Limits of Coverage
The CCC Program provides eligible VAP physicians coverage limits of $2.3 million per medical incident with an annual aggregate limit of $6.9 million.
The CCC Program is written on an occurrence basis at very competitive rates. The essential difference between occurrence and claims-made coverage is that occurrence coverage responds to all claims occurring within the policy period, regardless of when such claims are brought. A claims-made policy, in contrast, covers only claims arising and reported during the period of the policy. Claims-made insurance offers a lower price during the early years of coverage, but this is offset by sharp price increases after the first year. A typical physician's claims-made policy in New York has a premium which rises to 85% of the occurrence rate at the third-year renewal and peaks at 105% in year 5 and thereafter. Even when a claims-made policy is cancelled after only one year, the combined cost of the basic premium and tail coverage is over 105% of the occurrence rate.
Considerably more than half of all medical malpractice claims arise in a hospital setting, and plaintiffs usually sue jointly their hospitals and treating physicians. Joint hospital/VAP claims may be consolidated with one defense firm to minimize redundant legal expenses and generally prevent an adversarial relationship between the hospital and their VAP(s). The resulting reduction of legal and other costs contributes to the favorable premium structure of the Program.
Prior Acts Protections (PAP)
A physician leaving a claims-made program should purchase "tail" coverage to protect against late reported claims which otherwise may be uncovered. The CCC Program offers Prior Acts Protection (PAP) coverage to eligible physicians. PAP coverage addresses a physicians "tail" problems and is a cost-effective way to deal with unknown liabilities when a physician leaves a claims-made program. When you purchase PAP coverage you get standard CCC occurrence coverage with a Prior Acts Protection feature included. PAP coverage provides a limit of $1.3 million per medical incident with a $3.9 million total aggregate limit for all covered years combined.
Purchase of PAP coverage includes a three-year obligation to remain in the Program. After the three-year obligatory period the premium will drop to the then-prevailing occurrence rate. PAP coverage will remain in effect at no additional charge. The insured physician will continue to have ongoing occurrence coverage for each year that premium is paid. PAP coverage is available to qualifying physicians in all specialties except neurosurgery, orthopedic surgery, general surgery including bariatric surgery, obstetrics, gynecology, pediatrics and neonatology. Physicians in all other specialties are eligible to apply for PAP.
To apply for Prior Acts Protection coverage a standard CCC application is used, but it must be accompanied by a signed Prior Acts Protection Addendum and a copy of the Declarations Page from the physician's current malpractice insurance policy.
VAP physicians at a CCC hospital who have a part-time private practice may be eligible for a part-time policy, depending upon specialty classification and other practice parameters. Eligible physicians will qualify for premiums that are approximately 50% of the prevailing occurrence rate. To apply for Part-Time coverage a standard CCC application is used, but it must be accompanied by a signed Part-Time Addendum.
Full Time Policy Covered Activities
The insurance covers your professional activities during the coverage period, whether at a hospital or in your office. It excludes general liability coverage.
Insurers Issuing the Coverage
Hospitals Insurance Company, 50 Main Street, White Plains, N.Y. 10606 issues the primary layer of coverage. Hospitals Insurance Company is a New York State licensed insurer. Excess coverage for the CCC program is provided by offshore insurance captives owned by the CCC hospitals.
Coverage is subject to cancellation upon ten (15) days written notice for failure to pay premiums in a timely manner, and upon sixty (60) days written notice for other appropriate reasons. Should an insured elect to cancel coverage he must give prior written notice to CCC. If an insured wishes to cancel at a date other than July 1 or any quarterly date, he will be subject to a short-rate cancellation penalty.
Claims investigation and administration will be handled through Sedgwick CMS. Sedgwick CMS provides cost-effective claims administration, health care risk management, patient safety consultation and related services in more than one hundred and fifty offices and service locations in the U.S. and Canada. Information about claims under this insurance will be shared with representatives of your participating hospital and the CCC Program. All legal services related to claims covered by this insurance will be arranged and paid for on your behalf.
The Program's underwriters reserve the right to decide on claims settlements. An appeals process is available to handle cases where a physician wishes to appeal a settlement allocation.
The aim of the Program is to minimize losses and discourage frivolous lawsuits via prompt and thorough investigation of claims and vigorous legal defense. You should promptly report to your CCC hospital risk manager all of the following:
Eligibility for Coverage
If you are a voluntary attending physician, dentist or podiatrist on the staff of any of the CCC participating hospitals you are eligible to apply for this insurance. For professional corporation (P.C.) or partnership coverage contact CCC, Inc. directly for more information.
Individual applications are required and will be reviewed by Program underwriters for eligibility. Your signed application should be forwarded to your CCC hospital Risk Manager.
For more information about the Program or to request an application, contact the Risk Manager at your hospital.
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