Strengths

Member Selection.
We have historically accepted 80% of the physicians who have applied, a rate far lower than our competitors. Our underwriting staff assembles claims information and gathers references from current members. Then a panel of Member physicians reviews each applicant and decides who will be admitted.

Claims Management.
Our highly qualified claims specialists handle about 100 cases each, far lower than the industry average of 140. Before resolution, a committee of physicians evaluates each large claim. Smaller claims are evaluated by a physician and senior staff.

Our Members are defended by the finest defense attorneys in the state. In addition to our outside legal panel, we have a dedicated firm of 24 lawyers who work exclusively for our Members, defending 40% of our cases.

Part of our claims management philosophy includes alternative dispute resolution. Over 40% of our litigated cases are resolved through mandatory binding contractual arbitration, which saves about 37% in defense costs.

Every new CAP member attends an award-winning risk management seminar for which 3 Category I CME credits are earned. In addition, our risk management staff visits Members' offices to provide important in-service training to staff.

Our Risk Management Department publishes a quarterly newsletter featuring timely and informative articles written by our members, attorneys and claims specialists.

The Trust Structure

The Trust assesses Members based on estimated claims payments and defense and administrative costs for a 12 month period. This is different from insurance companies, who charge premiums to pay anticipated costs well into the future. In return for lower annual malpractice protection costs, members agree to pay additional assessments if actual costs exceed estimates. Conversely, if expenses are significantly lower than projections, the members may receive a refund.

Member Participation
Members make many of the important decisions at CAP. Your fellow physicians decide member acceptance and termination. Changes in coverage provisions, such as risk classification, are decided by a vote of the full membership. Physicians design and direct our award-winning, accredited educational programs.

 Coverages

Professional Liability Coverage
Members receive Medical Professional Liability coverage through the Mutual Protection Trust (MPT). We cover solo and group physicians, their employees, and affiliated entities.

Long Term Disability Coverage
New starting in 2006 -- $1,500 per month for a full year of coverage. CAP memebers can also purchase additional monthly benefits of up to $10,000 for this "own-occupation" coverage at favorable pricing. The waiting period for this policy benefit is 90 days, which is reduced to 30 days for maternity disability.

Two Additional forms of Coverage
As part of their membership, Members also receive MEDefense coverage and Employment Practices Defense Coverage (EPD) through group insurance annual policies purchased by the Cooperative of American Physicians (CAP).

MEDefense coverage provides two forms of protection. The cost of legal representation is provided in cases where Members face an inquiry by the Medical Board of California. The coverage also reimburses the cost of legal representation, and accounting services, if allegations of Medicare or Medicaid fraud & abuse are made against the physician. Members receive $25,000 in coverage with their membership, but may purchase increased limits if desired.

EPD covers Members against employment-related claims such as wrongful termination and sexual harassment. The coverage limits are $50,000 per claim and $50,000 annual aggregate. Members may purchase higher limits for this coverage.

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