Like other medical professionals, podiatrists must occasionally contend with malpractice lawsuits from patients. Below, we explain common negligence cases against podiatrists so professionals can understand the source of most liability lawsuits and try to avoid them.
Unnecessary Surgery
Surgery is a common source of malpractice claims against podiatrists, specifically surgery the patient later feels was unnecessary and harmful. While podiatrists are experts in relieving foot, ankle, and toe pain, the complexity of bones and ligaments makes it difficult to determine the source of discomfort.
Due to this, multiple surgical procedures are sometimes necessary to finally relieve the source of discomfort for a patient. This can be frustrating, especially if multiple surgeries still don’t fix the problem. Patients may feel they were misled to agreeing to an unnecessary surgery or weren’t informed of the risks or alternative treatment options. Therefore, they seek damages for their pain and discomfort.
Surgical Complications
As we mentioned, many common negligence cases against podiatrists involve surgery, with surgical complications at the top of the list. Every surgery comes with inherent risk, and even the most basic procedures can result in unintended complications and consequences. Considering most podiatry surgeries are elective procedures, patients are more likely to seek restitution if they feel they wasted money on a procedure that didn’t deliver the results they wanted.
Postoperative Negligence
Like all surgeons, podiatrists can also be liable for complications postsurgery if the postoperative care is insufficient. With every surgery, postoperative care is critical to the patient’s health and the procedure’s success, but it is also a prime area for complications. Infections, nerve damage, and other pain and discomfort are not uncommon postoperative complications, especially with foot surgeries. If any of these complications arise from a lack of postoperative care, the podiatrist could be liable.
Misdiagnosis
Like all doctors, podiatrists are also liable if they misdiagnose. As we mentioned, diagnosing the source of pain or discomfort in a person’s foot, ankle, or toes is difficult, even for the most skilled and experienced podiatrists. If a podiatrist makes a misdiagnosis by not performing the correct evaluation, ordering the wrong tests, or outright failing to diagnose the underlying issue, a patient could seek damages via a malpractice suit.
Where To Get Malpractice Insurance for Podiatrists
Clearly, there are plenty of opportunities for podiatrists to be liable, which is why malpractice insurance is critical for every podiatrist. If you need liability insurance as a podiatrist, Baxter & Associates is a malpractice insurance agency with years of experience connecting medical professionals with professional liability insurance providers. Browse our services and get a quote for a malpractice policy on our site today.
The cooperation clause is a common and critical provision in many liability insurance policies. We’ll help you understand everything about the malpractice insurance cooperation clause and what it means for policyholders and insurance providers.
What Is the Cooperation Clause?
The cooperation clause, or assistance provision, is one of the most common in malpractice and liability insurance policies. This clause is activated when a claim is filed against the policyholder.
The language of the clause may differ depending on the policy and the provider. Still, the basic provisions of the clause dictate the policyholder must work with the insurance provider and not hinder the investigation and defense against the claim. Cooperation clauses are common in auto and home insurance policies, but the language is typically different than in liability policies.
Why Is the Cooperation Clause Important?
The cooperation clause is a requirement in most insurance liability contracts, so you might wonder why it is so important. It’s a promise from the policyholder to the insurance provider that they won’t withhold information or block the investigation of a claim filed against them.
The cooperation clause makes the investigation much easier and faster for the insurance provider. It also guarantees they’ll get the information they need from the policyholder within a reasonable time. While it may force the policyholder to provide information, it’s almost always in their best interest.
What Are the Policyholder’s Requirements for the Cooperation Clause?
We know the policyholder must cooperate with the insurance provider, but what does cooperation mean? Individual policies have more specific language regarding fulfilling the cooperation clause. Still, it means the policyholder answers questions and provides context for the claim to the insurance provider in good faith.
Policyholders don’t have to conduct their own investigation, and their presence isn’t often required in settlement negotiations or court proceedings. Some clauses may require in-depth cooperation, but for most policies, the policyholder only has to answer a few questions honestly.
Is a Cooperation Clause Legally Binding?
Yes, the cooperation clause is a legally binding insurance contract provision and must be met for the policy to be legally active. If the insurance provider believes the policyholder is withholding information or not acting in good faith, they could sue the insured for breach of contract and have the court nullify the policy.
Then, the insured would be on the hook for their defense costs and any settlement regarding the claim. If the insured ignores or breaches the cooperation clause, the entire policy becomes legally null and void.
Levels of the Cooperation Clause
As mentioned, there’s a general understanding of the cooperation clause in most contracts, but some go further with higher levels and requirements of cooperation. Typically, the levels of cooperation outlined in a policy with the clause include the investigation of the claim, the payment of the settlement and costs, and the forbidding of unauthorized payments.
Investigation and Defense
The first and most basic aspect of the cooperation clause is the investigation and defense, which we’ve mostly covered. The insured must assist the insurance provider in investigating the claim and creating a defense strategy.
