Additional Benefits Included in OMIC’s Professional Liability Policy

Welcome to OMIC’s Additional Benefits information page. Coverage for the following exposures is included in OMIC’s standard professional liability policy at no additional premium.

Disciplinary Proceeding Protection – Section VII.A.

Updated 3/3/2021

OMIC will defend and pay legal expenses for insured ophthalmologists for investigations, disciplinary proceedings, or actions for review by any federal, state, or local regulatory agency arising from a complaint of an injury to a patient due to direct patient treatment. OMIC will pay $25,000 per proceeding and $75,000 for all proceedings per policy period.

Broad Regulatory Protection and Cyber/e-MD® Coverage – Sections VII.B. and C.

OMIC provides 16 BRP and Cyber/e-MD® benefits subject to a per policy period limit of $100,000 per claim and in the aggregate. For a summary of these benefits, scroll down to the table. For a detailed description of some of the major benefits, follow the links below.

General Information about BRP and Cyber/eMD® Coverage Benefits

To purchase higher limits than what is already included in your OMIC malpractice policy, or if you are not an OMIC insured but would like to purchase this benefit package as a stand-alone product, contact Tokio Marine HCC Insurance Agency. Visit OMIC’s Coverage Q&A page for answers to other coverage questions.

Broad Regulatory Protection (“BRP”) – Section VII.B.

Reimburses insureds for the 7 regulatory proceedings listed below ($100,000 limit**):

Coverage	For	Legal expenses	Audit Expenses	Fines & Penalties
Billing Errors Proceeding	Qui tam (whistleblower), government, or commercial payer proceeding	X	X	X
DEA Proceeding	Drug Enforcement Agency action re ability to prescribe drugs that require a DEA license	X
EMTALA Proceeding	Government action for violation of Emergency Medical Treatment and Active Labor Act	X		X
HIPAA Proceeding	Government action for violation of HIPAA privacy and security regulations	X		X
Covered Licensing proceeding	State licensing action related to ophthalmology practice (but not due to injury to a patient)	X
STARK Proceeding	Government action for violation of anti-kickback or self-referral laws	X		X
Peer Review	Actions against insured by review body of a hospital/other health care facility affecting privileges	X

e-MD® – Section VII.C.

Provides the 9 cyber liability coverages listed below ($100,000 limit**):

Coverage	For	Type of Claim	Pays	Pays
Multimedia Liability	Release or display of electronic or print media display that results in defamation, invasion of privacy, plagiarism, or copyright infringement	Pay on behalf	Legal expense	Loss (money an insured is legally obligated to pay)
Network Asset Protection: Loss of Digital Assets	Digital assets (data/ programs that exist in insured’s computer system; not hardware) loss due to accidental damage, crime the insured failed to prevent, etc., that causes damage, theft, or misuse of the insured’s digital assets	Pay	Restoration of digital assets (inc. materials, machine time, and employee expense)	Special expenses (to mitigate further damage)
Network Asset Protection: Non-Physical Business Interruption and Extra Expense	Accidental damage, crime the insured failed to prevent, etc., that causes interruption, degradation, or failure of insured’s computer system	Pay	Income loss and interruption expenses (to avoid or minimize suspension of business)	Special expenses (to mitigate further damage)
Cyber Extortion	Threat to release confidential information of third party from, corrupt, or restrict access to, insured’s computer system	Pay	Expenses incurred as a result of threat	Monies insured pays to terminate threat
Cyber Terrorism	Act of cyber (not physical) terrorism that causes interruption, degradation, or failure of insured’s computer system	Pay	Income loss and interruption expenses (to avoid or minimize suspension of business)	Special expenses (to mitigate further damage)
Security and Privacy Liability	Claim for security and privacy wrongful act	Pay on behalf	Legal expense	Loss (money an insured is legally obligated to pay)
Security and Privacy Regulatory Defense and Penalties	Government proceeding based on a security or privacy breach	Pay on behalf	Legal expense	Regulatory: fines & penalties or compensatory award
Security and Privacy Breach Response Costs, Notification Expense, and Support and Credit Monitoring Expense	Due to security or privacy breach, employing a public relations consultant to prevent or mitigate damage to the insured’s reputation or brands because of an adverse media report; notifying affected individuals; credit file monitoring and identity theft assistance (due to privacy breach)	Pay on behalf	Expenses (see coverage “For”)
BrandGuard®	Adverse media report or notification of privacy or security breach	Pay	Lost income
PCI DSS Assessment	Noncompliance with a Payment Card Industry Security Standard that results in a security or privacy breach	Pay on behalf	Legal expense	Fines & penalties assessed by bank or card association

** There is one $100,000 limit for any and all BRP and e-MD® claims per policy period.

Extended Reporting Period

BRP and e-MD® include a two year extended reporting period if the insured acquires tail coverage for the policy. However, the extended reporting period does not increase the limit of liability; it is shared with the prior policy period.

Who Is Insured

OMIC provides free BRP and e-MD® coverage for OMIC physician and entity policyholders only. OMIC-insured optometrists can purchase the coverage.

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