The Right Protection for Physicians at the Right Price

Integro connects physicians and physician groups with comprehensive medical malpractice insurance protection at a competitive price. When you trust Integro for your medical malpractice insurance needs, you benefit from our strong relationships with the top medical malpractice carriers in the country.

Your Advocate with Medical Malpractice Insurance Carriers

Professional liability coverage is one of the most crucial, yet most complicated lines of insurance that healthcare providers purchase. Medical malpractice insurance carriers issue policies to protect physicians, clinics and healthcare facilities in the event that a patient files a claim alleging negligence resulting in injury or harm.

Quickly and painlessly, Integro connects individual doctors and physician practices to the most comprehensive and competitively priced medical malpractice coverage. We offer access to general malpractice insurance and specialized medical malpractice insurance as well.

Click on a section below to learn more about our products and services.

The Hospitalist Insurance Alliance is leading the industry with cost-effective coverage. Our team will work closely with you to protect your practice by analyzing your professional liability exposure and risk management needs. In the Hospitalist Insurance Alliance, Integro offers Medical Malpractice Insurance designed to meet the unique needs of hospitalists. When standard liability insurance can’t provide the knowledge and expertise required for the specialized needs of hospitalists, look to Integro for a customized solution that can include these coverage options:

  • Premium based on: per physician; per encounter; and full time equivalent
  • Coverages based on: first dollar; defense within/outside limits; deductibles; no tails for individual departing physicians
  • Other variables: locum tenens; premium financing; tail options; ease of expanding into other states

Traditional per physician coverage may not be the most cost-effective way to purchase medical malpractice insurance. Integro’s medical malpractice insurance team protects practices by analyzing professional liability exposure and risk management needs to recommend the right liability protection at the right price.

Through a joint venture with the American Academy of Private Physicians (AAPP) and Applied Medico-Legal Solutions (AMS RRG), Integro is able to offer a large discount on malpractice coverage for physicians practicing Concierge Medicine.

The potential savings with this program could be up to 55% for those who qualify.

AMS RRG, the third largest physician Risk Retention Group in the U.S., has taken an in-depth look into the practice of Concierge Medicine and has determined that members of AAPP have far less liability than a typical family practice/internal medicine physician. As a result, AMS is able to offer a substantial credit in order to keep your medical malpractice insurance premiums down.

Concierge Medicine is a medical practice where the patient pays an annual fee to obtain "premium services and amenities" from a personal physician. The benefit of such a relationship is that patients receive better and more immediate access to (and more undivided attention from) their doctor. 

Integro is a leading medical malpractice insurance broker for Emergency Medicine and Urgent Care Providers. Our clients range from single site Emergency Medicine providers and Urgent Care Centers to large multi-location Urgent Care Networks and ER Contract Management Companies covering over 1 million visits annually. Our programs include:

  • First dollar coverage
  • Slot Rated and Full Time Equivalent based coverage
  • Per/Visit based policies

Features of Integro’s Emergency Medicine Solutions:

  • No Tails for individual departing physicians
  • Expanded coverage for mid-levels and ancillary providers
  • Ability to differentiate standard ER visits from Fast-track
  • Accommodations for per diem and temporary staffing
  • Medical Director Coverage
  • Rapid Deployment of additional coverage for new providers/new contracts

Whether you are buying first dollar coverage, are sharing risk through a deductible, or are looking to transition to a self-insured model, Integro builds coverage to match your specific needs.

Join the Ob/Gyn Specialists Risk Purchasing Group (RPG) and enjoy significant savings on your malpractice insurance premiums.
This RPG lets you, the individual or group obstetric or gynecology practice to be treated as a large group when purchasing your malpractice insurance. The program utilizes the collective loss histories of physicians with favorable claims history and enables them to secure premiums available only to large groups. This excellent claims history allows the insurance carrier to apply additional credits - the results are significant premium savings.

Coverage is available through an A.M. Best's Insurance "A" (Excellent) rated carrier that has been writing in Connecticut for over 10 years. This program is also open to Certified Nurse Midwives (CNM)and Gynecologists with limited to no surgery. Similar credits apply.

Integro Can Save You Money
The average obstetrician, gynecologist or CNM can save 15-30% on their current premiums by joining the RPG. Don't send in your premium to the hospital's insurance policy without checking with Integro first.

Integro delivers malpractice insurance designed for the Radiologist's real world.
In partnership with Applied Medico-Legal Solutions, Risk Retention Group (AMS RRG), Integro created a solution to address the liability problems associated with running a Radiology practice - Radiological Professional Liability Program - an RVU-based malpractice insurance program (RPL Program).