How much assistance the insured must provide depends on the language in their contract. This may include answering only a few questions and producing medical records, spending time with defense counsel, and attending court proceedings.
Coordination of Payment
Payment coordination is typically only applicable in cases where another policy may also cover some of the costs of the claim and settlement. Suppose a private practice owner has a claim filed against them for malpractice that also falls under general liability or business owners’ insurance. In that case, they would be responsible for coordinating the payment of the multiple insurance providers.
To fulfill the cooperation clause in this instance, the insured would coordinate the defense of this claim with the other insurance provider so one isn’t on the hook for covering the costs of the entire claim when another policy also covers it.
Unauthorized Payments
Lastly, the insured is not allowed to make unauthorized payments that could hinder or affect the investigation and defense of the claim. For example, if an insured hires a private investigator out of pocket without the approval of the insurance provider’s defense team, they could cause problems for the defense. Then, the insurer could claim the insured breached the cooperation clause.
Another example of policyholders breaching this level of cooperation is attempting to pay the case’s plaintiff directly, out-of-pocket, after the lawsuit is filed but before a settlement is agreed upon. This attempt at an early payment could jeopardize the defense, and the insurance provider could sue to say the policyholder breached the contract when they attempted an unauthorized payment.
Can the Cooperation Clause Force Me To Settle a Claim?
A common misconception regarding the cooperation clause is that it can cause the insured to settle a claim because the insurance provider says so. As we’ve explained, the clause does not give power to the insurance provider to settle a claim without consent from the insured.
Federal cases in the US have affirmed the right of the policyholder to refuse to settle or dismiss a claim and is not legally obligated to do so under the cooperation clause. The consent-to-settlement clause addresses the right of the policyholder and the insurance provider to settle a claim.
The Consent-to-Settlement Clause
The consent-to-settlement clause is another common clause in liability insurance policies. They are sometimes confused with one another but mean very different things. The consent-to-settlement clause requires an insurer to receive consent from the insured before settling a claim.
If the policyholder does not like the parameters of the settlement or wants to fight the claim in court, the consent-to-settlement clause gives them the right to do so. The insurance provider must follow these wishes.
Where To Find Malpractice Insurance for My Facility
We hope our guide has helped you better understand the cooperation clause of malpractice insurance. If you need malpractice insurance for yourself or liability insurance for healthcare facilities, Baxter & Associates is here to help. Contact our expert staff, and we’ll help you find an ideal group liability policy.
Tail coverage is integral to many insurance policies for businesses and professionals. We’ll explain everything you need to know about tail coverage in our guide, including how it works and the different types to consider.
Occurrence vs. Claims-Made Coverage
Before we get into the basics of tail coverage and the different policies it applies to, we should explain the differences between occurrence and claims-made insurance policy coverage. Tail coverage is for claims-made insurance policies that cover claims reported when the policy is active.
If a claims-made policy is inactive and a claim comes from a reported incident when the policy was active, it wouldn’t be covered. Occurrence is different, as it protects the insured from any covered incident when the policy was active, regardless of whether it’s expired. Tail coverage only applies to claims-made policies since it extends the time a claim can be reported against you. In contrast, the reporting time is irrelevant for occurrence coverage.
What Is Tail Coverage?
Now that you know about tail coverage for claims-made policies, you might wonder what exactly it does. Tail coverage is like an add-on to an insurance policy. It extends your coverage by giving you longer protection for claims reported after the insurance policy ends. This is also known as an Extended Reporting Period.
Tail coverage allows the insured to file a claim against the policy even though it’s expired or canceled. While it’s similar, don’t confuse tail coverage with nose coverage, which provides protection back to the first date of continuously maintained insurance coverage instead of extending reporting coverage of an expired policy.
Do I Need Tail Coverage?
While tail coverage is valuable and recommended, your need for it on top of your insurance policy depends on the policy. Tail coverage is especially common with medical malpractice insurance, as medical professionals may switch policies regularly, yet malpractice claims can come from incidents months or years in the past.
It’s quite common for medical malpractice claims to come from an incident years ago. If the target of the claim has since retired or changed policies, they could be vulnerable to the malpractice claim. If a medical professional retires, changes practices, leaves a practice for a hospital, or leaves their current work environment to start their own practice, they’ll likely have tail coverage for their malpractice insurance.
What Are the Alternatives to Tail Coverage?
While tail coverage is strongly recommended for many businesses and professionals, it’s not required. The alternatives to tail coverage include opting out (going bare) or choosing prior-acts coverage.
Going bare is just what it sounds like—the individual or business is left exposed without coverage for the gap in their coverage, but they save on monthly premiums. Prior acts coverage is similar yet different, as it applies coverage to the insured for any incidents that occurred to the policy’s purchase. Instead of extending the reporting of the previous policy, as with tail coverage, prior acts extend the reporting of the new policy.
How Long Does Tail Coverage Last?
