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Account Manager/Sales Representative

MEDICAL MALPRACTICE INSURANCE ACCOUNT MANAGER & SALES REPRESENTATIVE

*** NOTE : If you have applied with California Attending Physicians before, please do not resubmit your resume. You will be automatically rejected. You may follow-up on a previous application if you'd like by contacting us. ****

California Attending Physicians (CAP) Medical Malpractice Brokerage Firm is looking for hard working candidates who possess GREAT communication skills, AWESOME relationship-building skills, as well as SUPERIOR customer service skills. These candidates must also have great work ethics which include being *responsible, *honest, working well with teams, and *sincere.

California Attending Physicians has been providing medical malpractice insurance, as well as life insurance, and financial and estate planning to physicians associated with hospitals, IPA's, and medical associations all over California for over 35 years.

The best part of working with our firm is the RESIDUAL income every year, which will continue to increase annually. Sticking with our company for at least 3 years will bring in an annual residual income of $120,000.00 for at least the next 10-15 years. After 10 years with CAP, your annual residual income will be $250,000.00. We are a career building organization!

Account Manager & Sales Representative Position
As an Account Executive, under general supervision, you will be responsible for providing direct sales support and service in the State of California. In addition, the Account Manager is to provide administrative and technical support to the Business Development Director and Executive Management. Contacts for this position are: physician prospects, current policyholders, clinic administrators and staff, and internal employees at all levels of the organization.

Account Executive Responsibilities
• Oversee a dedicated client base of individual physicians, as well as physicians IPAs, entities, & cooperatives.
• Maintain accurate case files, prepare for renewals in a timely fashion and further the broker/client relationship through constant contact addressing the insured's insurance needs and concerns by offering extended services.
• Participation in the implementation of enterprise risk management services to group accounts.
• Utilize negotiation skills to develop complex settlement packages.
• Direct prospects in the application process and evaluate applications for accurate and appropriate response before submitting to underwriting.
• Maintains departmental calendar of Business Development events, meetings and travel schedules of staff.
• Performs other duties as assigned.
Active California Property& Casualty License is mandatory– We provide any training needed for obtaining credentials.

Account Representative Qualifications
• Excellent communication skills.
• Ability to work independently.
• Strong analytical and problem solving skills.
• Ability to exercise independent judgment and make critical business decisions effectively.
• Knowledge of Microsoft Office Suite as well as other business-related software.
• Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages.

At CAP, we are DEDICATED to providing our employees a safe and comfortable working environment, while holding high standards of professionalism, aiming to provide the necessary tools and resources needed to aid to accomplish your task.

If you feel you fit the profile of candidates we are seeking, please submit your resume. We are an equal opportunity employer.

Required experience:

  • Bachelors Degree or at least 2 years Professional Work Experience: 4 years

We have set up application questions for your job. Candidates will be asked to give a "yes" or "no" response to the following questions:

  • Do you have 4 years of Bachelors Degree or at least 2 years Professional Work Experience experience?

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Office Assistant and Data Entry

Office Assistant/Data Entry Clerk 
Medical Malpractice Insurance Agency & Brokerage Firm - Los Angeles, CA

MEDICAL MALPRACTICE INSURANCE - Office Assistant & Data Entry Clerk

Cal Attending Physicians Company is a Medical Malpractice Brokerage Firm, looking to provide career growth opportunities for new candidates who posses GREAT communication skills (bi-lingual preferred), AWESOME relationship-building skills, as well as SUPERIOR customer service skills. We are looking for candidates who posses the same core values, such as; *Honest, *Responsibility, *Humility, and the *Can Do Spirit.

Data Entry & Office Assistant Requirements
This is an ENTRY -LEVEL position. The primary position is data entry and office organization. Duties such as being an office assistant include capturing calls, maintaining messages, and maintaining the office environment. Under direct supervision, you will be responsible for editing and managing excel spreadsheets, and preparing them for marketing. You will also be responsible for entering information onto MS Excel and creating database files for marketing purposes. This is a very intensive Microsoft Excel oriented job with training included. This is a full or part time, entry level job with opportunity to grow and excel within the company.

