Deck 9: Professional Liability Insurance

Question 1

The declarations page usually describes which of the following aspects of liability?

A) Limits
B) Occurrence
C) Incident
D) Medical incident

Answer 1

Limits

Question 2

A policy was in effect from July 1, 2000, through August 31, 2015. A claim was made on the policy on October 24, 2017, related to an incident that happened while coverage was in effect. Which type of policy is most likely to cover the claim?

A) Tail coverage
B) Claims-made
C) Occurrence-basis
D) Umbrella coverage

Answer 2

Occurrence-basis

Question 3

What is the best way to notify an insurer if a claim has been made against an insured person or facility?

A) Call and leave a message.
B) Send a letter by certified mail, return receipt requested.
C) Wait until a lawsuit is filed to do anything.
D) Send a letter by regular first-class mail.

Answer 3

Send a letter by certified mail, return receipt requested.

Question 4

Several people sue a physician for medical professional liability over the course of a year, such that the limits of the policy are exceeded. What type of coverage may cover amounts over the limit of the regular policy?

A) Tail coverage
B) Occurrence
C) Claims-made
D) Umbrella

Question 5

If a policy was in effect from January 1, 2011, through December 31, 2016, and a liability claim was filed on June 23, 2017, what type of coverage could cover the claim, if purchased?

A) Claims-made
B) Tail coverage
C) Umbrella coverage
D) No coverage at all

Question 6

In general, an insurance carrier will settle a lawsuit if the claimant has a ___% chance of winning at trial.

A) 25
B) 30
C) 40
D) 50

Question 7

Which of the following claims would most likely be excluded from a professional liability policy?

A) Dispensing the wrong medication
B) Reporting incorrect lab results to a patient
C) Sexually assaulting a patient
D) Removing the wrong organ

Question 8

The declarations page of a policy would not include which of the following items?

A) Details of coverage
B) Names of the persons or institutions covered
C) Period of time for which the policy is in effect
D) Amount of aggregate coverage

Question 9

If the insurer determines that individuals not named in the claim played a role in the incident that led to the filing, the insurer may exercise the right of

A) indemnification.
B) cancellation.
C) contribution.
D) nonrenewal.

Question 10

What is the best reason to carry a professional liability policy?

A) It saves the physician money.
B) It ensures that the insurer maintains loyalty to its policyholders.
C) It is inexpensive.
D) It is guaranteed payment of liability claims.

Question 11

If an insurer pays a claim even though the physician contends that he or she was not at fault, the insurer may be exercising the right to

A) contribution.
B) settlement.
C) indemnification.
D) defense.

Question 12

The primary objective of obtaining liability coverage is to

A) avoid patient malpractice lawsuits.
B) protect assets in the event of a settlement in the claimant's favor.
C) avoid paying malpractice claims.
D) provide protection against high legal costs.

Question 13

Liability insurers are interested in whether individuals or facilities have ever had which of the following filed against them?

A) Lawsuit
B) Malpractice
C) Negligence
D) Claim

Question 14

Most physicians' offices carry a liability policy. Which would not be covered under the policy?

A) Physician
B) Medical assistant
C) Patients
D) Receptionist

Question 15

Which statement regarding individual liability insurance policies is correct?

A) A personal liability policy is not necessary if the healthcare professional is employed in any capacity at a healthcare facility, because the facility's policy will cover his or her actions.
B) A person who does not own any property does not have anything to protect and therefore does not need a liability policy.
C) Independent contractors may require individual liability coverage even though he or she may be covered under a healthcare facility's policy.
D) An independent contractor would not be sued and therefore does not need liability coverage.

Question 16

Provisions in a policy usually allow an insurer to cancel or refuse to do which of the following with respect to the policy?

A) Pay for
B) File a claim against
C) Process
D) Renew

Question 17

Which is not an advantage of a personal professional liability policy?

A) It is expensive.
B) It provides peace of mind.
C) It helps eliminate conflicts between employers and employees.
D) It may cover acts that the employer's policy does not cover.

Question 18

Liability policies usually require annual payment of which of the following?

A) Installment
B) Sum
C) Premium
D) Deduction

Question 19

When there are disagreements about a claim-related accident, exclusions in an employer's liability policy can cause which of the following?

A) Loyalty
B) Conflict
C) Penalties
D) Resolution

Question 20

Which individual is probably an independent contractor?

A) A private nurse who sits with a patient just moved from intensive care
B) A registered nurse who works a weekend double shift only
C) A laboratory employee who works inside a hospital but is employed by an independent lab
D) A physician who visits his or her patients during rounds in a hospital

Question 21

Professional liability insurers may also provide additional coverage, including

A) plaintiff expense benefit.
B) license protection.
C) professional liability.
D) professional injury protection.

Question 22

If you choose not to renew a policy as of June 30th, and a claim is made against you on July 30th for an incident that occurred on June 30th. According to your policy, you are covered. This is what type of policy?

A) Tail coverage
B) Occurrence-basis
C) Claims-made
D) Prior acts

Question 23

If you choose not to renew a policy as of June 30th, and a claim is made against you on July 30th for an incident that occurred on June 30th. According to your policy, you are not covered. This is what type of policy?

A) Tail coverage
B) Occurrence-basis
C) Claims-made
D) Prior acts

Question 24

A family practice physician wants to begin providing ultrasounds services in his clinic. In addition to having a basic insurance policy, what other policy should he get to cover this specific service?

A) Claims-made
B) Rider
C) Tail coverage
D) Umbrella policy

Question 25

This type of policy covers incidents that occurred before the beginning effective date of the policy.

A) Tail coverage
B) Occurrence-basis
C) Claims-made
D) Prior acts