APRIL 2023
SERVICE STANDARDS
Table of Contents
TABLE OF CONTENTS
Working to Beat the Standard
Each year, ProAssurance’s HCPL division sets a theme to define our strategic plan. The 2023 theme, Beat the Standard, is a roadmap for becoming the Carrier of Choice for our insureds and agent partners.
The hard work of the past three years has resulted in a solid foundation, which we are taking advantage of as 2023 progresses. Recent changes and integration reinforce our need to continue to build (or rebuild) trust with our customers and external business partners and to consistently demonstrate our commitment to them. To do this we must set, communicate, meet, and then beat the standard.
SET THE STANDARD
Before we can beat a standard, one has to exist. We pushed ourselves to set standards within our new business processes and will continue this work as new processes are established.
COMMUNICATE THE STANDARD
Having a standard becomes meaningful when the customer knows what is expected. As we set standards they must be communicated. This communication is a commitment that frees our partners and customers from uncertainty while doing business with us.
This communication is a commitment to communicating our service standards with you.
MEET THE STANDARD
Before we can exceed a standard, we must, at minimum, meet it; we must continually measure and report against our standard. Throughout 2023 we will continue to build measurements into our processes and report on our outcomes—demonstrating our commitment to taking ownership of those outcomes. We will use failures as opportunities to identify and implement process or technology improvements and seek input from our business partners where appropriate.
BEAT THE STANDARD
Our designation as Carrier of Choice is not satisfied by simply meeting the standard—but by beating it. By doing so, we set a new higher standard.
PUTTING INNOVATION AND OWNERSHIP INTO ACTION
Team members understand that beating standards demonstrates to customers an ownership of outcome that is part of our culture, which effectively builds relationships and, over time, results in more business.
In terms of products and services, the standard offering is synonymous with the status quo. External factors mean that our customers have new problems that are currently not being served by status quo offerings today. We must innovate both products and services in order to meet emerging customer needs. When we understand where the standard offering fails the customer, we can innovate to exceed the standard.
We have a tremendous opportunity enabled by the hard work of our past integration efforts. We hope you are excited about the opportunities to now build on that foundation and grow our business, strengthen relationships with our customers and partners, and beat the standard.
Coverage
Our first area of service standards revolves around coverage–meaning the processes, touchpoints, and support we provide to ensure you can both understand and offer our policy products with confidence.
Please reach out to your ProAssurance partners within our Business Development or Underwriting areas with any questions you have around these coverage service standards.
Phone Calls
Our commitment is to make every effort to pick up phone calls to our individual primary business lines as they come in. An annual calendar of holidays and associated company closures will be posted at ProAssurance.com/Calendar.
Voicemails
Our voicemail messages will share if we are away from the office and details around our return, as well as an alternative contact to reach in our absence.
Emails
Our email will be set to auto-respond if we are away from work and not checking email, along with details around our return and an alternative contact to reach in our absence. Our email signatures will always contain title and role information and appropriate alternative contact details, including phone number.
Key Points of Contact
For ProAssurance Accounts
To pay online 24/7, sign in to the secure services portal and select the “Payments” menu option.
To make a payment by phone, call 800-282-6242 during regular business hours (Option 1).
Key Points of Contact
For NORCAL Accounts
To enroll in/manage automatic payments, sign in to the secure services portal and select the “Payments” menu option.
To make a payment a one-time payment, visit ProAssurance.com/Pay or call 844-466-7225
Response Times
The lines of business across HCPL are committed to working together to maintain consistent response times throughout the business cycle. The table below summarizes what you can expect for key services.
(24-hour call direction, voicemail, web portal)
(Subject to state regulatory requirements)
(Subject to state regulatory requirements)
(or immediate pending available account info)
Coverage Service Leaders
The Standard Underwriting team is responsible for assessing the risks associated with exposures in the traditional medical professional liability space for small to large physician practices seeking first dollar coverage as well as deductible options, profit sharing, exposure rating, etc. The policies handled by Standard Underwriting are those written on the standard policy form where the gross primary premium is generally less than $2 million and large group policy exposures are in no more than two bordering states in a single Standard Underwriting region. Solos to small groups with multi-state exposure crossing regions will be evaluated by the Standard Underwriting team to determine capabilities of writing the exposure on the standard policy form before referring to the Custom Physicians team.
Policies outside these parameters that require greater policy customization or that involve unique risks characteristics are handled by Custom Physicians within the Specialty Underwriting Team.
