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At least 19 recordsLinked to original sources
PubMed2001

[Medical malpractice 2000. Malpractice from the viewpoint of expert witnesses if a malpractice insurance carrier].

Insurance industry statistics on medical malpractice are rare. The authors, who are in-house medical advisors of the Allianz Versicherungs-AG, report on their assessments of medical malpractice claims in 2000. Orthopedics/traumatology (24%) and gynecology/obstetrics (18%) are the medical fields in which liability demands are currently most frequent. Deviation from the medical state of the art (41%), false diagnosis (21%) and misinformation of patients (13%) are the main actual or alleged violations of the duty of care. The results, which are meant to provide a basis for future comparisons, are discussed with a view to establishing risk management strategies. On the basis of the literature and their own the authors have compiled a set of recommendations--"Ten commandments"--for decreasing medical malpractice claims.

Expert Testimony↗
PubMed1954

Industrial dermatologic problems; interrelationships between physician, patient, employer and insurance carrier.

Dermatologists, employers, insurance carriers and patients often flounder in misunderstanding when dealing with industrial dermatosis. A large part of such misunderstanding stems from too limited a knowledge of compensation insurance law by physicians, employee-patients and many employers. Physicians dealing with industrial cases should not only familiarize themselves with compensation law and insurance practices, but take it upon themselves to interpret such considerations to their employee-patients and, where necessary, to their patients' employers. Present-day employer-employee relationships are frequently on a most impersonal basis, and great mutual benefit will accrue to all parties when the position and objectives of each are understood by the others and the provisions and limitations of the law are known to all. The dermatologist handling industrial cases must take the responsibility of bringing this about.

Dermatitis↗
PubMed1998

Changes in benefit payments and health insurance premiums among firms switching health insurance carriers.

Employer-purchased group health insurance is a major source of funding in the US healthcare system, accounting for approximately one third of each healthcare dollar spent. Surprisingly, little is known about employers' behavior in purchasing health insurance or the circumstances leading employers to switch health insurance carriers. We descriptively analyzed data for a cohort of 95 insured groups between 1985 and 1991 to determine the frequency with which employers switch health insurance carriers and the growth pattern in premiums and benefit payments before the switch was made. Thirty-seven percent of groups switched carriers during the study period, with at least five groups switching each year from 1987 through 1991. The groups that switched insurance carriers experienced higher average annual rates of growth in benefit payments than those that did not switch (18% versus 11%). Groups that switched did not have significantly higher observed premium growth rates than those that did not switch, suggesting that employers decided to switch insurers before absorbing an increase in premiums. However, some firms that switched experienced below average increases in both benefit payments and premiums, indicating that premiums and anticipated premium increases are not solely responsible for the decision to switch health insurance carriers.

Cohort Studies↗
PubMed1979

The breast reconstruction patient and her health insurance carrier.

To determine policies of health insurance companies regarding payment for breast reconstruction following mastectomy, we polled 50 companies selected at random, as well as every Blue Cross-Blue Shield company. To verify that insurance carriers' replies represented their practices, we polled 96 plastic and reconstructive surgeons in 47 states. Although most health insurance carriers claim to fully cover breast reconstruction following mastectomy for cancer, practices vary widely; many postmastectomy patients receive incomplete or no coverage for reconstruction. Two major reasons for discrepancies appear to be (1) inadequate coverage prompted by unrealistic conception of reconstruction on the part of carriers and (2) specific contractual exclusion. We suggest (1) educating lay and professional persons about breast reconstruction, (2) encouraging more realistic coverage from insurance companies, and (3) if necessary, legislative protection for the postmastectomy patient.

Breast↗
PubMed1999

The insurance carrier's viewpoint. Practicing brinksmanship.

The author presents a guide to the most common elements of the insurance industry. A working familiarity of the provisions of one's policy would prevent the frequent quarrels between the insurance carrier and the insured. Thus, the author attempts to clear up the misconceptions many physicians have about the industry. Finally, he offers a word of advice to physicians when choosing an insurance carrier.

Humans↗
PubMed1995

Slam-dunked. New law forces insurance carriers to reduce rates.

No one saw it coming. Not consumer groups, not business or special interest groups, and especially not insurance carriers. The Texas Legislature did something this session no legislature had ever done, experts say. It ordered insurance carriers to cut premiums in practically all insurance lines, and for physicians, this will mean a 10% reduction in medical professional liability premiums effective January 1, 1996. Hospitals will see a 13% cut.

Insurance Carriers↗
PubMedDate not supplied

Guiding patient interaction with insurance carriers.

It is becoming essential for ambulatory care nurses to develop systems to help both themselves and their patients cope with increasingly complicated insurance issues. Nurses need to decide how involved to be, how much responsibility to assume, and how to help the patients understand their own role in dealing with their insurance carriers. Guidelines for involvement and for developing teaching tools and documentation are presented in the article.

Documentation↗
PubMed1986

Factors influencing consumers' selection of health insurance carriers.

The authors examine the factors and information influencing consumers' selection of health insurance carriers. The results indicate that consumers are sensitive to rising insurance premium costs. They perceive that the decision to select a carrier is critical, yet they are often unprepared (i.e., lack information) to make a judicious decision. Further, consumers are found to rely generally on personal experience rather than the traditional marketing media during the process of selecting insurers.

Advertising↗
PubMed1976

How to deliver a comprehensive preventive dentistry service that dental insurance carriers can underwrite.

The successful practice management of preventive dentistry requires that it be comprehensive and include both chairside and counseling procedures. The chairside clinical procedures are a prophylaxis, topical application of fluorides, application of pit and fissure sealants, and fabrication of mouth-guards and space maintainers. The counseling procedures include plaque control and nutritional guidance. The caries activity test can be used as a means of monitoring excessive sugar intake. It is the responsibility of the dentist to determine the preventive dentistry needs of his patient based on the latter's caries score, periodontal, gingival, and plaque indexes, and diet evaluation. Since patients are prone to certain dental problems during particular age periods, the preventive management procedures must consider the existing and anticipated dental problems on the basis of the patient's age. Each of the preventive services is objective in nature because it involves either chairside or counseling procedures. During the counseling service,worksheets and clinical case notes are kept as part of the patient's dental record. The progressive effectiveness of the home-care preventive dentistry counsling procedures can be measured by scores and indexes. The frequency of repeating the service depends on proven clinical merit and the individual needs of the patient. The delivery of preventive dentistry services can be monitored by dental insurance carriers through peer review of clinical services, data sheets, case notes, a preventive dentistry record, and by patient questionnaire. A method for managing, measuring, and monitoring an objective, comprehensive preventive dentistry service has been presented so that the insurance carrier can underwrite this type of coverage as part of its dental insurance plan.

Colorimetry↗
PubMed1999

Choosing a malpractice insurance carrier. What you should know!

It's one of your most important decisions, because the insurance company you choose protects your financial assets and your good name. From financial strength to an aggressive defense, here's what you should know about selecting a professional liability insurance company.

Humans↗