E&O Liability Insurance for
Managed Care Organizations, Plans, and Service Providers
Overview
Darwin’s health care team has been immersed in the health and
managed care environment since the early 1980s. It’s a legacy
we are proud of, but more importantly, it serves as the foundation
that supports our commitment to the health care industry.
- We view our resources as an extension of our customers’
efforts to manage risk.
- We understand and appreciate the nuances of local medical
delivery systems.
- We are personally invested in the business of health care
and we move with agility to respond to emerging exposures.
Before coverage is underwritten and after
a claim may arise, our focus is on serving the distinct needs
of each health care customer. And we do so with talented people
who offer a range of capabilities. Many organizations now turn
to Darwin for primary and lead excess coverage.
With a dedicated health care underwriting
practice, Darwin is building an infrastructure that demonstrates
commitment at every touch point—from risk assessment and coverage
terms to claims administration and risk management services.
NOTE:
For accounts with a retention under $100,000, Darwin typically
uses its duty-to-defend form. Accounts with a retention of $100,000
or more typically are written on an indemnity form.
Errors and omissions (E&O) liability coverage
for the following preferred segments is available on a primary
or excess basis.
Preferred
Segments
Managed Care Organizations/Plans, including:
- HMOs (Health Maintenance Organizations)
- IPAs (Independent Physician Associations)
- PBMs (Pharmacy Benefit management Organizations)
- PHOs (Physician Hospital Organizations)
- PPOs (Preferred Provider Organizations)
- Case/Disease Management Providers
- CVOs (Credentialing Verification Organizations)
- MSOs (Management Service Organizations)
- PRSOs (Peer Review Service Organizations)
- TPAs (Third Party Administrators)
- UROs (Utilization Review Organizations)
Capacity
Darwin can provide limits up to $20 million for managed care E&O
risks.
Coverage Highlights
- Definition of covered Managed Care Activities is broad and
includes (among others) provider selection; utilization review;
disease and case management; claims administration; administration,
management and marketing of health and managed care plans;
quality assurance and review; and establishment of provider
networks
- Broad definition of insured includes past and present employees,
medical directors, directors, officers, committee members,
and volunteers
- Specific coverage for breach of confidentiality or improper
disclosure of protected medical information under HIPAA managed
care activities
- Modified 60/40 hammer clause (Darwin will pay 60% of amounts
in excess of settlement rejected by Insured)
- Vicarious liability coverage
- Automatic 90-day coverage for mergers and acquisitions
- Broad provider selection coverage for claims by members
alleging negligent selection and for claims related to credentialing
Submission
Requirements
Darwin can quote from most competitors’ applications. However,
for primary coverage a completed, signed Darwin application
is required prior to issuing a policy.
Access to this product is available only
to Darwin-approved producers. Approved producers may email account
submissions to submissions@darwinpro.com,
fax them to 860 284 1302, or mail them to the address below.
If you are not a Darwin-approved producer,
click here for a list of approved
referral wholesalers for this line of business.
Darwin Professional Underwriters, Inc.
9 Farm Springs Road, Farmington, CT 06032
V 860-284-1300 | F 860-284-1301 | E info@darwinpro.com
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Professional Underwriters, Inc.
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