News & Insights

$10 Million Verdict: Could This Happen to You?

September 11, 2019

$10 Million Verdict: Could This Happen to You?

You might have read a recent article about a $10 million jury award in a pediatric orthopedic medical malpractice trial in Orleans Parish, Louisiana. It is reported that the verdict will not be reduced to the medical malpractice cap because the physician was not enrolled in the Louisiana Patient’s Compensation Fund (PCF). LAMMICO did not have an insured in this case so we do not have information about why the defendant physician was not qualified under the Medical Malpractice Act (MMA). 

Failing to properly enroll in the PCF or choosing to not participate in the PCF, could leave you exposed to uncapped claims. What does LAMMICO do to help you with your PCF coverage?

Because the medical malpractice cap is only applicable to healthcare providers practicing in Louisiana who enroll in the PCF, LAMMICO takes steps to help you ensure your timely and accurate enrollment in the PCF.  

Enrollment - We provide information to our insureds to assist them in understanding the Louisiana medical liability system.

  • LAMMICO automatically enrolls every eligible insured provider in the PCF, unless the provider specifically requests otherwise.  

  • If an eligible provider requests LAMMICO coverage without PCF enrollment, we request the provider to sign an acknowledgment that without PCF enrollment, the statutory cap will not apply to their claims.

Billing and remittance - While LAMMICO is statutorily required to bill and collect on behalf of the PCF, we also ensure that:

  • Every new premium quote and every renewal billing for LAMMICO coverage automatically includes the corresponding PCF surcharge. If we receive payment for LAMMICO coverage without payment of the PCF surcharge, the LAMMICO staff will follow up with the provider for payment of the PCF surcharge.

Corporate coverage - While it is the enrolled provider’s responsibility to ensure they have appropriate corporate coverage with the PCF, LAMMICO assists by doing the following:

  • We remind our insured providers annually to submit completed PCF Corporation Applications to the PCF for all corporate entities, in order to ensure the entities maintain PCF enrollment.

  • We routinely ask whether our insured corporations employ or contract with providers who are not enrolled in the PCF. If there are unenrolled providers, we recommend payment of a PCF corporate vicarious liability surcharge in order to avoid gaps in PCF coverage for the corporation.

Claims that fall outside of the MMA - Some claims are not covered by the MMA (such as claims filed by third parties):

  • LAMMICO consistently provides education on the potential for “uncapped” claims and the importance of purchasing higher limits for protection in the event of such a claim.  

LAMMICO writes insurance in seven states, and by far, Louisiana has complexities not present in any other venue, in great part because of the PCF. Because of LAMMICO’s position as a Louisiana-domiciled carrier and our dominant market share, we possess a level of knowledge and insight into the MMA and the PCF enrollment process which is lacking among out-of-state companies providing coverage here. Additionally, LAMMICO’s commitment to provide unparalleled service, as evidenced by the above, far exceeds that of other companies offering medical professional liability coverage in our state.  

If you have any questions about the coverage and services provided to you as a LAMMICO policyholder, please contact the Underwriting Department at 504.831.3756. If you have any questions about claim handling, please contact the Claim Department at 504.831.3756. 

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