“AANS members are definitely interested in participating in a medical malpractice insurance program, should such a program be offered,” said Dave Fellers, CAE, AANS Executive Director, when commenting on a recent survey distributed to AANS members. The survey, which was included in the summer 1999 issue of the Bulletin, queried AANS members on their interest in medical malpractice insurance, and asked if they would be interested in participating in a malpractice insurance program sponsored by the AANS. An overwhelming 56 percent of the survey respondents answered “yes,” as compared to only 31 percent who said they were “unsure.”
The survey questionnaire asked 10 questions about neurosurgeons’ medical malpractice insurance, including the name of their current carrier, their coverage limit, whether they feel their coverage is adequate, how many claims they may have filed over the past 24 months and the type of procedure the claim(s) was related to. The questionnaire also asked if members would be interested in a malpractice insurance program sponsored by the AANS.
The AANS will use the results of the medical malpractice insurance survey to investigate the feasibility of an AANS-sponsored malpractice insurance program and to assist in evaluating potential insurance carriers. The outcome of this study will be reported to the AANS Board of Directors along with a recommendation for action.
Survey Summary
Of the 4,700 medical malpractice insurance questionnaires distributed, 277 were returned, constituting a 5.8 percent response rate. Slightly more than 45 percent of the responses came from six states: California (13 percent of responses), Florida (9.7 percent), Texas (7.6 percent), Illinois (5.8 percent), Pennsylvania (4.7 percent), and New York (4.3 percent). The respondents listed more than 45 malpractice insurance carriers with whom they do business. Three companies – SCIPIE, CNA, and St. Paul – were mentioned most frequently.
Coverage limits varied among the respondents – more than 42 percent opt for coverage limited to $1 million per occurrence and $3 million annually. Coverage limits reported ranged from a low of zero (two respondents indicated that they currently are not covered by medical malpractice insurance) to a high of unlimited coverage (also reported by two respondents). Coverage limits in the high range were $1 million-$10 million, $2 million-$6 million, and $3 million-$5 million. The low end of the reported range of coverage limits included $100,000-$300,000, $200,000-$600,000, and $250,000-$750,000.
Reported annual medical malpractice insurance premiums ranged as widely as the coverage limits, from a high of $100,000 to a low of $7,673.
Not all of the respondents answered the question, “Do you consider your coverage to be adequate?” Of the 256 respondents who did answer this question, nearly 84 percent responded “yes.” Forty-two respondents do not consider their coverage adequate, and attributed their coverage shortfall most often to an environment of more lawsuits and unfavorable judgments, increasingly high judgments, and the high cost of greater coverage.
One respondent pointed out, “There is the possibility that physicians with more insurance will get sued more because suits are generally aimed at those with deep pockets. Although my limits may not be adequate, it is not clear to me that having more insurance would better protect me.”
Only 57 respondents offered feedback on the question, “What additional coverage would you prefer?” Of those who responded that they desired increased coverage limits, the limits mentioned most often were in the $3 million-$5 million range. These respondents mentioned tail coverage as a desirable addition; they also prefer an occurrence policy to a claims made policy. Finally, two respondents reported physician assistant coverage as an additional coverage need.
The group responding to the survey tended to have a low number of claims made during the 24 months preceding the survey. Of the 269 members responding to this question, 165, or more than 60 percent, had zero malpractice claims. Another 91, or about 34 percent, filed one or two claims. Eleven respondents filed three to five claims, and two respondents filed more than five claims.
If a respondent had claims experience, the claim(s) was most often related to spine procedures (average 77.2 percent), followed by intracranial procedures (average 41.59 percent), and all other procedures (average 19.43 percent).
“This survey was the first step in what is intended to be an ongoing effort on the part of the AANS to ask our members what kinds of new products and services they believe have value,” said Mr. Fellers. “We will continue to solicit feedback on these types of issues and in other areas on a regular basis so that we keep pace with our members’ needs.”