Managed Care Errors & Omissions Liability

Market-Leading Coverage Features

• Broadest Available Definition of Managed Care Services Our definition includes services and activities performed whether for the organization itself or for others, in person, on paper, electronically or in any other form. Services and activities are not tied to the application thus eliminating concern that a service will not be covered due to an inadvertent omission on the part of the insured or the producer.
• Additional Limit Option Included in Excess Policy The possibility of unforeseen gaps or catastrophic events is always real. Our Additional Limit Option is automatically included in every MCO E&O excess policy and gives the insured the option to purchase “top off” insurance over their existing tower of insurance during the policy period or during the 12 months after policy expiration (for insureds who renew their policy with IronHealth). Extra protection can mean significant savings.
• Private Information Protection coverage is on a first dollar basis including cost for notification and credit monitoring. This coverage is offered as an additional limit and has no coinsurance or constraints around the vendors that can be used.
• Broad Definition of Claim includes affirmative coverage for claims brought by the government in any capacity.
• Improved Related Claims Language We recognize that business practices change over time and the same allegations made a few years ago may be addressing very different business practices. To address this issue, we will not relate any claim made during our policy period to any other claim made against the insured more than 36 months prior to our policy inception.
  We also recognize that insureds might choose not to report what at the time is a very insignificant matter. Or if they do choose to report that small matter, they would not expect a class action claim later on to be “related back” to that small claim simply because the allegations in both are similar. Therefore, we will not relate any class action claim made against the insured during our policy back to any non-class action claim brought in a prior policy period.
• Minimal Exclusionary Language The result: A very broad form which allows insureds to avoid the need for multiple or multi-part policies. Significant privacy, security, media and crisis management coverage is built in.
• - No EDP exclusion including no unauthorized use, no security failure, and no virus transmission exclusions
• - No antitrust exclusion
• - No insurance company E&O exclusion
• - No contract or indemnification agreement exclusion
• - No property, auto, workers compensation or EPL exclusions
• - No nuclear or pollution exclusions
• - No patent, copyright or trademark exclusion
• - No insolvency exclusion
• Good Samaritan Coverage is included as well as coverage for the provision of flu shots and other non-invasive medical services.
• Definition of Insured Person is extended to anyone duly authorized to conduct any managed care service on behalf of the insured.

Underwriting Capabilities
Primary and Excess Coverage

• Comprehensive Managed Care E&O coverage
• $25 million capacity
• Coverage available on a duty to defend or reimbursement basis
• Directors & Officers Liability coverage is available to our E&O insureds

Note: Ironshore's IronPro division provides D&O coverage for all other private and publicly traded entities. Additional information is available in the IronPro section of this website.

Coverage Highlights in Addition to Market-Leading Features

• Coverage for fines and penalties imposed under HIPAA and any other similar federal, state or local privacy law or regulation
• Vicarious liability for medical services as well as all managed care services and private information protection
• Non-cancelable by insurer
• Definition of insured includes spousal coverage
• Punitive damages with most favorable venue wording
• 90 day claim reporting
• Final adjudication language
• Worldwide coverage

Underwriting Appetite
IronHealth underwrites the full range of managed care organizations. We understand and have expertise in underwriting not only the large traditional managed care organizations such as HMOs and PPOs, but also the myriad of other organizations which provide managed care services including IPAs, PHOs, UROs, MSOs, TPAs, PROs, QIOs, CVOs, care management and disease management companies, and healthcare consultants.

Risk Management Services
A robust portfolio of risk management services applicable to the vast range of risk management needs and concerns of our managed care insureds is under development and will be released shortly.

Payment Plans
Annual or quarterly payment options are available. Quarterly payment option includes no installment fee.

Service Commitment
We recognize that every time you recommend IronHealth to one of your valued clients, you put your reputation on the line. In order to help you provide the best service possible, we:

• Acknowledge all submissions within 48 hours of receipt, providing you the name of the assigned underwriter and contact information
• Issue all policies within 5 business days from date of receipt of last subjectivity (if applicable)
• Issue excess policies prior to receipt of all underlying policies, provided all underlying binders have been received
• Acknowledge all claim notices within 48 hours of receipt, providing the name of the assigned claims representative and contact information

Please refer to the actual policy for exact coverage descriptions; exclusions and deductibles may apply. Coverages are subject to policy terms and conditions and may not be available in all states.