Purchasing Tails
Radiology practices face challenges in recruiting and retaining physicians. Turnover causes the practice to purchase tails for departing staff at considerable expense. Coverage under the RPL Program is based upon a group's RVUs and not tied to a specific radiologist – thus, eliminating the need for purchasing high-priced tails.

Locums Issues
Shortages in certain sub-specialties (Breast MR, Interventional Radiology and Mammography) cause practices to manipulate locum rules in order to obtain additional coverage without having to absorb the cost of adding physicians – not a credible or sustainable business practice. With RVU based pricing, there is no additional cost regardless of the number of part-time, per diem, or locums physicians used.

With the expansion of tele-radiology, many practices accept work from markets outside the domicile of their primary insurance carrier. This may result in claims being filed in the jurisdiction of where the patient was examined and not where the read was performed; an issue most carriers are not prepared for and may result in the denial of the claim or worse, a woefully inadequate defense. Being underwritten by a Risk Retention Group, the RPL Program is afforded greater flexibility with regard to the states in which they register – broadening the markets in which the insured can deliver service. We would appreciate the opportunity to discuss this program with you in greater detail.

The average orthopedist can save 15-30% on their current premiums by joining the RPG.
The Orthopedic Specialists Risk Purchasing Group (RPG) allows you, the individual orthopedist or group orthopedic practice to have access to pricing historically only available to large group practices. This program utilizes the collective loss data of physicians with favorable claims history as well as their combined buying power to secure premium discounts available only to large mega-groups. This combination of excellent claims history and volume enables the insurance carrier to apply additional credits - the results are significant premium savings and pricing stability.

Are you ready for a RAC Audit? We're here to help.

Due to the increased attention the US Federal government has placed on controlling the rising costs of healthcare, medical providers of all types are coming under increased scrutiny with regards to medical billing practices. For expert advice on RAC Audits and whether you have the appropriate Billing Errors & Omission insurance, call Integro today.

According to a recent Centers for Medicare & Medicaid Services press release:

"The Centers for Medicare & Medicaid Services (CMS) has taken the next steps in the agency's comprehensive efforts to identify improper Medicare payments and fight fraud, waste and abuse in the Medicare program by awarding contracts to four permanent Recovery Audit Contractors (RACs) designed to guard the Medicare Trust Fund. In the Tax Relief and Health Care Act of 2006, Congress required a permanent and national RAC program to be in place by January 1, 2010. The national RAC program is the outgrowth of a successful demonstration program that used RACs to identify Medicare overpayments and underpayments to health care providers and suppliers in California, Florida, New York, Massachusetts, South Carolina and Arizona. The demonstration resulted in over $900 million in overpayments being returned to the Medicare Trust Fund between 2005 and 2008 and nearly $38 million in underpayments returned to health care providers.

The goal of the recovery audit program is to identify improper payments made on claims of health care services provided to Medicare beneficiaries. Improper payments may be overpayments or underpayments. Overpayments can occur when health care providers submit claims that do not meet Medicare's coding or medical necessity policies. Underpayments can occur when health care providers submit claims for a simple procedure but the medical record reveals that a more complicated procedure was actually performed. Health care providers that might be reviewed include hospitals, physician practices, nursing homes, home health agencies, durable medical equipment suppliers and any other provider or supplier that bills Medicare Parts A and B."

  • Is your practice prepared for a RAC audit?
  • Do you have Billing Errors and Omissions insurance? If so, is it adequate?
  • Does your Billing E&O cover RAC audits?
  • Does it cover fines and penalties?
  • Does it cover defense costs associated with RAC audits and potential defense of billing practices against CMS?
Defense Coverage for Medicare/Medicaid Audit
Includes allegations of billing violations from Recovery Audit Contractor (RAC) and Comprehensive Medicaid Integrity Plans (CMIP)
Limited May Be Available
at Low Limit/
High Deductible
$1,000,000 Not Covered
Qui Tam Plaintiff (Federal False Claims Act) Not Covered Limit by
specific policy
$1,000,000 Not Covered
Unintentional Billing Errors & Omission
Coverage includes unintentional acts made by providers or outside billing organizations
Not Covered $25,000 $1,000,000 Not Covered
Unintentional Release of Medical or Financial Data
Statutes Include: HIPAA , Financial Services Act, Fair Credit Reporting Act, other state privacy laws
Not Covered $25,000 Not Covered $1,000,000
HIPAA Proceeding-Governmental
Provides defense of violation of HIPAA privacy regulations
Not Covered May Be Available
at Low Limit/
High Deductible
$1,000,000 $1,000,000
EMTALA Proceeding Limited $25,000 $1,000,000 Not Covered
Stark Violations Limited $25,000 $1,000,000 Not Covered
Breach of Computers or Network Security
Includes: failure to prevent access failure to prevent identity theft inadvertent transmission of malicious code.
Not Covered Not Covered Not Covered $1,000,000
Patient Notification/Credit Monitoring
Notification is mandatory in the vast majority of America
Not Covered Not Covered Not Covered Up to $1,000,000
Data Recovery
All reasonable and necessary sums required to recover and/or replace data that is compromised, damaged, lost, erased or corrupted (First Party)
Not Covered Not Covered Not Covered Up to $1,000,000
Regulatory Fines and Penalties Not Covered Not Covered $1,000,000 $25,000
Multimedia Coverage
Includes coverage for Copyright/Trademark Infringement, Libel, Slander, Advertising, and more
Not Covered Not Covered Not Covered $1,000,000
Voluntary Self-Disclosure Allowed No No Yes Silent

