FAQ

Frequently Asked Questions About Argus Risk Advisors

What makes Argus Risk Advisors unique?

Argus Risk Advisors is unique for many reasons. Some of the highlights are our experience in the industry, our unique way of approaching malpractice insurance in which our client’s needs are first and foremost; our application free process which makes us easier to do business with. To find out more, check out the “about us” page.

Is our process really application free?

That’s what’s so unique about Argus Risk Advisors. Innovation and experience have allowed us to create a process that doesn’t require lengthy applications. In fact, all we need is your signature and a few other details like your UPIN number, and you’re done! Our simple release form can be found here.

Why is the exclusive relationship with CAQH important?

The many people that use CAQH are the reason our exclusive relationship with them is so important. Because there are so many doctors out there that have put their UPD provider profile onto the CAQH database, our patented process can be used for a wide variety of people. Our exclusive relationship means that CAQH will only release UPD profiles to the premium group.

What is meant by “soft” and “hard” market?

Hard and soft markets are a part of the insurance market cycle and are a function of supply and demand; they are influenced by a variety of financial issues.

In a “soft market” insurance companies (the underwriters) are eager to write new business and to hold onto existing business; they are likely to offer coverage improvements, increased discounts or credits and reduced premiums.

The spiral continues until there is no more room to cut prices and the “hard market” starts. There is usually an accompanying economic downturn connected with this market fluctuation which causes the change. In a “hard market” insurance companies will often increase premiums and take back some of the coverage enhancements they provided during the soft market.

This market condition may be caused by premium levels decreasing which leads to decreased profitability in global financial conditions and reinsurance availability.

Whether a soft or hard market, it is important to have an agency that can research multiple options to provide you with competitive and adequate coverage.

What is negligence?

Negligence is the broad category into which medical malpractice insurance claims against healthcare providers fall. They are:

• Duty owed – the legally required level of care a physician must provide to a patient (care a prudent, reasonable physician would provide under similar circumstances

• Breach of duty – failure to provide a level of care compatible with the duty owed -care inconsistent or failed to provide care that should have been provided in accordance with standards of care

• Proximate cause – notion that failure to meet standards of care legally caused the injury or further injuries to the patient

• Damages – monetary or emotional loss due to breach of duty that caused injury

Note: For a physician to successfully defend against a claim, the physician must demonstrate one of four elements is not present. If any element, not present, the claim will be unsuccessful.

Which A.M. Best ratings are in the “secure” range?

The ratings of A++ and A+ indicate a superior rating. This means that the companies have been judged to have a superior ability to meet their ongoing obligations to policyholders. The ratings of A and A- indicate an excellent rating. This means these companies have been judged to have an excellent ability to meeting their ongoing obligations to policyholders. Companies with A.M. Best ratings from A++ to B+ are considered to be “secure” and not at risk of defaulting on their ongoing obligations to policyholders.

For details, visit www.ambest.com

What is a non-admitted carrier?

An insurance company that is not admitted by the state is not subject to a number of the fees and contributions required to be an admitted carrier. This can allow them to pass on savings to a client. Non-admitted carriers are available through a third party, or surplus broker, which Argus Risk Advisors can help facilitate. Non-admitted companies carry the same ratings as do admitted carriers.

How long have the companies been in business?

Many of the companies we represent have been in existence for more than 20 years. Some of their names have changed as they have grown or merged with other insurance companies to form more stable and secure resources.

What carrier(s) do you represent? Are they financially sound?

Our admitted carriers typically have A.M. Best ratings from “A-” to “A++”. This indicates solid financial stability. Many of our non-admitted carriers also have “A” ratings. What happens if my insurance carrier goes out of business?

What is the difference between Claims-Made and Occurrence Policies?

Claims-Made policies cover claims that are made during the policy year. The claim must be related to a medical incident which took place subsequent to the retroactive date.

The retroactive date determines the span of time before the inception of the policy that physicians are covered for negligent acts, errors, or omissions that are reported during the coverage period of the policy. A retroactive date can match the policy’s inception date so that no prior acts are covered. Most medical liability companies will offer a free tail at retirement, subject to certain conditions.

