What types of policies does PMSLIC offer in Pennsylvania?

PMSLIC writes claims-made policies for Pennsylvania health-care providers.

Why Claims-Made

What is claims-made coverage?

A claims-made policy covers claims on the basis of when they are reported. The following document explains the mechanics of the policy in detail.

Why Claims-Made

Must I purchase a Reporting Endorsement?

Yes. When a claims-made policy is terminated, there is no coverage for claims reported after the policy's termination date unless the insured purchases a Reporting Endorsement ("tail" coverage) or equivalent coverage.

PMSLIC guarantees the right to purchase a Reporting Endorsement, provided that the option is exercised within the 60-day period following the effective date of cancellation or non-renewal of the claims-made policy. To exercise the option, PMSLIC must be advised in writing that the Reporting Endorsement is wanted, all policy premiums billed must be current, and the Reporting Endorsement premium must also be paid when due. The Reporting Endorsement is available only at the time the claims-made policy is terminated.

What does a Reporting Endorsement cost?

The cost of a reporting endorsement is calculated in accordance with PMSLIC rules, rates and rating plans and is determined by applying a reporting endorsement factor to the mature claims-made premium in effect at the time of cancellation. The factor is based on the number of years insured.

Contact PMSLIC’s Marketing or Underwriting Department for more specific information.

Is the cost of a Reporting Endorsement ever waived?

The Reporting Endorsement premium may be waived (please note there still may be a charge for the Mcare portion of the Reporting Endorsement) if the insured:

• dies or becomes totally and permanently disabled while the claims-made policy is in force, or
• retires at age 50 or older having been insured for five or more continuous years under a PMSLIC policy.

What is Prior Acts coverage?

Prior Acts coverage is equivalent to a Reporting Endorsement. It enables an insured to keep claims-made coverage continuously in force by transferring the risk from one company to another.

Contact PMSLIC’s Underwriting Department for additional information on Prior Acts coverage.

How can I obtain an application and/or a quote?

Please note that PMSLIC writes coverage in Pennsylvania and Delaware only.

Contact PMSLIC's Marketing Department for a quote. Applications in PDF format can be downloaded from our online applications center.

What changes in the practice should be reported to PMSLIC?

Any change in a practice should be reported to ensure that coverage is properly written. Examples include:

• address changes
• practice location changes
• personnel changes affecting any professional or allied health professional staff
• name changes
• changes in shareholder or partner status (e.g., a non-shareholding physician becoming a shareholding member of an insured group)
• changes in the number of hours worked weekly
• changes in the scope of practice (e.g., adding or eliminating medical procedures, changes in professional activities)
• changes in the status of prior carrier claims and/or new claims reported to a prior carrier

How should changes in the practice be reported?

Changes can be reported:

by phone

800 445-1212 or 717 791-1212

by mail

PMSLIC
P.O. Box 2080
Mechanicsburg, PA 17055-0787

by online contact form

Contact Page

Does out-of-state activity affect my policy?

Contact the Underwriting Department to discuss any out-of-state activity to determine whether it requires adjustments to the PMSLIC policy or if the activity affects eligibility to participate in the Mcare Fund.

Can a copy of the policy Declarations and Schedule page (face sheet) be submitted to a designated third party for credentialing or proof of insurance purposes?

If the third party does not require a claims history, the insured may choose to make a copy of the Declarations and Schedule page and send it as proof of insurance.

What information is required if it becomes necessary to cancel coverage?

The insured must provide written notification before the date of cancellation. The notification should include:

• The effective date of the cancellation
• The reason for the cancellation
• Change of address (if applicable)
• Refund instructions
• Name of the new carrier

Insureds who terminate claims-made policies should indicate whether they obtained prior acts coverage, or if they need to purchase a reporting endorsement from PMSLIC.

For ease of cancellation, contact the Underwriting Department for a cancellation form.