Full Transcript Medical director liability warning 0:00 Be 0:01 very cautious with this. Your medical 0:03 license is your own and do not allow 0:06 other nefarious people to [music] use 0:08 it. Had an important thing happen 0:11 over the last two weeks with a client 0:13 that it was a medical director of a 0:15 facility. 0:16 Now, this particular doctor have had 0:19 licenses in various states and basically 0:21 what what has happened is is that nurse 0:23 practitioner he was overseeing 0:26 in regards to the GLP-1s trying to get 0:28 their patients covered for the GLP-1s 0:31 underneath their health insurance plans 0:33 had written in their charts that every 0:35 one of them was a diabetic. What 0:37 subsequently happened is that state 0:39 board [music] came in, did an 0:40 investigation after complaints from the 0:43 health insurance companies in regards to 0:44 this 0:45 and also from Medicare. And guess what 0:49 happened? Nurse lost her license and the 0:51 process this particular guy who is a 0:54 medical director of this practice is now 0:56 losing [music] his license in 17 states 0:58 out of 40. 1:03 So, 1:04 what does our policy cover? Traditional 1:06 professional liability insurance policy 1:08 just with the advantage that the 1:11 non-FDA approved approved procedures
Professional liability policy coverage 1:13 that a lot of you guys are doing in your 1:14 practice are covered underneath that. We 1:17 don't have a whole lot of limitations on 1:19 our policy. 1:21 More often than not, it's kind of funny 1:22 when you come up, you know, when talk to 1:24 a few of you earlier, the 1:26 you know, it's better for you guys just 1:28 to ask what would you like to do and I 1:31 can tell you point blank if it's covered 1:32 or not. 1:34 And if there's something that I've not 1:35 heard of, just put it in writing to me 1:37 and we can always send it to the 1:37 underwriter and get it approved. That's 1:39 not a big deal whatsoever. Very rarely 1:41 do we say no. 1:42 If you are a owner of a practice and you 1:45 intend on running your practice for more 1:47 than 5 years, 1:49 a claims-made policy is the way to go. 1:52 An occurrence policy is fantastic for 1:54 individual a year-by-year contract work. 1:57 Uh so, if you're just a contract player 1:59 and you're bouncing from one job to the 2:01 next, and they require you to buy tail 2:03 coverage when you leave, an occurrence 2:04 policy is perfect because that cover 2:06 that 12-month time period on that policy 2:07 is covered indefinitely. 2:09 Um 2:10 the difference between a price 2:11 difference between an occurrence and a 2:12 claims-made policy is usually two times. 2:15 So, you know, you can cut your cost by 2:17 50% if you just go to a claims-made 2:19 policy. Cyber liability coverage, you 2:22 know, it's funny. Um 2:25 we don't see it a whole lot as far as a 2:27 need on individual offices. However, 2:29 I've had a few time times that it has. 2:32 Um but, it's it's really 2:35 come to focus for me actually. 2:37 A good buddy of mine just had this 2:39 happen to him. His business as far as 2:42 revenue-wise, they do about 2:45 I'd say about 25 million a year in rev. 2:48 And um so, you know, fairly they've got 2:50 about 35 employees. 2:53 One of the employees actually um 2:56 opened up a phishing email, 2:58 and a hacker group out of uh Ukraine
Cyber liability and ransomware response 3:03 uh took over their system. 3:05 This happened in 3:08 it started in 3:11 No, the first Yeah, it was the first 3:13 week in November of last year, and um 3:17 my buddy was just adamant. He goes, "I'm 3:19 not paying those bastards. I'm not doing 3:21 it." They wanted uh a ton of money. They 3:23 I think it was a quarter million they 3:24 wanted in Bitcoin. And he's like, "I'm 3:26 not doing it." So, 3:28 he's trying like all get out to rebuild 3:31 his systems and gather information from 3:33 every place that he could to do it. 3:36 Ultimately, after 6 weeks, 3:39 um he had to pay the ransom to to get 3:41 back into his system. When he did, all 3:45 of his financials were gone. 3:47 I mean, everything that he had in there 3:49 completely gone. He had to rebuild all 3:51 of it. And he's he's currently still in 3:53 the process of doing so. So, the reason 3:56 why I say that is he did have a cyber 3:58 liability policy. Even though he's being 4:00 obstinate, I don't understand why 4:01 because they would have paid that 4:02 ransom. And they did ultimately pay that 4:04 ransom. I mean, he paid it himself, but 4:07 sent the bill to the insurance company 4:08 and they actually reimbursed him for 4:10 that. They will also pay for underneath 4:12 the cyber liability covers to rebuild 4:14 your records as well. The next coverage 4:16 I would recommend for your practices um 4:18 employment practices liability coverage. 4:20 Why is this important? Well, 4:23 I mean, that's just one dumb thing. I 4:25 mean, I've seen a bazillion dumb things 4:28 that have happened because why? People 4:30 are people. 4:31 And an employment practices liability 4:33 insurance policy for your practice, if 4:35 you have, you know, any more than a 4:37 couple of employees is absolutely 4:38 important. Um it's not going to cost 4:40 that much money. Typically, you know, if 4:43 you're a practice, say, turning over 2 4:45 and 1/2 million a year, let's say you 4:46 got five five to seven people, you might 4:48 be paying 2,500 a year for that. That is 4:51 well worth laying off the risk on 4:53 somebody else. Um I mean, these things