Data Entry & Office Assistant Position

  • Maintain accurate files, prepare for any requested projects in a timely fashion and communicate to any direct supervisors throughout this process.
  • Work primarily with Microsoft Excel and create spreadsheets using pivot tables, formulas, statements, and any other applicable tool to optimize the process of any project given.
  • Handle any of the day-to-day phone calls, directing them as needed or taking a message, with a professional, customer service oriented attitude.
  • Maintains departmental calendar of business development events, meetings and travel schedules of staff.
  • Performs other duties as assigned.

Data Entry & Customer Service Qualifications

  • Excellent communication skills.
  • Ability to work independently.
  • Strong analytic and problem solving skills.
  • Ability to exercise independent judgment.
  • Knowledge of Microsoft Office Suite as well as other business-related software.
  • Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages.
  • At least a 40 WPM typing ability, and numeric pad proficient.

California Attending Physicians has been providing medical malpractice insurance, as well as life insurance, and financial and estate planning to physicians associated with hospitals, IPA's, and medical associations all over California for over 35 years.

At CAP, we are DEDICATED to providing our employees a safe and comfortable working environment, while holding high standards of professionalism, aiming to provide the necessary tools and resources needed to aid to accomplish your task.

If you feel you fit the profile of candidates we are seeking, please submit your resume. We are an equal opportunity employer.

Required experience:

  • Associates Degree or 2 Years Professional Work Experience: 2 years

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Recruiting: Account Executive position at California Attending Physicians

California Attending Physicians (CAP) Medical Malpractice Brokerage Firm is looking for new candidates who possess GREAT communication skills (bi-lingual preferred), AWESOME relationship-building skills, as well as SUPERIOR customer service skills. These candidates must also have great work ethics which include being *responsible, *honest and *sincere.

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Retired Head of CAP in California Reflects on Medical Malpractice

He’s only a few weeks into official retirement, but James L. Weidner is already looking back fondly at the last 20 years as chief executive officer of Cooperative of American Physicians.

“It was just an absolutely wonderful experience,” said Weidner, who officially handed over reins of the Los Angeles, Calif.-based, doctor-owned writer of medical malpractice insurance on March 1.

CAP named as his replacement Sarah E. Pacini in January. Since the announcement Weidner had served primarily in an advisory role until his official departure at the beginning of the month.

From here on out Weidner said he plans to travel, golf and relax. He also plans to stay active in philanthropy.

The Pasadena, Calif.-resident serves on the board of the Chicago Sinfonietta, a symphony orchestra – he has a second home in Chicago – and he is also involved with the City of Hope, a research and treatment center for cancer, diabetes and other life-threatening diseases. In 2009 he was given the Spirit of Life Award, the City of Hope’s most prestigious philanthropic honor.

Weidner also plans to remain actively involved with the Multiple Myeloma Research Foundation, which raises money for cancer research.

Aside from the good life and helping others, he said he may eventually seek to give his years of expertise back to the industry, possibly by joining an insurance industry board of directors or two.

“I expect I’ll do some consulting and some strategic development kind of stuff and I hope that will be on a board or two in the insurance industry,” Weidner said.

Before taking the lead at CAP in 1995 Weidner was Western vice president for New York, N.Y.-based Home Insurance Co. from 1983 to 1995. That company was bought by Zurich.

Before Home Insurance he was with CNA Insurance Co., first in claims and then as vice president of human resources. He eventually ended up as general manager of the carrier’s Phoenix, Ariz. branch.

He got his start in the business after earning his degree in psychology from Saint Joseph’s College in Indiana in 1970. Following graduation he headed right into the insurance business by landing an entry-level job with Allstate in Chicago.

Looking back on his time as head of CAP, Weidner sees mostly improvements in the medical liability industry over the past few decades.

“The medical professional liability business has improved dramatically in the 20 years that I was there,” he said.

He credited much of that improvement to initiatives by the Physician Insurers Association of America, a trade association of more than 60 providers of medical malpractice coverage owned and operated by doctors and dentists.

PIAA and its members pushed several initiatives to help improve patient safety and operational risk management policies.

“That really resulted in a lot better medicine and a much better control of losses and claims and so the premiums of this coverage have not escalated dramatically,” he said.

He believes efforts to improve safety and to continue ensuring best risk management practices will also help the industry continue to thrive in coming years.

“I think you will continue to see stable pricing and I think you will see even more emphasis on patient safety,” he said.

The future of the industry may be impacted by the Affordable Care Act by bringing new businesses into the field of medicine and medical insurance, and putting more nurse practitioners and more physicians’ assistants in positions of performing procedures under the supervision of doctors, Weidner said.