- Standard Underwriting Regions
- Standard Underwriting Leadership
- Karen Carlile, Senior Vice President
205-877-4438 KarenCarlile@ProAssurance.com- Tim Pingel, Assistant Vice President, Northeast Region
904-309-8115 TimPingel@ProAssurance.com - Christine Vaz, Assistant Vice President, Southeast Region
205-776-3096 ChristineVaz@ProAssurance.com - Debbie Farr, Assistant Vice President, Midwest Region
317-884-5630 DebbieFarr@ProAssurance.com - John Alexander, Vice President, Southwest Region
512-879-5131 JohnAlexander@ProAssurance.com - Lucy Sam, Vice President, West Region
415-735-2327 LucySam@ProAssurance.com
- Tim Pingel, Assistant Vice President, Northeast Region
- Karen Carlile, Senior Vice President
Provides guidance and assistance, helping get you to the right ProAssurance resources for your client’s needs. The Business Development regions are based on the location of your office as opposed to the location of your exposure.
- Business Development Leadership
- Mike Rosenthal, Senior Vice President
205-877-4488 MikeRosenthal@ProAssurance.com- Andrea Linder, Assistant Vice President, West Region
702-697-6401 AndreaLinder@ProAssurance.com - Seth Swanson, Director, Southwest Region
205-802-4769 SethSwanson@ProAssurance.com - Doug Darnell, Assistant Vice President, Midwest Region
608-826-5807 DougDarnell@ProAssurance.com - Lori Sunday, Director, Northeast Region
717-796-5601 LoriSunday@ProAssurance.com - Anthony Peterson, Assistant Vice President, Southeast Region
205-802-4757 AnthonyPeterson@ProAssurance.com
- Andrea Linder, Assistant Vice President, West Region
- Mike Rosenthal, Senior Vice President
Provides operational process alignment that ensures a competitive advantage through enhanced customer service and engagement, innovative digital experiences, and industry research and filings. Working collaboratively with IT and all business units, BOLT also supports transformative workflow integration.
- BOLT Includes
- Customer Experience & Engagement (customer service, new business submissions, credentialing, billing inquiries)
- Operational Process & Alignment
- Enterprise Digital Experience
- BOLT Leadership
- Pam Robertson, Senior Vice President
415-735-2013 PamRobertson@ProAssurance.com- Joe Giulivo, Vice President, Customer Experience & Engagement
717-796-5580 JoeGiulivo@ProAssurance.com - Max Malloy, Assistant Vice President, Enterprise Digital Experience
512-879-5142 MaxMalloy@ProAssurance.com
- Joe Giulivo, Vice President, Customer Experience & Engagement
- Pam Robertson, Senior Vice President
- Claims Leadership
- Darryl Thomas, Chief Claims Officer & SVP
205-445-2658 DarrylThomas@ProAssurance.com- Laura Ekery, Regional Vice President, Southwest
512-314-4360 LauraEkery@ProAssurance.com - Frank Bishop, Regional Claims Executive, Southeast
813-969-4559 FrankBishop@ProAssurance.com - Gina Harris, Regional Claims Executive, West
702-697-6424 GinaHarris@ProAssurance.com - Mark Lightfoot, Regional Claims Executive, Northeast
202-969-3102 MarkLightfoot@ProAssurance.com - Mike Severyn, Regional Claims Executive, Midwest
517-347-6262 MikeSeveryn@ProAssurance.com
- Laura Ekery, Regional Vice President, Southwest
- Darryl Thomas, Chief Claims Officer & SVP
Specialty Underwriting
ProAssurance Specialty Underwriting is designed to provide coverage options that address the changing dynamics of healthcare. Much of our work is done in the excess and surplus (E&S) space, an area that is growing rapidly in response to the current medical professional liability market conditions. Writing on E&S paper provides us more room to be creative and set policy terms that are in line with the risk presented. With each market experiencing its own trends, it often makes more sense to take that approach rather than attempting to work within the constraints of the admitted rate filings available. We have a flexible product and a broad appetite in Specialty Underwriting and seek to offer flexibility in our approach.
The Specialty HCPL business can be relatively complex and time consuming from both an underwriting and servicing perspective. Regardless, our Specialty Underwriting staff aims to be communicative and collaborative, and we always strive for excellent and responsive service.
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Submission Considerations*
Since early 2021, Specialty HCPL has operated with submission boxes specific to the individual product lines. This change has significantly improved the timeliness of our intake process.
Once submissions are sent to the correct submissions box (or directly to an underwriter for the correct product line), our goal is to acknowledge the submission within 24 hours and triage and prioritize within 72 hours.
