Guide Services - TMLT

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Guide Services - TMLT

GuideToServicesTEXAS MEDICAL LIABILITY TRUSTP.O. Box 160140Austin, TX 78716-0140800-580-8658512-425-5800fax 512-328-5637www.tmlt.orgRated A (Excellent) by A.M. Best CompaniesTMLT is the only health care liability claim trust created andendorsed by Texas Medical Association.Endorsed by:TMLT is a Gold Corporate Affiliate of the Texas Medical GroupManagement AssociationBexar County Medical SocietyCollin-Fannin County Medical SocietyDallas County Medical SocietyHarris County Medical SocietyLubbock-Crosby-Garza County Medical SocietyTarrant County Medical SocietyTexas Academy of Family PhysiciansTexas Medical AssociationTexas Orthopaedic AssociationTravis County Medical Society2


Guideheart To ofServices TMLTPhysicians are theOur physician policyholders are the lifeblood of TMLT. Their loyalty madeus the premier medical liability provider in Texas. In return, the Trustcontinues to provide superior coverage at responsible prices, backedby exceptional customer service, value-added benefits, and flexibility:Financial StabilityTMLT enjoys a strong financial position. Our excellent risk-adjusted capital position,favorable operating performance, experienced management team and leading marketposition in Texas has earned us an A.M. Best Company’s financial strength rating of A (Excellent).Our premium to surplus ratio and our operating expenses compare favorablywith other companies of our size. Financial strength and stability are important so that wecan keep our promises to protect you against claims and lawsuits in the future.Trust Rewards ProgramAs a physician-owned organization, we believe our benefits should be shared with ourpolicyholders. The TMLT Trust Rewards Program serves as a financial reward program forphysicians who have demonstrated a commitment to practicing quality medicine. Our goal isto provide an opportunity to enrolled physicians to accumulate funds, which will be distributedat the time of retirement or other qualifying events. For more information about the TrustRewards Program, visit www.tmlt.org/trustrewardsProducts and ServicesWe offer non-assessable claims-made and occurrence policies forindividuals, groups, and entities at a variety of limits; reimbursementor direct payment of legal expenses for disciplinary proceedingssuch as Texas Medical Board complaints, cyber liability protection;unbundled risk management and claims services; part-time coveragefor physicians practicing 30 hours a week or less (some restrictionsapply); locum tenens coverage for physicians providing care forpatients of TMLT policyholders; and prior acts and tail coverage.TMLT also has special programs in place for moonlighting physiciansand for physicians in their first and second years of practice.MedefenseRate ReductionsSince 2003, our policyholderssaw their rates drop.12% in 2004;5% in 2005 and 2006;7.5% in 2007;6.5% in 2008;4.7% (avg.) in 20091% in 2010,1% in 2011,6.9% (avg. ) in 2012.The cumulative savings for TMLTAll TMLT policies include Medefense, which pays for legal expensespolicyholders is $539.5 million.incurred from disciplinary proceedings. Policyholders are reimbursedfor up to $50,000 per incident and $100,000 per policy period (higherlimits are available) subject to a $1,000 deductible and 10% coinsurancepayment. If you use one of our approved lawyers, we will pay on your behalf and waivethe deductible and coinsurance payment. Covered disciplinary proceedings include:• actions by the Texas Medical Board alleging unprofessional conduct;• a professional review action regarding clinical privileges;3


