The Importance of Section 18 Coverage for New York Physicians

As a physician practicing in New York State, navigating the complexities of medical professional liability insurance is essential to protecting your career and financial well-being. In New York, physicians may be eligible for Section 18 excess coverage. This additional layer of coverage sits above the primary policy limits and can provide a safety net in New York’s highly litigious legal landscape when primary limits may not be sufficient.

What is Section 18 Excess Coverage?

In 1986, the Medical Malpractice Reform Act was passed. This program is commonly referred to as “Section 18 coverage”. The program was established by the laws of New York State in 1986 to provide an additional layer of medical liability protection free of charge to qualified physicians, surgeons and dentists.

Section 18 provides an additional layer of coverage in excess of primary insurance limits. For example, if a MLMIC primary policy provides limits of $1.3/$3.9 million, then Section 18 coverage would provide the next $1 million in excess of that primary limit at no additional cost and $3 million in excess of the aggregate limit. This would give a physician $2.3 million in coverage per occurrence and $6.9 million in aggregate each policy year.

Why is Excess Coverage Important for Physicians in New York?

1. Excess coverage protects physicians from high-value claims. Professional liability claims in New York often result in some of the highest payments in the country. With the rise of nuclear verdicts in New York, this extra layer of coverage acts as a buffer and provides physicians with peace of mind when involved in a trial.
2. While not common, a jury may award damages in excess of primary policy limits. Depending on the venue of the case, excess verdicts may be sustainable, possibly leaving an insured’s personal assets at risk.
3. Because Section 18 is state-funded, eligible physicians can obtain this extra layer of coverage at no additional cost. What better way to protect yourself?

How to Obtain Section 18 Coverage

Section 18 coverage may be available to those physicians who meet three qualifications:

1. Maintain a primary hospital affiliation in New York where you provide emergency medical services from time to time.
2. Complete the New York State Regulation 124 approved Risk Management Course offered by MLMIC within 24 months preceding the effective date; and
3. Have primary insurance coverage with an admitted New York insurance carrier, such as MLMIC, in the amounts of $1.3 million per occurrence and $3.9 million in aggregate per policy year.

It should be noted that as of Dec. 31, 2024, the Section 18 Program is now closed. It will reopen on July 1, 2025, pending approval of the New York State budget.

How to Renew Excess Coverage

MLMIC excess insurance policies require annual renewal. Physicians taking advantage of Section 18 coverage or who have purchased excess coverage directly from MLMIC must submit a renewal application each year to maintain their coverage. All excess policies renew on July 1, and the renewal application deadline is June 1.

Renewal notices are sent to current excess policyholders on May 1 and are also accessible through the MLMIC portal at that time. Before processing any excess coverage renewal, MLMIC underwriters must verify that the insured has completed a New York State-approved risk management course within the past 24 months. This requirement is mandatory for continued coverage. MLMIC insureds can conveniently fulfill this requirement by accessing the Pro-Active Risk Management Course through their portal by logging on and clicking ‘CME+’.

How to Apply for Excess Coverage

If you are not eligible for Section 18 coverage, you can apply for excess coverage directly from MLMIC for an additional cost.

To learn more about excess coverage, you can submit a question here.

To apply for excess coverage, look here.