“I think you’re going to see that there are different kinds of players getting into medicine,” he said, adding that changes in healthcare may also lead to more belt tightening. “I think you’re going to see some controlling of costs.”

One of the last big initiatives Weidner worked on as head of CAP was to take a lead role in an industry-wide effort to defeat Proposition 46, the Medical Malpractice Lawsuits Cap and Drug Testing of Doctors Initiative that was put on California’s ballot last year.

The proposition would have raised the cap on the Medical Injury Compensation Reform Act, signed into law in 1975 and capping noneconomic pain and suffering damages at $250,000, to $1.1 million to account for inflation. It would also have required doctors with hospital privileges to be tested randomly or when a physician is suspected of abusing alcohol or drugs or when a mistake occurs in treatment.

It was considered by the industry to be a potential threat to earnings, and opponents of the measure said it would have increased medical costs and reduced medical access for some.

Prop. 46 was defeated 67.1 percent to 32.9 percent. The gap between “yes” and “no” voters was more than 1.7 million votes.

“We soundly defeated that as an industry and as a public and I think that’s the right thing because this jackpot mentality may help a couple of people, but controlling costs for access to care for all California citizens is really, really important,” Weidner said.

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Join us in June at the Healthcare Vendor Fair & Expo in Sacramento

Healthcare Expo Sacramento, California
June 25, 2015

Bringing together the many different facets of the healthcare industry.
Don’t miss one of the largest healthcare events/trade shows in Northern California.

The mission of the upcoming event is to bring together the top 100+ healthcare related companies in the capital city of California, SacramentoWe will have a wide range of exhibitors from Northern/Southern California and abroad.

General Admission

Save time in line! Pre-register and a ticket will be emailed to you. Simply print it off and bring it with you to grab your wrist band through the pre-registered line for access to the exhibit hall. Deadline to grab your free tickets is June 24th, 2015. Tickets will be $20.00 at the door and will not be available for sale after June 24th online. Each attendee must fill in the required fields. You may contact us at (916) 521-3822 if you have any questions. We would be more than happy to assist with the registration process.

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E&O - Errors & Omissions Insurance

Almost all agents have clients with errors and omissions (E&O) exposure and the most difficult job the agent may have is convincing the client that they have the exposure. After 20 years of selling E&O/EPL/D&O exclusively, I have found some simple answers to the clients’ questions that seem to work best.

This article addresses the most frequently asked questions about Errors and Omissions Liability. What is E&O? Who needs E&O? Why do you need E&O? When should you buy E&O? And, where do you find E&O that fits your needs?

What is E&O insurance?
Errors and omissions (E&O) is the insurance that covers your company, or you individually, in the event that a client holds you responsible for a service you provided, or failed to provide, that did not have the expected or promised results. For doctors, dentists, chiropractors, etc., it is often called malpractice insurance. For lawyers, accountants, architects or engineers, it may be called professional liability. Whatever you call it, it covers you for errors (or omissions) that you have made or that the client perceives you have made.

Most E&O policies cover judgments, settlements and defense costs. Even if the allegations are found to be groundless, thousands of dollars may be needed to defend the lawsuit. They can bankrupt a smaller company or individual and have a lasting effect on the bottom line of larger companies.

In short, E&O coverage provides protection for you in the event that an error or omission on your part has caused a financial loss for your client.

Who needs E&O insurance?
The best-known professionals who need E&O insurance are doctors, lawyers, accountants, architects, engineers, etc. However, less thought about individuals range from advertising agencies to commercial printers, Web hosting companies to wedding planners. If you are in the business of providing a service to your client for a fee, you have an E&O exposure. You may want to consider what will happen if the service is not done correctly or on time, and it costs your client money or harms their reputation.

Why does my company need coverage?
To put it very simply, everyone makes mistakes. Even with the best employees and the best risk management practices in place, mistakes will be made. No one is perfect.

If a freight forwarder sends a shipment to South America instead of South Africa and it is a time sensitive shipment and their client loses a sale and, therefore, hundreds of thousands of dollars, who will pay the loss?

If a wedding planner reserves the reception hall, the band, the caterers, etc., for May 22 instead of May 29 and everyone shows up except the wedding party and guests, who pays? And imagine the emotional distress caused to the bride if this were to happen!

