WHAT IS THE FLORIDA MEDICAL MALPRACTICE JOINT UNDERWRITING ASSOCIATION (FMMJUA)?

The Association is officially an insurance risk apportionment plan created by law (Sec.627.351 F.S.) for the purpose of assuring the availability of medical liability (malpractice) insurance to Florida health care providers. It is structured on a non-profit basis, but otherwise functions in much the same manner as a commercial insurance company with a few notable exceptions.

In 1975, the Florida Legislature enacted law authorizing the Association. A number of health care providers found it difficult to obtain necessary insurance coverage for claims brought by patients.It is prudent, and often legally mandated that health care providers be financially responsible for negligent acts. Thus Florida law provides the Association as a source of insurance for those medical providers who may be unable to obtain coverage from the competitive voluntary insurance market. The law provides that the licensed casualty insurance companies in Florida join together to make coverage available from the Association. The Florida Office of Insurance Regulation was responsible for adopting the plan of operation after consulting with participating insurance companies.

WHAT INSTALLMENT PLANS ARE OFFERED?

The following chart illustrates the installment schedules. The FMMJUA also accepts outside financing for payment in full. No payment plan will be offered when the charged premium is less than $1,000.

Policy Effective Date	40% of Annual Premium	1/2 of Balance Due plus $15 service fee	Balance Due plus $15 service fee
07/01	Before Issue	90 days	180 days
07/02 - 12/30	Before Issue		90 days
12/31 - 07/01	Does Not Qualify For Installments

HOW CAN AN INSURED REQUEST A CHANGE IN COVERAGE?

A written and signed request by the insured for a change in coverage (e.g., limits, class, etc.) must be received by the FMMJUA from the agent prior to the change effective date.

WHAT IS REQUIRED FOR AN AGENT TO BIND COVERAGE?

For individuals, agents may bind coverage only upon receipt of a fully completed and signed application and the appropriate deposit premium based on the premium indication. The application and premium must be mailed to the FMMJUA immediately following receipt from the insured. Failure to follow this procedure could result in a gap in coverage. Agents have no binding authority for hospitals, facilities, or corporations.

WHEN CAN THE INSURED CHANGE PRODUCERS?

An insured can change producers at the time of renewal with an agent of record letter.

DOES THE FMMJUA ISSUE BINDERS OR CERTIFICATES OF INSURANCE?

The FMMJUA does not issue binders or certificates of insurance, although agents may issue certificates of insurance.

HOW MAY AN INSURED QUALIFY FOR PART TIME COVERAGE?

Part time coverage is calculated based on the maximum number of hours per week that the insured works, is on call, or performs administrative duties during the policy period.
Example: 9 hours a week = 75% discount.
30 hours or more per week is considered full time. To be considered for part time rates, a Limited Practice Supplement must accompany the original application.

HOW ARE PREMIUM COMMISSIONS PAID?

7.5% on the first $2,500 of premium.
6.0% on the next $2,500 of premium.
5.0% on the next $5,000 of premium.
3.0% on all premium over $10,000.

Commission checks and statements are issued at the end of every month. Negative commissions on return premiums are immediately due and payable to the FMMJUA.

WHAT IS PROPER NOTICE FOR POLICY CANCELLATION?

Policy cancellation requires a written request from the insured. The written request must be received, by the FMMJUA or the agent, prior to the cancellation effective date. If the cancellation request is received by the agent, it must be forwarded to the FMMJUA the day following receipt from the insured. The FMMJUA retains the greater of the earned premium or 10% of the annual premium, but not less than $100

WHO DIRECTS THE BUSINESS AND AFFAIRS OF THE ASSOCIATION?

Supervision is vested in a Board of Governors consisting of nine representatives selected from The Florida Bar, The Florida Medical Association, The Florida Dental Association, and The Florida Hospital Association and participating insurance companies. Subject to final approval by the Office of Insurance Regulation, the Board of Governors approves insurance rates, rate classifications, and policy forms and otherwise sets Association policy under the framework of the Plan of Operation. Operational and administrative functions are performed by a general manager and staff located in Tallahassee. The General Manager is responsible for implementing policy and conducting the daily activities of the Association.