While there are tail options for one, two or three years offered by some insurers, we recommend getting tail coverage for a term longer than that. Most of our tail policies and endorsements are unlimited and last a lifetime. Since malpractice claims can take a long time to be filed, we always recommend the longest tail your insurance company is offering.
Different Types of Tail Coverage
While we’ve mostly focused on tail coverage relating to medical malpractice insurance, our guide will now go over many different types of tail coverage. As mentioned previously, tail coverage is only for claims-made insurance coverage and applies to business and professional insurance.
Data Breach Insurance
Any business with an online presence or modern technology needs data breach cyber insurance. Data breach insurance protects businesses from cyber damage and other network-related issues, like a company computer getting a virus or customers suing the business because their personal information was stolen in a data breach.
Policy owners can add tail coverage to this policy to ensure protection if a claim comes forward months or years after the policy has expired. For cyber issues like data breaches and stolen private information, keep in mind that the victims may not notice they’ve been affected until months or years after the incident.
Employment Practices Insurance
Employment practices liability for businesses is another common type of insurance policy that includes tail coverage. This coverage protects businesses against claims regarding employment practices, like wrongful termination, discrimination, or harassment.
Practically every business with employees must have employment practices insurance to guarantee they’re protected if they terminate an employee and are faced with a wrongful termination lawsuit, which can be especially costly and damaging. Since these lawsuits and claims are so costly, it’s important to cover all gaps in their insurance, so tail coverage is necessary.
Management Liability Insurance
Management liability insurance, also known as directors and officers insurance, is another key business insurance policy. This policy protects the directors and officers of a business if they make mistakes or conduct wrongful acts while managing the company.
The claims against management may come from other employees, customers, competitors, or investors. Management liability is similar to employment practices but is limited to coverage for directors and officers instead of the business as an entity. As with employment practices, tail coverage is integral to the policy.
Professional Liability Insurance
Perhaps the most common version of tail coverage is for professional liability insurance. Professional liability policies are essential for many professionals, including doctors, CPAs, real estate agents, and lawyers.
This policy is ideal for professionals targeted for negligence, personal injury, malpractice, or other issues. Tail coverage is even more crucial for professional liability insurance because the individual could be left financially responsible for defending the claim with legal and court costs.
Where Can I Get Tail Coverage for My Insurance Policy?
If you require tail coverage for your professional liability or medical malpractice insurance policy, Baxter & Associates can help. As a renowned and experienced medical malpractice insurance agency, we can help you find the ideal policy and coverage, including tail coverage. Get a quote from our website online, or contact our staff if you have any questions.
Medical malpractice suits are always a concern for medical professionals. Below, we explain the four “Cs” of medical malpractice prevention that each medical professional should know to avoid malpractice cases.
Compassion
Compassion or caring should be self-explanatory for anyone in the medical profession who wants to help people. Doctors and nurses must sympathize with and show concern for their patients to help create a bond of trust.
One of the most common complaints and catalysts of medical malpractice claims against nurses or doctors is that the patient felt ignored or that the medical professional didn’t care about them. Take the time to go the extra mile with a patient and be honest with them to create a more compassionate yet professional relationship.
Communication
Communication is another critical factor in medical malpractice prevention. Communication encompasses verbal and non-verbal contact between medical professionals and between the medical professional and the patient.
Communication with a patient is critical, as the patient must feel their doctor or nurse is listening and giving them plenty of opportunities to ask questions as they review the problem and course of treatment, so they understand what’s happening. Communication between staff is also critical, as miscommunication or delayed communication can cause a domino effect that negatively impacts the patient’s health and causes harm.
Competence
Obviously, a medical professional must be competent if they want to avoid medical malpractice claims. A doctor or nurse should realize when a situation is outside their purview and recommend a patient to someone more competent when needed.
But the competence of malpractice prevention is also about staying capable in their position. The medical industry changes so often that doctors and nurses must constantly stay up-to-date with their training and education, so as not to use outdated practices and technology on the patients, potentially causing harm.
Charting
Charting is perhaps the most important factor in malpractice prevention and can be the easiest strategy. Proper documentation is critical to competent treatment and provides a detailed written record of the patient’s medical history.
A doctor needs quality documentation to adequately treat a patient, as it can cause significant harm if something’s missing or incorrect. The chart is often a key piece of evidence, so it’s crucial to ensure it’s accurate and up-to-date if a medical malpractice case goes to court.
Even if you follow every strategy of malpractice prevention, you may still be hit with a malpractice claim. Baxter & Associates can help medical professionals find specialized policies, like CRNA liability insurance. Contact our staff if you have medical malpractice questions or need a professional liability policy today.
Malpractice cases are an unfortunate part of the job of every health-care provider, including nurse practitioners. Below, we’ll explain the elements of medical malpractice and discuss some common examples of malpractice suits brought against nurse practitioners.
The Elements of Medical Malpractice
Before we get into examples of professional liability cases against nurse practitioners (NPs), we’ll discuss what it takes for a court to find a nurse practitioner liable. In the courts, four elements of malpractice liability must be present for the courts to find an NP or other medical professional professionally liable for harm to a patient.
