As a matter of course, physicians are required to provide evidence of their medical professional liability insurance to the emergency department group and/or hospital with which they are contracting. This has become standard operating procedure to ensure that all contracting group members meet the insurance requirements set forth by the group and/or hospital at which the professional services are being provided. Meeting requisite insurance requirements is a component of the physician credentialing process undertaken by hospitals and is an important consideration for emergency department groups engaging in their own credentialing activities. Evidence of insurance is generally required on an annual basis so that there are no gaps in coverage that leave the physician bare or the group exposed.

The proof of insurance provided by physicians is referred to as a certificate of insurance. These certificates are issued by the physician’s insurance carrier, usually on the carrier’s letterhead or in the form of a declarations page. In some circumstances, if the contract group or physician utilizes the services of an insurance broker or agent, the request for a certificate of insurance can be made of the broker/agent. In those situations, the broker commonly issues a standard form (ACORD) that is universally accepted and sets forth all of the coverage information required for compliance with groups and hospitals.

Many employed physicians find that their coverage is offered through their employer hospital. The hospital, through its own professional liability program, would need to produce the evidence of insurance document (certificate) on behalf of the employed physician. In that scenario, the physician should contact the hospital risk manager, insurance officer, or administrator responsible for the operations of the organization’s hospital professional liability program. In numerous circumstances, hospitals are self-insured for professional liability and a letter, form, or certificate will state such.

Certificates of insurance, obtained by physicians to illustrate coverage in good standing, regardless of its origin, should contain, at a minimum, the following information: the insured party’s name and title; the limits of liability on a per occurrence and aggregate basis (commonly expressed as $1 million/$3 million); the inception and expiration dates of the policy (the policy term or period); the insurance company name and location; the date of certificate issuance; and the individual issuing the certificate. Other information may include: the physician’s rating and classification; retroactive dates; tail provisions; schedule of locations of practice; and additional insureds, among other details.