HOW MUCH INSURANCE IS AVAILABLE THROUGH THE ASSOCIATION?

The law sets the maximum limits of Association coverage. Various limits of liability are available. The maximum available is:

· Hospitals - $1.5 million per claim/$5 million aggregate
· All others - $250,000 per claim/$750,000 annual aggregate

Health care providers other than hospitals can purchase excess coverage for the layer of coverage between their primary coverage and the total limits of $250,000/$750,000. The available coverage in most cases meets or exceeds Financial Responsibility limits required by law.

WHO SETS THE PREMIUMS FOR ASSOCIATION COVERAGES?

The law requires that rates (premiums) must be adequate to pay claims and expenses, based upon an independent actuarial analysis of past and prospective losses and expenses performed annually.The Board of Governors submits a filing to the Office of Insurance Regulation. The Office of Insurance Regulation must approve rates or rate changes that are fully supported by the filing. There is no profit factor in Association rates. Rates are, in essence, a function of claims and expenses. Rate changes can only be applied on the renewal date.

WHY ARE ASSOCIATION RATES GENERALLY HIGHER THAN OTHERS?

The Association serves as a supplement to the existing voluntary insurance market. It is not a substitute or competitor. The Association cannot refuse to insure any eligible applicant. Previous loss experience, more hazardous types of medical practice, or higher risk patients or procedures, for example, cannot be used as factors to reject an application. The competitive insurance market can, and often does, restrict coverage to the less hazardous risks thus making available lower rates. In addition, occurrence policy premiums are initially higher than claims made policy premiums, particularly in the first four years of the claims made policies.

WHAT TYPE OF COVERAGE DOES THE JUA PROVIDE?

Occurrence form policies are used in all cases. Tail (prior acts) coverage is available (up to the Association maximum limit) to insureds whose claims made coverage with another insurer or trust has been or will be terminated.

HOW DO THE ASSESSABLE/PARTICIPATING PROVISIONS OF THE POLICY WORK?

Policies contain both Assessable and Participating Policy Provisions due to the nonprofit structure of the FMMJUA. Subject to plans approved by the Office of Insurance Regulation, surplus funds, after payment of claims and expenses are returned to policyholders. Should there be an underwriting deficit, individual policyholders for the deficit years may be required to pay premium contingency assessments, not to exceed one-third of the individuals premium paid for the association year for which the deficit was recorded. Remaining underwriting deficits would be fully absorbed by the participating insurance companies, self-insurers and risk retention groups. Actual loss experience and rate levels are the major factors that cause a surplus or deficit. Refunds to policyholders have occurred. Assessments have not occurred.

WHAT IS THE POLICY PERIOD?

The normal policy period is for one year with July 1 being the inception and expiration date. New policies, during the year, are written short-term to expire on July 1. For example, a new application requesting a January 1 effective date will be issued at a pro rata premium for six months. Upon renewal the policy term would be one year. Premiums for policies with terms over six months may be paid by installments; otherwise, the premium must be paid in full.

WHAT IS THE DIFFERENCE IN OCCURRENCE AND CLAIMS MADE POLICIES?

Occurrence policies respond to claims resulting from incidents that occur within the policy period without regard to when the claim is made to the company. Claims made policies provide basically the same coverage but the claim must be made to the company within the policy period of the original or renewal policy. Claims made policies also contain terms such as retroactive date, prior acts coverage or tail coverage, all of which have the effect of expanding the time period allowed for reporting a claim. A comparison of actual policies is necessary to completely identify the specific differences between occurrence and claims made policies.

HOW MAY COVERAGE BE OBTAINED?

An eligible health care provider may apply to any Florida licensed property/casualty insurance agent. Such an agent is most commonly identified as one who offers auto, homeowners, workers compensation, and other casualty insurance. Procedures exist for the immediate binding by the agent of coverage for individuals. The application effective date shall not precede the date and time the application is completed, and the appropriate premium is collected. All applications, correspondence, premium payments, etc. should be directed by the agent to the Servicing Carrier.