Duty Owed to Patient
The first element the plaintiff must prove against the defendant is that the NP had a professional responsibility to care for the patient. This element is pretty basic and rarely contested by the defendant.
All the patient or the patient’s family must do is prove that the NP had a duty of care toward the patient. They can prove this if there’s any basic documentation or witnesses that prove the NP cared for the patient. The defendant can contest this if they claim that there was some miscommunication regarding who was responsible for the patient’s care, but such cases are rare.
Breach of Duty
After establishing the responsibility of care, the plaintiff must prove that the NP neglected or violated that responsibility. This is the most difficult element to prove, and the defense will usually contest it.
The breach of duty can come in many forms, like medication errors or absent patient monitoring, but another medical expert witness must corroborate this claim. It often requires medical expertise to decipher documentation and offer testimony about how the NP made an error.
Causality of Breach to Patient Injury
After the breach of duty, the plaintiff must also prove that the breach of duty directly caused the patient injury. Every malpractice case must include an injury to the victim; otherwise, there’s no basis for malpractice and no recourse that the courts can take.
Several things can cause the patient’s injury other than malpractice, including a worsening condition, a new injury/illness, or emotional distress. This element is often straightforward, and the plaintiff or defense can prove or disprove it with simple medical records or victim testimony.
Damages
Lastly, for the plaintiff to receive compensation for their injuries or injuries to their loved ones, they have to show the value of their case in damages. If there are no damages to the individual, the court cannot reward compensation.
Again, this element is often easy to prove if the plaintiff has already proved the breach of duty. Damages can include additional medical bills, lost wages, or out-of-pocket expenses related to the breach of duty. Often, the defense doesn’t contest the existence of damages but only the extent of them.
Examples of Medical Malpractice for Nurse Practitioners
While malpractice cases can come in all forms, there are many ways that NPs can receive a claim. Below, we’ve compiled a list of common malpractice suits brought against nurse practitioners.
Improper Documentation
One of the most common reasons an NP can receive a malpractice claim is errors in the documentation or a failure to document altogether. Documentation is a large aspect of an NP’s responsibilities, like documenting when they administered treatment or medication.
If there are errors in the documentation, like an NP forgetting to document how much medication they administered, that lead to harm, they could be liable for malpractice. Even something as simple as having illegible handwriting can lead to miscommunications and harm to the patient, so always write legibly!
Medication Errors
Another significant reason someone may bring up a malpractice case against NPs is medication. NPs must prescribe and administer medication, and even the slightest errors in prescribing or administering drugs can cause significant harm to a patient.
If an NP administers the wrong medication or the incorrect amount, they could be professionally liable. The same is true if they prescribe a medication that the patient is allergic to. With the opioid crisis, there’s also been a rise in NPs receiving cases due to overprescribing opioids to patients and causing opioid dependence. NPs must always look for the signs of addiction in their patients when prescribing powerful opioids.
Failure To Provide Care
One of the most basic examples of an NP breaching duty of care is failing to provide proper care altogether. This area of malpractice is vague and can relate to many responsibilities of NPs, like failing to diagnose a patient or not providing adequate medical intervention in an emergency.
If an NP neglects simple responsibilities, like helping a patient out of their bed, helping them move around for exercise, and preventing bed sores, they can be professionally liable.
Absent Monitoring
Another key part of the job as an NP is monitoring and observing patients. It’s often an NP’s responsibility to monitor the well-being of their patients and identify any signs of distress or harm, report those signs, and act immediately.
If a patient suffers a medical event, like a cardiac arrest, while under the supervision of an NP, and that NP doesn’t act quickly enough, causing greater harm or death to the patient, the patient could hold them responsible.
Treatment Error or Failure To Provide Standard of Care
NPs also have many responsibilities for treatment, which is another area of malpractice cases. NPs often perform hands-on treatment and perform medical procedures for patients. They could be liable if they make a mistake during these treatments that cause bodily harm or emotional distress.
Not every error is malpractice, but if the error results from an NP not following the standards of care, like failing to implement necessary safety protocols, they’d be vulnerable to a malpractice claim.
Conclusion
Malpractice suits are something that every NP must prepare for in case they make an error. Baxter & Associates helps NPs find insurance and even nurse practitioner student liability insurance for those working while still studying. If you’re a nurse practitioner who needs insurance, contact our helpful staff at Baxter & Associates and ask about malpractice insurance today.
A common reason for a malpractice lawsuit against a medical practice is unethical conduct from the clinic or a staff member. Below, we explain some of the most significant ethical breaches that can occur in medical practice.
Confidentiality Breach
Confidentiality is a significant concern for patients, so any breach of that confidentiality by a doctor or clinic is a serious form of unethical conduct. The Health Insurance Portability and Accountability Act (HIPAA) strictly prohibits the disclosure of sensitive health information without the patient’s consent.