• actions by the Texas Department of State Health Services or the U.S. Department of Health andHuman Services;• RAC Audit or other private contractor audit;• proceedings alleging fraud or non-compliance with Medicare or Medicaid regulations; and• IRS audits of an individual physician or, if applicable, an entity’s federal tax return.To learn more about Medefense, visit www.tmlt.org/services/insurance/medefense.htmlCyber LiabilityTMLT includes Cyber Liability coverage for data breaches and privacy liability actions. The policyprovides coverage for Network Security and Privacy, Patient Notification and Credit MonitoringCosts, Data Recovery Costs, and Regulatory Fines and Penalties. Policyholders are covered up to$50,000 per policy year. (Higher limits are available).Tail CoverageTMLT also offers free tail coverage to policyholders who meet the following requirements:• permanent retirement from medical practice;• TMLT policyholder for five consecutive years; and• age 50 or above.Locum TenensAll policyholders can request locum tenens coverage at no additional charge. Coverage for more than21 days is available for a fee.MoonlightingTMLT offers moonlighting coverage at a discounted premium for residents or fellows who practiceoutside of their training program. We will waive the tail cost if a moonlighting policy is converted to astandard individual policy upon completion of medical training.Premises LiabilityTMLT includes a limited Professional Premises Liability Coverage Endorsement on every policyat no additional cost. This endorsement provides premises liability coverage to a policyholder if apatient suffers a qualifying injury or damage while on premises you own or lease for your Texasmedical practice.The endorsement only applies to claims by patients, and it does not eliminate the need for ageneral liability policy. For complete details, please read the full Endorsement or talk with a TMLTunderwriter.Part-time DiscountsDiscounts up to 15% are now availablefor surgical specialties and discountsup to 25% are available for non-surgicalspecialties.Visit our discounts web site —www.tmlt.org/policyholder/discounts.htmlDIScountsAt TMLT, we recognize that physicians must make a strong commitment to patientsafety in order to spend valuable time participating in risk management activities.Because we believe risk management helps reduce the chances of a claim orlawsuit, we offer premium credits to our policyholders for their participation.Rising Star (new-to-practice) discountThe Rising Star discount is offered to physicians establishing their first practiceupon completion of residency. We offer a 40% discount off the first year premiumand a 20% discount off of the second year.4Part-time discountPhysicians who work less than 30 hours per week or 120 hours a month are eligible for part-timediscounts of up to 25% for non-surgical specialties and 15% for surgical specialties.


Risk Management DiscountsTMLT is committed to patient safety. Practice review and CME credits can now be applied retroactively ifthey are completed within the first 120 days of the policy’s effective date (groups only).CME DISCOUNTsTake a risk management 2.5 hr CME course and earn a 3% discount (up to $1,000 per course). Take up totwo 2.5 hr TMLT-approved courses per year and receive up to a 6% discount (up to $2,000 total).Contact the Risk Management Department to request a home-study course. Available courses include CaseClosed Volumes 1, 2, 3, 4, and the Reporter CME activities.You can also earn your risk management discount through TMLT’s online courses and CME videos.On-Site Risk Management Practice ReviewPhysicians who complete a practice review may be eligible for a 5% premium discount after review recommendationsare met. This discount continues through the expiration of the current policy plus an additionaltwo full policy periods.The practice review is designed to assist you in determining your risk exposures.A risk management professional visits your office to:• evaluate medical record documentation;• review practice policies and procedures;• tour the facility to evaluate patient safety processes; and• provide feedback with a confidential, written summary.Experience Discount ProgramWe offer automatic premium discounts to policyholders with favorable claim experience.The discounts range from 3% to 20%, based on the number of years the physician has been insuredwith TMLT. Each year at renewal, the discount is evaluated and credited to your renewal premium.RISK MANAGEMENTOnline CMEEarn CME when and where you need it with TMLT’s online risk management courses. These courses areavailable at www.tmlt.org/CME. Information about discounts are available at www.tmlt.org/policyholder/discounts.htmlVideo CMEWe offer the convenience of CME in the comfort of your office or home. Our CME includes the awardwinningvideos Successfully Navigating Your Deposition; CMS, MAC, RAC, and MIC: what do they meanto me? and You’re Not Alone! Managing Litigation Stress. Physicians who complete three CME videos canearn a discount – learn more at www.tmlt.org/policyholders/discounts.html. Read more about our CMEvideos — www.tmlt.org/services/video/Other Risk Management ActivitiesTMLT staff present risk management seminars and workshops throughout the year at different locations inTexas. Our popular publications, the Reporter and Case Closed provide valuable information on reducingrisk and are available free to policyholders. Available in four volumes, Case Closed offers physicians theopportunity to earn 4 hours of CME, including 1 ethics hour, by completing the CME activity in the booksor online.Members OnlymyTMLT is a secure section of ourweb site that allows you to:• download a proof of coverage;• check your claims history;• pay premiums with a credit card;and review the status of risk managementdiscounts and CME credits.For physicians with specific risk management questions, our staff is available to answer questionsduring business hours.5