When transferring coverage from one insurance company to another on a claims-made policy, it is important to have the new company “pick up” the retroactive date on the previous policy, so there is no protection gap.

If this is not possible, we recommend that our clients consider purchasing a “tail” to protect themselves from future claims arising from the time the policy was active.

Occurrence policies provide coverage that responds to incidents/claims arising during the coverage period, regardless of when those claims are reported.

Physicians need not worry about canceling an Occurrence policy and moving to a different insurer; coverage remains locked in for incidents occurring while the policy was in force, so long as the insurer is in business.

What enables your carriers to offer such competitive quotes? There can be a number of reasons for this including:

Appetite for specialty: The company may have a greater number of specialists in your field than do other insurers and may perform more thorough market risk evaluations which enables them to focus on your specialty. They also may be anticipating future growth in your particular type of practice, thus acknowledging a favorable opportunity and risk.

Geographic rating: Insurance companies frequently establish their rates by geographic territory, usually by state and county.

When do I need to purchase a tail?

Typically a physician only need to purchase a tail when leaving a practice that requires it by contract, or when changing to a different policy form. Call us for details.

Does my policy cover me if I start working at an additional location, or add procedures to my practice?

This depends on your coverage. It is important to notify your insurance company of any changes or additions to your practice profile. Depending on your individual policy, the company may or may not be able to cover you for your change. It is important to consult with your PGI agent for guidance, BEFORE making any changes.

Is there a discount for part-time?

Yes, part-time is frequently discounted, but rates vary depending on specialty and carrier.

How is premium calculated for ancillary employees (RN, LPN, PA, and NP)?

RNs, LPNs, and other ancillary providers are typically covered under the liability policy of the practice. PAs, NPs, CNMs, and CRNAs frequently need to obtain a separate limit of coverage, although there are select companies that will include them under the main policy. The cost to insure a higher level ancillary is generally less than a physician but can vary depending on the risk profile.

Do I have to complete multiple applications to receive quotes from multiple companies?

No, we offer a streamlined process in which you complete and sign one form enabling us to obtain competitive quotes from multiple companies. When it comes time for renewal through PGI, our clients typically only need to fill out an updated form and/or a short renewal application from their current carrier.

Malpractice Insurance

Medical Malpractice Insurance for Physicians

Solo physicians are a primary specialty at Argus Risk Advisors. We provide broad, flexible insurance solutions for a wide range of physicians and surgeons including hospital employees, locum tenens, and employees of contracted groups. Policyholders also benefit from experienced risk consulting and claim services of our carriers.

Malpractice Insurance for Dentists

With extensive experience in the unique insurance needs of dental practices, Argus Risk Advisors offers comprehensive solutions and competitive pricing for dental malpractice insurance. Coverage can include, but is not limited to;

• Defendant expense benefit

• Disciplinary defense

• Employment practices liability

• ERISA fiduciary liability

• Vicarious liability

Medical Malpractice Insurance for Group Practices

The close working relationship with the physician practices and staffing companies that are sister companies to PGI provide a unique insight into the challenges and opportunities of group practices. We provide broad, flexible medical malpractice insurance solutions for a wide range of practices ranging from two to 250 physicians and their facilities.

High-Risk Insurance Solutions

Never make a decision on an alternative financial vehicle without expert consultation. Medical malpractice insurance risks that don’t fit the traditional market due to unique specialty or risk, claims history, license issues or other issues can be covered in the surplus lines insurance market. Premium Group has the ability to shop and evaluate numerous highly-rated carriers for competitive quotes.

Allied Healthcare Facilities

Healthcare providers need a strategic partner that has an in-depth understanding of their industry. PGI is dedicated to delivering superior and competitive insurance services to hospitals, physicians and other

Pricing

Do I have to complete multiple applications to receive quotes from multiple companies?

No, we offer a streamlined process in which you complete and sign one form enabling us to obtain competitive quotes from multiple companies. When it comes time for renewal through PGI, our clients typically only need to fill out an updated form and/or a short renewal application from their current carrier.

How is premium calculated for ancillary employees (RN, LPN, PA, and NP)?

