Limits of Coverage

The CCC Program provides each VAP insured coverage limits of $2.3 million per occurrence with an annual aggregate limit of $6.9 million.

Occurrence-Based Coverage

The CCC Program continues to be 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 85% of the occurrence rate at the third-year renewal, 99% at the fifth-year renewal, and peaks at 105% in year 8 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.

Joint Defense

Over 80% of malpractice claims arise in a hospital setting, and plaintiffs usually sue jointly their hospitals and treating physicians. It is for this reason that one of the criteria of the CCC Program is that a substantial number of physician’s admissions be to their sponsoring CCC hospital. In the CCC Program, VAPs are insured as “additional insureds" under their hospitals’ insurance policies, so in the event of a claim they generally are not forced into an adversarial relationship with the hospital. 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 has a total aggregate limit, for all coverage years, of $1 million per occurrence and/$3 million aggregate.

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 as 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, 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.

Part-time Physicians

Employed physicians at a CCC hospital who have a part-time private practice may be eligible for Part-Time coverage, depending upon specialty classification. 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, in your office or elsewhere. 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 various carriers, including an offshore insurer owned by the seven CCC hospitals.

Cancellation Provisions

Coverage is subject to cancellation upon ten (10) 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 Management

Claims Handling

Claims Reporting

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:

• A medical occurrence which you believe could potentially result in a claim
• A request for information or medical records by a patient’s attorney
• A threat of legal action or demand for compensation
• The service of formal papers in a lawsuit.

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. A professional corporation (P.C.) or partnership is automatically covered for professional liability if all physicians, dentists and podiatrists employed by the corporation are insured through the CCC program.

Individuals other than physicians, dentists or podiatrists who are your employees or those of your P.C. or partnership are automatically covered, with the exception of registered physician’s assistants, registered specialist’s assistants, certified registered nurse anesthetists, nurse practitioners and certified nurse midwives. Coverage for these types of employees (other than certified nurse midwives) may be obtained at an additional premium.

Application Procedure

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 or VAP contact.