance premiums and retentions. There has also been a significant decrease in available insurers, the limits of liability offered and who is eligible for their policy.

Expert representation of your Managed Care Directors & Officers and Professional Liability Coverage is needed especially during these difficult times.

The Wood Insurance Group has specialized in Managed Care Directors & Officers and Professional Liability coverage since 1986. We have maintained outstanding relationships with the key insurers that write the coverage. These relationships will assist you and your clients in achieving the best possible terms and service from the insurers.

Some of the key coverage considerations are:

• Vicarious Medical Professional Liability
• Medical Directorship Liability
• Telephone Triage Services and Call Centers
• Coverage for your organization even if you have employed providers
• Anti-trust Coverage for suits brought by both providers and competitors
• UR, Claims Administration, Case Management, Advertising, Marketing & Selling Activities
• Prior Acts Coverage
• Entity Coverage
• Pay on behalf wording
• Class Action Suit Coverage
• EPL Coverage
• Coverage for your employed provider that delivers the direct medical service

Common problem areas we discover when working with new clients:

• The entity is a partnership and it is not written on a form that properly addresses the structure
• The client offers some type of service that is perceived to be direct medical services (i.e. triage or call center)
• Medical Directors often misunderstand the extent of their coverage
• Contracts for delegated services have hold-harmless agreements that are not addressed by the policy
• Entities that employ providers cannot find an insurer to cover their Managed Care Liability exposures
• Medical Information claims and HIPAA exposures are not addressed or covered

For more informaion, please contact David Wood, President, or Jodie Cole, Senior Vice President

Download an application here