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AmHS forms largest multihospital system liability insurance company.

American Healthcare Systems has formed an excess liability insurance company for about 225 affiliated hospitals and more than 100 nursing homes. The alliance expects to protect members from wide swings in premiums, and to save money by cutting out the insurer middleman.

Bermuda↗

Selection of a professional liability insurance policy.

A review of the professional liability insurance policy of one corporation's physicians stimulated a review of the policies used to protect the physicians and corporation from the financial risk of professional liability. It was clear that little was known about the insurance carrier. This case study chronicles the group's actions to address this problem.

Decision Making, Organizational↗

Causes of the liability insurance crisis.

In this article the reasons for recent dramatic premium increases for liability insurance are explored by examination of available data on industry premiums, losses, and expenses. The suggestions that the premium increases were primarily caused by collusion among insurers, cyclical behavior, or systematic errors in forecasting losses are rejected. Instead, the evidence indicates that the jump in liability insurance premiums is most plausibly due to the growth in the discounted value of expected liability losses.

Accidents, Traffic↗

Professional liability insurance.

The American Association of Nurse Attorneys recommends that all nurses engaged in the practice of nursing insure themselves against liability to third parties arising out of that practice. To make an informed decision whether to purchase individual insurance and how much to purchase, each school nurse must personally evaluate a multitude of factors. Each school nurse should also understand the various types of insurance policies available and how an individual policy is affected by coverage provided through the school district policy or self-insurance program. In certain states, school nurses also may be protected by the legal doctrine of sovereign immunity. This article provides answers to some of the questions frequently posed by school nurses about individual professional liability insurance.

Humans↗

Tort reform and malpractice liability insurance.

Legal factors related to the malpractice liability insurance purchased by general dentists in the United States were investigated using a comprehensive multivariate model that assessed the contribution of legal provisions affecting the probability of a malpractice claim, the probability of a payment, and the average size of the payment. General practice dentists in the United States were selected randomly, and 3,048 dentists were studied by mail survey. A number of legal statutes (periodic payment allowed, percentage fault liability informed consent limits, limits on res ipsa loquitor, attorney fee control, some statute of limitations provisions) had the intended effect of reducing the malpractice insurance sought by dentists. Other provisions, such as binding arbitration, may have unintended cost-raising effects. Previous malpractice claims were associated with purchasing greater amounts of insurance. These findings have implications for future changes in the legal system as part of health care reform.

Dentistry↗

Effects of changes in professional liability insurance on certified nurse-midwives.

A stratified random sample of 500 ACNM members was surveyed by mail in June, 1987, using a questionnaire designed to describe the effects of the liability insurance crisis on the practice of nurse-midwifery. A majority of the 286 respondents indicated that the increased cost and decreased coverage of liability insurance is having a direct and negative impact on midwifery practice in terms of financial burden, increased defensive interventions, increased cost of care, decreased availability of care, restricted practice privileges, and stressed employer/employee relationships. A dramatic increase in insurance premiums has occurred without a comparable increase in income. The increased use of defensive medicine reported by CNMs has produced higher costs to the public. Job opportunities have diminished due to loss of insurance coverage, physician back-up, and hospital privileges. The active political involvement of nurse-midwives is needed in order to reverse the negative effects of the liability insurance crisis.

Certification↗

Alternative liability insurance: a physician-owned captive insurance company.

The physician-owned captive insurance company is a lesser known but dynamic alternative to commercial insurance. The Physicians Reimbursement Fund, Ltd., was founded in 1975 in response to the malpractice crisis of that year. The company insures about 100 physicians in high-risk specialties. Approximately one half are obstetrician-gynecologists. Innovative management has enabled this company to operate successfully at a fraction of the premium charged by typical insurance companies. Fourteen years of experience have demonstrated the ability of this company to successfully serve the needs of the community.

Insurance, Liability↗