Disclosing sensitive health information can sometimes occur accidentally, but it’s still a significant ethics violation that could expose the doctor and clinic legally.
Discrimination
Discriminatory behavior is obviously a major unethical conduct in medical practice—whether it’s discrimination of a patient’s gender, race, sexual orientation, or other protected category. Discrimination in health care can come in many forms, from doctors selectively choosing the patients they want to treat to being dismissive about specific gender issues.
Discriminatory conduct can also come in the form of verbal abuse if a doctor or clinic staff is inappropriate or abusive to a patient based on race, gender, or other criteria. This conduct is why diversity training and seminars can be valuable resources for clinics to avoid malpractice and discrimination lawsuits.
Covering Up a Mistake
Sometimes in medical practice, it’s not the mistake but the actions of the doctor and clinic afterward that are unethical. We’re all human, and we make mistakes. Still, if a doctor/clinic is deceitful about that mistake and withholds information from the patient regarding their medical condition, that’s a severe ethical and legal breach.
Patients have a legal and ethical right to information about their medical conditions—mistakes and all. If a patient later learns that a previous doctor/clinic made a mistake in their treatment and covered it up, they would have a strong case for malpractice and violation of informed consent.
Deceptive Billing Practices
An, unfortunately, all too common ethical breach in the health-care industry has little to do with doctors and patients and revolves around billing practices. The insurance billing system is complex and difficult for many to understand, which makes it a rife opportunity for shady medical billing professionals and clinics to dupe patients and insurance providers.
There are many examples and types of shady billing practices in health care, including:
Upcoding (overbilling)
Duplicate charges
Phantom charges (billed for services never rendered)
Unbundling (separation of charges that the insurance company should bill together)
Incorrect quantities (inflating total items/medications received by the patient)
Any of these billing practices are an ethical breach for a clinic and could lead to legal action from the patient and the insurance provider.
Conclusion
There are clearly many opportunities for a clinic to face legal action due to unethical conduct, which is why group malpractice insurance is essential for any medical clinic. If you have questions about unethical conduct or malpractice insurance, contact our expert team at Baxter & Associates.
Insurance agents help professionals and ordinary people get the insurance coverage they need. You might wonder if professional insurance agents need malpractice coverage themselves. They do, and we’ll explain policies every insurance agent needs, like errors and omissions coverage.
Yes, Insurance Agents Need Liability Coverage
Every professional insurance agent should have liability policies to protect themselves and their business. Professional liability insurance is especially important. An insurance agent who runs their own business will need basic business coverage, like a business owner’s policy, worker’s compensation, and cyber liability insurance.
Insurance agents offer advice and counsel to clients, but that counsel doesn’t always work out. When this happens, the client may seek retribution against the agent. Every insurance agent needs malpractice coverage for protection in these cases, primarily errors and omissions (E&O) insurance.
Errors & Omissions Insurance
E&O insurance is a specialized policy to protect the insured against the legal cost of errors not traditionally covered by standard liability insurance. Insurance agents are people, too, and can make mistakes in the counsel or recommendations of their clients. Errors that E&O covers include the following:
• Giving the wrong advice accidentally
• Missing a deadline
• Failing to recommend coverage
• Not explaining policy provisions
• Errors made by the agent, team, or subcontractor
• Inadequate work
If a client feels that any of these errors by their insurance agent cost them a substantial sum or payout from the insurance provider, they may file a malpractice claim to force the agent to make up the difference.
What Errors & Omissions Insurance Covers
If the claim falls under one of the protected acts in E&O insurance, the policy will cover most of the costs of defending the agent in court. That includes attorney fees, court costs, and unfavorable judgments or settlements up to the policy’s limits.
Judgments and settlements regarding liability and malpractice can reach hundreds of thousands or millions of dollars, depending on the situation. Without liability insurance, the agent could be left on the hook for that payment themselves.
Conclusion
Now you understand why insurance agents need malpractice coverage and some policies the average agent needs. Baxter & Associates is a trusted malpractice insurance agency that connects professionals with suitable providers and can offer a liability policy. Learn more on our website or contact our staff to get started on a policy today.
Opening a medical clinic, like any small business, is a massive undertaking that’s difficult for many people—especially for those who know only the medical side of a practice. If you’re thinking of starting a medicine practice, our key tips below will help your clinic begin on the right foot toward becoming functional and profitable.
Obtain Funding
The first concern when building a medical clinic from scratch is securing the cash to get it up and running. Dollar amounts for how much a medical practice needs to get started depend on the situation and the practice itself.
There are two main considerations for securing funding: the startup costs, such as the medical and office equipment, and the initial operating expenses for overhead costs, staff, vendors, and more. It takes months or years for a medical practice to come close to earning a profit and generating a stable revenue stream. So until then, keeping the lights on will require additional funding. Unless you’re independently wealthy, the best way to secure funding is to get investors and loans from banks, and to do that will require a business plan.