In general, larger accounts and those with multiple product needs (e.g., facility plus physician policies) are going to take longer to underwrite. However, it’s really about the submission quality, content, and timeliness.
A few key considerations:
- Timeliness: We prefer to see submissions at least 45 days prior to need-by date (i.e., 60-90 days prior to effective date). Note that large accounts needing actuarial referrals should be submitted 90+ days out from effective date.
- Completeness: Detailed loss runs, exposure history, completed physician schedules, applications, recent financials, and actuarial funding studies are a must for complete submissions.
- Account Summary or Specs: It is important that we understand the account structure, target pricing, and key coverage needs.
- Guidance: Why is the account being marketed? Is there any target pricing? Did ProAssurance write the account in the past?
- Accounts Requiring Actuarial Review: If you find yourself with an aggressive timeframe, the submission should be complete and include detailed claims history in Excel format. Note that the larger the account, the more important that we have complete historical loss and exposure data.
Underwriters recognize and understand that every situation and opportunity may be unique, but the foregoing sets the general standard to which every submission is measured.
Service and Communication
- If the minimum submission quality standard is met, our underwriters aim to acknowledge the submission within 24 hours. If additional information is required, we aim to advise the broker within five business days about what else is needed or, within the same time period, notify with declination.
- Our underwriters make communication a priority when quoting new business opportunities as well as renewals. We strongly encourage direct conversations (versus solely email) on opportunities that are important to our distribution partners.
- We strive to return all phone calls within 24 hours (or one business day).
- Despite our service standard objectives, sometimes issues will still arise. We invite our distribution partners to contact the relevant Product Line leader, or Shep Tapasak, when an issue requires escalation. The sooner we know about a problem, the sooner we can address it.
The Specialty Underwriting team is always ready to discuss prospects and provide insights on most healthcare sectors/classes. Whether you want to learn more about our E&S products and how we are approaching different areas of business or you want to discuss a specific piece of business you are working with, our team is happy to provide some insight. We want to be a source of expertise for you and your team as we continue to build a strong, productive relationship with our agency and broker partners.
*Turnaround time on quotes, including renewal quotes, is impacted by timing and thoroughness of the submission received.
Specialty Underwriting Team
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Shep Tapasak |
Custom Physicians
205-877-4454
Hospitals & Facilities
317-884-5621
Misc. Medical & Senior Care
205-877-4420
Assumed Reinsurance, Alternative Risk, & LPTs
205-776-3080
ProAssurance Agency
Your resource for custom solutions
Agencies looking for bespoke insurance solutions for healthcare practices use ProAssurance Agency as a placement solution.
Our retail distribution partners leverage our capabilities to access ProAssurance’s coverages along with accessing other A-rated carriers for standard risks such as business owners’ policy, workers’ compensation, management liability, and more in all 50 states.
The ProAssurance Agency team is extremely well versed in the needs of healthcare clients and understands the nuances of coverages needed. ProAssurance Agency, with its technical expertise, aims to be a one-stop solution for our agency partners.
We take a collaborative approach with retailers and underwriters to ensure all parties work together to provide the best, most innovative solution for the insured. We also work on a commission-sharing basis, with the majority of commissions going to our partners.
Examples of recent placements include:
- A West Coast retail agent seeking access to wholesale placement of Miscellaneous Medical professional liability coverage used ProAssurance Agency’s support to place with ProAssurance’s Miscellaneous Medical malpractice team.
- A retail professional lines agent looking for commercial lines coverage for their multi-state client leveraged the Agency’s network of A-rated carriers and partner wholesalers to place the coverage.
- A retail agent leveraged the ProAssurance Agency team to provide coverage to a telehealth client looking for specialty coverage with ProAssurance.
SUBMISSIONS ProAssurance Agency is customer focused and aims to acknowledge all submissions within 48 hours. Our agents work closely with underwriters who understand the complexities of the market. Because we are an internal agency, we have close working relationships with the professional lines underwriters and work in tandem to provide creative solutions for clients. If you think you may benefit from ProAssurance Agency for placements, please reach out at 844-331-6298 or email PRAAgency@ProAssurance.com. |
Risk Management
Risk Management is committed to providing added value to the insured’s current policy with the following services, offered based on premium dollar level. For premiums greater than $250,000 (Service Level 2), a tailored service plan plus onsite seminars, virtual networking events, and an assigned Risk Management Consultant are offered in addition to the basic services as featured in Service Level 1.
* Average onsite service cost: $2000
~ Not for discount
^ Coming soon
Marketing
ProAssurance’s Marketing and Communications team represents the healthcare and professional liability division. The team is committed to connecting agents with valuable, informative, and up-to-date resources including marketing collateral, publications, merchandise, and more.