There is also the less tangible loss of reputation for both the professional and his client. What will the cost be to the business that now has equipment in South America instead of South Africa? Will they lose future contracts with their current client as well as future clients?

By not purchasing E&O a company can be taking a serious financial risk. These types of losses are not covered under a general liability policy. And, as stated earlier, even if you are not at fault, litigation is both time consuming and expensive.

When should you buy E&O insurance?
As with any insurance, the best time to buy an E&O policy is before the risk is taken. If you are in the service industry and you know you will have the exposure, make E&O insurance a part of your insurance portfolio. Many contracts with clients will require insurance to be in place. In some cases, it is a selling point with your clients. It gives them the peace of mind of knowing they will be compensated if there is an error or omission.

Where do you find E&O coverage?
There are no “standard” policy wordings for E&O coverage. Each policy must be read carefully to make sure that the coverage being offered fits your exposures. An attorney, a doctor and a computer programmer all have exposures; however, the same policy would not work for all. There is no “one size fits all” E&O policy.

Most E&O policies are written on a “claims made” or “claims made and reported” form. This means that any claims must be made or, in some cases, made and reported, within the policy period. These policies have a retroactive date that becomes very important. Claims that arise out of acts committed prior to the retroactive date will not be covered. The farther back the retroactive date, the more coverage provided.

Some policies also include the defense expenses within the limit of liability. Some will exclude punitive damages. The wording of these policies can vary greatly, and each policy must be read carefully to make sure the coverage fits the exposure.

This is why it is very important for retail agents to find specialty insurance professionals that understand the E&O coverage and marketplace. Different information may be needed depending upon the type of exposure.

The cost of E&O insurance may vary greatly depending on the class of business, location, claims experience (both of the individual insured and of the industry they are in) and from insurance company to insurance company. An insurance company that is very competitive on insurance agents or real estate agents, may not be competitive, or may not even offer coverage on business consultants, even if the consultant works with real estate or insurance agents.

An insurance company underwriter may ask for copies of contracts, a description of quality control procedures, documentation procedures, training procedures, etc., or they may want nothing more than a completed application.

The underwriter will not only look at your experience to see if you have had claims, but they will also try to determine the reason you haven’t had claims. Is it luck or are you doing something that prevents the claim in the first place? And if you have had claims, what steps have you taken to ensure that the same errors will not continue to occur?

Here are some steps you can take to mitigate claims:
• Always have a written contract that spells out what will be done, what will not be done and what the fees will be.
• Communicate throughout the job and keep the expectations realistic.
• Have quality control procedures in place and use internal and external audits to check them.

The more comfortable you can make the underwriter with your operation, the more likely they are to give you a competitive price on your policy and to provide the coverage needed

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The difference between Agent & Broker in California - Medical Malpractice Insurance

The distinction between an agent and broker has had increased significance in California following Proposition 103 as brokers may charge broker fees and agents may not. Producers rely heavily on broker fee income due to declining commissions on certain property and casualty risks, most notably for automobile and homeowners. While some brokers do not charge broker fees, many others do. The recent Krumme v. Mercury litigation and several recent actions by the Department of Insurance suggest that insurance producers need to fully understand the distinction between a broker and agent. Brokers especially need to ensure that their contracts with insurers are brought up to date to properly reflect this distinction.

Legal distinctions between agents & brokers
The most basic definition of an insurance agent is provided in Section 31 of the California Insurance Code, which states that an insurance agent is “a person authorized, by and on behalf of an insurer, to transact all classes of insurance other than life insurance.” [All statutory references herein are to the California Insurance Code or Title X of the California Administrative Code (the “Regulations”)]. In contrast, an insurance broker, is defined by Section 33, is “a person who, for compensation and on behalf of another person, transacts insurance other than life with, but not on behalf of, an insurer.” These statutory sections explain that at the most fundamental level, agents transact on behalf of the insurer while brokers transact on behalf of the insured.

More than the differences in statutory definitions, however, agents and brokers are not regulated in exactly the same manner, even though California issues a joint broker-agent licensee for fire and casualty insurance. For example, fire and casualty broker-agents who act as agents are required to have on file with the Department a notice of appointment executed by the insurance company or companies that the agent represents. No similar requirement exists for brokers. [See Section 1704].

