Terms:

• Policy - Insurance is purchased through this contractual agreement. 
• Premium - Policy is purchased in exchange for this payment, a premium. 
• Malpractice insurance provides reimbursement to the third party (injured person or family) called indemnity; most policies provide coverage to the doctor for cost incurred in defending a claim (first party coverage). 
• Liability limit (example 1 mil/3 mil) means you are covered up to 1 million per event and up to 3 million per policy period. 

Types of Policies:

• Occurrence Policy - The insurance company is responsible for covering a claim if that event that gave rise to that claim takes place during the term of the policy (even if you are no longer currently under that policy). 
• Claims-Made Policy - The date on which the event took place that gave rise to the claim does not matter; only the date on which the claim is made matters.
• Tail coverage - Converts a claims made policy to an occurrence policy. 

When Will My Insurance Carrier Not Cover Me?

• Emergency Physician policies are site specific and patient specific - ED doctors are covered for care in the emergency room; check with your insurance company before you provide care to a non-emergency room patient like if you volunteer at an event or a camp. 
• Good Samartian is an exception to the above! There are 3 criteria to meet this:
• You do not bill for services. 
• No pre-arranged doctor-patient relationship. 
• Services provided in a situation for which you were chanced upon. 
• No Chart = No Coverage
• Altering a medical record negates the credibility of your chart and my void your insurance coverage (and you may find yourself in trouble with the medical board). 
• Beware of medical care, medical advice and writing prescriptions to friends and family as you often do not have a chart if something goes wrong. 
• Not following your state laws:
• Know your mandatory reporting laws as you have an obligation to the known and predictable third party (child abuse, infectious disease, Tarasoff, etc.)
• Intentional Torts/ Criminal Charges:
• Willful or gross negligence 
• Assault, especially sexual assault - always remember your chaperones
• Battery - remember informed consent for procedures
• Concealment of physician impairment
• Insurance fraud
• Illegal use of controlled substances

What happens if the verdict is greater than my policy limit? 

• Common misconception that a doctor can lose house and life savings in a runaway jury verdict when in fact it is rare for a physician to pay out of pocket even when a verdict exceeds the policy limit; almost all cases settle without the doctor having to pay anything. 
• For emergency medicine, most payments are less than $500,000.
• It is rare for a plaintiff to pursue a physician for excess damages and the plaintiff's will typically target the limits of all defendants named in the suit and will often go for the deep pockets (hospital). 
• Data is sparse, however, as legal system publishes information about filed cases and judgements rendered but doesn't publish data about collection of these judgements.