Healthcare solutions

Increased litigation, administrative demands, and new government regulations continue to create legal, financial, and reputational risks for health-related businesses.  Our custom account and asset protection solutions from Ironshore can help protect healthcare organizations with complex or unique professional liability exposures.

Our team, led by actuaries and attorneys with backgrounds in underwriting, claims, reinsurance, and corporate finance, will take the time to partner with you to find and finance the right alternative risk solution for your clients.

Coverage highlights:

• Limits up to $50M
• Available on a claims-made and occurrence basis
• Fronting arrangements for captives
• Swing-rated or “loss sensitive” arrangements
• Fully funded policies
• Stop loss coverage for an insured’s self-insured retention
• Loss portfolio transfers
• Unlimited tail coverage for previously self-insured or captive-insured retentions

Target classes:

• Healthcare providers/payers (e.g., health systems, hospitals, long-term care facilities, outpatient, managed care organizations, physician group practices)
• Life sciences companies

This solution is designed for healthcare and consultation delivered electronically, via video, as well as for virtual physical therapy, counseling, staffing, and home healthcare.

Key coverage highlights:

• Claims made and occurrence coverage available
• Primary policy limits $1M/$3M
• Excess limits available up to $5M
• Coverage includes:
  • Professional liability
  • Commercial general liability
  • Technology errors and omissions
• Additional coverage available for:
  • Cyber liability
  • Products liability (applies to wearable medical devices, service disruption, etc.)

Value-added risk-management services:

Customers can choose to allocate risk-management dollars toward risk-management products and services. While we don’t require customers to choose our vendors, we invite you to take advantage of our well-established relationships with leading healthcare risk-management professionals.

Our healthcare programs from Ironshore deliver comprehensive solutions for medical providers with unique coverage needs or hard-to-place risk. Supported by a team that has more than 30 years of combined experience working with program administrators to develop customized protection, we are ready to partner with wholesale brokers to meet the needs of this unique sector.

Program features:

• Minimum premium: $3M
• Limits: for individuals $1M/$3M up to $2M/$6M in Virginia; for other risks up to $10M
• Available on a claims-made and occurrence depending on product

Current business profile:

• Individual allied healthcare practitioners
• Individual doctors and small groups of six or fewer
• Small miscellaneous facilities under $25K*
• Small home health under $175K*

*Offered on both a program and open brokerage basis, as preferred by the broker

Programs portfolio:

• Blanket school programs for healthcare students
• Certified registered nurse anesthetists
• Chiropractors
• Dental hygienists
• Medical assistants
• Medical technologists
• Occupational therapists
• Optometrists
• Pharmacists
• Phlebotomists
• Physical therapists
• Physician assistants
• Physicians and surgeons
• Physiologists
• Respiratory therapists
• Speech pathologists

Our reinsurance solutions help HMOs manage growing financial risk associated with member care costs and curtail the impact of catastrophic claims.

Coverage highlights:

• Specific retentions per member ranging from $100K up to $2M
• Option for unlimited maximum benefit coverage per member
• Up to $10M continuation of benefit coverage
• Minimum premiums as low as $100K

Target classes:

• Healthcare providers that take risk
• HMOs
• PPOs
• ACOs

The combination of financial pressure and healthcare reform has spurred tremendous change in the way healthcare providers and payors are organizing themselves to deliver and finance care effectively.

Our hospital professional liability team at Ironshore is ready to work with wholesale brokers to develop solutions to help protect healthcare organizations against legal, financial, and reputational risk arising from treatment decisions and actions.

Coverage highlights:

• $1M/$3M or $2M/$4M in primary capacity
• Limits up to $15M in excess capacity
• Available on a claims-made basis for professional liability and occurrence basis for general liability
• Stand-alone tail policies
• Reinsurance for captives

Coverage differentiators:  

• Child abduction expense reimbursement
• Disinfection event expense reimbursement
• Evacuation expense reimbursement
• Government billing legal expense reimbursement
• Legal defense expense reimbursement
• Medical waste civil fines reimbursement
• Personal information protection expense reimbursement
• Professional liability for insured individuals who provide Charitable Medical Services anywhere in the world, up to $1M/$1M
• Public relations expense reimbursement

Value-added risk-management services: 

Our customers can also allocate “risk-management dollars” toward risk-management products and services, such as education and event reporting software solutions, from leading healthcare providers. We don’t require the use of specific services or select vendors, as we understand that our insureds know their needs best and may have existing vendor relationships. To assist our insureds, we have proactively established relationships with some of the industry’s leading healthcare risk-management providers.