Integro understands that professional liability coverage is complex and offers traditional medical malpractice insurance that falls into three categories. 

Claims-Made Coverage
Claims-made policies cover policyholders for alleged acts of malpractice that take place and are reported to the carrier during the policy period. Claims-made policy premiums are relatively low for the first few years due to the fact that there is often a significant lag between when a treatment is administered and the filing of a claim resulting from that treatment. Because of this, claims-made premiums are structured to increase each year that the coverage is in continuous force until the risk presented approximates a "mature" risk. This is usually in years 5 or 6 for individual physicians.

As a result, one advantage of claims-made coverage is that premiums are based on actual past and current experience. Policyholders therefore do not pay premiums for future liability that is difficult to project. Another advantage of claims-made coverage is that it enables physicians to increase liability limits when necessary. For example, the limits of liability in effect at a policy's inception may not be enough to cover a settlement incurred today. In this case, the physician may wish to increase his or her limits of liability. The most desirable claims-made policies establish the limits of liability available to the policyholder as those in effect at the time a claim is reported rather than those in effect at the time the incident occurred.

Since claims-made policies only cover claims reported, and arising from, incidents that occurred while that policy is in effect, policyholders must be wary when switching carriers or otherwise terminating coverage. When terminating a claims-made policy with one carrier, physicians should obtain either "tail" coverage (extended reporting coverage) from their old carrier or retroactive (prior-acts) coverage from their new carrier. Both of these coverages insure against claims reported after the end of the original policy period for incidents that occurred while that policy was in effect.

When purchasing a claims-made policy, prospective insureds should look for a guaranteed right to purchase tail or nose coverages. They should also verify the length of time that this coverage will be available since some companies offer tail coverage only for a fixed number of years. Another feature to look for is tail coverage that is provided at no charge upon retirement for permanent and total disability and in the event of death.

Tail Coverage
Premiums for tail coverage are determined by a doctor's specialty, territory, limits of liability and length of continuous claims-made coverage. Tail coverage gets more expensive the further back in time it must provide coverage since the liability assumed by the carrier becomes greater. It is usually a percentage of the insured's prior years premium.

Prior Acts ("Nose") Coverage
Prior acts coverage provides similar protection as reporting endorsement coverage. However, unlike a "tail," nose coverage is purchased through the new insurer.

Occurrence Coverage
An occurrence policy insures for any incident that occurs while the policy is in effect, regardless of when a claim is filed. Under an occurrence policy, insured's pay premiums that take into account not current experience, but future projections as well. Such claims are called "incurred but not reported" (IBNR). Occurrence insurance rates can vary significantly because of the difficulty in projecting future claims expenses. Under an occurrence policy, the limits of liability are those in effect when the incident occurred. The advantage of an occurrence policy is that neither retroactive (prior acts) nor tail coverage is needed when terminating coverage.

Claims-Paid Coverage
Claims-paid coverage is often used by Trusts. Under a claims-paid policy, premiums are based only on claims settled during the previous year and projected for the current year. Claims-paid policies are generally assessable for a number of years after the policy has been terminated. In addition, claims-paid policies usually have restrictive claims "triggers," under which a claim is not considered formally made until a "Summons and Complaint" is received. As a result, policyholders changing from claims-paid coverage to claims-made coverage might find it difficult to obtain retroactive (prior acts) coverage from the new carrier. Physicians leaving a claims-paid carrier will most likely have to purchase expensive tail coverage from that claims-paid carrier.

Integro’s team of RRG and RPG specialists are experts in the creation and implementation of risk retention groups and risk purchasing groups. These groups can help minimize the liability exposures and increase the amount of control over that liability in the practice of medicine.

