Rhode Island Medical Malpractice Lawyers: Case Digest Malpractice Insurance

Wednesday, 25 June 2014


Medical malpractice and personal injury attorneys practicing in Rhode Island should be aware of a recent state Supreme Court decision that is helpful for our state’s consumers.

Rhode Island law has long required healthcare providers to have malpractice insurance, and that the malpractice insurance carriers hold certain amounts of professional liability coverage. R.I. Gen. Laws. § 42-14.1-2. Recently, the Rhode Island Supreme Court addressed whether medical providers could purchase self-insured retention plans to comply with the statute. 

Self-insured retention (“SIRs”) plans require the insurance policy purchaser to pay a certain initial amount of all costs and expenses required to litigate or pay an insurance claim before the insurance policy seller makes a payment. In contrast, an insurance deductible requires the insurance provider to pay the legal and medical costs and then charge the insurance policy holder for the amount of the deductible. Self-insured retention plans basically mean that the insurance policy purchaser provides their own insurance up to the initial retention limit and only holds insurance coverage for greater amounts.

Specifically, in Peloquin v. Haven Health Ctr. of Greenville, 61 A. 3d 419 (R.I. 2013), the Rhode Island Supreme Court held that self-insured retention is not an option for medical service providers because it does not meet the minimum insurance coverage required by R.I. Gen. Laws § 42-14.1-2(a). 

The Peloquin court decided not to allow medical service providers to self-insure, including through the use of SIRs, at least until Rhode Island’s Department of Business Regulation (“DBR”) set certain standards for healthcare providers. The DBR make rules and regulations for medical and dental health care providers. Rhode Island created DBR by statute to balance the need to protect Rhode Island citizens with the needs of insurance companies providing malpractice funds. 

The Court in Peloquin mandated that the DBR first set standards to include stating how to analyze the risk of insurance claims a medical services company faces. The standards would also need to include a way to determine how much money a company or person needs to keep on hand to cover their risks of medical malpractice lawsuits before the medical service provider would be allowed to insure themselves. 

Rhode Island consumers harmed by personal injury such as medical malpractice or nursing home abuse and malpractice should, as required by statute, be protected by the existence of professional liability coverage. This ensures that there is coverage for medical mistakes and the like, whether caused by doctors, nurses, nursing homes, or other medical care professionals. The Peloquin decision clarifies that, at least at this point, medical providers cannot purchase cheaper SIRs that could also make it more difficult for malpractice victims to pursue and obtain justice for their injured selves and family members.

ABOUT THE AUTHOR: Mike Bottaro
Mike Bottaro is a Rhode Island personal injury attorney. With offices in Providence, Pawtucket, Cranston, and several other locations, The Bottaro Law Firm serves clients throughout Rhode Island and Southeast Massachusetts.

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