Target classes:

• Acute care hospitals (stand-alone or multi-hospital systems)
• Critical access hospitals
• Integrated delivery systems
• Long-term acute care and rehabilitation facilities
• Psychiatric hospitals
• Specialty hospitals

For companies that research and deliver new drugs, medical devices, and other life sciences products to treat and cure disease, the pressure to perform has never been greater. Our life sciences liability solutions from Ironshore help protect biotechnology, pharmaceutical, medical device, and medical product companies that operate in this fast-paced, complex, and highly regulated world against legal, financial, and reputational risk arising from their products or their work.

Coverage highlights:

• $15M capacity
• Products-completed operations coverage with option to add professional liability coverage under one policy aggregate
• Separate policy aggregate available for general liability
• Claims made and defense within limits for product and professional liability
• Occurrence made available for premises operations
• Seven-year extended reporting period (ERP) available upon request; additional premium not to exceed 200 percent of policy premium
• Follow form excess with duty to defend when required by underlying policies
• Includes punitive damages, where allowable by law
• Blanket additional insured coverage
• Worldwide territory
• Definition of bodily injury includes humiliation
• Seven-year claim reporting for written notice of circumstances prior to policy expiration or subsequent, continuous renewal
• Products-completed operations coverage enhancements available

Target classes:

• Biotechnology companies
• Clinical research organizations
• Human clinical trials
• Medical device and medical products manufacturers and distributors
• Nutraceuticals/OTC
• Over-the-counter products
• Site management organizations
• Specialty and generic pharmaceutical companies

Long-term care facilities face a variety of challenges: care models are evolving, the population continues to age, resources are tight, and regulations continue to increase. We are ready to partner with wholesale brokers to protect providers in this uncertain environment.  Our long-term care professional and general liability solutions from Ironshore help protect long-term care facilities against legal, financial, and reputational risk arising from the services they provide.

Coverage highlights:

• Primary policy limits $1M/$3M, with separate limits for:
  • Professional liability
  • General liability
  • Employee benefits liability
• Excess limits available up to $10M
• Available on a claims-made and occurrence basis
• Coverage available for:
  • Public relations
  • Evacuation
  • Resident loss of property
  • Disinfection event expense
  • Regulatory proceeding defense coverage
• Policies include a complimentary hour of legal review of admission agreements and/or contracts with telemedicine monitoring providers by Ironshore panel counsel.
• Flexibility with respect to coverage for sexual misconduct
• Express coverage for employed or contracted medical director
• Separate or shared limits available for scheduled physicians by endorsement

Value-added risk-management services:

We provide preferred risk-management services for long-term care clients. Accounts may be allocated a budget for risk-management services from an extensive menu provided by preferred vendors. Our unique approach offers insureds and their brokers involvement in the selection of risk-management services, which range from access to highly skilled consultants who can help with policies and procedures or survey responses to software tools that can track incidents or risk indicators. We want to provide our policyholders with risk-management services that they know they need, not ones that the insurer thinks they need.

 Target classes:

• Not-for-profit and for-profit long-term care entities, including independent, assisted, dementia/Alzheimer’s, and skilled nursing facilities

HMOs, PPOs, disease management companies, and other businesses in the managed care space are facing higher scrutiny and more risks than ever before. Our managed care liability solutions from Ironshore can offer errors and omissions (E&O) and directors and officers (D&O) liability protection to help safeguard managed care organizations against legal, financial, and reputational risk arising from the services that they provide.

