Professional Liability InsuranceOverview of Professional Liability Exposures and InsuranceSlide 3Slide 4Common Characteristics (cont)Physicians Professional Liability InsuranceSlide 7Slide 8Slide 9Slide 10Physicians Professional Liability InsuranceAccountants Professional Liability InsuranceSlide 13Slide 14Slide 15Professional Liability InsuranceOverview of Exposure and InsurancePhysicians Professional Liability InsuranceAccountants Professional Liability InsuranceOverview of Professional Liability Exposures and InsuranceDuties of ProfessionalsContractual dutyDamages Compensatory ConsequentialLiquidated NominalTort-related dutyContract versus tort actionsProfessional corporationsOverview of Professional Liability Exposures and InsuranceProfessional Liability Coverage under CGLProfessional health care services exclusionCoverage restricted to:Bodily injuryProperty damagePersonal injuryAdvertising injuryProfessional liability exclusion sometimes addedProfessional Liability InsuranceCommon CharacteristicsMost coverage written by specialized insurersCovered acts and consequencesDiffers from business exposureCoverage depends on professionMedical - injuryAccountants, attorneys - financial harmErrors and omissions coverage - negligenceCommon Characteristics (cont)Who is coveredProfessionals, partners, owners, officersDefense coverageSometimes included in policy limitsSometimes settlement requires insured’s consentCoverage triggersClaims-made commonExtended reporting period is not guaranteed and not unlimitedCoverage territoryPhysicians Professional Liability InsuranceLoss exposureLegal standards - negligenceStandard of careLocality ruleSpecialists and duty of referralDelegationDiligence and abandonmentInformed consentPhysicians Professional Liability InsuranceCommon allegationsSurgical errorImproper diagnosisImproper testsLack of informed consentUse and administration of anesthetics or drugsPhysicians Professional Liability InsuranceDefenses Statute of limitationsGood Samaritan statutesContributory negligenceInformed consentPhysicians Professional Liability InsurancePolicy provisionsInsuring agreementsIndividual coverageOrganization coverageExclusions (varies by policy)High risk medical proceduresCriminal actsSexual misconductProprietary activitiesPunitive damages DiscriminationPollution ContractualPhysicians Professional Liability InsuranceLoss Control Know the patientMaintain communication and exercise courtesyKeep thorough recordsAvoid even the appearance of negligenceDiagnose and test thoroughlyKeep informed about informed consentKnow what’s happening in the hospitalDon’t take on too much workMonitor partners and staffPrevention is the best defensePhysicians Professional Liability InsuranceLoss Control - Measures to reduce or eliminate hazardsDo not diagnose by phoneDo not press for collection of fees if any basis for suitVerify patient identity and operation before surgeryDo not admit faultMaintain professional manner and tactful approachDelegate carefullyCheck medical equipmentMaintain accurate recordsAvoid overly optimistic prognosisMaintain confidentialityArrange for a qualified substituteAccountants Professional Liability InsuranceLoss exposureBreach of contractImproper or incomplete performanceTort liabilityFailure to perform with reasonable professional care and competenceStatutory liabilitySecurities lawsERISAAccountants Professional Liability InsuranceCommon allegations against accountantsTax servicesAudit servicesAccounting servicesClient counterclaims (when suing to collect fees)Failure to detect embezzlementSecurities lawsBusiness and investment adviceBreach of fiduciary dutiesManagement advisory servicesAccountants Professional Liability InsurancePolicy provisionsInsuring agreement Professional servicesDefense costs usually within policy limitsWho is insuredNamed insured, officers, directors, partners,stockholders and employees for professional servicesHeirs, executors, administrators and legalrepresentativesAccountants Professional Liability InsuranceExclusions that may applyBodily injury or property damageDishonest or criminal actsDefense against these charges coveredInnocent insureds liable for dishonest acts ofanother coveredPunitive damagesContractual