AMBULATORY SURGERY CENTERS LIABILITY – INSURANCE PRIMER
Ambulatory surgery centers (ASCs), by the nature of their business, always face liability risks. Although many of these risks can be lessened through implementation of risk-management practices, they can rarely be eliminated. Thus, it is prudent to define a liability-insurance program that addresses the ASC’s needs and ensures your peace of mind should the unexpected event(s) occur.
The following is a listing of the liability coverages that comprise the inventory selected by many ASCs:
Professional Liability Insurance (Medical Malpractice)
Commercial General Liability Insurance
Workers’ Compensation Insurance
Cyber Liability Insurance
Regulatory Liability Insurance
Employee Benefits Liability Insurance
Employment Practices Liability Insurance
Below is a brief description of these liability coverages:
Professional Liability Insurance (Medical Malpractice): Provides indemnity and expense protection for errors and omissions emanating from professional mistakes. These include professional negligence, provision of services that are below the prevailing standard of care, and misrepresentation. Policy terms and conditions are not standardized and must be reviewed closely. Some key components to look for are incident-sensitive trigger, defense outside limits, prior-acts coverage, and coverage for ancillary personnel and medical-director duties.
Commercial General Liability Insurance: Provides indemnity and expense protection for incidents, including third parties, arising from negligence causing bodily injuries, property damage, and personal injuries that your business caused. This includes slips and falls and loss of or damage to property.
Workers’ Compensation Insurance: Covers medical and rehabilitation costs and lost wages for employees injured at work. Florida, along with most states (with a few exceptions), essentially requires employers to purchase an insurance policy to handle their statutory obligations to workers who are injured or made ill due to a workplace exposure. Typically, workers’ compensation covers medical expenses, lost earnings, disability payments, funeral expenses, and legal fees.
Cyber Liability Insurance: Offers financial protection when a data breach, theft of data, or cyber-attack compromises valuable or private information. Cyber coverage can include crisis management, multimedia liability, and security and privacy liability. Coverage can also protect you with regards to privacy regulatory defense and penalties as well as privacy breach and network asset protection. Cyber extortion and cyber terrorism coverages are also desirable attributes of many policies.
Regulatory Liability Insurance: In today’s rapidly changing regulatory environment many operators are choosing this coverage to provide reimbursements for regulatory fines, penalties, claims expenses, and shadow-audit expenses resulting from regulatory proceedings. Desirable policies include coverage for allegations of billing errors resulting from ZPIC, RAC, and other similar audits; fines and penalties; as well as defense of EMTALA and STARK violations.
Employee Benefits Liability Insurance: Covers an insured in the event of a claim that arises out of errors and/or omissions in the administration of a benefit plan. These can include failing to advise an employee of a benefit program; failure to enroll, terminate, or cancel an employee in the plan; and administering improper advice in regards to the benefits. Employee benefits programs can include group life insurance, group health insurance, profit-sharing plans, employee stock plans, workers’ compensation, unemployment insurance, and COBRA.
Employment Practices Liability Insurance: Protects your business against the high cost of lawsuits due to discrimination, harassment, wrongful termination, and other potential charges stemming from employment practices. This coverage can cover your business from the cost of legal defense, settlements, and other court fees when faced with an allegation of violating a person’s or group’s civil rights or failing to provide a fair, acceptable environment for them to complete their work.
Navigating the various types of coverages can be a challenge. Avoiding potential gaps and needless overlapping can be crucial to your operations and bottom line. Thus, professional guidance is often the best route to take, by conducting a review of all alternatives with your liability-insurance consultant.
Written by Bill Gompers of Danna-Gracey, professional liability experts. Bill and Danna-Gracey have been instrumental, in concert with the FSASC, in developing a purchasing program that is a broad, cost-effective, stable approach to meet ASCs’ liability-insurance needs. [email protected] or 888.777.7173.