- 4 - based” policies–-i.e., policies that cover alleged acts of malpractice committed while the policy is in force, regardless of when the injury is discovered or the claim is reported. Under petitioner’s policies, no formal claim was required to establish coverage within a given policy period. Rather, to establish coverage, it sufficed for an insured to notify petitioner of an incident that might ultimately give rise to a claim. Petitioner referred to such informal notifications as “incident reports”. To discourage frivolous claims and protect the reputations of its physician insureds, petitioner maintained an aggressive defense policy with respect to any claim that was viewed as nonmeritorious. The existence of the Fund, which covered indemnity payments above petitioner’s statutorily mandated policy limits, constrained petitioner’s risk exposure.3 Petitioner was statutorily required, however, to defend the interests of the Fund for claims that might involve indemnity payments above the policy limits. Because of the existence of the Fund, petitioner did not secure any reinsurance protection concerning its medical malpractice risks. 3 By Wisconsin statute, the policy limits for property and casualty (P&C) companies issuing malpractice policies were $200,000 per claim arising from an occurrence (and $600,000 aggregate per year) for occurrences before July 1, 1987; $300,000 for each such claim ($900,000 aggregate) for occurrences between July 1, 1987, and June 30, 1988; and $400,000 for each such claim ($1 million aggregate) for occurrences after June 30, 1988.Page: Previous 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Next
Last modified: May 25, 2011