Physicians Who Have Lost Their Malpractice Insurance-Reply

Abstract

In Reply.— Dr Howland incorrectly suggests that length of time in practice is the key determinant of whether a physician is likely to lose his or her malpractice insurance. In fact, insurance companies typically reach termination decisions without considering claims that occurred more than 5 (or at the most 10) years previously. Moreover, if tenure were the key to termination, one would expect to see older physicians in excess numbers in the surplus-lines pool. However, it is not older physicians but those in the 45- to 54-year age bracket who are overrepresented. As noted in our article, a physician's coverage is typically terminated in circumstances where he or she has a claims history that is substantially more adverse than others in the same specialty, or following an action by the state medical board. In the case of most physicianowned companies (which now insure about half of US practitioners), decisions are