New Procedure? Check Your Medical Malpractice Insurance Coverage First

A recent inquiry from an existing physician client highlighted the issue of obtaining medical malpractice coverage BEFORE introducing new procedures to your practice.  In this case, a physician client contacted our office to advise us of a new procedure he would be performing as a part of his existing pain management practice.  The client had completed appropriate training from VERTOS Medical (the medical device company that developed the MILD procedure, to perform the Minimally Invasive Lumbar Decompression  (MILD) to treat patients diagnosed with lumbar spinal stenosis (LSS).   As a matter of process, Presidio submitted a request to extend coverage for this procedure to the carrier insuring our client’s practice.

To our surprise, coverage through The Doctors Company was denied.  The basis of the declination was the insurance company’s underwriting opinion that the MILD procedures was a “surgical” procedure and not included in the scope of practice for a pain management physician.  Assuming the easy solution entailed simply increasing the medical specialty classification to one the underwriter agreed included this exposure (in other words: higher premiums), a request was made to change the medical specialty classification.  This request was also denied as the carrier’s underwriter opined the procedure was intended to be performed by surgeons only and thereby they would not extend coverage under any circumstances.


The next step was to determine if other carriers might be able to extend the coverage for the client to perform the MILD procedures while maintaining the same or better coverage and pricing already in place.  After several inquiries and submissions and many, many conversations explaining the procedure, coverage was offered with another insurance company willing to extend coverage for the doctor to perform the MILD procedure within his practice.  All in all the additional premium to the doctor is $1,500 per year to include the MILD procedure.  A satisfactory result for all those involved.

As always, it is wise to contact your qualified medical malpractice insurance broker to determine whether you have the coverage you need.  Never assume your medical malpractice insurance covers you for any new procedures, contracts, locations or healthcare providers. As a matter of course, we will always look for the best coverage at the best price by querying several sources for you. We do all the running around so you can concentrate on what it is you do!


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