Doctors, nurses will be harder to insure

Chris Jones

Friday, March 1, 2002 | 11:02 a.m.

Medical malpractice insurance will soon be even more difficult to obtain on the open market in Nevada, a number of insurers told the Nevada Division of Insurance Thursday.

Citing factors that ranged from increased expenses to skyrocketing losses in the state's courtrooms, only two of the 15 companies currently licensed to insure Nevada's doctors and nurses said they will offer unrestricted medical coverage when their existing policies expire, according to statements submitted by insurers earlier this week.

More than 60 percent of Nevada's physicians were forced to seek out new insurance coverage when the state's largest malpractice underwriter, the St. Paul Cos. of Minnesota, announced late last year it would no longer underwrite medical malpractice insurance.

Some doctors said they have since been forced to pay premiums up to 500 percent more than their old rates; others have threatened to retire or leave the state because they claim they are unable to purchase new policies due to increased exposure to high-priced lawsuits.

Before she can enact emergency insurance procedures to maintain coverage for all medical personnel, state law requires Nevada Insurance Commissioner Alice Molasky-Arman to conduct a public hearing to determine the availability of essential insurance coverage. That hearing is scheduled for Monday in Carson City.

In preparation for the hearing, the insurance division on Feb. 19 sent letters to the state's licensed medical malpractice insurers. The letters included a series of questions about the companies' current business practices as well as their intentions in the marketplace.

The insurers' responses indicate Nevada's medical malpractice protection will be severely reduced over the next few months.

Although 15 companies can offer medical malpractice insurance in Nevada, only 11 currently make such coverage available. And insurance options are reduced for most of the state's doctors and nurses because one of the active companies, the Iowa-based NCMIC Group, restricts its coverage to chiropractors and their assistants.

Of the 10 active general medical insurers, three -- St. Paul Cos., Interstate Insurance Co. of Chicago and the New York-based National Union Fire Insurance Co. -- said they will discontinue providing coverage in Nevada when their current policies expire.

An additional five companies intend to be more selective in underwriting new policies or limit their existing coverage for those who work in high-risk areas of medicine.

Continental Casualty Co., also known as CNA, said it will not accept new medical clients, regardless of their field.

The American Physicians Assurance Co. will not write new policies for obstetricians/gynecologists (OB/ GYNs), nurse midwives or family practice physicians who practice obstetrics. TIG Insurance of Irving, Texas, said it will also take extra caution before it underwrites OB/GYNs -- along with emergency room physicians, radiologists, pathologists and ophthalmologists.

Physicians Insurance Co. of Wisconsin, plans to hold its new writings to less than $1.5 million in 2002, while the California-based Doctors Co. said it will only take on new clients after careful review and will not insure emergency medical personnel.

The Medical Insurance Exchange of California (MEIC), which has fewer than 50 Nevada policyholders, is one of two companies that has not announced plans to limit its coverage in the state. While it has received numerous inquiries from potential policyholders since St. Paul first announced it would drop out of the market, MEIC told the insurance division it will make no policy changes until its board of governors meets March 21.

Indiana-based Medical Protective Co., which had not written any policies in Nevada until late last year, also has no plans to limit or discontinue its coverage in the state.

The remaining four licensees have no active policies in Nevada and do not intend to enter the market under current conditions.

Full testimonies from all 15 licensed insurers will be read at Monday's hearing, which will also include remarks from members of various medical organizations and associations, insurance brokers and agents, trial lawyers and insurance division members, among others.