October 23–25, 2008
J.W. Marriott Hotel
Introduction to Medical
Professional Liability Insurance
The PIAA’s new educational program, Introduction to Medical Professional Liability Insurance (MPLI),
will be held at the J.W. Marriott in Washington, D.C., on October 23–25, 2008. This unique program
will provide attendees with a comprehensive review of key insurance fundamentals and dynamics—
knowledge that can play a critical role in excelling in the medical professional liability insurance industry.
This innovative program is designed for:
• employees who are in the early phase of their insurance career;
• longer-term employees who have not had exposure to all disciplines or department processes
within an insurance operation;
• physicians or other directors who are new to the insurance governance process; and
• PIAA affiliate member company employees who want to learn more about the inner workings
of the companies that they service.
An American Experience
Known for its vast green centers, sweeping memorials, and majestic neoclassical
architecture, Washington, D.C. inspires millions of visitors each year. While there is no
question the city is rich with history, you’ll quickly notice that it’s much more than a
Beyond the city’s most familiar vistas, which include museums, historical sites, and
national monuments, Washington, D.C. unwinds into a lively urban center. With a rich
network of colorful neighborhoods, vibrant nightlife, and noted cultural attractions, the
city is brimming with endless entertainment possibilities.
We look forward to welcoming you to the Nation’s Capital!
Note: Registration for Introduction to Medical Professional Liability Insurance
is restricted to Board members and employees of PIAA member companies and
Continuing Introduction to MPLI has no prerequisites, and advanced preparation for
attendees is not necessary. The Introduction to MPLI program content is
Education designed for basic and intermediate levels. The delivery method for all sessions
is group live. We are accredited providers of the following CE programs:
Continuing Medical Education Continuing Professional Education Continuing Education for Dentists
The PIAA is accredited by the Accreditation The PIAA is registered with the National The PIAA is an ADA CERP recognized provider
Council for Continuing Medical Education Association of State Boards of Accountancy of continuing education for dentists. Continu-
(ACCME) to sponsor medical education for (NASBA) as a sponsor of continuing profes- ing education credits awarded for participa-
physicians. The PIAA designates this continuing sional education on the National Registry of tion in the CE activity may not apply toward
medical education for up to 8.75 credit hours CPE sponsors. State boards of accountancy license renewal in all states. It is the responsi-
in Category 1 of the Physician’s Recognition have final authority on the acceptance of bility of each dental participant to verify the
Award of the American Medical Association. individual courses for CPE credit. Complaints requirements of his state licensing board. The
Each physician should claim only those hours of regarding registered sponsors may be ad- PIAA designates this meeting for up to 8.75
credit that he actually spends in each educa- dressed to NASBA, 150 Fourth Avenue North, hours of dental CE credit.
tional activity. Suite 700, Nashville, TN 27319-2417. Website:
www.nasba.org. The PIAA designates this
activity for up to 10.5 hours of CPE credit.
Thursday, October 23, 2008 3:00–3:15 p.m. Refreshment Break
5:30–8:30 p.m. Welcome Reception and Dinner 3:15–4:15 p.m. Risk Management
and Patient Safety
Debra McBride, RN, JD,
Vice President of Aon Healthcare,
Friday, October 24, 2008 Aon Risk Services of Minnesota, Inc.
7:45–8:15 a.m. Continental Breakfast
Saturday, October 25, 2008
8:15–8:30 a.m. Welcome and
Introductory Remarks 8:00–8:30 a.m. Continental Breakfast
Lawrence E. Smarr, President, 8:30–9:30 a.m. Fundamentals of
Physician Insurers Association
Finance and Accounting
Robert P. Boren, Executive Vice
8:30–9:30 a.m. The Basics of Insurance— President and CFO, State Volunteer
A General Overview Mutual Insurance Company
William E. Burgess, Vice President 9:30–10:30 a.m. Understanding Reinsurance
of Association Services, Physician Insurers
Association of America E. Dow Walker, Jr., Executive Vice
President-Nashville, Willis Re Inc.
