Supplemental Liability Insurance

[DrSambo]

Do any of you carry a personal malpractice policy to supplement your coverage under the Federal Tort Claims Act (FTCA)? If so, which company do you use? What type of policy is it (claims made, occurance, etc)? What is your premium?

When I previously worked in a Federally Qualified Community Health Center, we were covered under FTCA, but the clinic also provided us with a supplemental policy for any claims that fell outside of that coverage. I'm currently in the process of taking a job in a U.S. Army clinic overseas and looking to obtain a similar policy, but so far the quotes I've received have been sort of absurdly expensive.

If any of you carry a personal policy, I'd appreciate any advice on where to get a decent policy for a decent price.

Thanks in advance.

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[GreenHousePub]

I didn't, and I don't know anyone else who did. Sounds like an expensive waste of money.

 

[comp1]

What claims would fall outside of FTCA?

 

[DrSambo]

What claims would fall outside of FTCA?

I'm totally not a lawyer, but my attorney has advised me that there are plaintiff's firms that specifically focus on going after government physicians by trying to get the alleged tortuous action ruled as having occurred outside the scope of the physician's employment. Again, IANAL, so am somewhat hesitant to try to come up with a specific example where something like this might succeed, but even if it didn't succeed, I could foresee potential legal expenses one might incur in fighting against such a ruling being made. Alternatively, even without a plaintiff engaging one of these plaintiff's firms, there could be the potential that the government itself (in the form of an Attorney General lawyer, etc.) might pre-emptively determine (rightly or wrongly) that the alleged tortuous action occurred outside the scope of the physician's employment, thus enabling the plaintiff to go after the individual physician. Again, one could incur significant legal expenses fighting this non-scope-of-employment determination and/or defending oneself in court (assuming one is unsuccessful in fighting the government's determination) as well as possibly facing monetary judgements should such as case against the individual proceed.

The other hiccup here that I could potentially see has to do with jurisdiction. If I'm practicing in an overseas MTF, I could imagine the possibility of some creative attorney seeking damages in a non-U.S. court in order to try to get around the FTCA. (when I spoke with my insurance broker, he told me that the overseas aspect of the job, particularly with regards to me potential treating military dependents who hold non-U.S. citizenship, was the reason the premium quotes he was receiving were so high. They have thus far been about triple what I currently pay for my personal Occurrence-Based Liability policy as a self employed civilian physician in the U.S. )

Given the premium quotes I've received so far, my inclination is to just skip the supplemental insurance and take my chances with FTCA alone, but if I could find something more reasonably priced, I'd be willing to pay for the added protection and peace of mind.

 

[pgg]

This is bizarre. I would never have considered buying supplemental liability insurance while on active duty, to cover my work at a MTF. It strikes me as crazy ridiculous.

Curious - who is this attorney who's advising you? Why have you retained his services in the first place? Can they point to any actual cases of physicians being found liable outside of FTCA coverage? Or even of a case where a physician was sued for something they did working for the government, but the government declined to defend them? I mean, sure, anyone can sue anybody for anything ... so the risk isn't zero ...

Last, it seems absolutely preposterous on the face of it that there are firms who'd sue military physicians and NOT go after the deep pockets of the government. The average military physician is young, and since he's recently completed training and is earning a not-fat government wage, has minimal assets to go after. Lawyers, even scuzzy ambulance chasing lawyers, don't tend to zero in on targets who don't have any assets.

I'm a pro-insurance kind of guy. I've paid for an individual own-occ disability policy for many years while on active duty, which is something that almost nobody does. But my gut reaction is to not merely decline this kind of coverage, but to give a snarling F YOU to the greasy agent trying to scam me into buying it.

 

[DrSambo]

She (the attorney) is my personal attorney and has been for years. I don't know if she can point to any actual cases and I'm not inclined to waster her time (or my money) demanding a memo to that effect. She's simply mentioned to me that the FTCA is not necessarily an ironclad protection as is commonly believed and that I should look into a supplemental policy. The fact that a former FTCA-covered employer carried a supplemental policy when I worked there suggests that their attorney offered similar advice to them.

Regarding the deep pockets thing, I agree with you and there is the argument to be made that having a supplemental policy (or general malpractice policy in the civilian world for that matter) perhaps effectively deepens the physician's pockets somewhat and makes them a more attractive target. In any case, I'm by no means super rich or even wealthy, but I'm also not fresh out of school. Been doing the doctor thing for more than a few years at this point, and do have some meager assets that I'd like to protect.

Regarding the greasy agent trying to scam me, there isn't one. My insurance broker is the guy who has brokered my personal business and liability insurance in my private medical practice. He's always been on the level and it was I who reached out to him to inquire about a supplemental policy. He then simply requested quotes from various insurance companies, all of which so far have provided rather high quotes citing their concerns around the idea that I would be practicing in a foreign country and potentially seeing/treating patients who are non-US citizens (such as a foreign national married to a soldier for instance).

Perhaps just a weird coincidence, but last night, just a day or so after starting this thread an advertisement popped up in Duolingo on my smartphone for a company that provides personal liability policies for federal employees. While their products are not specifically medical malpractice policies, they claim to provide coverage for stuff that falls outside of FTCA, and the premiums mentioned in the advertisement are quite low. As mentioned above, I'm inclined to NOT purchase one of the policies quoted to me by my broker as the premiums are high enough to justify just "self-insuring", but the policies mentioned in the advertisement I received might be worth looking into. I won't post a link to that company here publicly as I don't want to do free advertising for them. I'm not super active on SDN, so I'm not sure how to send a direct message (of if that's possible here), but happy to share a link that way if desired/possible.

 

[HighPriest]

It seems like overkill. I always had insurance any time I worked off post for moonlighting or call coverage, but never additional coverage while performing my duties as a physician for the military. Never heard of a situation where that would have been warranted, but I don’t k ow of everything situation.

That being said, keep in mind that they’ll sell you insurance against alien attack if you ask for it.

 

[DrSambo]

they’ll sell you insurance against alien attack if you ask for it.

What's the typical premium for that sort of insurance?

 

[HighPriest]

What's the typical premium for that sort of insurance?

Depends. If you live in the South it’s higher due to the increased incidence of anal probing.