New Med-Mal Provider Applies in Fla.

Florida Healthcare Providers Insurance Exchange, (The Exchange) announced it filed an application with the state to offer medical malpractice insurance to physicians in Florida. The Exchange expects to begin issuing policies that would take effect as of Jan. 1, 2004.

The Exchange is managed by an affiliate of Duane Morris LLP (www.duanemorris.com). Duane Morris is among the hundred largest law firms in the nation with offices in 21 cities including Miami and Palm Beach.

Known technically as a reciprocal insurance exchange, The Exchange is a program in which participants in the plan share insurance risk. Essentially, each participant is also an owner who contributes capital in addition to paying premiums. The program is designed to attract physicians who have a strong record of sound clinical practice and are willing to assume some risk as well as a certain amount of practice oversight. The program’s objective is to assure that Florida’s physicians and hospitals have adequate access to medical malpractice insurance over the long term.

“Recognizing a market need for medical malpractice insurance coverage in Florida, we are utilizing the successful experience of our Pennsylvania Exchange which provides medical malpractice insurance to physicians in Pennsylvania,” said Charles C. Pappy III, partner in charge of Duane Morris’ Miami office. “There is clearly a strong parallel between the Pennsylvania and Florida medical malpractice insurance situations. We will offer a viable alternative for medical malpractice insurance that will benefit the physicians, hospitals and people of Florida.”

The Exchange will be based in Miami. Thomas S. Gaudiosi, an insurance professional with extensive medical malpractice insurance experience, will serve as president and chief executive officer of The Exchange’s management company. In addition, there will be locally-based management, marketing and underwriting operations.

According to Gaudiosi, The Exchange will use the same tenets of operation that have proven their success in the Pennsylvania Exchange. This “behavioral modification” methodology includes an underwriting approach that incorporates both quantitative and qualitative elements encompassing not only the frequency of claims, but also the specific details of each case including the physician’s role; scope and type of treatment; the alleged injury or bad result; medical record documentation; the defensibility of the “medicine”; and changes in practice as prompted by specific incidents/claims.

The Exchange will also seek to partner with self-insured hospitals and health systems to work cooperatively on risk management and claims management efforts such as early intervention on adverse patient events as well as joint claims defense when feasible.

Prospective insured physicians will be required to agree to the Exchange’s Conditions of Membership as criteria for both initial underwriting as well continued insurability. These criteria include early reporting of adverse outcomes; coordination of legal defense; mandatory risk management education; and compliance with office practice audits.

Finally, prospective insureds will need to submit detailed claims/loss information with their applications. They must also commit to direct discussions with the Exchange’s staff to discuss underwriting, risk management or claims issues that are identified.