According to Section 1731, a person licensed as a broker-agent who has a notice of appointment on file with the Department shall be deemed to be acting as an insurance agent. There is, however, no reciprocal presumption that a broker-agent is acting as a broker if he or she does not have a notice of appointment on file. Moreover, notwithstanding Section 1731, the case law indicates that there is no single dispositive factor for determining whether a producer is acting as an agent or a broker.

Although case law demonstrates some of the difficulty of distinguishing agents and brokers, the line is also blurred in the statutes. For example, Section 1732 provides that a fire and casualty broker-agent can perform the role of an agent for the insurer and a broker for the insured within the same transaction. In rather cryptic fashion, Section 1623 as recently amended states that if an insurance application lists the producer as an insurance broker it is presumed that that the person is acting as a broker, but for licensing purposes only. [This section was amended in 2000].

It is unclear what the legislature intended by including the phrase “for licensing purposes only” in Section 1623. Considering that only a person licensed as an insurance broker can legally act as broker or indicate on an application that he or she is a broker, the caveat “for licensing purposes only” seems to add nothing to the section. For example, what legal significance does this have on the license status of a fire and casualty broker-agent who indicates on an insurance application that he or she is acting as a broker? To limit the purpose of the statute to a licensing matter when the person is already licensed to transact insurance as a broker is a non sequitur. Without the seemingly meaningless phrase “for licensing purposes only,” the statute indicates that if a licensed broker states on an application that he or she is acting as a broker it is presumed the person is acting as a broker.

A final regulatory requirement for fire and casualty broker-agents who act as brokers is established by Section 1662. Specifically, that section mandates fire and casualty broker-agents who act as brokers must post a bond with the Department.

The statutory differences between agents and brokers with regard to agents and brokers can be summarized roughly as follows: An agent represents the insurer and must have the insurance company or companies it represents file an Action Notice of Appointment (i.e., agent appointment) on its behalf with the Department; a broker represents the insured and must post a bond with the Department. As demonstrated above, §§ 1623 and 1732 muddy the waters by suggesting that a producer’s labeling of him or herself as a “broker” on an insurance application may determine the role of that producer in a particular transaction and that a producer may act as an agent and a broker in the same transaction. Additional confusion is caused by the fact that insurance brokers are often referred to as “agents.” However, this is only accurate in so far as the broker has an agency relationship with the insured.

Although the statutory guidance set forth above provides a general framework with respect to classifying agents and brokers, the practical realities of insurance production often make distinctions more difficult. This fact is borne out by applicable case law.

Applicable case law
A variety of cases in California address the general distinctions between agents and brokers. Three cases in particular concentrate on important distinguishing factors. As these cases demonstrate, the question of whether a producer is an agent for the insurer or broker for the insured, or both, is generally a question of fact and the court will look at the totality of circumstances in making its decision.

The court in the well known case, Marsh & McLennan v. City of Los Angeles, suggests that strictly looking to whether there is an agent appointment on file is an overly simplistic way to distinguish agents and brokers. Although the case applies the totality of the circumstances with respect to this distinction, it should be noted that the court was examining whether a producer who was lacking an agent appointment could be construed as an agent. It did not involve an appointed agent who may have in fact been acting as a broker. Moreover, there is no case to date where the court considered an appointed agent to be a broker. Accordingly, the Department of Insurance holds that if the producer has an agent appointment on file he will be considered to be an agent of the appointing insurer; whereas, if the producer does not have an agent appointment on file the Department or reviewing court may examine all the circumstances to determine if the producer is acting as an agent or broker.

Three cases that provide significant insight as to how courts analyze and categorize insurance agents and brokers are Eddy v. Sharp, 199 Cal. App. 3d 858 (1988), Loehr v. Great Republic Insurance Company, 226 Cal. app. 2d 727 (1990) and Marsh & McLennan. The foremost principles of these cases can be summarized as follows:

Independent agents (i.e. those with multiple agent appointments on file with the Department) can be found to be agents and brokers depending on the circumstances. The totality of the circumstances is relevant to the analysis, but one of the most important distinguishing characteristics between agents and brokers is the ability of an agent to bind the insurer.

Although the existence of an agent appointment should not be the sole criterion for determining whether a producer is an agent or a broker, a producer that knowingly has an agent appointment on file will almost certainly be considered an agent to the appointing insurer; whereas the lack of an agent appointment does not preclude a court from finding that the producer is acting as an agent.