Create a Business Plan
Like any other business, a key tip for starting a functional medicine practice is to create an informative and detailed business plan. A business plan acts as a pitch for banks and investors to secure funding and a roadmap for the medical clinic’s first couple of years of operation.
Most medical professionals launching a practice are more concerned about the medical side of the business. However, the operational and administrative side of things requires much of the thought and resources. There are many aspects of a business plan, so we’ll touch on some key elements below and how they relate to medical practice.
Executive Summary
The executive summary is the first section of a business plan and the first thing banks and investors will read. As the name suggests, this section is all the big ideas and plans of the other sections boiled down to a concise and attractive summary.
While it appears as the first section in the document, you should write it last to summarize the rest of the business plan accurately. The summary should be around a page or two long and feature the plan’s general information and best points, including who you are, what your practice offers, the competition, etc.
Problem and Solution
The core of any profitable business, whether a medical practice or a hot dog stand, is the problem and solution. What is the problem that the business is solving, and how will it solve the problem?
This section for a new medical clinic generally concerns the lack of specialty care in the practice area. For example, the problem may be that the aging population in such-and-such areas doesn’t have reliable chiropractic care within 50 miles, which this new chiropractic clinic will solve.
Target Market
Every business has a target market, which comprises the people the business will market toward and who will make up the core of its customer base. The target market section will relate to the problem and solution section. For example, if there aren’t enough gynecological or pediatric services in the area that a gynecology or pediatric clinic is proposing to solve, target market research will support the claim.
The target market section of a medical business plan should also include an ideal patient profile. This profile should include information like the patient’s income, health problems, where they live, their insurance, etc. It’s also wise to include a list of competitors for this target market and how this new practice will offer something different.
Marking and Sales Plan
After outlining the target market of the new practice, it’s time to explain how the practice will attract and retain this target market. A new practice has the disadvantage of not being known in the community and industry, so the marketing and sales plan is crucial for reaching the target market.
Will the clinic focus on direct mail campaigns or advertise more online? What areas will the advertising budget be most focused on and why?
Incorporate the Practice
Assuming you secure funding for your medical practice, it’s time to start the legal proceedings of starting the business, which include incorporating the practice. In many states, medical clinics can only operate as professional medical corporations, so it’s not much of a choice.
Incorporation provides many benefits to the owner—mainly, it protects the owner from personal liability for the business. So if it fails or faces problems, the business—not the owner—is liable. But owners who operate as medical professionals, like a chiropractor who runs their own clinic, would still be liable professionally for malpractice or negligence.
Invest in Quality Equipment and Staff
It may be tempting to cut corners regarding initial expenses and equipment to reduce costs at your new clinic. And while there are plenty of areas where you can make compromises, the equipment and staff are worth investing more money into for greater long-term value to the medical clinic. For example, for a chiropractic clinic, high-quality treatment tables and experienced chiropractors are well worth the investment over shoddy equipment and new staff.
New owners should also want to invest in experienced professionals for their front-office team, if they have one. An experienced front-office team will help clinic operators navigate the tumultuous waters of the first months and provide a clear delineation between the administrative and treatment side of the business.
Purchase Medical Business Insurance
Like any other business, a medicine clinic needs quality insurance coverage to protect management, employees, and the incorporated business. The following is coverage that every medical clinic requires:
General liability insurance
Business income insurance
Commercial property insurance
Workers compensation insurance
Medical clinics also have specialized insurance that caters to the unique circumstances of medical practices, such as medical malpractice insurance and medical office business insurance. Overall, quality insurance coverage is as critical to a business’s survival as the management and employees are.
Conclusion
We hope our guide on creating a medical clinic has been informative and helpful. If you’re starting a practice and need insurance coverage, Baxter & Associates can help you find medical malpractice insurance quotes that suit your business and situation. Contact our staff to learn more and find the right insurance policy for you.
Risk assessment is an integral part of insurance. Insurance carriers categorize potential policies by risk, affecting premiums, coverage, and all other parts of the policy. In this guide, we’ll examine the risk classifications for malpractice insurance, explain the elements of a successful malpractice lawsuit, and more.
How Risks Are Classified in Malpractice Insurance
When attaining malpractice insurance for an individual or group, the insurance carrier will place the policy into one of their risk categories. Below, we’ll highlight the main risk classifications for malpractice insurance and what they mean, so individuals can better understand their policy.
Preferred Risk
The best risk category for a policy to be in is preferred risk. A preferred risk individual or group policy is a medical professional or practice with a lower risk than average of filing a claim.
Medical malpractice liability Insurance providers use stats to determine these classifications—certain specialties and practices are more or less likely to be sued for malpractice than others. Examples of low-risk practices and professions include pediatrics, psychiatry, and general family practice. These aren’t guaranteed risk-free, but they come with the least risk statistically.
Standard Risk
As one could guess, the standard risk classification is the average risk for most malpractice policies. These individuals and groups are not significantly risky or low-risk and constitute the majority of medical malpractice policies.
