Peer Review Is Cornerstone of MLMIC’s Underwriting Philosophy

Did you know that – unlike other carriers in New York’s medical malpractice marketplace – MLMIC’s entire underwriting and claims process is overseen and guided by physician peer review?

Whether reviewing a prospective policyholder’s new application or performing a review of an existing policyholder’s underwriting record, physician peer review is the cornerstone of MLMIC’s underwriting philosophy. Individual healthcare provider applications are reviewed under the auspices of fellow physicians who provide their analysis of the risk presented by the applicant to the company.  No decision on an application is rendered without first receiving peer review authority. Moreover, an existing policyholder who is subject to an underwriting review as a result of their individual experience will always have their record analyzed by and, when necessary, a personal interview with, a fellow physician before any decision affecting coverage is rendered.

The basic principle of MLMIC’s underwriting acknowledges the complexity of medical treatment in today’s environment and the corresponding potential for unfavorable outcomes despite the utmost in care rendered. This is why, when a personal interview is deemed necessary, that it is conducted by fellow practitioners who seek to establish an informative, non-adversarial and collegial discussion of the underlying factors leading to a policyholder’s loss experience. While no practitioner wishes to be the subject of such circumstance, our policyholders take comfort in the knowledge of being provided with a fair and supportive decision-making environment.

In the same manner, the methodology behind MLMIC’s peer review of claims remains true to its mission: to assess merit and vigorously defend non-meritorious claims while attempting to provide prompt and equitable compensation to those with legitimacy. Of course, this process is more time consuming than our competitors’, but MLMIC recognizes the importance of impartial and comprehensive specialty-specific review to ensure the integrity of the reputations of our policyholders who are defending the care they provided while still looking out for the best interests of all others.

Policyholders can click here to log in to MLMIC’s secure website to view MLMIC’s Merit Rating Plan (under the “Publications” tab) and read about this aspect of MLMIC’s unique underwriting process.