Agents, especially independent agents who represent multiple insurers, when acting beyond the scope of their agency may represent the insured in a limited capacity and in doing so may incur additional duties to the insured—duties beyond the general duty of reasonable care an insurance agent owes his client.

Generally, whether a producer who accepts an application for insurance is an agent of the insurer or a broker is a question of fact to be determined by the manner in which the producer acts rather than by the label given him by the insurer. 43 Am.Jur.2d Insurance § 113. Section 113 of that treatise suggests that answering the following additional questions can also help identify whether a producer represents the insurer or insured in a particular transaction:

Was the broker at the time of effecting the insurance actually or ostensibly connected with the insurer and employed by it, or was he acting independently of any employment by the company?

From whom did the broker’s express or implied authority to do the act in question originally proceed?

Was the act one which the broker was expressly authorized to do, or was it a usual and necessary means to accomplish the execution of the authority conferred?

Was the act done independently of the original employment, and if so, for whom, or at what instance?

Which party could the broker hold directly responsible for his remuneration at the time the act in question was done?

The problem with agent and broker fees
The foregoing analysis regarding the distinctions between agents and brokers becomes increasingly important for those producers who charge broker fees. If producers who charge fees are categorized as agents then the Department of Insurance maintains that additional charges to the insured would violate the rating statutes because the fees were not part of a filed or approved rate filing. The Department could hold the agent responsible as a violation of the broker fee regulations, as well as take action against the insurer under the rating law.

Pursuant to § 1861.05 insurers must file and have approved by the Department all rates they desire to change or remain in effect. In McLennan, the premium charged by an insurer’s agent is imputed to the insurer thereby exempting the insurance agent from paying municipal taxes. Moreover, as the insurer’s representative, the agent’s actions are generally imputed to the insurer. Therefore, anything the agent charges the insured in connection with placing insurance with a particular insurer is considered part of premium charged by the insurer which, in turn, must have been approved by the Department.

Krumme v. Mercury
In the recent Krumme case [currently on appeal] the court applied a totality of circumstances test in reaching its conclusion that certain Mercury brokers who sell Mercury’s personal lines auto insurance were not appointed as insurance agents and may have improperly charged broker fees. The court held that the consolidation of the broker/agent license in 1990 and subsequent amendments to Insurance Code sections 1625 and 1625.5 did not abolish the requirement for insurance companies to file action notices under section 1704(a) for all licensees acting as agents on behalf of a carrier.

As such, Mercury’s insurance agents that were charging broker fees were held by the court as doing so improperly and violate the broker fee regulations. The court specifically rejected Mercury’s contention that a producer may be both an agent and broker under existing licensing laws in California, which is the equivalent of a dual agent.

We expect that the courts will continue to wrestle with the dual agency concept in the future especially in the area of auto insurance.

Under the dual agency concept, insurance producers who subscribe to comparative rater systems such as the FSC rater, are sought out by customers to determine the best and cheapest coverage. Notwithstanding that the producer is appointed, the argument is that the producer in aiding the customer in selecting insurance from a number of insurance companies regardless of appointment is acting on behalf of the customer as a broker. In this scenario, the dual agency theory has merit if the producer acts as a broker in shopping the market and ultimately selecting the best insurance for the customer’s needs. If appointed by the selected insurer, the producer’s status then changes from a broker to an agent for the remainder of the transaction. Under this theory the producer would be entitled to charge a broker fee for searching the market on behalf of its customer.

AB 1297 is a two-year bill, which in its original form sought to deal with the ambiguity in the 2000 amendment to section 1623, discussed above, which created a presumption of broker status “for licensing purposes only” if the application states that the producer is acting as a broker. AB 1297 sought to extend section 1623 by creating a conclusive presumption of broker status if the producer utilized a broker fee agreement and disclosure form signed by the applicant and the producer maintained a broker’s bond. It also attempted to clean up the binding authority issue by extending binding authority to brokers in compliance with this section.

However, opponents to the bill, including the Department, have exerted pressure to “water down” the bill by eliminating the conclusive presumption effect of broker’s status. Under the revision, the same factual proof requirement as in the “totality of the circumstances” would be retained, thus undermining the initial purpose of the initial bill.

It is suggested that producers which have appointments on file with particular insurers refrain from charging broker fees on business placed with those insurers. Brokers should review their producer contracts to ensure that the contract language clearly delineates that the broker is actually representing the interest of the consumer or the insurer.

