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What is the medical malpractice insurance pool and who needs it?

March 20, 2017

Medical malpractice insurance is a must-have for any health care provider, but what happens when you can’t qualify for this necessary insurance due to a history of malpractice claims? With some of the highest rates of medical malpractice claims in the country, New York state health care providers are at a much greater risk of being denied insurance coverage. For this reason, the state created the Medical Malpractice Insurance Pool (MMIP) as a way to ensure that physicians, surgeons, dentists and other providers can receive the coverage they need to continue their practices.

Medical Malpractice Insurance in New York

New York is one of the few states with no legal reform to place a cap on malpractice payouts. This factor, combined with the higher-than-average rates of malpractice claims, has resulted in the steady rise of medical malpractice insurance premiums. An even bigger problem is the excessive payout amounts being awarded to claimants. Malpractice insurance is something doctors hope they never to have to use. When a patient files a malpractice claim and the doctor needs to use the insurance, the insurance company might drop the doctor from the plan after making a large payout. The doctor might also fail to qualify for future coverage from any of the state’s standard providers, such as Medical Liability Mutual Insurance Company (MLMIC) or Physicians Reciprocal Insurers (PRI).

Who is Eligible for Coverage under MMIP?

Since there is no cap on payouts, increasing numbers of physicians and other New York health care providers are being denied malpractice coverage. For this reason, the state’s Superintendent of Financial Services created the Medical Malpractice Insurance Pool. This plan provides malpractice insurance to providers who have been turned down for coverage by the state’s approved carriers and who would otherwise be unable to continue their practices. The MMIP is a vital program that ensures the continued smooth functioning of the state’s health care system. The insurance is available to any healthcare provider who is licensed to practice in New York, and no physician can be refused coverage.

Continuing Your Practice with MMIP

MMIP is primarily considered an insurance of last resort. If you have excessive malpractice claims, MMIP ensures you can still practice. The plan also covers physicians who have been denied coverage for a range of other underwriting issues, such as having a medical license or hospital privileges temporarily revoked or being sanctioned by the state Medical Board. A provider who has been turned down by at least three approved insurers is guaranteed to receive coverage under MMIP. With MMIP malpractice insurance, a doctor is free to practice anywhere in New York, as it is accepted at every hospital within the state. The insurance provides the same standard liability limits as the state’s other approved insurers, and providers can be eligible for either a $1 million claim limit with a $3 million aggregate limit or a $1.3 million claim limit with a $3.9 million aggregate. As hospitals only require the $1/$3 million limit, even the smaller policy allows you to work wherever you wish.

MMIP Insurance Rates

Although MMIP provides the coverage you need to practice, it does come at a cost. The premiums for MMIP malpractice insurance are two to three times higher than standard insurance rates offered by PRI and other approved carriers. Still, these higher premiums aren’t all that surprising, considering that all the physicians and health care facilities receiving coverage under the program have previously experienced problems relating to their practices. Most providers are willing to pay these higher rates, since the alternative is potentially shutting the doors on their practices forever.

Due to the continued rise of malpractice premiums in New York, many physicians and healthcare facilities struggle to keep up with the costs. However, until serious legal reform is enacted to curb excessive malpractice claims and settlements, providers must pay the high price or move their practices to another state. MMIP may not be able to help keep the cost of premiums lower, but it can provide the necessary coverage to providers adversely affected by excessive claims.

Filed Under: Uncategorized Tagged With: medical malpractice, medical malpractice insurance pool, MMIP, New York, payout, Physicians Reciprocal Insurers, pool, premiums, PRI

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