Van Wagner CCAPP Presentation - RPG
- 1. CCAPP Conference 2016 October 27-30 San Diego Individual Professional Liability
- 2. 2 Presented by: Robert Sperber from The Van Wagner Group & Kent Barnes from Great American Insurance Group The information contained in this presentation is for informational and discussion purposes only and is not intended as legal advice. Great American Insurance Company, 301 E. Fourth St., Cincinnati, OH 45202. Coverage description is summarized. Refer to the actual policy for a full description of applicable terms, conditions, limits and exclusions. Policies are underwritten by Great American Insurance Company, Great American Assurance Company, Great American Alliance Insurance Company, Great American Insurance Company of New York, and Great American Spirit Insurance Company, authorized insurers in all 50 states and DC. The Great American Insurance Group eagle logo and the word marks Great American ® and Great American Insurance Group ® are registered service marks of Great American Insurance Company. © 2016 Great American Insurance Company. All rights reserved.
- 3. 3 If you are employed at a facility, are you included under their professional liability? Are your personal assets adequately covered? Does this mean I do not need my own professional liability coverage? Even though you are covered under your employer’s policy, here are reasons you should still purchase your own separate liability coverage. • All practicing healthcare providers need Professional Liability Insurance. • Your employer’s coverage may not provide coverage for you for past incidents once you leave their employment. • Your employer’s coverage may lapse or be cancelled without your knowledge • Coverage provided by your workplace generally will not cover you for actions brought against you by a licensing board or other regulatory body. • The cost of a malpractice claim brought against your employer and you may exhaust your employer’s policy limits. • Having your own individual coverage gives you “peace of mind” that you have an insurance company that represents your interests only. Why Are We Here?
- 4. 4 IMPORTANT FACTS • If you are or will be insured under an employer/agency/policy, find out the extent to which you as an individual are covered and seriously consider purchasing your own coverage. • Employer or facility-based insurance policies are designed primarily to provide coverage for the larger entity, and then by extension cover the individual employee. • When an individual separates from employment, depending on the scope of the policy, he or she should remain covered under the employer’s policy for services provided during the employment period, as long as the employer or facility remains in operation and renews coverage. Why Are We Here?
- 5. 5 • Van Wagner Group is now the official endorsed insurance broker for the California Consortium of Addiction Programs and Professionals (CCAPP). • Van Wagner Group is committed to growing and providing the highest service level to CCAPP and its members at a premium discount. We have five experienced insurance professionals dedicated solely to our Behavioral Health Purchasing Group. • Van Wagner and Great American focus on human and social service organizations’ insurance needs and offer industry-leading coverage, expert knowledge, unmatched service and financial strength. Why Us?
- 6. 6 • Extensive Coverage to a Multitude of Organizations: You want a policy that insures a wide range of exposures and delivers essential services. • Extensive coverage available with easy-to-understand policy language: We offer an inclusive policy with General Liability, Abuse, Professional and available Umbrella. • Expert Knowledge: You will work with professionals who protect thousands of organizations like you. To stay on top of industry trends we emphasize continuing education and industry certification. Our team has over 30 years experience. • Unmatched Service & Direct Access: When you have a question, it deserves a quick answer. So, we give you direct access to our underwriters. Patty Kenny is always available to take your call or email. Why Us?
