, JD, has practiced law exclusively in the areas of asset protection, risk management and wealth preservation for the last 16 years. He helps protect a national client base with more than $5 billion in personal assets, including several thousand physicians. He is a contributing author to multiple books for physicians and a frequent medical conference speaker and CME presenter. 

Ike Devji, JD

Asset Protection Attorney and regular Physicians Practice contributor 

, an investment advisor representative and the founder and president of 

 to discuss the most common and costly asset protection and wealth preservation mistakes high-earners make, what high earners need for a compressive asset protection and wealth preservation plan, and more.

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Two experts discuss the most common and costly mistakes high-earners make.

Ike Devji, JD and Anthony Williams, Part 2

 to discuss the impact of Covid-19 on assets, alternatives to hedge against downside risk, what high earners can expect with impending tax changes, and more.

Two experts sit down and talk about asset protection.

Ike Devji, JD and Anthony Williams, Part 1

In part eight of our ongoing series on medical malpractice and asset protection, we look at the important details every doctor must understand about their medical malpractice insurance, and why not all polices are equal.

Among the most important layers in a physician’s asset protection planning is their 

 as we touched on in part five of this series. We’ve previously discussed on many occasions that asset protection has three primary layers:

 Following industry best practices (like maintaining strict standards on 

), laws and compliance, and ethical standards in all areas to avoid liability in the first place.

 This means all the right kinds of insurance, to the right coverage limits with the right features and scope of coverage. This includes medical malpractice insurance to cover both any possible judgment against you and the significant and unavoidable costs of legal defense, which are easily six figures on their own.

Legal tools to proactively separate business and personal assets and liabilities.

 This limits your personal exposure for any gaps in your insurance for issues that are either 

 by insurance, or which create a liability 

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Basic Medical Malpractice Policy Vocabulary Every Physician Must Understand

 you must pay for unexpected or excessive liability that your insurance carrier may incur. Assessment risk is most common in risk retention groups and captive insurance arrangements where there may not be adequate excess reserves to cover this variance. Most commercial insurance policies, on the other hand have this risk built into their premiums, so buyers should know if their coverage carries this assessment risk (an extra bill) and carefully consider if the lower premium is worth the potential additional risk.

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 insurance indemnifies you from malpractice “claims made” by patients when the policy is active and requires tail coverage. 

 insurance covers any incident that occurs when the policy is active, regardless of when a claim is made, more inclusive, no tail required.

 clause determines if your consent is required by your insurance carrier to settle your case. The 

 determines how the insurance carrier’s liability may be limited, and how yours may actually be increased if you do not provide consent to settle and a trial results in a verdict that is larger than the amount they wanted to settle for. Patricia Legant, MD, PhD a solo oncologist who served on the board of a physician-run malpractice insurance company, 

Some carriers prefer to settle a suit, even one without merit, because the cost of defense might exceed the amount of settlement. But any settlement made on your behalf must be reported to the National Practitioner Data Bank, so a settlement can adversely affect your insurance status, ability to participate in a managed-care group, and application for hospital privileges.

Before you purchase a policy, try to negotiate the terms so that your policy includes a consent-to-settlement clause and omits a hammer clause.

Defense Inside the Limits vs. Defense in Addition, who pays the lawyers?

 It’s vital that you understand who bears the liability for the costs of your defense including legal fees, court costs, experts, and all other related expenses. You should be able to answer the following questions about your policy:

Is that coverage limited to a specific dollar amount?

Do defense costs come from inside the policy, thereby reducing the amount available for judgments or settlements, or are they separate; if so, is there a limit? Example, $1MM policy limit, $300K for defense costs may equal $700K available for judgment or settlement.