Robert W. Hogeboom is a partner in the Los Angeles office of Barger & Wolen LLP. He has been an insurance regulatory specialist since 1977, dealing exclusively with insurance regulatory and administrative matters. He currently serves as the general counsel to the American Agents Alliance.

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Healthcare Reform Impacts Medical Malpractice

Though the impact of the Affordable Care Act (ACA) on medical malpractice insurance remains a bit of a puzzle, three insurance experts pieced together likely effects at an insurance conference for actuaries in late May.

Forecasting a coherent future from sparse data can be difficult, but it’s a skill casualty actuaries have gained through years of experience. There aren’t a lot of data yet – and the facts that do exist are subject to more political spin than usual. Still, two casualty actuaries and a veteran medical malpractice underwriter were able to use demographic and health industry trends to predict how the medical malpractice world could change over the next decade.

They gave their forecasts at the Casualty Actuarial Society’s Seminar on Reinsurance in New York, in a session titled “The Impact of the Affordable Care Act on Medical Professional Liability – an Update.”

Through early April, seven to eight million people had signed up for healthcare insurance through exchanges, noted Elke Kirsten-Brauer, executive vice president and chief underwriting officer of MGIS, a national insurance program manager for medical professionals. She said about one-fourth did not have insurance before; within a few years, more than 22 million people will gain health insurance.

The doctor-patient relationship is becoming diluted.

The mere presence of more insureds will increase the number of medical malpractice claims, Kirsten-Brauer said. Compounding the issue is the fact that they are largely unfamiliar with the healthcare system. “We need to educate them” on matters that will seem trivial, she said.

Another important trend: The doctor-patient relationship is becoming diluted. The old model of a single doctor diagnosing a patient’s problem and then participating heavily at every step of treatment is giving way to expanded-care teams.

This is best seen with a new sort of doctor: the hospitalist. As casualty actuary Kevin Bingham of Deloitte Consulting explained, the term was coined in 1996 and is just now coming into vogue. These are doctors who monitor the hospital stays of patients — a job that the patients’ physician would have taken on in the past.

The hospitalist is part of the new paradigm, with some parts looking familiar but others less so. The physician still diagnoses outside the hospital; the surgeon still operates. But nurses are taking on larger roles in the doctor’s office, and the hospitalist picks up medical center duties. The physician re-enters for out-of-hospital follow-up.

Under this new model, patients are far less likely to be treated by a single professional. The series of professionals they move through is part of an accountable care organization, or ACO.

Thanks in large part to the Affordable Care Act, ACOs are growing rapidly. Hospitals are buying small physician practices countrywide, hiring the doctors and nurses, and blending them all into ACOs.

The new model bears a new set of risks for medical malpractice insurers, Bingham said. There is no continuity of care, as patients are handed off from professional to professional. They lose the personal connection to the medical community. “That’s how most med mal claims start,” Bingham said, “with a loss of connection with the patient.”

On the other hand, as hospitals buy up practices, the market for med mal for physicians shrinks. The exposure shifts to the hospitals that employ them.

Hospitals, being much larger than a physicians’ practice, will absorb more of that risk, leaving insurers to compete harder for malpractice premiums, said Brian Ingle, an executive vice president at Willis Re and Fellow of the Casualty Actuarial Society.

Meanwhile, the ACO will standardize treatment methods. Usually the standardized method will be sound. Occasionally, Ingle noted, it will not be. Responsibility could trace back to the deep-pocketed hospital. Suddenly, med mal insurers could be facing a mass tort — at an extreme, the “next asbestos” the property/casualty industry dreads.

In response, Ingle said, insurers are considering expanding their medical malpractice coverage to handle exposures usually left to errors and omissions or directors and officers policies.

While the ACA plays out, important demographic trends also will affect medical malpractice.

  • Americans are aging, and older patients often have more complaints, which translates into more care needs in an already overburdened system and an ever growing provider shortage.
  • Physicians are getting older and want to enjoy a better work-life balance, moving from a 60-hour work week to 45 or so.
  • Americans are getting heavier, leading to more cases of diabetes and more joint ailments like bad knees and hips.

All of these trends portend higher med mal exposures, Bingham pointed out

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California Proposition 46

California Proposition 46, the Medical Malpractice Lawsuits Cap and Drug Testing of Doctors Initiative, was on theNovember 4, 2014 ballot in California as an initiated state statute. The measure was defeated.