- 7. 7 When you experience a claim, this is the insurance policy’s moment of truth. Great American believes in fair claims handling and conduct ourselves with integrity in all claims matters. To help manage expenses for your clients, we: • Settle meritorious claims in a timely manner and appropriately challenge non-meritorious claims; • Proactively manage files to ensure efficient litigation • Target signs of fraud • Aggressively pursue subrogation to seek reimbursement from a responsible party who may cause damage to your clients. Claims Handling
- 9. 9 Why Should I Sign Up for The Van Wagner Program • CCAPP Endorsed • Exclusive and Proprietary Program with Great American • Low cost policy • Comprehensive Coverage Against a Wide Variety of Claims • 30+ Year of Experience Why Us? Endorsed by:
- 10. 10 Thomas Van Wagner, founder of the Van Wagner Group, always had strong ties to the addiction treatment field. He was in recovery starting in 1968 and was an advocate to the field in many ways. He was a founder of the Friends of Long Island Council on Alcoholism; has served as president of the New York State Council on Alcoholism and was a board member of the National Council on Alcoholism and Drug Dependence. He continued to organize and participate in many fund raising activities for the field until his retirement in 2004. Tom’s insurance background began in lower Manhattan. He is proud that he was able to combine his vocation and avocation into an agency that helps people who are in the business of helping others. Although Tom is retired and is no longer working with The Van Wagner Group, he leaves the Professional Liability insurance program he helped to create and refine for over 20 years as his legacy. The program provides comprehensive professional liability insurance to all mental health professionals, including students, peer recovery specials and individual drug and alcohol counselors all at an affordable cost. The Van Wagner Group was acquired by SterlingRisk in 2004. SterlingRisk is a top national insurance brokerage that has helped the Van Wagner Group expand its ability to serve the needs of the addiction treatment industry. About Van Wagner Group
- 11. 11 A Company You Can Count On For 35 years, Great American Insurance Group has provided insurance solutions to the human and social service marketplace. Over the years, they have expanded coverage and services to ensure that they are experts who can meet the evolving needs of this marketplace. Great American Insurance Group’s roots go back to 1872 with the founding of its flagship company, Great American Insurance Company. Based in Cincinnati, Ohio, the operations of Great American Insurance Group are engaged primarily in property and casualty insurance, focusing on specialty commercial products for businesses, and in the sale of traditional fixed and indexed annuities. Great American Insurance Company is currently rated “A+” (Superior) by A.M. Best*, and has received an “A” (Excellent) or higher rating from the A.M. Best Company for more than 100 years. The members of Great American Insurance Group are subsidiaries of American Financial Group, Inc. AFG’s common stock is listed and traded on the New York Stock Exchange under the symbol AFG. *A.M. Best rating affirmed May 12, 2016 About Great American
- 12. Great American – Undeniable Financial Strength • Parent company named to the 2016 Ward’s 50 list of top performers • Parent company named by Forbes as one of the most trustworthy companies in America
- 13. 13 Three Separate Coverage Parts and Limits in One Policy 1. Professional Liability Insurance 2. Commercial General Liability 3. Abuse or Molestation Coverage Avoids any erosion of primary limits by maintaining three separate silos of coverage
- 14. Professional Liability Coverage • Covers Wrongful Act or Failure to Provide Services • “Professional Services” includes any service that involves specialized education, knowledge, labor, judgment, and skill that is predominately mental or intellectual – No cap and gown required • Separate limit from General Liability or Abuse coverage • Defense costs are outside limit of liability • Direct and vicarious coverage for employees
- 15. Professional Liability Claim Scenarios 15 • Claimant alleges that Counselor implanted memories of abuse during a counseling session • Breach of confidentiality is alleged against a Counselor when certain information is released to a probation officer • After a client commits suicide, a Counselor is accused of failing to render professional services
- 16. General Liability Coverage • Broad named insured definition • Broad additional insured coverage • Defense costs outside the limit • Broadened definition of personal injury Also consider • Pay on behalf of vs. reimbursement • No binding arbitration clauses • Special events? • Volunteers? • Board members?
- 17. Abuse Coverage 17 Why do you need Abuse coverage? • Individuals and corporate counselors often provide care and other services to vulnerable clients, such as children, elderly adults and the developmentally challenged. • These clients and the agencies that serve them need to have insurance protection regarding damages from any form of abuse, not just sexual abuse or vicarious liability. How does Abuse Coverage apply • Our Abuse or Molestation coverage limits are provided separately from the Professional and Commercial General Liability coverage parts. This is an important feature because other insurance industry abuse coverage forms often reduce the amount of insurance limits available to pay for Professional or General Liability losses. • In addition, our Abuse or Molestation form provides claim and legal defense expenses outside the coverage limits. This feature is significant because abuse or molestation related claims may require the hiring of experts and specialized legal representation which can be very costly.
- 18. Abuse Coverage 18 • Coverage highlights – Broad Named Insured Provision – Broad Definition of Abuse • Any act, threatened, or alleged act • Sexual or non-sexual act • Defense costs outside limit
- 19. 19 Is the policy “Occurrence” or “Claims Made”? This is probably the most important coverage feature to understand. Occurrence coverage • With this coverage it does not matter when a claim or suit is reported, the policy will apply as long as the injury or damage sustained was during the policy period. • The premium will typically not vary year by year on an occurrence form policy. Claims-Made Policy • This coverage will only cover claims reported while the policy is in effect provided the injury or damage occurred after the retroactive date. • If a claim is reported after the expiration date of a policy there would need to be a “tail coverage” in place in order for that claim to be covered. • Claims-Made policy premiums vary over the first five years.