 There are two important numbers here, first the 

, how much your policy covers per each claim filed. Second, the 

, the total dollar amount the policy will pay out during the policy period. For Example, many doctors have $1 million 

 during the policy period and are personally financially responsible for 

 and Exclusions. Know if the policy covers your staff, your practice and 

, JD, has practiced law exclusively in the areas of asset protection, risk management and wealth preservation for the last 16 years. He helps protect a national client base with more than $5 billion in personal assets, including several thousand physicians. He is a contributing author to multiple books for physicians and a frequent medical conference speaker and CME presenter. Learn more at

Articles

What doctors must understand about their insurance and why not all polices are equal.

Medical Malpractice and Asset Protection, Part 8: Med Mal Insurance

Our last installment in this series covered the potential 

 for the off-label prescribing of Ivermectin for the treatment and prevention of COVID-19. A recent article published by the American Council on Science and Health, “

Ivermectin and the Practice of Mob Medicine

” further highlights the dangers to both patients and healthcare facilities when the administration of specific treatment is dictated by a public “mob” comprised of politicians, the public, and lay people, and the courts rather than scientific evidence and the sound judgment of treating physicians. The article covers the legal issues at play, including a recent case overruling the court ordered administration of Ivermectin by a hospital at the demands of a family and a 

“While this court is sympathetic to the Plaintiff and understands the idea of wanting to do anything to help her loved one, public policy should not and does not support allowing a physician to try “any” type of treatment on human beings. Rather, public policy supports the safe and effective development of medications and medical practices. … What is more, public policy, in this case, encompasses

broader issues, including a hospital's standard of care decisions, mandating doctors and nurses to provide care they believe unnecessary, ethical concerns of all doctors involved, patient autonomy, fiduciary duty, accreditation standards for patient protections, obligating one doctor to carry out the treatment regimen/plan of another doctor, interplay of RC. 4743.10, and whether a court should medicate or legislate from the bench.”

Physicians and hospitals across the country 

 and refusing to allow the mob to control care decisions, and with those decisions, the 

 assumed for providing it. In some cases, the treatment has had actual adverse results that treating physicians and hospitals who are litigating this issue can point to. 

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Robotic Surgery Risk – Is the Doctor or the Robot Responsible?

The law, like medicine, is a constantly evolving discipline and it changes and expands with technology. The advent and increasing use of robotic devices that can do specific things with greater dexterity or accuracy than humanly possible with the right human guidance has been good for patients and medicine in general. One question that the law is unsettled on however is the division of liability between the physician responsible for the selection and administration of a specific robotic procedure and the manufacturer of a machine designed for a specific purpose. As an example from 

In his essay, Pasquale offers an example of a traditional surgery in which a surgeon slips cutting a vital tendon with the scalpel. But what if, Pasquale poses, that surgeon is using a robotic device designed and marketed with a special component to avoid such a mistake. Who’s liable then? The surgeon or the device maker?

The article touches on a variety of the legal issues at play including the strict liability standard that may be applied by the courts, how liability may be apportioned between parties, the question of adequate training, and points to the importance of documenting the selection and use of a specific device for a specific patient.

Three Examples of Self-Inflicted Business Liabilities by Physicians

Covid-19 Disinformation Leads to License Suspension

 for allegedly engaging in a variety of unsafe practices with patients in his office including violating safety protocols and actively promoting disinformation on masks and vaccines.

Fertility Clinic Liable for HIPAA Breach in Group Email

 brought by a patient after emailing her private information to the individual’s entire work team. Illustrates the need for compliance, training and high limits of data breach liability insurance coverage.

Seven social skills they don’t teach in medical school

Reputational Damage to Employer Brings Lawsuit

 and is the subject of a restraining order for falsely using his former titles repeatedly in media and in interviews. The employer argues that the disinformation that the physician promotes on a variety of COVID-19 and vaccine related issues creates reputational damage and risk for the institution. Essentially, he can say what he wants, but not that he still works here, when he in fact does not.

In part seven of our look at medical malpractice risk we examine specific liability issues from recent media reports and about physicians and healthcare. 