RNs, LPNs, and other ancillary providers are typically covered under the liability policy of the practice. PAs, NPs, CNMs, and CRNAs frequently need to obtain a separate limit of coverage, although there are select companies that will include them under the main policy. The cost to insure a higher level ancillary is generally less than a physician but can vary depending on the risk profile.

Is there a discount for part-time?

Yes, part-time is frequently discounted, but rates vary depending on specialty and carrier.

How do I qualify for a free retirement tail?

Many companies will provide a free retirement tail if a physician has been insured with them for 5 years and is completely retiring from the practice of medicine and in some instances is at least 55 years of age. Certain carriers may offer a free trial after only one year; refer to your specific policy, or ask us for specific details.

Coverage

Do I need separate coverage for allied medical professionals?

Generally, employed ancillary providers can be covered under your policy to share in your limits at no additional premium. All higher-level ancillaries (ie CRNA’s) can be added to the policy with a shared or separate limit but must be endorsed with additional premium.

Does my policy cover me if I start working at an additional location, or add procedures to my practice?

This depends on your coverage. It is important to notify your insurance company of any changes or additions to your practice profile. Depending on your individual policy, the company may or may not be able to cover you for your change. It is important to consult with your PGI agent for guidance, BEFORE making any changes.

When do I need to purchase a tail?

Typically a physician only need to purchase a tail when leaving a practice that requires it by contract, or when changing to a different policy form. Call us for details.

What is the difference between Claims-Made and Occurrence Policies?

Claims-Made policies cover claims that are made during the policy year. The claim must be related to a medical incident which took place subsequent to the retroactive date.

The retroactive date determines the span of time before the inception of the policy that physicians are covered for negligent acts, errors, or omissions that are reported during the coverage period of the policy. A retroactive date can match the policy’s inception date so that no prior acts are covered. Most medical liability companies will offer a free tail at retirement, subject to certain conditions.

When transferring coverage from one insurance company to another on a claims-made policy, it is important to have the new company “pick up” the retroactive date on the previous policy, so there is no protection gap.

If this is not possible, we recommend that our clients consider purchasing a “tail” to protect themselves from future claims arising from the time the policy was active.

Occurrence policies provide coverage that responds to incidents/claims arising during the coverage period, regardless of when those claims are reported.

Physicians need not worry about canceling an Occurrence policy and moving to a different insurer; coverage remains locked in for incidents occurring while the policy was in force, so long as the insurer is in business

Carriers

Do I need separate coverage for allied medical professionals?

Generally, employed ancillary providers can be covered under your policy to share in your limits at no additional premium. All higher-level ancillaries (ie CRNA’s) can be added to the policy with a shared or separate limit but must be endorsed with additional premium.

Does my policy cover me if I start working at an additional location, or add procedures to my practice?

This depends on your coverage. It is important to notify your insurance company of any changes or additions to your practice profile. Depending on your individual policy, the company may or may not be able to cover you for your change. It is important to consult with your PGI agent for guidance, BEFORE making any changes.

When do I need to purchase a tail?

Typically a physician only need to purchase a tail when leaving a practice that requires it by contract, or when changing to a different policy form. Call us for details.

What is the difference between Claims-Made and Occurrence Policies?

Claims-Made policies cover claims that are made during the policy year. The claim must be related to a medical incident which took place subsequent to the retroactive date.

The retroactive date determines the span of time before the inception of the policy that physicians are covered for negligent acts, errors, or omissions that are reported during the coverage period of the policy. A retroactive date can match the policy’s inception date so that no prior acts are covered. Most medical liability companies will offer a free tail at retirement, subject to certain conditions.

When transferring coverage from one insurance company to another on a claims-made policy, it is important to have the new company “pick up” the retroactive date on the previous policy, so there is no protection gap.

If this is not possible, we recommend that our clients consider purchasing a “tail” to protect themselves from future claims arising from the time the policy was active.

Occurrence policies provide coverage that responds to incidents/claims arising during the coverage period, regardless of when those claims are reported.

Physicians need not worry about canceling an Occurrence policy and moving to a different insurer; coverage remains locked in for incidents occurring while the policy was in force, so long as the insurer is in business