Frequently Asked Questions

Application & Quotes

How do I apply for medical malpractice coverage with Advocate, D.O.?

1. You can apply here by downloading the Advocate, D.O. application.
2. You may contact a sales representative at 800.686.2734 or your local medical malpractice agent; if you do not have an agent we can refer one to you.
3. Fill out our Sales department contact form and we will send you the necessary information.

How long will it take my application to be reviewed by Underwriting?
An application usually takes between 10-14 business days to fully process. We can, however, put an application in high priority if the effective date is immediate.

What is the difference between an indication and a quote?
Indications are available to physicians prior to reviewing their application. The indication is a premium estimate that is based on the physician's county of practice, specialty, desired limits, effective date, and retroactive date. Indications are NOT binding. Once the physician applies, the underwriter can evaluate if the applicant qualifies for added discounts. It is important to disclose full and truthful information on the application so that your policy has proper coverage. If you fail to disclose important procedures, you may not be covered for that added exposure. Once all information on the applicant is reviewed a quote is given which the physician can then accept or decline. A policy is bound and issued upon receipt of premium payment.

What does rate year mean in medical liability terms?
When starting a new practice for the first time, when you have an ‘occurrence’ policy in prior years, or you purchase tail coverage from your previous policy, your claims made policy will be written at a first year rate (which is about 25% of a fully developed or "mature" rate). Each succeeding year, your premium will increase until the fourth year of coverage, at which time the premium is fully developed (mature).

Coverage & Policy

Do you cover all areas of Texas and Mississippi?
Yes, Advocate, D.O. is here for all Texas and Mississippi physicians. We write physicians in all areas of Texas and Mississippi.

What limits of liability do you offer?
We offer a wide variety of coverage limits in Texas from $100,000/$300,000 to $1 million/$3 million and in Mississippi from $500,000/$2 million to $1 million/$3 million limits for the Standard and Continuous Policies.

What is a "claims-made" policy?
A claims-made policy provides coverage for claims and/or suits made on or after the retroactive date of the policy and are reported while the policy is in force. Once coverage is terminated, reporting rights cease unless extended reporting rights, commonly referred to as "tail", are purchased. I.E. A claims-made policy is triggered by the date the claim is reported to the carrier as long as the treatment occurred after the retroactive date and before the cancellation date. Advocate, D.O. offers Claims-Made policies.

What is an "occurrence" policy?
An occurrence policy provides coverage for claims and/or suits that occurred during the policy period regardless of the date reported. I.E. An occurrence policy is triggered by the effective date of treatment.

How do I make adjustments to my policy?
Contact Advocate, D.O.'s Underwriting Department at 800.686.2734 or the Underwriting contact form or your agent.

What is the difference between "tail" coverage and "prior acts" (retroactive) coverage?
Extended Reporting Coverage or Tail Coverage, is purchased at the time a claims-made policy terminates and offers coverage for claims/suits that have occurred while the policy was still in effect, but which were not actually reported until after the policy terminated.
Prior Acts Coverage covers claims first made against the physician after the effective date of coverage on the current policy but occurring in the prior years. To be covered, such claims must arise out of the physician's acts or omissions prior to the Advocate, D.O. policy's effective date and after its retroactive date. Both dates are shown on the declarations page of the policy for an individual physician.

What if I leave my present carrier without purchasing "tail coverage"?
To avoid lapse of coverage, it is necessary to either purchase tail coverage from your present insurer or prior acts coverage with your new carrier on your new policy.

What is Medical Defense Coverage?
Medical Defense Coverage provides protection against Government Agency Investigations such as Medicare, Medicaid, RAC/ZPIC Audits, HIPAA, HITECH, EMTALA/Patient Anti-Dumping, TX & MS Medical Board & Other Professional Licensing Agencies, Medical Associations, Peer Reviews, Billing Errors, Hospitals/Surgical Centers, OSHA, ADA, CLIA, Stark & Anti-Kickback, EMR/EHR, Subpoenas, Shadow Audits and Government Agencies.

Claims

What is considered a claim?
A claim is considered a written notice to Advocate, D.O. of the following:

1. notice of claim sent to our Insured pursuant to Chapter 74 of the Civil Practice and Remedies Code.
2. a written demand sent to our Insured from a patient or patient's representative for monetary damages.
3. a summons or citation that has been served upon our Insured.

What is a notice of claim?
A notice of claim is a letter sent via Certified mail and Return Receipt Requested pursuant to Chapter 74 of the Civil Practice and Remedies Code. It provides for an investigatory time period and tolls the statute of limitations as to all potential defendants for 60 days. The notice of claim provides the physician and his insurer 60 days in which to investigate and evaluate the patient's alleged claim.

How do I report a claim?
Upon receipt of a written notice of claim or service of a lawsuit, the Insured should contact the Advocate, MD Claims Department immediately at 800.686.2734. In addition, the original of the written notice of claim or lawsuit should be mailed to Advocate, MD. Attention: Claims Department. A completed Advocate, MD Notice of Claim form should also be included with the original notice of claim or lawsuit.

Does the company have the right to settle my claim without my permission?
Advocate, D.O.'s Physicians and Surgeons Liability Insurance Policy contains a Consent to Settle Clause. Advocate, D.O. will require the written consent of the Insured prior to closing or settling a claim.

What do I do if a lawsuit is filed against me for an amount greater than my limits of coverage?
You will be assigned an attorney by the company for your representation, up to the limits of your policy. It may be necessary for you to hire an attorney to represent you for exposure in excess of your limits.

Does the attorney appointed to defend me represent me or the Insurance Company?
The attorney represents you, the insured. Advocate, D.O. pays for legal expenses incurred. If the verdict is in excess of your limits, Advocate, D.O. pays legal fees for services rendered to protect the policy limits.

If I am joined in suit with others (hospital, other doctors) how am I represented?
The attorney represents you, and will cooperate with attorneys representing the other defendants.

Do I have my choice of attorney?
Advocate, D.O. has an approved list of core Group of Attorneys that are experienced in medical malpractice. The defense attorneys selected to participate in our core Group of Attorneys are highly experienced attorneys located throughout the state. The list of core Group of Attorneys is continually monitored and is also frequently updated upon receipt of recommendations for inclusion of a defense council to the group. Advocate, D.O. retains the right to choose defense counsel from its core Group of Attorneys.

How to Choose a Carrier

Payments