Policyholder Services

What will OMIC pay for if I am sued?

Kimberly K. Wynkoop, ESQ, OMIC General Counsel

2018 Digest, Number 2 Volume 28

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You probably know the limits of liability you carry for your medical professional liability insurance. But have you wondered what these limits pay for? 

Many insureds carry $1 million per claim/$3 million aggregate limits. This means they have $1 million to pay damages for each claim that comes in that policy year, and the total coverage for claims made that policy year is $3 million, no matter how many claims are made. So, if five claims were made that policy year and each settled for $200,000, the insured would have used $1 million of their total $3 million aggregate. If three claims were made that policy year and each settled for $1 million dollars, the insured would have reached their aggregate limit and no more funds would be available to pay other claims made that year. (Remember that the aggregate only applies to claims made in a single policy year; each year there is a separate aggregate.) Exceeding one’s aggregate limit would be very unlikely to occur. No one in OMIC’s 30 year history has ever done so. Such a large number of claims, worsened by the high severity of the losses, would be worrisome to the company as well as the insured. 

Read the article in its entirety on page 3 under Policy Issues by clicking the image.