Most medical professionals would fall into this category—typically registered nurses to physicians and specialists. But while an individual may work in a standard risk job, if they have a history of malpractice or prior lawsuits, they may be bumped into the impaired risk category.
Impaired Risk
Lastly, the policies considered the riskiest are placed in the impaired category. The insurance carrier considers an impaired risk to be an individual or practice that is riskier than the average but not such a liability that they’re not worthy of a policy.
Those that fall in the impaired risk category are typically those that work in specialties with the highest rate of malpractice claims, which include:
• Plastic surgeons
• Cardiovascular surgeons
• OB-GYNs
• Urologists
Surgeons are often classified as impaired risks because they’re common targets for malpractice claims.
The Elements of a Successful Malpractice Claim
Along with understanding the risk classifications, it’s also wise to understand the basic elements of a malpractice claim. For a malpractice lawsuit to be successful, it must prove four elements—a duty owed to the patient, a breach of that duty, injury caused by the breach, and damages.
These elements are sometimes called the four Ds: Duty, Dereliction, Direct Cause, and Damages.
Duty Owed to Patient
The first element that a malpractice lawsuit must prove is that the defendant had a duty of care to the patient (plaintiff). A primary physician has a duty to provide competent and careful treatment and diagnosis to the patient, and a surgeon has a duty to perform the surgery competently to the best of their abilities.
A patient who suffers injury can’t simply sue whoever they want to and expect them to be held responsible if they did not have a duty of care. This element is typically the easiest part of the malpractice suit to prove and is generally uncontested by the defendant.
Breach of Duty
Once the defendant’s duty of care to the plaintiff is proven, the lawsuit must also establish that there was a breach (otherwise known as dereliction) of duty. This element is much harder to prove as it must show the defendant deviated from their duty and failed to fulfill their obligations.
Examples of breach of duty include misdiagnosing a patient, prescribing the wrong type of medication, or making surgical mistakes. Since understanding the core duties of medical treatment requires a lot of education and skill, expert witnesses and testimony are typically needed to establish whether the defendant breached their duty.
Injury Caused by Breach
If the breach of duty is proven, then the case can move to prove that the plaintiff suffered an injury due to the cause of the breach. In medical malpractice, it’s not enough that there was a mistake, but it must be proven that the mistake caused harm.
A plaintiff may claim that a misdiagnosis caused injury, but the defendant may point to pre-existing conditions or other circumstances that caused the injury, not the breach of duty. In some cases, though, this element can be obvious—like if a surgeon leaves a surgical instrument in the patient (which happens more than you think), that’s a clear line from breach of duty to injury.
Damages
Lastly, the plaintiff must prove that damages resulted from the injury caused by the breach of duty. In some cases, a mistake was made and caused injury, but the damages weren’t significant enough to reward compensation.
Damages are placed into two groups: special and general. Special damages include lost pay or the cost of corrective surgery when needed. General damages are vaguer and include pain and suffering or loss of quality of life. If a malpractice claim can prove these four elements, they will likely be successful and be rewarded compensation or a settlement with the defendant.
The 4 Cs of Medical Malpractice Risk Reduction
Naturally, its in the best interests of medical professionals and practices to reduce risk as best they can. There are many strategies for reducing risk in healthcare, but the core elements are sometimes called the four Cs: compassion, communication, competence, and charting.
Compassion & Communication
Compassion is vital in developing the doctor-patient relationship and avoiding strife that can result in a malpractice lawsuit. One of the most common reasons patients and families pursue litigation is that they felt mistreated or disrespected by the individual—so if a doctor shows compassion and understanding, they’re more likely to receive it from patients and families if a negative result occurs.
Communication is also crucial in avoiding malpractice litigation. For one, proper communication with staff helps avoid mistakes like delayed diagnosis and incorrect prescription drug administration. Communicating with patients and families also helps them understand better what’s happening and why and makes them feel heard instead of ignored.
Competence & Charting
Of course, healthcare professionals must be competent if they want to avoid malpractice litigation. But competence also refers to physicians not going past their area of expertise—consulting with colleagues and referring patients to specialists when needed.
Lastly, charting (or documentation) helps to improve communication and is useful in potential litigation. For one, it provides a written record of everything that’s happened to the patient and gives healthcare professionals the most up-to-date information regarding the patient for quality and safe care.
Conclusion
If you’d like to learn more about medical malpractice liability risk for individuals and practices, our helpful staff is eager to answer all your questions and can help you find the ideal malpractice insurance policy for you.
When it comes to insurance, especially malpractice insurance, there are many aspects of the policy that the insured individual should be familiar with. One of the most important components of any insurance policy is the deductible.
Malpractice insurance deductibles are different than the typical deductibles found in other policies, such as those for home or car owners. Below, we’ll explain everything you need to know about malpractice insurance deductibles, from how they’re structured to the options available.
What Is an Insurance Deductible?