Unbundled Risk Management servicesTMLT offers unbundled risk management services to individuals and groups. We can create customizedprograms to help you identify the risks in your practice setting, and create a plan to prevent ormitigate those risks.CLAIMSTMLT provides you with the best defense for your premium dollars. Since 1979, we have resolvedmore than 44,000 claims.Best DefenseSince 2005, TMLT has closed more than 86.65% of our claims with no indemnity payment. We alsohave an outstanding trial record since 1998, we have won more than 88% of our cases.Experienced claim staffOur claim staff specialize in medical liability claims in Texas. Our claims staff averages 27 years ofclaim experience and 16 years of service with TMLT. Our claim executive staff averages 33 years ofexperience. Because they attend policyholder trials, our claim supervisors have first-hand jury experiencein medical liability cases. After 32 years, we know the trial venues, claim trends, and nuances ofthe Texas legal system.Unbundled Claims ServicesIf you want the benefit of TMLT’s superior claims handling, our unbundled claims package may fityour needs. You will receive the same strong defense and the same superior claims management thatour TMLT policyholders receive.UNBUNDLED PROFESSIONAL SERVICESWe offer unbundled risk management services, claim management services, and other products that fityour needs.APPLICATION PROCEDURESRequest a QuoteCall 800-580-8658 to speak to one of our sales representatives or request a quote online atwww.tmlt.org/policyholder. TMLT’s sales staff can respond to your coverage questions and assistyou in completing your application.Apply for CoverageONLINEAs long as you have an email address you can apply for coverage at www.tmlt.org/policyholder.BY MAILOnce your application forms have been received, our Underwriting staff will review your applicationand contact you if additional information is needed.Need faster processing? Let us know: TMLT staff will make every effort to accommodate you.After all documents have been received and your application has been processed, you will receivewritten confirmation of your policy status. We underwrite all applications in house to provide the bestprotection for our policyholders.6Need protection for your professional medical staff? TMLT offers policyholders medical liabilitycoverage for ancillary staff through its wholly-owned subsidiary, Texas Medical Insurance Company(TMIC). Applications are available online at www.tmic.biz.


TMIC PROTECTION FOR YOUR Professional staffAs a TMLT policyholder, you know the value of having comprehensive medical liability protectionin the event of a claim or lawsuit. Doesn’t it make sense to provide your professional staff and yourorganization with the same kind of protection?Medical Liability Coverage for Professional StaffProtect your team of allied professionals with medical liability insurance from TMIC. This coveragecomplements TMLT’s medical liability coverage for physicians, and provides additional vicariousliability protection for your practice. Both claims-made and occurrence coverage are offered fornurses, nurse practitioners, technicians, and therapists. Claims-made coverage is available for nursemidwives, physician assistants, and CRNAs. Our quick application process and competitive ratesmake TMIC’s professional medical liability coverage a first choice for medical professionals. Readmore about TMIC coverage — www.tmic.biz/TMIC Online ApplicationWe have made it easy to apply for coverage with TMIC. Visit www.tmic.biz to download your application.Print, complete and sign the application and return it via fax or mail to TMIC. If you have anyquestions about your application, please contact sales at 800-580-8658.We’re proud to announce...…the latest policyholder benefitfor TMLT physician insureds, theTMLT Trust Rewards Program!This program, which is designed to reward TMLT policyholdersfor their loyalty and commitment to quality medicine, establishes“savings” accounts for policyholders and provides benefits uponyour retirement or other qualifying events.If you were insured with TMLT on December 31,you simply need to complete the enrollment formand you’re in!There is no catch, there is no cost! This is simply anotherwonderful benefit of being a TMLT policyholder. Don’t let thisopportunity pass you by – complete your enrollment form today!For more information go towww.tmlt.org/trustrewardsOr call 800-580-8658, ext. 50507


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