Risk Retention Group (RRG)
A group self-insurance plan or group captive insurer operating under the auspices of the Risk Retention Act (RRA) of 1986 that can cover all the liability exposures; general liability, errors and omissions, directors and officers, medical malpractice, professional liability, and products liability of its owners. It does not extend to workers compensation, property insurance or to personal lines insurance like homeowners and personal auto. Risk retention groups are not subject to the individual state laws that would otherwise prohibit the formation of group captives or make it difficult to form or operate them.

As insurance companies owned by their members, some of the key advantages offered by risk retention groups (RRGs) to their members relate to the control members obtain over their liability programs. This control often translates into lower rates, broader coverage, effective loss control/risk management programs, participation by RRG members in favorable loss experience, access to reinsurance markets, and stability of coverage, notwithstanding insurance market cycles.

Advantages of RRGs Include:

  • Avoidance of multiple state filing and licensing requirements.
  • Member control over risk and litigation management issues.
  • Establishment of stable market for coverage and rates.
  • Elimination of market residuals.
  • Exemption from countersignature laws for agents and brokers.
  • No expense for fronting fees.
  • Unbundling of services.

Risk Purchasing Group (RPG)
A Risk Purchasing Group (RPG) is comprised of insurance buyers who band together, typically on a national basis, to purchase their liability insurance coverage from an insurance company, including a company operating on an admitted basis, a surplus lines basis, or a risk retention group. As the name implies, the RPG serves as an insurance purchasing vehicle for its members.

For both risk retention groups (RRGs) and purchasing groups (PGs), the type of insurance coverage permitted is set forth in the Liability Risk Retention Act's (LRRA's) definition of "liability," which includes all types of third party liability, such as general liability, errors and omissions, directors and officers, medical malpractice, professional liability, products liability, and so forth. The LRRA does not extend to workers compensation, property insurance, or to personal lines insurance, such as homeowners and personal auto insurance coverage.

Purchasing groups (PGs) provide advantages for their members, their insurers, and the agents/brokers who administer the group program. For PG members, the PG offers tailor-made coverage, broader coverage terms, lower rates, loss control/risk management programs, and often provides rewards for good loss experience, such as dividends in the form of credits against next year's premium. For insurers, PGs offer the ability to achieve greater profitability. For agents and brokers, PGs offer the ability to add value to transactions and retain business.

Advantages of RPGs

  • Can use custom-made forms and pricing.
  • Control over risk-management concerns.
  • No capitalization requirement.
  • Group business more attractive to underwriter.

The primary difference between risk retention groups (RRGs) and purchasing groups (PGs) is that RRGs retain risk while PGs do not. Purchasing Groups purchase insurance from an insurer, which issues the policies and serves as the risk bearer. RRGs, as insurers, issue policies to their members and bear risk. Another key difference between the two entities is that RRGs typically require members to capitalize the company whereas PGs require no capital. Other differences derive from the way in which the two entities are regulated, both under the Liability Risk Retention Act (LRRA), as well as state laws. Another difference has to do with reinsurance, which almost all RRGs purchase.

Differences Between RRGs and RPGs
The primary difference between risk retention groups (RRGs) and purchasing groups (PGs) is that RRGs retain risk while PGs do not. Purchasing Groups purchase insurance from an insurer, which issues the policies and serves as the risk bearer. RRGs, as insurers, issue policies to their members and bear risk. Another key difference between the two entities is that RRGs typically require members to capitalize the company whereas PGs require no capital. Other differences derive from the way in which the two entities are regulated, both under the Liability Risk Retention Act (LRRA), as well as state laws. Another difference has to do with reinsurance, which almost all RRGs purchase.

This coverage offers a new choice for a changing insurance marketplace. "Stand-Alone Tail Coverage" is an extended reporting endorsement policy purchased from a new malpractice insurance carrier which covers only claims made against an insured during the years after their traditional claims made policy has expired. Historically, physicians could only purchase a "tail" or "extended reporting endorsement" from their incumbent carrier. However, in today's market, some carriers are willing to offer lower pricing for these "tails" than the cost of coverage from the expiring carrier.

It is also used in special circumstances where a medical operation is being sold or shut down, and will therefore not have any ongoing procedures performed but may have ongoing exposure to prior liabilities.

Providers that work in high risk environments, specialties, or have been hit with multiple medical malpractice lawsuits may not fit the traditional insurance companies acceptable "pool of risk". In this event, negotiations with non-traditional insurance companies are required to secure the necessary medical malpractice insurance needed.

The high risk medical malpractice market is rich with competitive insurance companies. This competitive marketplace helps to broaden policy provisions as well as drive prices down.

Get a free, no obligation premium comparison from multiple, “A” rated carriers through Integro today!