Employment practices and telehealth coverage 4:55 happen on a regular basis and it's 4:57 something to be aware of um you know, 5:01 because people do dumb things, 5:02 unfortunately. And now, there have been 5:04 things instances that I have, you know, 5:06 that have been covered under our EPI 5:07 policies that were intentional acts as 5:09 well. And also, too, it does cover for 5:11 wrongful termination suits. So, if you 5:12 fire somebody and you're worried about 5:13 them suing them, this is the policy to 5:15 cover for that as well. 5:18 Um telehealth coverage underneath their 5:20 main professional liability policy, not 5:21 a problem as far as doing so. It's just 5:23 there's multiple states that um you 5:25 know, um 5:26 >> [snorts] 5:26 >> we operate in. So, that's not an issue 5:28 as far as covering across state lines. 5:31 I want to also point out to that our 5:33 policy, if you wanted to, say, go and do 5:35 some work in Dubai or you wanted to do 5:37 some work in the South of France or 5:39 whatever, we've we've been asked this 5:41 multiple times. The coverage is uh would 5:43 extend to that work that you're doing 5:45 outside the United States as well. Uh 5:47 just as long as the claim is filed in 5:49 the territorial United States. 5:51 GLP-1s, uh, getting back to this, we do 5:54 cover them underneath our policy. That's 5:56 not an issue as far as you prescribing 5:58 them. Um, again, 6:01 um, I would highly suggest that as far 6:03 as the, you know, if you're trying to 6:05 get the patients covered under the 6:06 health insurance, watch out. Um, make 6:09 they are looking at this stuff, both CMS 6:11 and the health insurance companies as 6:13 far as claiming people that have 6:14 diabetes 6:15 >> that do not. 6:16 >> Again, we cover everything under our 6:19 policy. There's not much that we don't. 6:21 Um, hormone therapy, ozone, hyperbaric, 6:24 any kind of human tissue products, 351, 6:25 361 products. 6:27 Um, 6:29 uh, you know, we cover the weird stuff
GLP-1s and out-of-state coverage 6:30 is what we say. Um, again, anything 6:32 that's avant-garde, we like it. Um, the 6:35 claims activity is low. I mean, case in 6:37 point, underneath our program, if we 6:40 were running it specifically for family 6:42 and general practitioners, um, or say 6:44 internal medicine physicians doing 6:45 traditional medicine here in the United 6:47 States, I would expect to lose 90 cents 6:49 for every dollar we took in. 6:51 In regards to our program, our loss 6:53 ratio typically hovers between 37% and 6:55 41%. It just varies from year to year. 6:58 Um, the reason why the lawsuit activity 7:01 is so low with the, uh, that I feel with 7:03 the integrated and wellness practices 7:05 and the safety of them is because 7:08 there's a much more positive outcome for 7:10 the patient on a regular basis because, 7:13 hey, guess what? What you actually do 7:15 works. 7:16 And that's the thing is like, I'm a 7:18 statistics wonk. I'm a numbers guy. And 7:22 quite honestly, the numbers just spell 7:24 it out, period, that statistically 7:27 speaking, this is one of the safest 7:28 areas of medicine in the United States. 7:31 And again, too, for us, we've been able 7:33 to keep our rates pretty low with our 7:35 program when a lot of other companies 7:37 have had to raise rates and all kind of 7:38 good stuff like that, it's because this 7:40 area of medicine does not generate
Avant-garde treatments and claims trends 7:42 claims activity. 7:44 I mean, yes, we've had a couple of 7:45 claims infections at injection sites, 7:47 which is, you know, standard when you're 7:49 doing any kind of trigger point 7:50 injection. Um and that can happen. 7:53 That's a known complication. 7:54 Um you know, again, we've had a few 7:57 cases. We What we see more often than 7:59 not is actually refund cases. Where it 8:02 didn't work for a patient, say they 8:03 signed up and did say a a $20,000 8:07 program or 20 or $40,000 program, 8:09 depending on whatever you guys sold it 8:11 for. And you know, much like a plastic 8:13 surgeon, there's buyer remorse, right? 8:15 Somebody had a facelift and they look in 8:16 the mirror like, well, I I don't look 8:18 the way I should, right? Maybe the stem, 8:20 you know, stem cell treatment didn't 8:21 exactly go exactly what they thought it 8:24 was going to be. So, they're demanding a 8:26 refund. And more often than not, it's 8:27 kind of funny, it always comes from the 8:28 family of the patients, not from the 8:30 patient themselves. 8:32 Um but um those That's the kind of stuff 8:34 we see. 8:36 The one The one big thing is is the the 8:39 license defense. The Board of Medicine 8:42 A lot of the different state Board of 8:43 Medicine has uh been very active as far 8:46 as going after clinics, especially 8:48 chiropractor mixed practices. We see 8:50 that more often than not, unfortunately. 8:52 Um so, that's where the primarily as far 8:55 as the the claims activity that we see 8:59 um out of the program is not a 9:01 professional like a an actual patient 9:03 treatment driven thing. It's more of a a 9:05 complaint. So, 9:07 that's a cautionary tale. Again, I I'm 9:10 I'm I know I give old school safety 9:11 [music] briefings, but to be perfectly 9:13 honest with you, that's something just 9:14 to be aware of if you are a medical 9:16 director. 9:17 Um remember, you are the captain of the 9:18 ship and you are ultimately responsible. 9:20 You're Just be aware on that.
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