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Miscellaneous Professional Liability

» Miscellaneous Professional Liability Insurance APPLICATION

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» Independent medical examiners – IME

errors & omissions

Independent medical examiners – IME

Independent medical examiners – IME application

An independent medical examination (IME) is an evaluation performed by a doctor who is not involved in the patient’s care for the purpose of establishing medical and job-related issues.

The worker’s compensation insurance carrier or self-insured employer has a legal right to request an independent medical examination . Should an IME determine that the patient’s medical condition is not work-related, the insurer can deny the claim and refuse payment. But the insurer must have a physician’s medical opinion prior to denying a claim.

IMEs are often conducted for injured workers to determine the cause, extent and medical treatment of an injury. Most requests for IMEs are for discovering whether a worker has reached maximum benefit from treatment or whether any permanent impairment remains from the injury. While an independent medical examination involves a physician and a patient, an independent medical examination does not constitute the normal physician-patient treating relationship

Because of the lack of the normal physician/patient relationship, procuring liability insurance for independent medical examiners is often times frustrating and time consuming.

Liability insurance for independent medical examiners (IME) is also referred to Professional Indemnity for independent medical examiners IME, Errors and Omissions Insurance for independent medical examiners IME and professional liability insurance for independent medical examiners IME’s. We use these terms interchangeable throughout this section.

Liability insurance for independent medical examiners is sometimes elusive as medical malpractice carriers will not typically endorse their policies to pick up the liability insurance needs of IME’s. Professional liability for independent medical examiners is often required by state workers compensation boards who engage IME’s to examine insured workers in their particular state. Insurance for independent medical examiners is also required by many private insurers who also order exams for workers compensation claims.

There may be examiners who are not required to carry professional liability for their IME work however we would highly recommend against not carrying liability insurance for independent medical examiner work due to the liability exposures present in our litigious society as well as their litigious profession. Liability insurance for IME’s is recommended to protect the IME from both frivolous and non-frivolous law suits for negligence which can bankrupt the IME’s business. Many times we see businesses in all areas who ignore the protection available to protect their business, which they have built over the years and which they planned to rely on for retirement or pass along to their children, lost in a frivolous liability claim.

With respect to liability insurance for independent medical examiners, please ask your agent or broker to obtain an errors and omissions policy for independent medical examiners which provides for contingent bodily injury coverage. Contingent bodily injury coverage is usually provided for by a carve out to the bodily injury and property (BI/PD) damage exclusion in the liability policy for independent medical examiners. The BI/PD is a common exclusion for an errors and omissions policy as the intent is not to cover bodily injury or property damage under a professional liability policy. That said, there are some professions which this “carve back” makes sense and for which professional liability insurers are willing to accept the exposure. Liability insurance for independent medical examinations is one such profession.

Independent medical examiners should not have significant exposure relating to bodily injury due to the fact they are not diagnosing or offering patient care however there have been documented law suits against independent medical examiners for injury sustained during an actual exam. As an example, a range of motion test, if taken too far, can result in an injury to the individual undergoing the examination. This is the type of bodily injury claim that can be made against an independent medical examiner. Other bodily injury claims can include allegations that an independent medical examiner should have notified the person being examined if the examiner discovered an injury non-related to the injury for which the exam was engaged. Liability and coverage for this type of allegation is unclear.

Other important insurance for independent medical examiners would include coverage for Network Security Wrongful Acts which would address the independent medical examiners exposure to misappropriation or disclosure of Personally Identifiable Information including health information as defined by HIPPA, that is in the IME’s care, custody or control.

Another relevant coverage relating to liability insurance for independent medical examiners is a $5,000 supplemental payment for disciplinary proceedings, an independent contractor extension and a duty to defend policy form. The duty to defend policy forms commits the insurer to defending the IME if any part of a claim could find coverage under the liability policy for independent medical examiners.

It can be frustrating procuring Insurance for IME’s if you are looking for the medical malpractice carriers to pick up this exposure as many med mal carriers do not want to bother with the issues relating to insuring independent medical examiners. Stateside is dedicated to ending those frustration with placing liability insurance for IME’s and the first step is to complete the attached application for errors and omissions insurance for Independent medical examiners.

Our minimum premiums for IME’s start at around $1,200.

Please also note that Stateside can also assist with liability insurance for medical management consultants, liability insurance for medical case managers, liability insurance for medical file reviewers, liability insurance for expert medical witness (excluding medical examinations), liability insurance for medical case manager, liability insurance for medical records administrator, and liability insurance for practice management.

In summary:

Errors and omissions for Expert Medical Witness (Excluding Medical Examinations)
Errors and omissions for Medical Management Consultant
Errors and omissions for Medical Case Manager
Errors and omissions for Medical Records Administrator
Errors and omissions for Practice Management
Errors and omissions for independent medical examiners

 


CLAIM DETERMINATION...Any claim is subject to the actual policy wording/endorsements and the coverage for a claim shall be determined using the policy wording.

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