MARKETING MATERIALS
ProAssurance Marketing materials are available for download at ProAssurance.com and may be ordered in print by emailing AskMarketing@ProAssurance.com or by completing an online marketing materials form. Materials are subject to annual review and shipped to the requester, usually within one week or up to 10 business days depending on current available stock.
Available materials include:
- Brochures and flyers
- National communication pieces
- Regional and state-specific communication pieces
- Ascension communication pieces
- Ob-Gyn Risk Alliance communication pieces
- Cyber communication pieces
- Specialty Underwriting materials (agent use only)
HCPL PRODUCER GUIDE
The HCPL Producer Guide provides everything agents need to do business with ProAssurance. The guide is updated regularly and provides service models, information on Risk Management services, branding insights, industry news, and important contact directories. Find the Producer Guide at ProAssurance.com/Producer-Guide.
PROVISIONS & OTHER EMAIL COMMUNICATIONS
ProVisions is a monthly magazine available for agents and is our main channel providing company and MPL industry news as well as ProAssurance leadership and sales insights. Each issue features a focused theme impacting medical professional liability insurance.
All new issues are available on our recently launched agent website. Agents can subscribe to the ProVisions email list or receive printed copies of the magazine by emailing AskMarketing@ProAssurance.com.
ProAssurance occasionally sends ProVisions Flash eblasts that highlight timely and essential HCPL news, as well as Agent Bulletins that focus on business and operational updates.
BRANDING
ProAssurance is working to ensure a smooth transition with the acquisition of NORCAL, unifying the two companies under one brand, ProAssurance—with NORCAL Insurance Company being treated as a non-branded issuing company. As such, all marketing materials above are updated to reflect these changes, and all previous NORCAL assets have been retired. NORCAL’s website has been rebranded, and the site will also be decommissioned by the close of 2023.
The Power of Timing and Personal Touch
Several months before my homeowner’s insurance was set to renew, I received a call from Brittany, my insurance agent. She wanted to warn me that I would likely experience sticker shock when my renewal notice arrived, showing a 35% premium increase from the prior year.
I was ready to hang up and start calling other agencies. Then Brittany informed me she had prepared a complete analysis of my homeowner's policy with comparison quotes from similarly rated underwriters. She reviewed the quotes with me, then walked me through my current policy line by line to see where I was over-insured or underinsured. Although I wasn't happy paying $1,500 more for my home insurance, my urge to find a lower premium subsided. I understood the situation and felt Brittany had earned my trust and business.
Your clients are no different. They might not be surprised by a reasonable increase in their MPL premium given the continued increase in claim severity nationwide. Still, it's best to reach out proactively to address any potential concerns, as the idea of what's reasonable is subjective. Timing is crucial in retaining or acquiring business from physicians, as they tend to quickly look for alternatives if they're dissatisfied or uncertain about a product or service.
Approach clients with the confidence that you’re prepared to help them identify, understand, and work through any concerns. While it's likely that they’re already familiar with new or changed laws or circumstances increasing liability risks and MPL insurance premiums, don't assume they've connected the dots with how and why they're affected. Make sure they understand the whole story as it relates to them. Just as Brittany did with me, let them know that you've reviewed their coverage and are ready to assist them in assessing their situation.
Here are some examples of situations that could impact MPL insurance needs and premiums in 2023:
- Providers are likely familiar with the recent changes to California's Medical Injury Compensation Reform Act (MICRA), but do they understand how this affects their medical professional liability coverage? For example, the increased caps allow plaintiff's attorneys larger fees due to increased non-economic damages and the ability to stack. What can you discuss or provide to help them take any necessary actions regarding their coverage?
- Do providers in states with increased litigation understand the implications for them? In Pennsylvania, for example, the Supreme Court's elimination of the venue rule requiring plaintiffs to file liability lawsuits in the county where the treatment occurred has led to venue shopping, where plaintiff’s attorneys file in a county favorable to plaintiffs. Do providers in rural areas understand how lawsuits filed in a city like Philadelphia increase the potential risk that they will suffer a more severe verdict?
- The recent COVID-19 pandemic led to shortages of healthcare personnel that can and have led to medical malpractice through understaffing, dangerous conditions, negligent hiring or training, poor record keeping, patient falls, medication errors, missed diagnoses, and surgical mistakes. If working with traveling nurses or locum tenens, what steps can providers take to minimize medical errors and associated liability?