9:30–10:30 a.m. Elements of Healthcare Risks
10:30–10:45 a.m. Refreshment Break
Kurt Scott, CEO, Kansas Medical
Mutual Insurance Company 10:45–11:45 a.m. Medicine and Liability:
A Physician Perspective
10:30–10:45 a.m. Refreshment Break
Paul McNabb II, MD, Director, State
10:45–11:45 a.m. Rate-making and Reserves Volunteer Mutual Insurance Company and
Chief Clinical Officer, Baptist Hospital,
Chad C. Karls, FCAS, MAAA,
Internal Medicine/Infectious Disease
Principal and Consulting Actuary,
11:45 a.m.–Noon Closing Remarks
11:45 a.m.–1:00 p.m. Networking Luncheon Lawrence E. Smarr, President,
Physician Insurers Association
1:00–2:00 p.m. Underwriting of America
John Karlen, CPCU, ARe, APA,
President, Conventus Inter-
2:00–3:00 p.m. Claims Administration
Todd Rittle, Vice President of Claims,
Pennsylvania Healthcare Providers
Introduction to MPLI Agenda
Thursday, October 23, 2008 Learning Objective: At the conclusion of this session, attendees
will be able to explain how the insurance products of a medi-
5:30–8:30 p.m. cal liability company protect its policyholders from financial
catastrophe, and how the company assesses the relative risk of
Welcome Reception and Dinner
applicants for insurance.
Friday, October 24, 2008
Rate-making and Reserves
Chad C. Karls, FCAS, MAAA, Principal and Consulting
8:15–8:30 a.m. Actuary, Milliman, Inc.
Welcome and Introductory Remarks To ensure its financial security, a medical liability insurance
Lawrence E. Smarr, President, Physician Insurers company must calculate how much to charge for its products
Association of America (rate-making) and how much money it must set aside to pay for
claims and the administrative expenses of claims (claims reserv-
8:30–9:30 a.m. ing). In this session, attendees will learn the details of how these
calculations are made and how company data is used to project
The Basics of Insurance—A General Overview
the costs of sustaining the company in the future.
William E. Burgess, Vice President of Association Services,
Learning Objectives: At the conclusion of this session, attendees
Physician Insurers Association of America will be able to define what an actuary is, and explain how rate-
Here, we provide you with an essential orientation to the funda- making and reserves impact the financial security of companies
mentals of an insurance enterprise. We will explain the concept writing medical professional liability insurance.
of medical liability insurance, and tell you why it is vital to
healthcare professionals. You will learn what it takes to manage 11:45 a.m.–1:00 p.m.
a successful insurance company, including: selecting the risks Networking Luncheon
(policyholders), pricing the insurance coverage, and defending
a policyholder in the event of a claim. The different business 1:00–2:00 p.m.
models for insurers will be explained and you will learn how, Underwriting
and why, the PIAA member companies were established and the
critical difference between their business model and that of the John Karlen, CPCU, ARe, APA, President, Conventus
commercial carriers. Inter-Insurance Exchange
Learning Objective: At the conclusion of this session, attend- In this session, attendees will learn how an underwriter uses the
ees will be able to describe the key elements in an insurance policy, application, and company guidelines for assessing and
enterprise, considering both internal and external drivers, and managing risks, and ultimately determining individual rates. Risk
also explain the differences between PIAA companies and factors analyzed include prior claims linked with the applicant,
commercial carriers. the specialty he practices, and the demographics of the geographic
area of the practice. Two basic types of policies, claims-made and
9:30–10:30 a.m. occurrence, as well as other coverage types, will be reviewed.
Elements of Healthcare Risks Learning Objective: At the conclusion of the session, attendees
Kurt Scott, CEO, Kansas Medical Mutual will be able to explain how an underwriter assesses the extent of
risk for an applicant for insurance, and then determines the rate
to be charged. Also, attendees will be able to explain the signifi-
To maintain financial stability for their policyholders, PIAA cant differences between claims-made and occurrence policies.
companies must determine an acceptable level of risk. Companies
assess risk in several dimensions: which sorts of risks are covered, 2:00–3:00 p.m.