The initiative would have:[1]

  • Increased the state's cap on non-economic damages that can be assessed in medical negligence lawsuits to over $1 million from the current cap of $250,000.
  • Required drug and alcohol testing of doctors and reporting of positive tests to the California Medical Board.
  • Required the California Medical Board to suspend doctors pending investigation of positive tests and take disciplinary action if the doctor was found impaired while on duty.
  • Required health care practitioners to report any doctor suspected of drug or alcohol impairment or medical negligence.
  • Required health care practitioners to consult the state prescription drug history database before prescribing certain controlled substances.

Supporters of the initiative refered to it as the Troy and Alana Pack Patient Safety Act of 2014, after two children who were killed by a driver under the influence of alcohol and abused prescription drugs.[2]

The measure would have created the first law in the United States to require the random drug testing of physicians.[3]

Supporters of Proposition 46 argued that medical negligence is too common and pain and suffering damage awards are too low. Opponents said the initiative wasn't about protecting patients, but increasing medical lawsuit payouts to trial lawyers.

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Why do Physicians settle

Why do doctors settle?

The report says, “ the high settlement figure is due to sample bias — doctors presumably agree to settle cases where their negligence is more obvious, and fight cases where they are more confident that they did nothing wrong. In part the high settlement figure is part of the moral hazard of insurance – doctors often tire of the emotional drain of a lawsuit, and signal a desire to settle (after all, the payout is insurers’ money and doesn’t come out of the physicians’ own pockets) – and insurers are loathe in many cases to make enemies of doctors, who could sue them for bad faith if a very bad verdict occurs at trial.”

The statistics are followed by some observations by the author. He states, “More work remains to be done here, obviously. There are so many questions to answer: How much under-reporting to the NPDB (whether legal or illegal) goes on? Is there a tradition of reporting in some states (New York?) but not in others? Why is New York so seemingly different from every other state? Do statutes inadvertently skew results? [South Carolina, for instance, mandates mediation before any medical malpractice suit – some settlements that take place during that time might not be reported, as no “written demand” has necessarily taken place.] And, of course, per capita payout is not the same as per practitioner payout — some jurisdictions (perhaps DC, MD (Johns Hopkins), etc.) have a much greater concentration of practitioners serving out-of-state residents than do others, and this could skew results.

The data is presented in various ways in order to address concerns with the collected information. For example, a few really big settlements or judgments could skew results, especially for smaller states. While the study certainly provides much needed statistics and information regarding malpractice payouts, more analytical work needs to be done to better interpret the data.

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Now hiring Account Executives

To respond, please email cover letters and resumes to

MEDICAL MALPRACTICE INSURANCE ACCOUNT EXECUTIVE

California Attending Physicians (CAP) Medical Malpractice Brokerage Firm is looking for new candidates who possess GREAT communication skills (bi-lingual preferred), AWESOME relationship-building skills, as well as SUPERIOR customer service skills. These candidates must also have great work ethics which include being *responsible, *honest and *sincere.

California Attending Physicians has been providing medical malpractice insurance, as well as life insurance, and financial and estate planning to physicians associated with hospitals, IPA's, and medical associations all over California for over 35 years.

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Account Executive Position

As an Account Executive, under general supervision, you will be responsible for providing direct sales support and service in the State of California. In addition, the Account Executive is to provide administrative and technical support to the Business Development Director and Executive Management. Contacts for this position are: physician prospects, current policyholders, clinic administrators and staff, and internal employees at all levels of the organization.

Account Executive Responsibilities
• Oversee a dedicated client base of individual physicians, as well as physicians IPAs, entities, & cooperatives. 
• Maintain accurate case files, prepare for renewals in a timely fashion and further the broker/client relationship through constant contact addressing the insured's insurance needs and concerns by offering extended services.
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• Utilize negotiation skills to develop complex settlement packages. 
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• Performs other duties as assigned. 
Active California Property& Casualty License is mandatory– We provide any training needed for obtaining credentials.
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• Excellent communication skills.
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At CAP, we are DEDICATED to providing our employees a safe and comfortable working environment, while holding high standards of professionalism, aiming to provide the necessary tools and resources needed to aid to accomplish your task.

If you feel you fit the profile of candidates we are seeking, please submit your resume. We are an equal opportunity employer.

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