First, consider the basics of deductibles and insurance policies. Deductibles are common parts of many insurance policies, whether healthcare, homeowner’s, or auto insurance. An insurance deductible is the specified amount an insured pays toward their insured loss.
The deductible is a lump sum the insured pays the insurer if the policy and coverage are activated. To use the example of auto insurance, if the insured has a $500 deductible insurance policy and gets in an accident that causes damages in the amount of $5,000, the insured would be responsible for paying the $500 before the repairs can be made or reimbursed for $4,500 for the repairs minus the deductible.
Does Every Malpractice Insurance Policy Carry a Deductible?
While deductibles are standard on most homeowner’s and auto insurance policies, they’re not typical with malpractice and professional liability policies. Since malpractice insurance differs from other types of insurance and covers different costs, most policies don’t include a deductible.
Many policies will carry a deductible option, but it’s not mandatory unless the individual is joining a group malpractice insurance policy where the deductible is required. Those seeking individual malpractice insurance policies will likely have the option of having a deductible. And while the deductible may be a substantial lump sum, a higher deductible could mean lower premiums, so it is worth considering.
How Are Malpractice Insurance Deductibles Different?
Malpractice insurance is already quite different from other forms of insurance regarding deductibles, but they’re also structured differently. While deductibles for most insurance policies, like auto and home coverage, must be paid immediately to activate policy coverage, malpractice deductibles are slightly different.
Individuals looking for malpractice insurance have two options regarding deductibles—indemnity-only or indemnity and expense. Both deductible types are fairly common, but they do have distinct characteristics.
Indemnity-Only Deductibles
An indemnity-only deductible, otherwise known as loss-only, is a deductible that is only required when the insurance provider pays an indemnity. An indemnity is compensation for damages or losses agreed upon in a settlement or levied on the defendant by the court.
If there is no indemnity, where the claim is either dismissed or resolved in favor of the insured defendant, then the insured wouldn’t have to pay the deductible at all. An indemnity-only deductible is only required when a settlement is agreed to or the lawsuit is resolved.
Consent-to-Settlement Clause & Deductibles
Those with an indemnity-only deductible should also consider a consent-to-settlement clause in their insurance policy. A consent-to-settlement clause is a provision that requires the insurer to seek the insured’s approval before settling a claim. While this clause is common in many policies, it’s not standard and shouldn’t be assumed by the insured.
Those with an indemnity-only deductible would naturally want to consent to a settlement, as that’s when the indemnity-only deductible would activate and they’d have to pay a large sum. Without the clause, there’s an incentive for the insurer to agree on a settlement to resolve the claim and activate the indemnity-only deductible.
Indemnity & Expense Deductibles
The other type of deductible in malpractice insurance is indemnity and expense. While the deductible covers the indemnity—should any be paid—it also covers other expenses, like court and legal fees.
It doesn’t matter if an indemnity has been reached yet; most indemnity and expense deductibles are required immediately once the claim is filed. The indemnity and expense deductible is typically more common than an indemnity-only deductible if the policy has any deductible at all.
Which Malpractice Deductible Is Best for Me?
Choosing which deductible is best for you and your insurance policy will primarily come down to your preferences. Each deductible type has its advantages, as an indemnity-only deductible is paid only when the claim is resolved and may not be paid at all if the claim is dismissed or resolved in favor of the defendant.
However, indemnity-only deductibles are typically higher than indemnity and expense deductibles, which must be paid immediately to cover legal costs like lawyer and court fees. One type of deductible may also yield a lower policy premium, so you should carefully weigh each deductible’s pros and cons before deciding.
How Much Should I Pay for My Malpractice Insurance Deductible?
One of the most common questions that many searching for new malpractice insurance policies ask is how much they should pay for a deductible. The price of a malpractice policy deductible depends on numerous factors, including the individual’s risk factor. Some medical professions have inherently higher risk factors and are more likely to have higher premiums or deductibles for coverage.
Some malpractice deductibles are as low as $1,000, while some are as high as $25,000 or more. Keep in mind, a higher deductible typically means a lower premium and vice versa. Those shopping for a new malpractice policy should decide if they’re more financially capable of paying a higher monthly premium or greater lump sum for their coverage.
How Do I Find Suitable Malpractice Insurance?
If you’re ready to find a malpractice insurance policy that best fits you, Baxter & Associates can help. Baxter & Associates provides professional liability insurance for many medical professions, from CRNA medical malpractice insurance to group insurance policies for healthcare facilities.
Some examples of the medical professions we serve as malpractice insurance brokers include:
Doctors
Dental professionals
Podiatrists
Chiropractors
Nurse practitioners
Physician assistants and more
As a national insurance broker with decades of experience, we’ll help connect you with a policy that’s ideally tailored to your situation, whether you know exactly what you want or if need help finding the right policy. Contact our helpful staff at Baxter & Associates, and we’ll ensure that you’re sufficiently covered in the case of a medical malpractice claim.
