The growing demand and rising exposures for the Advanced Practice Clinicians segment, a category which can include nurse practitioners, certified registered nurse anesthetists, and physician assistants, has led to the creation of new standalone products and coverages from carriers, alongside a drip feed of rate hikes.
The increased reliance on these segments in the healthcare space has led to concern that a spike in claims is looming, particularly as the physician shortage continues, and nurse practitioners particularly are saddled with more responsibility, longer hours, and subsequently more potential exposures. The COVID-19 pandemic exacerbated an already growing trend of APCs increasingly operating outside of their scope of practice, and though a common narrative exists that the pandemic is nearly over, sustained vaccine hesitancy, particularly in rural cities and counties, continues to stretch already beleaguered healthcare facilities and hospitals to their limits in terms of staffing and care availability, increasing exposures even further.
As such, insurers are looking to adopt standalone insurance coverages to account for such exposures. One such company is The Doctors Company, which is aiming to launch a new product to its playbook, dubbed Advance Practice Clinicians Medical Professional Liability Insurance. In public filings, the carrier notes that the creation of this product is in direct response to “the growing trend for APCs to work independently.” The product will be offered in both claims-made and occurrence coverages, offering APCs their own independent policy, which the carrier notes will “provide flexibility as the continuum shifts from required supervision to complete independence.”
The Doctors Company modeled most of the forms and endorsements on this product on its existing Physicians and Surgeons Medical Professional Liability program, though it made some exceptions for excess coverage and certain provisions for APCs. The Doctors Company is aiming to launch this offering in Tennessee by June 1, 2022. The carrier tapped similar offerings from competitors in the Volunteer State to develop rates for the product, which included products from Liberty Insurance Underwriters, Inc., and American Casualty Company of Reading, Pennsylvania. Limits for the offering will start at $100,000/$300,000, with available limits of $200,000/$600,000, $500,000/$1M, $1M/$3M, $1M/$6M, and $2M/$6M. The product will also offer variable excess limits.
While there can be an expected wave of new related APC standalone coverages hitting in the market in the coming months, some carriers will look to bolster existing offerings to account for the increased demand. State Volunteer Mutual Insurance Company implemented a rate hike in North Carolina at the onset of 2022 to its Physicians & Surgeons Medical Professional Liability product, with an overall rate increase of 4.3% to all classes under the coverage. This rate increase was developed utilizing competitor rate filing from MAGMutual, Medical Mutual Insurance Company of North Carolina, and The Doctors Company. However, relative to the growing demand for physician extenders, the company also introduced a shared limit option for extender employees, in addition to an increased/decreased aggregate limit option.
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