The past few years have brought serious turmoil to the chiropractic malpractice insurance industry. In 1990, DCs could choose from over 20 different companies; now there are only 12. Several leading carriers made the choice to exit the market; others have become insolvent. Some chiropractic malpractice insurance brokers have had to switch insurance companies as often as every two to three years.
A number of seemingly successful chiropractic malpractice insurance companies have gone out of business, leaving DCs scrambling to find another carrier. Reliance Insurance Company (a former CBS insurance company) was ordered into liquidation by the Pennsylvania Insurance Department on October 3, 2001, while PHICO, the state's second-largest carrier, according to AM Best State Product/Line reports for 2000, was liquidated on February 1, 2002.
Last year brought many changes to the chiropractic malpractice arena via mergers/acquisitions or clean breaks for some companies altogether:
In today's market, the choice of a malpractice carrier should reside on more than just price. DCs should evaluate a variety of factors when choosing a malpractice carrier, as it is one of the most important practice decisions. Some of the questions that should be asked include:
Because of the instability of the market today, it is more important than ever to be aware of the company that insures you, including the company's financial stability and whether it is an admitted carrier in the state in which you practice. If you choose insurance with a broker, look carefully at the insurance company they are insured with and confirm how they are rated. The insurance company is ultimately expected to protect you in the event of a claim. Some underwriters are more highly rated and therefore much more stable than others.
As an example, five carriers have underwritten Chiropractic Benefits Services' (CBS) coverage over the last 10 years. TransAmerica Insurance Company, Investor Insurance Company, Gulf Insurance Company and Reliance were each an insurance company for CBS policyholders from 1990 through 2000. In 2000, Reliance was in financial crisis, so CBS switched all of its clients' malpractice insurance coverage to TIG Insurance Company, which remains its current underwriter, though its rating was downgraded last November to B++, the lowest on the list.2
As stated in a previous article,3 the only way to protect insureds in the event their malpractice coverage is moved from a nonadmitted carrier (which Reliance was) to another carrier is to arrange a novation by the new insurance company. A novation is an agreement made with the new insurance company in which it agrees to retroactively cover all claims occurring during the old policy period, in addition to claims made under the new policies. This is extremely important. If an insurance company is not an admitted carrier and goes bankrupt, the insured has no protection through the state's insurance guarantee fund. This leaves the insured to pay out-of-pocket for any defense costs and settlements that arise.
In addition to having faith in the underwriting company, it is equally important you understand the terms of the policy you are purchasing. Many doctors have purchased a policy believing they have coverage for certain events, only to find out at the time of a claim that the particular coverage is excluded from their policy. Ask specific questions and read your policy thoroughly. Make certain that the coverage you thought you were buying is what you actually got. After a claim is filed, it is too late to discover that your coverage or your company is not what you thought it to be. Take time to read and review your policy carefully. It is without a doubt time well spent.
References
When sports chiropractors first appeared at the Olympic Games in the 1980s, it was alongside individual athletes who had experienced the benefits of chiropractic care in their training and recovery processes at home. Fast forward to Paris 2024, where chiropractic care was available in the polyclinic for all athletes, and the attitude has now evolved to recognize that “every athlete deserves access to sports chiropractic."
It is estimated that 61% of patients with CTS avoid taking surgical options due to postoperative complications and costly surgical procedures. Chiropractic care offers a comprehensive and effective treatment for carpal tunnel syndrome, addressing the condition from multiple angles. Recent studies also have unveiled a game-changing adjunct to chiropractic treatments for CTS: nerve flossing.
Some doctors thrive in a personality-based clinic and have a loyal following no matter what services or equipment they offer, but for most chiropractic offices who are trying to grow and expand, new equipment purchases help us stay relevant and continue to service our client base in the best, most up-to-date manner possible. So, regarding equipment purchasing: should you lease, get a bank loan, or pay cash?