how much the coverage will cost, and the demographics of the Claims Administration
market where these products will be sold. In this session, you
will learn how the process of evaluating risk is generally accom- Todd Rittle, Vice President of Claims, Pennsylvania
plished: how a company assesses each applicant’s relative risk for Healthcare Providers Insurance Exchange
a liability claim, in light of specialty, location, and prior claims Once a claim has been submitted to an insurer, a team of pro-
history. You will also hear about reinsurance which is used by fessionals begin their work. Attendees will learn how claims
PIAA companies to pass some of their risk along to a second administrators respond to reports of adverse medical incidents,
financial institution. claims, and lawsuits. They investigate the circumstances of each
allegation made against their insured, and then decide how best
to proceed—settling the claim or denying it. The claims profes- will understand the fundamentals of finance and accounting and
sionals advocate for and advise the insured throughout the claims the role it plays in the medical professional liability company.
process. A team approach, including retaining defense counsel
and employing strategic partners such as economists and medical 9:30–10:30 a.m.
illustrators, is used to defend the insured. Understanding Reinsurance
Learning Objective: At the conclusion of this session, attendees E. Dow Walker, Jr., Executive Vice President-Nashville,
will understand the role played by the claims administrator, and Willis Re Inc.
will be able to explain the process that the claims department
Reinsurance is a financial vehicle used for distributing risk.
uses to assist policyholders.
Medical liability insurers purchase reinsurance to protect them
against excess losses. Here, it is the insurance company that pays
the premium. The reinsurance contract specifies the levels of
Refreshment Break losses incurred by the primary insurer that trigger an indemnity
payment by the reinsurer, to help cover these losses. Attendees
3:15–4:15 p.m. will learn the basic principles underlying reinsurance contracts,
Risk Management and Patient Safety and why these contracts are arranged on a proportional or an
Debra McBride, RN, JD, Vice President of Aon Healthcare, excess-of-loss basis, among other important concepts.
Aon Risk Services of Minnesota, Inc. Learning Objective: At the conclusion of this session, attendees
Risk managers perform the essential task of educating insureds will understand the fundamentals of reinsurance and be able to
about how to limit risk in delivering healthcare, and thereby explain how it helps protect the viability of a medical professional
create a safer environment for patients. When patient safety is liability insurance company.
optimized, an adverse medical event is less likely—so the pos-
sibility of a claim decreases, too. Attendees will learn how these 10:30–10:45 a.m.
programs are devised: by reviewing losses and trends in losses, Refreshment Break
both past and present, evaluating the medical practices that are
linked to risk of loss, and making refinements to diagnosis and 10:45–11:45 a.m.
treatment that lead to better care. Specialty specific programs are Medicine and Liability: A Physician Perspective
designed as necessary to address the ever-changing advancements
Paul McNabb II, MD, Director, State Volunteer Mutual
Insurance Company and Chief Clinical Officer, Baptist
Learning Objective: At the conclusion this session, participants Hospital, Internal Medicine/Infectious Disease
will understand the occupation of risk manager, and will be able
to explain the process used in obtaining the information used in The specter of medical liability is not what potential applicants to
patient safety programs. medical school like to think about. Anyone who is contemplating
a medical career must seriously consider it. In this session, attend-
ees will find out about the process and requirements in securing
Saturday, October 25, 2008 coverage, reporting “claims and incidents,” and risk managers’
assessment of how the practice office is operated. Dr. McNabb
8:00–8:30 a.m. will emphasize the time commitment and associated stress in
preparing the defense to a claim, and relying on the defense team
to resolve it.
8:30–9:30 a.m. Learning Objective: At the conclusion of this session, attendees
Fundamentals of Finance and Accounting will understand how the practice of medicine, for each physi-
cian, is influenced by professional liability exposure, and be able
Robert P. Boren, Executive Vice President and CFO, State to list the challenges that confront individuals contemplating a
Volunteer Mutual Insurance Company career in medicine.
Corporate financial records must be categorized, recorded,
and retrieved for reporting to management or outside auditors. 11:45 a.m.–Noon
This is the task of the finance and accounting staff, as this session Closing Remarks
will relate. They also manage the complex mix of investments of
the company, adhering to the company’s established investment Lawrence E. Smarr, President, Physician Insurers Association
policies, and play a role in determining rates and what is included of America
in rate filings. Reinsurance contracts, billing, collecting policy
premiums, and responding to questions about coverage—all fall
within the domain of the finance and accounting department.
