IMPORTANT QUESTIONS PHYSICIANS SHOULD ASK
Is the carrier licensed and admitted in the Commonwealth of Pennsylvania?
PCA is licensed and admitted in Pennsylvania.
Is there a capital contribution requirement to become a policyholder?
As of august 2006, PCA no longer requires a capital contribution to become a policyholder. Moreover, PCA was the first of the “new” reciprocal exchanges to receive Department of Insurance approval to begin refunding fees previously collected. Effective January 1, 2007, PCA began returning fees at a rate of 20% per year to those physicians that remain policyholders. The 20% return takes the form of a credit against 2007 and subsequent renewals. Through December 31, 2009, PCA has returned more than $1,600,000 under this initiative.
Am I, as a policyholder, or my carrier subject to assessments due to reserve inadequacies?
Neither the company nor our insureds are subject to assessments. That’s because the policies we issue are non-assessable, plus our practice of setting reserves at ultimate is the best defense against reserve inadequacies.
Is your company supported by a reinsurance arrangement?
From its inception, PCA has recognized the value and importance of protecting against catastrophic loss by purchasing reinsurance for its own account. Since January 2009, PCA’s reinsurance partner – on an excess of loss basis – has been ACE Tempest Re, which is rated A+ (Superior) by A.M. Best, A+ by Standard and Poor’s and A2 by Moody’s.
Back to Top
Can the carrier settle my claim without my consent?
Under PCA’s General Conditions, Item 2, Settlement of Claims, the policy clearly states that “the Company will not settle any claim without the insured’s consent.” (Note: You should be aware of other policy forms in the market which appear to provide the same feature, but instead, significantly modify it. That is, the insured will be responsible for any amount above the value the carrier establishes as a settlement, in the event the insured withholds his or her consent. This is sometimes referred to as a “hammer clause.”
In the event of a claim, will I have input regarding legal representation or will the carrier dictate which law firm I use?
At PCA, you can select any lawyer from those with which we already do business, or you may use your own attorney once he or she is approved.
Will I have access to the carrier’s decision makers? What avenues are open to me if I disagree with a decision by the carrier?
Regardless of whether it is to appeal a decision or to answer a general inquiry, PCA senior management is always available to its insureds
Does the carrier offer claims and risk management services as part of the insurance product, or are these unbundled at a separate cost?
PCA policyholders have access to very aggressive risk management and claim services at no additional cost. We view our risk management program as preventative medicine against lawsuits. Simultaneously, our legal team has an over 90% win rate defending malpractice lawsuits.
Will the carrier cover my locum tenens?
PCA not only extends coverage to Locum Tenens, our rates are among the most competitive in the state.
Back to Top
What Tail provisions are available from your company? Are there any restrictive covenants in your policy form for physicians practicing outside Pennsylvania?
PCA has adopted generally accepted industry standards for Tail Waivers:
- Death………Granted upon receipt of death certificates
- Retirement...Granted at age 55 with five (5) years of continuous coverage, on
the basis that the physician retires completely from the practice of
medicine.
- Disability…..Granted for total and permanent disability after certification from an independent physician.
As long as a physician’s Pennsylvania practice is greater than 50% of the total, PCA (and Mcare) will provide the same limits in a neighboring state, e.g. New Jersey or Delaware.
Has the carrier, it its history, ever left any jurisdiction or terminated writing new business for any reason?
The underwriting mission at PCA has been to help restore a level of confidence and stability for the Pennsylvania physician community. Our strategy therefore has been to establish a competitive but sustainable rating structure. We think we’ve been successful in this regard – our growth and results bear that out – and we do not foresee a scenario where we will either have to cease writing new business or pull out of a jurisdiction.
Premium-to-Surplus Ratio is a standard measurement of a company’s health. What is the ratio for the carriers under consideration?
As of December 31, 2009, PCA’s ratio is 1.79 : 1 (read 1.79 to 1), based on written premium of $18,847,113 and policyholder’s surplus of $10,516,716.
|
