Healthcare

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Healthcare

ICA’s clientele in healthcare populate all areas of the industry and are throughout North America, Europe and Asia. These clients include hospitals, pharmaceutical companies, national senior living facilities, visiting nurse services, ambulance companies, medical billing services and of course, drug and alcoholism rehabilitation centers etc. In that all of these industry players have risks that are intertwined and supportive of each other, it is critical to understand what holistic solutions are needed to manage these risks and help our clients achieve their management, financial and public health objectives. Therefore, no link in the global healthcare supply chain–from patient care to infrastructure, or manufacturing to transportation–can be addressed in isolation. Furthermore, because risks mutate and evolve rapidly in the Healthcare industry, it is critical to control the root causes of loss, promote preventive risk management and treat the company–not just the peril. In this regard, ICA’s Enterprise Risk Management Services provide our clients with solutions that affect their industry. 

In that it is no secret that modern medicine is litigious, and plaintiff’s attorneys seek recovery from deep pockets, it is therefore critical to ensure that directors, officers and professionals are personally protected when they are inevitably dragged into costly litigation.  Given the ever-expanding breadth of bodily injury exclusions in D&O policies, especially following the global SARS-CoV-2 pandemic in 2020, ICA’s subject matter experts work to ensure that our client’s coverage is sound. Also, this is one of the reasons that ICA reviews the organization’s bylaws and indemnification agreements, comparing them against the D&O policy, to determine if the corporate documents need to be altered, thereby maximizing coverage on behalf of the Directors and Officers. See ICA’s Risk Management for Directors and Officers solution.

In addressing the areas of bodily injury that can lead to claims against healthcare providers, these claims typically emanate from their General Liability and Professional Liability exposures from their operations, caring for their patients. Typically, the issuance of drugs and who the prescribers are, as respects the facility or outside resources, can be problematic depending on the breadth of or lack of coverage. A pharmaceutical exclusion that could be part of the above General Liability and/or Professional Liability policy would be an area of concern, which is why the caregivers have to be sure that the patient is not taking any drugs other than what is prescribed by their organization. Other bodily injury concerns may be caused by the procedures implemented providing care and the possibility of sexual abuse and molestation, which could lead to assault and battery claims as well.

If the organization owns their real estate or has a net lease and is responsible to insure the building etc., that creates a completely different exposure and many more concerns. For instance, flood exposure and the proper rating for these facilities, tornadoes and/or hurricanes influence the rating of these facilities. In addition, crime statistics in the area are accessed by insurance companies through the use of zip codes to immediately assess the crime in the area, and determine from the level of crime statistics the availability and cost of insurance coverage. Furthermore, because these perils could potentially disrupt the operations of these facilities, it is most important that disaster plans are in place, updated and exercised on a regular basis. In addition, there are software programs available today that allow all the employees in a facility to be apprised in real time of disasters that could seriously impact their organization. This software can also be a lifesaver should there be an active shooter in the facility because of the notice to employees in real time. 

For healthcare companies, real and personal property leases and other contracts present unique risks.  Operations and systems are inherently sensitive; many invitees are ill or prone to injury; and the line between professional negligence and “general” liability is not always clear.  Allocating and transferring risk in contract can consequently be very difficult. ICA helps our clients integrate the operational, legal and insurance issues to ensure that risk(s) have been addressed, through contractual review, hopefully to avoid a claim before it occurs. See ICA’s Contractual Risk Assessment Services solution.

Since the Healthcare industry is the fastest growing and expanding industry all over the country, the issue of organic growth or acquisition is most important in terms of the due diligence in acquiring smaller operations. The type of insurance policies, if not properly evaluated, as claims made or occurrence policies, could be of significance going forward when these organizations are integrated into the parent company, as respects the coverage afforded or not. ICA’s insurance audit practice evaluates the breadth of coverage of the organization to be acquired and the most cost-effective method to integrate this coverage into the insurance policies of the acquiring company, as well as, if needed, preserve the integrity of insurance coverage in force. See ICA’s Risk Management and Insurance Coverage Analysis solution.

Further, since the pharmaceutical and medical manufacturing industries’ exposures are global, ICA’s healthcare and international practice groups have extensive experience assisting clients to navigate the maze of international insurance rules and implement a comprehensive, global risk management program. In this regard, ICA would want to evaluate other risk transfer mechanisms and alternatives that include association programs, captive arrangements and other risk transfer opportunities.

Contact ICA for a comprehensive list of client references.

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