Clients may not always welcome discussions about premium increases or the need for more coverage, but these situations provide opportunities to strengthen relationships and build trust. They also help clients better understand their MPL policy's value and why ensuring appropriate liability protection is more important than ever.
Written by Mace Horoff of Medical Sales Performance
Mace Horoff is a representative of Sales Pilot. He helps sales teams and individual representatives who sell medical devices, pharmaceuticals, biotechnology, healthcare services, and other healthcare-related products to sell more and earn more by employing a specialized healthcare system.
Have a topic you’d like to see covered? Email your suggestions to AskMarketing@ProAssurance.com.
Each year WalletHub evaluates each state using 19 relevant metrics—physician salary, competition, hospitals per capita, and so on. Each metric is graded on a 100-point scale, with a score of 100 representing the most favorable conditions for practicing doctors. Montana received the highest score at 73.45 points, with South Dakota, Idaho, Wisconsin, and Minnesota rounding out the top five. (WalletHub)
Weather-related losses persisted for the U.S. property/casualty (P/C) insurance segment in 2022, pressuring financial results in a year that also included a 40-year high for inflation and the second costliest catastrophe event on record, according to a new AM Best report. Trends within personal auto space provided the biggest drag on the overall U.S. P/C segment’s results, despite auto insurers’ best efforts to contend with rising severity, supply chain issues, and increased medical costs. (Business Wire – AM Best)
Only about 5.7% of physicians in the United States identify as Black or African American, according to the latest data from the Association of American Medical Colleges. This statistic does not reflect the communities they serve, as an estimated 12% of the U.S. population is Black or African American. (CNN)
A total of 48,156 applicants participated in the 2023 Match, up by 481 from last year, according to the National Resident Matching Program (NRMP). This rise in applicants was driven primarily by the increase of 707 more non-U.S.-citizen IMG (international medical graduate) applicants and 153 more U.S. osteopathic (DO) seniors over last year, while the number of U.S. MD senior applicants dropped by 236. (MedPage Today)
Twenty-four hospitals in the U.S., Canada, and Western Europe are using "black boxes"—named after the recording devices in airplanes—to collect and analyze operating-room practice data in hopes of reducing medical errors and improving patient safety and operating room efficiency. (Becker’s Hospital Review)
The Biden administration’s decision to end the COVID-19 public health emergency in May will institute sweeping changes across the healthcare system that go far beyond many people having to pay more for COVID tests. In response to the pandemic, the federal government in 2020 suspended many of its rules on how care is delivered. That transformed essentially every corner of American healthcare—from hospitals and nursing homes to public health and treatment for people recovering from addiction. Now the government prepares to reverse some of those steps. (Kaiser Family Foundation)
ECRI Names Top 10 Patient Safety Concerns for 2023
The pediatric mental health crisis is named the number one patient safety concern, according to ECRI’s 2023 list of most pressing patient safety concerns. The nation’s largest nonprofit patient safety organization also notes that, while rates of depression and anxiety in children have increased since 2017, the COVID-19 pandemic has elevated the situation to crisis levels.
"I am struck by a common theme: lack of communication. With 30-plus years as a registered nurse, most recently in care coordination and population health, I still see poor communication among healthcare providers as a major patient safety concern, despite the investment in technology meant to improve it. Healthcare communication is complex and multifaceted, involving multiple providers, patients, and caregivers across different care settings. Improving it requires a multifaceted approach that includes improved communication technology and fostering a culture of collaboration and open dialogue, providing education and training to healthcare providers, and continuously evaluating and improving communication processes."
Read the expanded commentary by Joanne Simmons, Senior Risk Management Consultant.
"I would add staffing shortages to the list. Staffing levels are mentioned under item 10 for preventable harm, but shortages do so much more than that by magnifying many of the other issues on this list. Shortages also stress the remaining workforce, increasing burnout and worsening the crisis."
“I would include drug shortages resulting from both supply chain issues and the undersupply of raw materials in the list of patient safety issues the industry should be monitoring. Drug shortages have significant potential to cause cascading, downstream effects on the demand for specific drugs as well as other related medications. When demand exceeds availability, patients are faced with difficult decisions, whether that be rationing their existing supply, using prescriptions they can’t afford, or simply going without.”
"Patient safety is defined by the National Academy of Medicine as 'the prevention of harm to patients.' However, harm remains frequent in the hospital setting. The use of electronic risk assessment algorithms may assist in reversing this trend, especially in medication management, infection prevention and control, surgical complications, and many other aspects of care. The adoption of event software systems could be used to identify and monitor risks over time, ultimately reducing patient harm and decreasing potential medical liabilities associated with the provision of care."