In the world of insurance, providers face a myriad of choices when it comes to protecting their practice and reputation. Two primary options stand out: admitted and surplus lines insurance. Understanding the differences between them is crucial for healthcare providers seeking comprehensive coverage.
ADMITTED INSURANCE: THE TRADITIONAL CHOICE
Admitted insurance, also known as standard insurance, refers to coverage provided by insurers licensed and adhere to strict regulatory standards & underwriting. Admitted insurance policies typically offer standardized coverage, based on the guidance of multiple associations and the FDA. Typically, this kind of insurance covers “WITHIN THE SCOPE OF PRACTICE” for your specialty.
COMMON OUT OF SCOPE PITFALLS:
- Off-Label Usage (i.e. Medical Weight Loss Alternatives)
- New Cutting-Edge Products or Services (i.e. Peptides, Stem Cells, Ketamine)
- Non-FDA Approved (i.e. Prescribing Compounded Products)
SURPLUS LINES INSURANCE: A TAILORED APPROACH
Surplus lines insurance, also known as non-admitted insurance, offers coverage for risks that standard insurers are unwilling or unable to cover. Surplus lines insurers operate outside the regulatory framework of state insurance departments, providing greater flexibility in underwriting and pricing. While surplus lines insurance may seem unconventional, it offers several distinct advantages for healthcare professionals seeking specialized coverage.
BENEFITS OF SURPLUS LINES COVERAGE:
- Flexibility in Coverage: Surplus lines insurers are not bound by the same regulatory constraints as admitted insurers, allowing for greater flexibility in underwriting and pricing. This flexibility enables healthcare professionals to tailor their coverage to suit their specific practice needs, including high-risk specialties and emerging risks.
- Innovative Solutions: Surplus lines insurers are often more willing to underwrite coverage for unique or unconventional risks, such as procedures involving off-label drug use or experimental treatments. This innovation allows healthcare providers to stay ahead of evolving industry trends and offer cutting-edge care to their patients.
- Specialized Expertise: Surplus lines insurers typically have specialized knowledge and expertise in niche areas of healthcare, enabling them to offer tailored solutions and proactive risk management advice. This expertise can be invaluable for healthcare professionals navigating complex legal and regulatory landscapes.
- Access to Capacity: In situations where standard insurers are unable to provide adequate coverage limits or terms, surplus lines insurers can offer access to additional capacity from the global insurance market. This ensures that healthcare professionals have sufficient coverage to protect their practice and assets against catastrophic losses.
AVOIDING DON’T ASK DON’T TELL:
The onus is on the provider to insure they have adequate malpractice coverage. It’s to your advantage when you provide the following to your insurance agent:
- Every procedure you provide in your practice.
- Average Annual Quantity Per Procedure.
- The providers performing these procedures.
By offering all this information, you’re putting the onus back on your insurance agent & carrier to give you the coverage approval in writing, protecting your practice and avoiding non-renewals or unqualified claims that will not be covered.
WHAT CAN I DO FOR MY PRACTICE?
First, request the ‘FULL POLICY’ from your agent and have a look at language that has to do with FDA Approval exclusions, scope of practice and any other aspects pertaining to the limits you are being offered for any listed procedures.
CONCLUSION: SURPLUS LINES ADVANTAGE
While admitted insurance serves as the traditional choice for many healthcare professionals, surplus lines insurance offers unique benefits that cannot be overlooked. From flexibility in coverage options to innovative solutions and specialized expertise, surplus lines insurance provides healthcare providers with the comprehensive protection they need to thrive in today’s dynamic healthcare landscape. By exploring surplus lines insurance options, healthcare professionals can ensure they have the robust coverage necessary to safeguard their practice and reputation against a wide range of risks and liabilities.