TriState Medical Insurance Company TriState Medical Insurance Company
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Key Policy Provisions
TriMed offers a medical professional liabilty insurance policy with the following key provisions:

  • Claims made coverage
  • $1 million/$3 million limits of liability per physician
  • Prior acts coverage subject to advance underwriting approval
  • Extended reporting endorsement ("tail") coverage also subject to advance underwriting
  • Defense cost in addition to (outside) the limits of liability
  • Prior written consent of physician to settle a claim; consent not to be unreasonably withheld
  • Shared limit of liability among physician member, professional entity if any, allied healthcare extenders and employees

Prior Acts & Extended Reporting Coverage
Coverage for claims arising out of the act of an insured 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.

Extended reporting coverage (so-called "tail" coverage) is provided by endorsement to TriMed'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 TriMed from assuming risk that was never intended in its original coverage grant as described in its professional liability insurance policy.

Surplus Contribution
TriMed is a physician-owned professional liability insurance company. To become an owner and a policyholder each individual physician must make a surplus contribution to TriMed. In return, TriMed issues a surplus contribution certificate to the individual specifying the amount of its contribution. These funds represent the surplus of TriMed and serve as a statutorily required pool to protect the company if premium rates and reserves turn out to be inadequate. Doctors that join TriMed 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 his/her physician policyholders.

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

  • Historical claims experience
  • Geographical location of the practice
  • Medical specialty
  • Practice characteristics of the individual

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