Tail vs Incurred But Not Reported for Locum Tenens???

[DrCabral3074]

I was looking to do some locums work as an anesthesiologist for Xenon Health. Normally I request tail coverage so that I won't be stuck with $15-20k for coverage as a prerequisite for other health insurance or jobs in the future. Their insurance policy doesn't provide tail but provide Incurred But Not Reported (IBNR) coverage. As I understand it, insurance is covered as long as Xenon has an active policy even after a provider ends their contract with Xenon. Then if Xenon decides to terminate the policy they will have the option to purchase tail coverage for all providers and the company. I was concerned that this would put me at risk for lack of coverage if they don't maintain an active policy or elect not to purchase tail after I terminate my contract. What are your thoughts?

"Coverage is provided on a continuous basis for any acts or omissions even if an individual physician/professional leaves or terminates his/her employment or contract with Xenon Health, LLC as long as the policy is renewed on an annual basis. In the event of the cancellation or non-renewal of the policy, Xenon Health LLC will have the option to purchase an Extended Reporting Period (tail) endorsement which will include tail coverage for all terminated physicians/professionals under the policy. The need for such tail coverage only applies in the event of cancellation or non-renewal of the policy itself. In the event that a physician or other insured person terminates his or her relationship with Xenon Health LLC, Landmark American Insurance Company will continue to respond to claims made against the insured, subject to applicable policy terms, conditions and exclusions, as long as the policy remains in force. As such, individual “tail” policies/endorsements are not required for departed physicians."

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[abolt18]

Barely related, but somehow xenon health texted my wife trying to advertise locums positions to me. How on earth do these tools get my wife's phone number? (This is the first time any recruiter has reached out to me, and it was not welcomed or invited)

 

[IMGASMD]

Barely related, but somehow xenon health texted my wife trying to advertise locums positions to me. How on earth do these tools get my wife's phone number? (This is the first time any recruiter has reached out to me, and it was not welcomed or invited)

That just sounds very very shady..... is your wife in health care field? Even if she is, how do they know you are related?!

 

[abolt18]

That just sounds very very shady..... is your wife in health care field? Even if she is, how do they know you are related?!

She is not. She is a stay at home mom and homemaker. Super sketchy. Makes me mad. (Just happened yesterday)

 

[IMGASMD]

She is not. She is a stay at home mom and homemaker. Super sketchy. Makes me mad. (Just happened yesterday)

S H A D Y

You should play along and find out how the faak they got her number. Tell them to lose that number and vow to never work for them.

 

[chocomorsel]

I was looking to do some locums work as an anesthesiologist for Xenon Health. Normally I request tail coverage so that I won't be stuck with $15-20k for coverage as a prerequisite for other health insurance or jobs in the future. Their insurance policy doesn't provide tail but provide Incurred But Not Reported (IBNR) coverage. As I understand it, insurance is covered as long as Xenon has an active policy even after a provider ends their contract with Xenon. Then if Xenon decides to terminate the policy they will have the option to purchase tail coverage for all providers and the company. I was concerned that this would put me at risk for lack of coverage if they don't maintain an active policy or elect not to purchase tail after I terminate my contract. What are your thoughts?

"Coverage is provided on a continuous basis for any acts or omissions even if an individual physician/professional leaves or terminates his/her employment or contract with Xenon Health, LLC as long as the policy is renewed on an annual basis. In the event of the cancellation or non-renewal of the policy, Xenon Health LLC will have the option to purchase an Extended Reporting Period (tail) endorsement which will include tail coverage for all terminated physicians/professionals under the policy. The need for such tail coverage only applies in the event of cancellation or non-renewal of the policy itself. In the event that a physician or other insured person terminates his or her relationship with Xenon Health LLC, Landmark American Insurance Company will continue to respond to claims made against the insured, subject to applicable policy terms, conditions and exclusions, as long as the policy remains in force. As such, individual “tail” policies/endorsements are not required for departed physicians."

This has been discussed before. This is how locums companies work. You aren’t going to make them change it. They take care of thousands of docs this same exact way. Malpractice is covered by then. They pay for tail if they ever need it.
What you are reading in the contract makes perfect sense. What you are asking makes not too much sense. What is “incurred but not reported” coverage?

 

[deleted126335]

This has been discussed before. This is how locums companies work. You aren’t going to make them change it. They take care of thousands of docs this same exact way. Malpractice is covered by then. They pay for tail if they ever need it.
What you are reading in the contract makes perfect sense. What you are asking makes not too much sense. What is “incurred but not reported” coverage?

Suppose they go bankrupt?

 

[IMGASMD]

Suppose they go bankrupt?