Learning Objective: At the conclusion of this session, attendees
Workshop Location Refund and Cancellation Policy
J.W. Marriott Hotel All requests for refunds must be made in writing and sent via
1331 Pennsylvania Avenue fax or mail to the PIAA. Those who request a refund on or
Washington, D.C. 20004 before Tuesday, September 23, 2008, will receive a refund of
Telephone: (202) 393-2000 75% of the registration fee. No refunds will be issued after
Tuesday, September 23, 2008. For additional information
Hotel accommodations are available for Introduction to MPLI regarding the refund or cancellation policy, please contact the
participants at the J.W. Marriott Hotel. The PIAA special Meetings Department at (301) 947-9000.
discounted hotel room rate is $279 per night for a single/
double occupancy (plus a 14.5% state and local tax). The PIAA
discounted hotel room rate is available on a first-come, first- Workshop Attire
served basis. Hotel rooms are offered on a space-available
basis only and may sell out at any time. Please note that the The dress code for all PIAA workshops is business casual.
discounted hotel room rate may not be eligible for nights before October weather in Washington, D.C. averages a daytime
or after the Introduction to MPLI meeting dates. Arrangements high in the upper-60s, with nighttime lows in the upper-40s.
for accommodations must be made directly through the hotel
no later than Tuesday, September 23, 2008, by calling
(202) 393-2000. Please reference the PIAA meeting. Travel Information
The J.W. Marriott Hotel is located four miles from Ronald
Reagan National Airport. Taxi service is approximately
Registration $14.00 one way between the airport and hotel.
Registration Deadline for Discounted Rate—
Tuesday, September 23, 2008
Meeting registration is required for all participants. The
registration fee for the Introduction to MPLI meeting is
$550 for all registrations postmarked on or before Tuesday, Affiliate Members
September 23, 2008. For registrations postmarked after
that date, the registration fee is $600. You may register for We would like to recognize the following standard and
the Introduction to MPLI meeting by faxing or mailing your sustaining level affiliate members:
registration form as specified below.
Defense Law Firm Standard Affiliates
Bonne, Bridges, Mueller, O’Keefe & Nichols
Please fax completed registration forms to:
(301) 947-9090 Naulty, Scaricamazza & McDevitt, LLC
Please mail completed registration forms to: Standard Affiliates
2008 PIAA Introduction to MPLI Meeting Aon Re Global Optimal Service Group
2275 Research Blvd., Suite 250 Benfield Inc. of Wachovia Securities
Rockville, MD 20850 Professional Risk Management
An e-mail confirmation will be sent to you within three Guy Carpenter
business days of receipt. & Company, LLC ReSource Intermediaries, Inc.
Huggins Actuarial Towers Perrin
Registration for the Introduction to MPLI meeting is restricted
Services, Inc. Willis Re Inc.
to Board members and employees of PIAA member companies
and their subsidiaries.
For questions regarding the Introduction to MPLI
meeting, please contact the Meetings Department
at (301) 947-9000.
For all inquiries regarding continuing education,
please contact Bill Burgess at (301) 947-9000,
extension 236, or firstname.lastname@example.org.
Introduction to MPLI Registration Fee (please check one)
October 23–25, 2008 Discounted Rate – $550 (must be postmarked by 9/23/08 with payment included)
Regular Rate – $600 (postmarked after 9/23/08)
Note: Registration for Introduction to MPLI is restricted to Board members and employees of
PIAA member companies and their subsidiaries.
Registrant Information (please print)
Introduction to MPLI Professional Designation
2275 Research Blvd., Suite 250
Rockville, MD 20850 Name on Badge
Payment must accompany registration
form. For additional forms, please go to
our website, www.piaa.us.
Country Zip Code
Additional e-mail address for registration confirmation
Note: Confirmation will be provided by e-mail within three business days of receipt of registration.
Dietary Needs (please check all that apply)
Vegetarian Lunch Food Allergies
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Check (please make check payable to PIAA and reference the 2008 Introduction
to MPLI meeting)
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Don’t Miss the new PIAA educational program,
Introduction to Medical Professional Liability
Insurance, in Washington, D.C. Register TODAY to
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Mark your calendar for the
2009 PIAA Annual Meeting
in Waikoloa, Hawaii on
May 13–16, 2009. Watch
your mail for more information
or visit www.piaa.us.
Association of America
2275 Research Blvd., Suite 250
Rockville, MD 20850