Policyholder Services

Behind the Scenes: How OMIC Considers Coverage for Procedures That Could Present a Higher Risk

When making the decision whether to offer coverage for procedures that could present an increased risk to the company or our policyholders, OMIC examines many factors we believe may affect the defensibility of claims. We collect available peer-reviewed literature that supports the safety and efficacy of the procedure and solicit input from a variety of experts in the specialty regarding standard of care issues and risks, benefits, and alternatives.  We also attempt to determine the percentage of ophthalmologists currently performing, or intending to perform, the procedure. Finally, we consult with attorneys regarding potential legal obstacles, including suggested strategies for mitigating exposure to claims or lawsuits.

Because OMIC’s premiums are directly related to the shared claims experience of our policyholders, continued review and management of identified risks is essential to maintaining OMIC’s industry-leading operating performance. Our mission is to provide comprehensive coverage for the full scope of ophthalmic practice while maintaining competitive rates and consistent above-average dividend returns.

Recent Example

After careful consideration and analysis of available data regarding the performance of immediately sequential bilateral refractive lens exchange and phakic implant surgery, OMIC has approved coverage for these procedures subject to special conditions for patient selection, informed consent, and surgical protocols. Policyholders performing these procedures require a special coverage endorsement. If you need to add this coverage or verify the current endorsements on your policy, contact your representative. To review OMIC’s required protocols for immediately sequential bilateral refractive lens exchange and phakic implant surgery, visit http://www.omic.com/policyholder/am-i-covered-for-performing-bilateral-same-day-rle-or-bilateral-same-day-phakic-implant-procedures/.