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ProVisions April 2023

APRIL 2023

SERVICE STANDARDS

Table of Contents

About Our Issue...

Working to Beat the Standard

Working to Beat the StandardEach 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.

 

SERVICE STANDARDS:

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

CUSTOMER SERVICE 800-282-6242  
CREDENTIALING

Credentialing@ProAssurance.com
800-282-6242

 
SUBMISSIONS

Submissions@ProAssurance.com
800-282-6242

 
CLAIMS REPORTING

ClaimsIntake@ProAssurance.com
877-778-2524

 
RISK MANAGEMENT

RiskAdvisor@ProAssurance.com
844-223-9648

 
COMMISSIONS 800-282-6242  
PAY ONLINE

To pay online 24/7, sign in to the secure services portal and select the “Payments” menu option.

 
PAY BY PHONE

To make a payment by phone, call 800-282-6242 during regular business hours (Option 1).

 

Key Points of Contact

For NORCAL Accounts

CUSTOMER SERVICE

CustomerService@norcal-group.com
844-466-7225 (Option 0)

 
CREDENTIALING

Info@norcal-group.com
844-466-7225 (Option 4)

 
SUBMISSIONS

Submissions@norcal-group.com
844-466-7225 (Option 0)

 
BILLING

Billing@norcal-group.com
844-466-7225 (Option 3)

 
CLAIMS REPORTING

ReportOfClaim@norcal-group.com
844-466-7225 (Option 5)

 
RISK MANAGEMENT

RiskAdvisor@ProAssurance.com
844-223-9648

 
COMMISSIONS

AgencyServices@ProAssurance.com
844-466-7225 (Option 0, request Agency Services)

 
PAY ONLINE

To enroll in/manage automatic payments, sign in to the secure services portal and select the “Payments” menu option.

 
ONE-TIME PAYMENT

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.

Services
Response Times
COVERAGE SERVICE SUPPORT
Live Customer Service Phone Response
8am - 5pm Central Time
(24-hour call direction, voicemail, web portal)
Voicemail Support
1 business day
Email Response
1 business day
NEW BUSINESS
Submission Acknowledgement
1 business day
Quote or Contact
2 business days
Policy Issuance
5 business days upon receipt of bind order
RENEWAL OR CONTINUING BUSINESS
Renewal Quotes
45-90 days prior to policy expiration
(Subject to state regulatory requirements)
Renewal Policy Issuance
30-45 days prior to policy expiration
(Subject to state regulatory requirements)
Endorsement Requests
3 business days
Coverage & Policy Question Response
2 business days
MISCELLANEOUS:
Credentialing (COIs and Loss Runs)
2 business days
Customer/Agent Portal New Account Registration
2 business days
(or immediate pending available account info)
Customer/Agent Portal Access to New Policies or Changes
2 business days
Claims Intake Responses
1 business day
Risk Management Hotline Responses
1 business day
Owners_4x

Coverage Service Leaders

Standard Underwriting

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.

Business Development

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 Operations, Logistics & Transformation (BOLT)

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
Claims
SERVICE STANDARDS:

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.

50states

  • CUSTOM PHYSICIANS
  • HOSPITALS & INTEGRATED HEALTHCARE SYSTEMS
  • MISCELLANEOUS MEDICAL FACILITIES
  • SENIOR CARE/LONG-TERM CARE FACILITIES
  • ALTERNATIVE RISK & ASSUMED REINSURANCE
SPECIALITY UNDERWRITING

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.

SPECIALTY UNDERWRITING

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

ShepTapasak

Shep Tapasak 
Senior Vice President,
Specialty Underwriting
205-776-3034

Chris Sweet
Chris Sweet Vice President,
Custom Physicians
205-877-4454
HeatherVanBibber
Heather Van Bibber Vice President,
Hospitals & Facilities
317-884-5621
MikeIovine
Mike Iovine Vice President,
Misc. Medical & Senior Care
205-877-4420
KatyLadisch
Katy Ladisch Assistant Vice President,
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.

PRAAgency

 

 

 

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.

 

SERVICE OFFERINGS:

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.

RISK MANAGEMENT SERVICE
Service 1
Up to $250,000
SERVICE 2
Greater than $250,000
Access to Risk Management Help Line
Personalized Orientation for Online Access & Services
Provide Risk Management Resources/Guidelines/Forms
Receive Publications (Vital Signs & Claims Rx)
Access CME Programs (Live Webinars & Online Seminars)
Available Litigation Stress Coaching with Winning Focus
Baseline Self-Assessment with Report & Consultation
Onsite*/Virtual Assessment - UW Request
Onsite*/Virtual Assessment - Insured Request~
Guidance for Unanticipated Outcomes/Patient Complaints
Review of Loss History
Website Requested Appointment with Consultant^
Tailored Service Plan as Needed
Onsite* Seminars
Virtual Networking Events for Insureds
Assigned Risk Management Consultant
N/A

* Average onsite service cost: $2000
~ Not for discount
^ Coming soon

SERVICE STANDARDS:

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)

UPDATED Sales-Kit-Mock-up_Combined

 

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.

HCPL 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.

April ProVisions Webpage Graphics11

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.

NORCAL site-1
Ties that Bind updated Banner
NAVIGATING CHANGE:

The Power of Timing and Personal Touch

April ProVisions Webpage Graphics9

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.

Mace Horoff

 

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.

News & Updates
2023’s Best and Worst States for Doctors

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)

Read more →

Best’s Market Segment Report: Volatile Weather, Rising Personal Auto Losses Drag on U.S. Property Casualty Insurers’ 2022 Results

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)

Read more →

Only 5.7% of U.S. Doctors Are Black, and Experts Warn the Shortage Harms Public Health

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)

Read more →

Match Day Breaks Records for Numbers of Positions and Applicants

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)

Read more →

“Black Boxes” Make Their Way into Hospital ORs

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)

Read more →

End of COVID Emergency Will Usher in Changes Across the U.S. Health System

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)

Read more →

Comments Section Banner

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.

Read the article.

Joanne Simmons Headshot
Joanne SimmonsSenior Risk Management Consultant

"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.

Aaron Hamming Headshot
Aaron HammingRisk Management Data Analytics and Technology Manager

"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."

Kethra Keeling
Kethra KeelingSenior Administrative Assistant

“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.”

Brenda Tuck
Brenda TuckSenior Risk Management Consultant

"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."

April 2023