WHY YOUR MEDICAL SOCIETY ENDORSES
MEDICAL LIABILITY MUTUAL INSURANCE COMPANY

MLMIC is endorsed exclusively by the Medical Society of the State of New York, virtually all of its component county medical societies and a number of specialty societies. A close look at this company helps to reveal why it is embraced by organized medicine.

HISTORY & BACKGROUND OF THE COMPANY

MLMIC was established as a mutual company, which means that its physician insureds are owners of the company and, through its Board of Directors, they control its operations. The Board of Directors is primarily comprised of physicians representing a diverse array of specialties and geographical areas. These physician Directors are able to "keep their finger on the pulse" of the practice of medicine, as well as on the needs and concerns of their colleagues. There are no stockholders to answer to or to share in the profits, as is the case with stock companies. Instead, profits realized by the Company are returned to its policyholders in the form of dividends or premium reductions. MLMIC has returned a 15% dividend to its physician and surgeon policyholders for two consecutive years and will do so for a third.)

Today, nearly twenty five years later, the Company has grown to become the largest physician dentist, and hospital owned and operated professional liability carrier in New York State, as well as the nation. MLMIC currently insures approximately 15,000 physicians, 27 hospitals, and more than 2000 dentists. These policyholders continue to provide input through their representatives on MLMIC' S Board of Directors, and their influence permeates every aspect of the Company's daily operations. MLMIC proudly declares itself to be the most "physician friendly" company, a fact that will become much clearer as we examine the Company's various departments.

UNDERWRITING

MLMIC 's underwriting goals have always remained two-fold: that is, to provide the most comprehensive coverage at the most reasonable cost, and also, at the same time, provide a level of service unmatched by any other company. In fact, MLMIC has a distinct rate advantage when compared with all other New York State admitted carriers in virtually every specialty classification throughout the State.

With a keen ear to the State's practicing physicians, MLMIC remains sensitive to the many changes that have taken place in medical practice and to needs of its insureds. As a result, the standard professional liability policy is frequently altered by endorsement and/or language revisions to reflect these practice changes. Through its various underwriting committees, MLMIC listens to its insureds, as it monitors practice patterns within a rapidly changing environment. As a result, new forms of coverage - such as, managed care contractual liability, coverage for a group administrator's vicarious liability, and limited defense costs coverage for administrative hearings - have been added to policyholders' standard policy at no additional cost.

In addition, MLMIC insureds have the added benefit of full peer review. If deemed necessary, a physician applying for coverage may be asked to submit to an interview by a committee of his/her peers to discuss past claims history and, if applicable, disciplinary actions. A current policyholder whose conduct, methods of practice, or claims experience are predictive of the likelihood of future claims in excess of the norm may be required to attend such an interview. Insured members of the Medical Society of the State of New York are interviewed by the Society's Professional Medical Liability Insurance Defense Board. Non-members and applicants are interviewed by one of MLMIC's claims committees.

MLMIC's pledge to provide full peer review is truly a unique benefit. All of the State's other admitted carriers are mandated to utilize the State of New York's automatic surcharge plan. This means that a practitioner who incurs a certain number of claims within a stated time, and/or whose company pays out a certain dollar amount within a given time, is automatically surcharged. MLMIC insureds are not surcharged in this matter and continue to enjoy the benefit of full peer review.

POLICYHOLDER SERVICES DEPARTMENT

PHS staff serve as the "front-line" for basic underwriting related calls or correspondence with accurate and timely service being the standard. They are also responsible for generating all Certificates of Insurance and claims histories, documents frequently requested by MLMIC insureds for purposes of credentialing and inclusion in HMO panels. In addition, PHS staff serve as the in-house liaison for policyholders involved in group practices, acting as their "eyes and ears," and assisting them by addressing their unique needs.

CLAIMS

MLMIC claims teams are well aware of the importance of conducting prompt evaluations and in maintaining direct personal contact with our policyholders. By conducting early and comprehensive analyses of claims and lawsuits, the Company is able to minimize defense costs and settlement costs which typically increase the longer a case remains open.

Every claim MLMIC receives against a physician or surgeon is reviewed by a physician member of MLMIC's Claims Review Committee. The reviewing doctor advises MLMIC 's claims personnel of his/her evaluation of the claim's validity. When indicated, the Committee calls upon other recognized specialists to help evaluate claims. As a mutual company, MLMIC has been able to obtain a high degree of cooperation from the doctors of New York State in its claims review program.

Generally, MLMIC may not settle any claim or suit against an insured physician or hospital without the written consent of that insured. In the event that the physicians on the claims committee feel strongly that a case should be settled and an insured refuses to agree to the settlement, the matter may be referred by either MLMIC or the insured to an advisory committee of three licensed physicians or surgeons (or hospital risk manager or administrator for hospital policyholders) for binding arbitration. No claim against an insured dentist will be settled without the consent of a majority of the members of the District Claims Committee of the insured's component of DSSNY.

MLMIC retains attorneys with the highest qualifications to defend suits against its policyholders. As a result, approximately ninety firms have been approved to defend cases based upon their competence, their willingness to resist groundless claims, and their practice location. Further, in the interest of providing the best possible defense to its insureds, MLMIC has established certain minimum guidelines. These guidelines require each attorney to: (1) provide individualized attention to the insured defendant and keep the insured apprised of the claim's progress: (2) meet as necessary with the insured after receipt of the basic investigation from MLMIC representatives: (3) explain the anticipated activities, expand on the investigation as necessary, and report to MLMIC representatives on the results of these procedures: and, (4) provide thorough preparation of the insured well in advance of the Examination Before Trial or any other court appearance that may be required. MLMIC has published these guidelines and distributes questionnaires, which evaluate the attorney's performance, to each defendant physician and dentist when the case is closed.

RISK MANAGEMENT/LEGAL SERVICES

Through continuing medical education programs, MLMIC affirms its mission to help physicians provide high quality medical care, increase patient safety, and ultimately reduce the risk of claims and losses. The Risk Management Department maintains an extensive satellite network to broadcast its teleconference programs. The network, which consists of approximately forty conference sites across the state, is designed to provide policyholders with frequent and convenient risk management programs. It is utilized for the mandatory Voluntary Attending Physician(VAP) and Rochester Area Professional Liability Association (RAPLA) programs, and the New York State Insurance Department approved programs, which afford attending physicians a discount on their annual premium. Additionally, the Risk Management Department provides a number of other services including on-site office audits, in-service educational programs, and related lectures for medical and specialty societies, hospital staffs, and residents.

In an effort to keep MLMIC insureds informed and up-to-date, the Risk Management Department and attorneys at Fager & Amsler are engaged in on-going communications with our insureds. A number of publications are available to insureds at no cost (please see the list below). The Company's newsletter, DATELINE, features current issues of importance, a review of new laws pertaining to health care, and case studies. Also available from MLMIC are a number of standardized forms such as those used for termination of the physician-patient relationship and informed consent, designed to "make life easier" for physicians and their staffs.

RISK MANAGEMENT PUBLICATIONS AVAILABLE TO INSUREDS:


• Anatomy of a Lawsuit
• AMA Specialty Society/Risk Management Principles and Commentaries for the Medical Office
• Office Staff Handbook
• Doctor Self-Assessment Checklist
• Telephone Message Pads
• PIAA Studies: Breast Cancer Study, Lung Cancer Study, Medication Errors Study, Laparoscopic Procedure Study, Acute Myocardial Infarction Study

CONCLUSION