E&O coverage highlights:

• Primary and excess coverage
• $10M capacity
• Coverage available on a duty to defend or reimbursement basis
• Offered stand-alone or with D&O coverage
• Minimal exclusionary language
• Privacy, security, media, and crisis management coverage included
• Worldwide coverage

Additional E&O coverage highlights:  

• Coverage for fines and penalties imposed under HIPAA and any other similar federal, state, or local privacy law or regulation
• Vicarious liability for medical services as well as all managed care services and private information protection
• Definition of insured includes spousal coverage
• Punitive damages with most favorable venue wording

D&O coverage highlights:

• Primary and excess coverage
• $10M capacity
• Offered with managed care E&O coverage
• Coverage for regulatory claims including Medicare and Medicaid fraud and abuse claims
• Broad definition of insured person includes leased and contracted employees, volunteers, and spousal/domestic partners
• Broad definition of claim, including civil, criminal, governmental, regulatory, administrative, and arbitration proceedings

Target classes:

• Large traditional managed care organizations such as HMOs and PPOs
• Other organizations providing managed care services, including ACOs, IPAs, PHOs, UROs, MSOs, TPAs, PROs, QIOs, CVOs, care management, and disease management companies
• Healthcare consultants

The healthcare sector continues to change, and more outpatient facilities are providing medical services such as adult care, home health, imaging, pharmacy, laboratory, and rehabilitation. Our miscellaneous medical facilities professional liability solutions from Ironshore can help outpatient medical service providers from liability associated with alleged errors, omissions, or other wrongful acts.

Coverage highlights:

• Available on an occurrence and a claims-made basis
• Primary policy limits of $1M/$3M or $2M/$4M, with separate limits for:
  • Professional liability
  • General liability
  • Employee benefits liability
  • Hired/Non-owned auto
• Excess limits available up to $10M
• Coverage available for:
  • HIPAA violations
  • Evacuation expense reimbursement
  • Public relations event reimbursement
  • Patient loss of property
  • Defense outside limit

Target classes:

• Ambulance
• Blood/tissue/organ banks
• Dialysis centers
• Home health agencies
• Hospice
• Imaging centers (including mobile imaging)
• Laboratories
• Medical clinics/health departments/student health centers
• Medical staffing agencies, registries
• Mental health/substance abuse counseling clinics
• Oncology centers
• Optical centers
• Pharmacies
• Rehabilitation
• Sleep centers
• Surgery centers

The business of healthcare delivery is evolving, creating significant exposures for physician group practices that are no longer adequately covered by traditional physician professional liability (PPL) products.

Our offering from Ironshore combines PPL and enterprise risk-management coverage in a single package to help protect physicians and their practices from liability associated with alleged errors and omissions in treatment.

Coverage highlights: 

• Primary policy limits of $1M/$3M ($2M/$6M available upon request)
• Excess limits available up to $10M
• Available on a claims-made coverage for groups of 10 or more physicians
• Stand-alone “tail” coverage for physician groups
• Alternative risk options, such as reinsurance and fronting for captives and loss portfolio transfers, are also available.

Target classes:

Including but not limited to:

• Single specialty and multispecialty groups
• Single state or multistate physician groups

Our provider excess insurance solutions support medical providers with an extra layer of protection. Whether it’s for start-up groups or well-established providers, this option can help protect against catastrophic claims.

Coverage highlights:

• Specific retentions per member ranging from $25K up to $2M
• Option for unlimited maximum benefit coverage per member
• Minimum premiums as low as $25K

Nonprofit hospitals, private physician groups, and other healthcare organizations face more risk than ever before as their billing practices come under increased scrutiny by Federal and state governments and commercial payors.

Our regulatory liability errors and omissions (E&O) solutions from Ironshore can help protect  healthcare organizations and their leaders against costly lawsuits, penalties, and fines related to issues such as:

• False Claims Act allegations (including qui tam suits)
• Anti-Kickback Statute and Stark Law allegations
• Voluntary disclosure of billing errors to the government or commercial payors

Coverage highlights:  

• Primary and excess coverage available
• $10M capacity
• Optional retroactive coverage for up to three years
• Coverage for defense and investigative costs, civil fines, and penalties including multiplied damages component
• Regulatory risk mitigation consultation services

Target classes:

• Nonprofit hospitals
• Physician groups (greater than 25 physicians)