About Us

Insurance 101

Welcome to the Insurance 101 library. At OMIC, we want you to make informed decisions about your insurance. We encourage you to call us to discuss your personal insurance needs. For self reference, we have also included answers to common questions below. Feel free to use this general information as a starting point for your discussion with OMIC’s staff.

In the General Insurance 101 section below you will find answers to common questions regarding insurance and definitions for frequently used insurance terms and concepts.

In the OMIC 101 section below you will learn more about OMIC’s application process, coverage and premium information, and other details about our ophthalmic specific insurance program.

For specific information regarding OMIC’s coverage for practices and procedures, please see the Coverage Q&A page.

Insurance 101

General Insurance 101
-   -- Definitions and Terms (8)
          What is a Risk Retention Group?
          What is a claims made and reported policy?
          What is an occurrence policy?
          What is a retroactive date?
          What is prior acts coverage?
          What is an extended reporting period endorsement ("tail")?
          What is a step rate?
          What is meant by "liability limits"?
-   -- Discussion Topics (3)
          Are there benefits to a claims made and reported policy?
          How do I decide whether to purchase prior acts from OMIC or a "tail" from my present carrier?
          What should I consider in deciding the limits I should carry?
-   -- Insurance Products (6)
          What does Business Owners insurance cover?
          What does Regulatory Protection insurance cover?
          What does Errors & Omissions insurance cover?
          What does Directors & Officers (D&O) insurance cover?
          What does Workers' Compensation insurance cover?
          What does Employment Practices Liability (EPL) insurance cover?
OMIC 101
- -- Ancillary Products (1)
  What coverage for regulatory exposures such as fraud and abuse billing actions and HIPAA violations are covered by OMIC's policy?
-   -- Application Process (15)
          Must I be a member of the AAO to be insured with OMIC?
          The application asks how many physician’s assistants and surgical assistants I employ. Should I also list how many nurses and technicians I employ?
          Do I have to be ABO or AOBOO certified to qualify for OMIC coverage?
          Is coverage available to me before I complete my residency?
          What happens if an application is denied?
          How do I apply for coverage with OMIC?
          Can my application on file with the Academy be used?
          Why are there so many questions on the application?
          Whom do I contact if I have any questions about the application?
          Do I need to send payment with my application?
          How long will it take to process my application?
          What does OMIC look for when reviewing my application?
          Will OMIC consider me if I have had any claims?
          Will I have to complete this detailed application every year?
          When should I cancel my current policy?
-   -- Claim Reporting (18)
          OMIC Claim Statistics
          Will OMIC reimburse me for lost wages as a result of court appearances?
          Will my OMIC policy cover me for claims arising from testimony I give as an expert witness?
          Does OMIC participate in state Insurance Guaranty Funds?
          Is OMIC's ability to pay claims limited by the amount of capital it has?
          If I report a claim to OMIC and subsequently cancel my policy, will OMIC cover the claim?
          Will my claim be reported to the National Practitioner Data Bank?
          Will the company settle a claim without my consent?
          What is OMIC's position on settling cases?
          Can I choose my own legal counsel?
          Who will be my legal counsel in the event of a claim?
          What happens to the claim after a file is created?
          What general advice will you give if a claim is reported against me?
          What happens to the claim once I report it?
          What should I do if I receive a request for medical records from an attorney?
          What should I report to OMIC, and when should I report it?
          If I have a claim, will it increase my premium or allow you to cancel my coverage?
          If I report an incident before it becomes a claim, won't it look bad on my record and cause my premium to go up?
-   -- Financial Strength (3)
          Does OMIC have a "Best" Rating?
          Does OMIC participate in state Insurance Guaranty Funds?
          Is OMIC's ability to pay claims limited by the amount of capital it has?
-   -- History and Philosophy (2)
          What is OMIC?
          What is the Academy's role with respect to OMIC?
-   -- Hospital Verification (8)
          Can I produce my own certificates of insurance online?
          Hospital Privileges
          How can I get evidence of my OMIC coverage for my hospitals?
          Can I also get proof of my claims experience?
          How long does it take to get a certificate of insurance or loss history?
          Does OMIC charge a fee for this service?
          Is a copy of my declarations page sufficient evidence of coverage?
          Will my hospital accept my OMIC coverage?
-   -- Premium Information (22)
          Will I start out at a first year step the first year I join OMIC?
          What if I have been in practice five years but have been previously insured on a claims made and reported basis for only three years?
          Can I estimate my premium by using the rate chart?
          Does OMIC offer a risk management discount to physicians who use electronic medical records (EMR)?
          How are premiums determined?
          What if I practice in more than one state or territory?
          If I’m in a Patient Compensation or Excess Liability Fund state, can I buy OMIC coverage and still participate in the benefits of the PCF?
          Will I pay a lower premium if I limit my practice to refractions, low vision screening, or other non-surgical activities?
          Are refractive surgeons charged a higher premium than physicians who do not perform refractive surgery?
          Will my premium be based on the types of procedures I perform?
          Suspension of Coverage
          Does OMIC offer a part-time discount?
          If I have a claim, will it increase my premium or allow you to cancel my coverage?
          Does OMIC offer discounts to new doctors?
          What will my premium be if I perform liposuction, facelifts, and rhinoplasty?
          If I'm new to OMIC, do I get the new doctor discount?
          What other discounts are available?
          Which risk management seminars qualify me for a discount?
          Do I have to pay my annual premium in full when I join?
          Do I have to pay a capital contribution or surplus contribution to join OMIC?
          Can OMIC ever assess me for additional premium?
          Does OMIC pay dividends?
-   -- Tail Extended Reporting Coverage (5)
          If I have to pay for a "tail", how much will it cost?
          Is the "tail" ever free of charge?
          Does OMIC offer a "tail" when I leave the company?
          What happens to my coverage if I cancel?
          If I report a claim to OMIC and subsequently cancel my policy, will OMIC cover the claim?

Six reasons OMIC is the best choice for ophthalmologists in America.

Best at defending claims.

An ophthalmologist pays nearly half a million dollars in premiums over the course of a career. Premium paid is directly related to a carrier’s claims experience. OMIC has a higher win rate taking tough cases to trial, full consent to settle (no hammer) clause, and access to the best experts. OMIC pays 25% less per claim than other carriers. As a result, OMIC has consistently maintained lower base rates than multispecialty carriers in the U.S.

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