EPIC: Emergency Physicians Insurance Company

EPIC is solely owned by its physician-policyholders and is controlled by its Board of Governors. The board is comprised of a majority of physicians – who ensure the company is run in the best interests of its physician-policyholders – and highly qualified, experienced liability insurance executives.

Only policyholders who share common liability exposures may own a Risk Retention Group (RRG). Although nonpolicyholders may provide a surplus note that serves as an RRG’s initial capitalization and surplus, that note confers no ownership or governing rights.

As an emergency physician-owned insurance carrier, our goal is simple: to operate in a financially sound manner for the benefit of our emergency physician policyholder-owners to assure the ongoing availability of a stable, long-term source of professional liability insurance.

The key to our success is in preventing claims from occuring. To this end, we use a collaborative patient safety and risk management model.

EPIC has a physician-owned company market standard policy form. Some of the key features are:

Claims made coverage
$1 million/$3 million limits of liability per physician
Claim settlement requires the group’s consent
Defense costs outside the limits of liability
Each group receives their own $1 million/$3 million limits of individual coverage
Broader coverage definition; an incident report triggers claims made coverage
Slot rating approach for replacement physicians
Entity shares a maximum of one limit of liability with one physician member
Involved in a claim irrespective of the number of other physicians named in the action
Extended reporting endorsement (“tail”) coverage also subject to advance underwriting

Prior Acts & Extended Reporting Coverage
Coverage for claims arising out of the acts of insureds prior to the policy effective date, but reported on or after the coverage effective date, is not automatic but is subject to advance underwriting approval. Groups applying for prior acts coverage with EPIC must provide a roster of physicians who worked for the group during any prior acts period and also must include details of any claims against these physicians during the prior period being applied for.

Extended reporting coverage (so-called “tail” coverage) is provided by endorsement to EPIC’s professional liability insurance policy. Like prior acts coverage, however, “tail” coverage is subject to advance underwriting approval.

The primary purpose of this pre-approval process for prior acts and “tail” coverage is to prevent EPIC from assuming risk that was never intended in its original coverage grant as described in its professional liability insurance policy.

Surplus Contribution
EPIC is owned by its physician policyholders. To become a policyholder owner, each emergency medical group must make a surplus contribution to EPIC on behalf of its physicians. The surplus contribution is used to create a funding pool, required by regulators, which may be used in the event that reserves turn out to be inadequate.

EPIC issues a surplus contribution certificate to the group specifying the amount of its contribution. Emergency medical groups that join EPIC and make a surplus contribution should not expect that these funds will ever be returned, but should consider the contribution as their stake in the ownership of an insurer whose primary goal is to provide a stable, long term source of professional liability insurance for its emergency physician policyholders.

Financing for surplus contributions is available. For details, contact a broker.

Rating Plan
Premium rates for each group applying to and joining EPIC are based primarily on the following factors:

Historical claims experience
Geographical location of the practice
Practice characteristics of the group
Any self-insured retention or deductibles