- 20. 20 What is Tail Coverage, or an Extended Reporting Period, and why is this necessary? “Tail Coverage” extends the amount of time insureds can report a claim after the expiration date and can typically cost up to 175% of premium. The extended reporting period extends the amount of time you can report a claim that occurred back during your claims made coverage dates. You would need to purchase the extended reporting period if you choose not to renew your coverage, retire, or your coverage will lapse. There is a real need for tail coverage in the event your carrier decides to non- renew your coverage due to claims history or decides to non-renew the program entirely. What is a retroactive date? Does my policy have one? Policies written on a Claims-Made basis contain a specific date on which coverage begins (commonly known as the “retroactive date”) and provides no coverage for claims arising out of occurrences that take place prior to this date. Tail Coverage and Extended Reporting
- 21. 21 Van Wagner Product Offerings: Professional Liability with a broad definition of professional services • The policy also covers those with specialized knowledge, not just degree professionals. • Professional Liability is available for full-time counselors and students as well as at a discounted rate for those working part-time. • Limits are offered at $1 million each incident / $3 million annual aggregate and up to $2 million per incident / $7 million annual aggregate when required by state, contract, or for those who just want higher limits. (Cost: $25) A Signature General Liability Broadening Endorsement with: • Increased medical payments and property damage extension or coverage for damage to premises rented to you. • Personal and Advertising Injury included. Abuse or Molestation with limits of $100,000 each act of abuse / $100,000 aggregate. Defense expense outside limits. Additional Insured – Automatic status when required by contract (Example: Landlord)
- 22. 22 Allied Health Professional Plus Endorsement • Peer Review • $25,000 / $50,000 Administrative Defense of HIPAA Notification Cost. • Our definition of a complaint is audit, investigation, ADM proceedings, arbitration, claim, civil lawsuit or legal action brought against you by any person, entity, or federal, state or local agency. • Also covers complaint brought by health care insurance company to determine if fees you have charged as resolvable and proper. LLC, PC, Inc., S. Corp • This applies to sole owners/members of a Corporation or LLC when the owner/member is the only person providing services and there are no employees or any other individuals providing services on behalf of the Corporation or LLC. • If you don’t have employees then this coverage is important for you. • If you carry only an individual policy and your corporation is named in a claim or suit, you will not have protection for the action against your corporation. • This is covered at no additional premium, provided you are the sole owner and sole employee. Van Wagner Product Offerings:
- 23. 23 Education Programs such as: • Abuse Prevention • Slip and Fall Elimination Program • Social Networking Safety Newsletter and Brochure Our easy automatic renewal and pay on-line access E Learning: Let us know suggestions for future topics! Van Wagner Website: www.vanwagnergroup.com or www.insure-addictioncounselor.com 1(800) 735-1588 Van Wagner Product Offerings:
- 24. 24 Who is Eligible? All members of CCAPP who are licensed/certified addiction counselors, clinical supervisors, associates who have completed required education programs and are working toward license/certification, students and credentialed peer recovery support specialists are eligible for coverage. Do you offer a reduced premium if I work part-time? Yes, provide your total working hours in all positions (including W2 employment and clinical supervision) do not exceed 20 hours a week, you are eligible for a lower, part-time rate. FAQs
- 25. 25 I operate under a corporate name. Can I obtain coverage for my corporate entity? Yes, a professional liability policy can be provided that covers your corporate entity as well as all owners and professional employees, para-professional employees and independent contractors. I am a Student member of CCAPP working on my educational requirements. Is there an insurance option for me? Yes, students in an approved educational program can obtain insurance on an Occurrence Form for a low price per year. Limits range from $1,000,000/$1,000,000 to $2,000,000/$4,000,000 and will also cover you while working in field placement. Where do I get an application and submit? Go to our website to download our application or quote/bind/pay online. If you prefer, call us at 800-735-1588. As an insured, what should I do if I receive a summons or if I am aware a client has a complaint about me? Always report a summons or become aware of an incident that could lead to a claim being brought against you. Liability policies require that claims and incidents be reported as soon as possible. FAQs
- 26. 26 Questions?
- 27. 27 Thank you for attending our seminar today! The information contained in this presentation is intended to provide guidance and is not intended as legal advice. Great American Insurance Company, 301 E. Fourth St., Cincinnati, OH 45202. Coverage description is summarized. Refer to the actual policy for a full description of applicable terms, conditions, limits and exclusions. Policies are underwritten by Great American Insurance Company, Great American Assurance Company, Great American Alliance Insurance Company, Great American Insurance Company of New York, and Great American Spirit Insurance Company, authorized insurers in all 50 states and DC. The Great American Insurance Group eagle logo and the word marks Great American® and Great American Insurance Group ® are registered service marks of Great American Insurance Company. © 2015 Great American Insurance Company. All rights reserved. Van Wagner Website: www.vanwagnergroup.com or www.insure-addictioncounselor.com 1(800) 735-1588
Editor's Notes
- #4: This is the case whether an individual is employed, self-employed in independent practice or in training.