CAN COVERAGE BE CANCELLED?

The policyholder can cancel at any time after proper written notice. The Association cannot cancel unless the policyholder ceases to be qualified for coverage (See What Would Disqualify an Applicant or Insured.) Premium refunds or adjustments are computed pro rata in all cases, subject to a minimum 10% earned premium on short-term policies.

HOW IS ASSOCIATION BUSINESS SERVICED?

The Association contracts with one or more insurance companies to act as Servicing Carriers. The Servicing Carrier (s) performs all policy functions including issuance of the Florida Medical Malpractice Joint Underwriting Association policy, premium accounting, settlement of claims, and miscellaneous reporting requirements, all in accordance with Florida law and Association Plan of Operations. Operations generally follow normal insurance practices. Premiums collected and invested are used to pay claims and expenses.

HOW CAN ASSOCIATION ACTS, RULINGS OR DECISIONS BE APPEALED BY AN AGGRIEVED PARTY?

The Association Plan of Operation provided an appeal process as follows:

Any person or organization aggrieved with respect to any action or decision of the Board of the Association, or any Committee thereof, may make written request of the Board for specific relief. If the request is not granted within sixty (60) days after it is made, the requestor may treat it as rejected. The person or organization aggrieved by the refusal of the Board to grant the relief requested may appeal to the Commissioner in the manner provided by the provisions of the Florida Insurance Code.

HOW IS A CLAIM REPORTED?

Insureds should immediately notify the Servicing Carrier listed on the policy with details of any injury, claim or suit.

HOW IS THE ASSOCIATION FUNDED?

Premiums and investment income are used to pay claims and expenses. There are no tax dollars or other public funds used by the Association. The Board of Governors serves on a voluntary basis and receives no compensation.

WHAT IS THE FINANCIAL VIABILITY OF THE ASSOCIATION?

The present law and Office of Insurance Regulation rules virtually guarantee the financial integrity of the Association. If losses and expenses (outgo) exceed premiums and investments (income), an assessment would be made to offset the deficit. The Association does not participate in the Florida Insurance Guaranty Association.

IS LOCUM TENENS COVERAGE AVAILABLE?

Locum Tenens coverage questions can be answered by the Locum Tenens Guide found under the "Forms" section on the website. For questions not covered in the guide, please contact the FMMJUA.

HOW ARE DEFENSE COSTS TREATED?

Defense costs are payable in addition to policy limits.

HOW DO AGENTS REGISTER FOR ACCESS TO THE FMMJUA WEBSITE?

Click the Login link and a Sign In screen will be displayed.

Click Register Now

Agency - Select your agency from the list. Information for active agencies has been loaded on the site. Please verify your agency information. Email the FMMJUA if corrections are needed. If the agency is not listed, contact the FMMJUA to set it up.

User Name - Create your user name. This is for use with this web site only. This field is case sensitive.

Password Create your password. This field is case sensitive. A minimum of 4 characters is required.

Confirm Password Re-enter the same password as above.

First Name Enter your first name.

Middle Name Enter your middle name or initial.

Last Name Enter your last name.

Office Phone Number Enter your office telephone number.

Office Fax Number Enter your office fax number.

E-mail Enter your business e-mail address. An e-mail address is required to register with the FMMJUA.

Street Address Enter your office street address.

City Enter the city where your office is located.

County Enter the county where your office is located.

State Enter the state where your office is located.

Zip Code Enter the zip code for your office.

License Number Enter your Florida 2-20 or 9-20 license number.

Click the Register User button.

An email will be sent to the email address entered stating that the registration process has begun.

Scan or fax a copy of the current 2-20 or 9-20 Florida license to the FMMJUA.

Upon receiving the 2-20 or 9-20 license, the JUA will activate the User and email notification of approval to the email address provided. The agent will be able to access the Indication Tool, Commission Calculator, Agent FAQs, etc.

If you have any questions or problems with the registration process, please email FMMJUA@medpro.com.

WHAT IS CONSIDERED A PROPER PREMIUM PAYMENT?