Never thought about that. Or what happens if they were bought or sold? Do they maintain the insurance? Do they (locum or insurance company) give you an option of securing a tail?

 

[chocomorsel]

Suppose they go bankrupt?

Well if they do, you pray you don’t get sued. You can otherwise try to get them to let you pay for your own malpractice in exchange if a higher rate. It’s difficult to do but I bet not impossible. They don’t like to do that.

Or leave the country. That’s my plan.

 

[chocomorsel]

Never thought about that. Or what happens if they were bought or sold? Do they maintain the insurance? Do they (locum or insurance company) give you an option of securing a tail?

If they are bought and sold then my understanding is they have to buy tail.

 

[IMGASMD]

If they are bought and sold then my understanding is they have to buy tail.

Thanks.
Recently applying for a new medical license, the board asked to list all the malpractice carrier since I’ve had a full medical license. That was a nightmare, and I didn’t even work that many locum jobs! One of the company was acquired by a bigger agency, that was not fun. Just even trying to find out who actually have access to my old file was pretty difficult.

That’s not just true of locum agencies. Had a job that was directly through the hospital.... some of these hospital/health systems are shady as hell too. The malpractice carrier is offshore, and funded partial by the hospital system. No wonder some of my old attendings warned about hospital employed model.

 

[chocomorsel]

Thanks.
Recently applying for a new medical license, the board asked to list all the malpractice carrier since I’ve had a full medical license. That was a nightmare, and I didn’t even work that many locum jobs! One of the company was acquired by a bigger agency, that was not fun. Just even trying to find out who actually have access to my old file was pretty difficult.

That’s not just true of locum agencies. Had a job that was directly through the hospital.... some of these hospital/health systems are shady as hell too. The malpractice carrier is offshore, and funded partial by the hospital system. No wonder some of my old attendings warned about hospital employed model.

Only ever listed the Malpractice companies that I have been directly involved with. Not the ones through agencies.
And it’s never been an issue. And I have some locums for at least two years with at least three companies.

 

[narcotics999]

Only ever listed the Malpractice companies that I have been directly involved with. Not the ones through agencies.
And it’s never been an issue. And I have some locums for at least two years with at least three companies.

If I have my own malpractice insurance, can I use it for locums and request some extra compensation?

 

[chocomorsel]

If I have my own malpractice insurance, can I use it for locums and request some extra compensation?

Like I said. You can try. But the one time I did try they told me that they don’t allow it. Because technically it can lead to a conflict of interest if there was a lawsuit. Your lawyers and their lawyers may not be in agreement.
But you can always try.

 

[DrCabral3074]

This has been discussed before. This is how locums companies work. You aren’t going to make them change it. They take care of thousands of docs this same exact way. Malpractice is covered by then. They pay for tail if they ever need it.
What you are reading in the contract makes perfect sense. What you are asking makes not too much sense. What is “incurred but not reported” coverage?

The locums companies I used in the past had tail coverage. The question was also posted on FB Physician Side Gigs and the general consensus was that physicians open themselves up to a gap in coverage. Thus, there is a risk that future malpractice insurance companies won't cover you unless you pay the tail (15-20k) to cover the gap. I don't know if IBNR is the locum standard for anesthesia or if it simply provided by smaller companies. Certainly, some companies offer claims based, occurrence-based or tail coverage. I suspect larger companies with strong reputations will offer tail. Locums companies are taking a hit along with everyone else and there is a high probability that some will go bankrupt or be sold thus opening physicians up for risk. So I guess it's the old buyer beware.

 

[deleted126335]

Like I said. You can try. But the one time I did try they told me that they don’t allow it. Because technically it can lead to a conflict of interest if there was a lawsuit. Your lawyers and their lawyers may not be in agreement.
But you can always try.

If possible, I want my lawyer representing ME only. I want the ability to have my lawyer separate themselves from the defense of the locums company, possibly the CRNA and the surgeon as well.

 

[chocomorsel]

If possible, I want my lawyer representing ME only. I want the ability to have my lawyer separate themselves from the defense of the locums company, possibly the CRNA and the surgeon as well.

That’s in the ideal world. You can certainly try and make that happen.

 

[narcotics999]

Like I said. You can try. But the one time I did try they told me that they don’t allow it. Because technically it can lead to a conflict of interest if there was a lawsuit. Your lawyers and their lawyers may not be in agreement.
But you can always try.

If their lawyers represent both the company and me, most likely I will be the one thrown under the bus.

 

[chocomorsel]

If their lawyers represent both the company and me, most likely I will be the one thrown under the bus.

You can always try and bring your lawyer in.
Hows this any different than any employed position though?
Even in PP, you are in a group and do you all have individual plans from different companies? Or do y’all use the same company?