USA – Healthcare Liability

We’ve spent years developing niche products and services that are targeted to the needs of diverse Healthcare organizations. Our underwriting expertise gives us the ability to separate perceived risk from actual risk. In addition to our comprehensive professional liability coverage, all policyholders receive customized risk management services as part of their policy.

Within Medical Professional we also write:
Hospital Professional
Miscellaneous Medical Facilities
Physician and Surgeon Groups
Clinical Research

This policy covers a broad range of environmental exposures confronted by healthcare facilities while offering insurance coverage for claims arising from healthcare-associated infections (HAIs). Allied World not only offers enhanced insurance coverage, but also provides our insureds with a comprehensive protection plan to help mitigate infections and reduce future claims. Allied World is a member of the Healthcare Environmental Risk Management Alliance (HERMA), a coalition of healthcare, risk management and insurance organizations, established to provide a standardized risk-based approach for healthcare facilities to reduce HAIs and avoid environmental losses.

Product features

• $25M per occurrence/aggregate limits available
• Protection from claims arising from bodily injury, property damage, clean-up costs, emergency response expense and claim expense
• Blanket coverage for owned or operated locations, non-owned locations and transportation
• Covers microbial matter, Legionella, medical infectious and pathological materials or waste, low-level radioactive materials or waste, and other contaminants
• Coverage for HAI disinfection and business interruption including the cost to move or evacuate patients
• Coverage for bodily injury and property damage for HAI excess of the insured’s other insurance for bodily injury and property damage is available
• Strategic Response® coverage available by endorsement

Allied World offers a number E&O solutions for managed care organizations. In addition to our comprehensive Managed Care E&O product, we also offer a package product for Affordable Care Organizations (ACOs), 365Complete®, a package product for organizations with under $150 million in revenue, and Benefit Plan Purchaser E&O, for organizations that self-insure all or part of their employee benefit programs.

Managed Care E&O Liability

Allied World specializes in the complex healthcare environment and is committed to providing comprehensive and innovative solutions for our customers. We understand that each policy needs to be tailored to the specific needs of the insured, and we are continually evolving to manage risk and provide coverage against emerging exposures. With nearly three decades of combined experience, our underwriting team is among the foremost leaders in the industry. Companies both large and small turn to Allied World for primary and lead excess coverage.

Product features

• Definition of covered managed care activities is broad and includes provider selection, utilization review, disease and case management, claims administration, administration, management and marketing of health and managed care plans, quality assurance and establishment of provider networks
• Broad definition of insured includes past and present employees, medical directors, directors, officers, committee members and volunteers
• Vicarious liability coverage for medical services as well as managed care services
• 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
• Antitrust coverage
• Incidental medical services coverage (flu shots, nurse call line, blood draws, blood pressure screening)
• Worldwide coverage

Accountable Care Organizations

With years of experience insuring the healthcare industry, Allied World Healthcare is in the unique position to address the needs of Accountable Care Organizations (ACOs). We understand the myriad of exposures that ACOs may encounter.  Allied World’s ACO liability protection offers a flexible and comprehensive solution for ACO liability coverage needs.

Product features

• Errors & Omissions: covers a broad range of services to reflect the full range of services that ACOs will offer, including peer review, utilization review, coordination of care, management and marketing of the ACO, providing quality assurance, and establishment of provider networks.
• Regulatory Coverage: anticipates the regulatory reality and works to support policyholders with ACO-specific concerns (includes coverage for judicial, administrative and regulatory proceedings brought on federal, state or local level, and also responds to investigations).
• Privacy Liability: customizes network security and privacy coverage based on the ACO structure, allowing protection for the ACO itself, as well as for the ACO members.
• Directors & Officers Liability: specifically addresses ACO-specific challenges including Dedicated Side A Coverage – Excess Coverage for Insured Persons.
• Employment Practices Liability: includes, but is not limited to, protection for wrongful dismissal, discharge or termination, harassment, discrimination, wrongful failure to employ or promote, deprivation of career opportunity, demotion, evaluation or wrongful discipline, and retaliation claims.
• Fiduciary Liability: offers broad coverage for individuals deemed to have a fiduciary role, even if they are not specifically listed as a Fiduciary of a Plan. It also has a broad definition of the types of plans for which an ACO might be responsible.
• Crime Coverage: reimburses ACOs for direct losses from criminal activities. ACOs can select insuring agreements that apply to their specific needs, giving them critical protection and flexibility.

Capacity: $5 million on a Surplus Lines basis

365Complete®

All managed care organizations have risk exposures, regardless of their size or the activities in which they engage. 365Complete® is a seamless, single source package that combines several individual specialty liability options – including Managed Care E&O, Cyber and Management Liability coverage – into one single source solution that covers more (and costs less) than piecing different policies together. This is the ideal one-stop solution for organizations with under $150 million in revenue.

Product features

• Duty-to-defend coverage
• Regulatory claim coverage
• Anti-trust coverage
• Final adjudication language in fraud exclusion
• Punitive damages with most favorable venue
• Plaintiffs’ attorney’s fees covered where legally obligated to pay
• Managed Care and Professional Services, including Cyber Coverage
• Management Liability coverage options include Directors and Officers (D&O), Employment Practices Liability (EPL), and Fiduciary coverage components
• Worldwide coverage

Benefit Plan Purchasers

As a way to control rising healthcare (and other benefit) costs, employers are increasingly offering alternative employee benefit programs. Some organizations now manage all or part of their own programs, which can expose them to many of the same liabilities typically faced by managed care organizations. Allied World recognizes the growing need to protect employers that take on additional responsibility with their benefit plan offerings.

As a leading insurer of traditional healthcare organizations, we created a Benefit Plan Purchaser policy that includes the same spectrum of protection we normally provide to our managed care insureds. Using our specialized experience and vast knowledge of the healthcare market, Allied World crafted a new type of coverage for organizations that are outside the healthcare spectrum but are now exposed to healthcare liability risks.

Product features

• Broad definition of claim, including regulatory proceedings and investigations
• Vicarious bodily injury coverage
• Includes “By or on behalf of” language
• Full coverage for punitive damages with most favorable venue, where insurable by law
• Coverage for HIPAA fines and penalties included
• Coverage available for unions/collective bargaining units
• Personally identifiable information protection included
• Automatic 90-day ERP
• Worldwide coverage
• Coverage for medical tourism available

Excess / Follow Form for D&O, EPL and Managed Care E&O

Available on an admitted basis with limits up to $10M

Product features

• Excess form has no definitions
• All major terms and conditions are designed to be truly follow form
• Easy to read policy language