All premium payments must be either an insureds or premium finance company check. All checks must be made payable to the FMMJUA for the gross amount. Agency checks will only be accepted if accompanied by a premium finance agreement. The following information should accompany each payment: the insureds full name, policy number, and the purpose of payment (e.g., renewal deposit, installments, etc.). Any payment applicable to more than one policy or insured should specify the manner in which payment is to be applied by policy or insured

ARE SHARED LIMITS AVAILABLE?

Shared limits between the insured and a professional corporation are available when the professional corporation consists of a single individual.

WHO IS ELIGIBLE FOR INSURANCE THROUGH THE ASSOCIATION?

Florida law (sec. 627.351 F.S.) designates the following health care providers as eligible for coverage in the Association. - Hospitals licensed under chapter 395 - Physicians licensed under chapter 458 - Osteopaths licensed under chapter 459 - Podiatrists licensed under chapter 461 - Dentists licensed under chapter 466 - Chiropractors licensed under chapter 460 - Naturopaths licensed under chapter 462 - Midwives licensed under chapter 467 - Nurses licensed under chapter 464 - Clinical Laboratories registered under chapter 483 - Physicians Assistants certified under chapter 458 - Physical Therapists and Physical Therapists Assistants licensed under chapter 468 - Health Maintenance Organizations certified under Part I of chapter 641 - Ambulatory Surgical Centers licensed under chapter 395 - Other Medical Facilities as defined by law - Blood Banks, Plasma Centers, Industrial Clinics, and Renal Dialysis Facilities - Professional Associations, Partnerships, Corporations, Joint Ventures, or other Associations for professional activity by health care providers

WHO IS ELIGIBLE FOR INSURANCE THROUGH THE ASSOCIATION?

Florida law (sec. 627.351 F.S.) designates the following health care providers as eligible for coverage in the Association.

- Hospitals licensed under chapter 395
- Physicians licensed under chapter 458
- Osteopaths licensed under chapter 459
- Podiatrists licensed under chapter 461
- Dentists licensed under chapter 466
- Chiropractors licensed under chapter 460
- Naturopaths licensed under chapter 462
- Midwives licensed under chapter 467
- Nurses licensed under chapter 464
- Clinical Laboratories registered under chapter 483
- Physicians Assistants certified under chapter 458
- Physical Therapists and Physical Therapists Assistants licensed under chapter 468
- Health Maintenance Organizations certified under Part I of chapter 641
- Ambulatory Surgical Centers licensed under chapter 395
- Other Medical Facilities as defined by law
- Blood Banks, Plasma Centers, Industrial Clinics, and Renal Dialysis Facilities
- Professional Associations, Partnerships, Corporations, Joint Ventures, or other Associations for professional activity by health care providers

Can I pay using a credit card?

No, at this time we can only accept checks or money orders.

WHAT WOULD DISQUALIFY AN APPLICANT OR INSURED?

- Loss of license, certification, or other conditions of eligibility (see Who is Eligible for Insurance Through the Association).
- Failure to pay premiums or assessments when due.
- Material misstatement of fact on the application.
- Failure to comply substantially with the conditions and terms of the policy.

WHERE SHOULD CORRESPONDENCE BE SENT?

Other Than Claims:

Florida Medical Malpractice Joint Underwriting Association
c/o The Medical Protective Company
5814 Reed Road
Fort Wayne, IN 46835-3568
Phone: 800-836-6003

Claims:

Florida Medical Malpractice Joint Underwriting Association
c/o The Medical Protective Company
PO Box 15020
Fort Wayne, IN 46885
Phone: 407-951-1866

WHO IS ENTITLED TO A RETURN PREMIUM?

If the premium is financed, the entire return premium will be made payable to the premium finance company pursuant to the finance agreement. All other return premiums due will be made payable to the insured.

HOW IS CREDENTIALING OR A LOSS RUN REQUESTED?

The Insured should sign and date a written request. However, the FMMJUA does allow the current Agent of Record this authority. Written requests should be submitted to the FMMJUA office:

Florida Medical Malpractice Joint Underwriting Association
C/o The Medical Protective Company
5814 Reed Road
Fort Wayne, IN 46835-3568