1. Forms
2. PR
3. PR-00-01

What the Form Is

The Physicians, Surgeons and Dentists Professional Liability Coverage Form PR 00 01 is an insurance policy form developed by the Insurance Services Office (ISO) that provides professional liability coverage, commonly known as malpractice insurance, on an "occurrence" basis. This means the policy responds to claims for medical incidents that occur during the policy period, regardless of when the claim is actually reported, subject to policy terms and conditions. The form outlines the insuring agreements, who is an insured, limits of insurance, conditions, and definitions applicable to this coverage. It typically includes two primary insuring agreements: Coverage A for Individual Professional Liability and Coverage B for Partnership, Limited Liability Company, Association, or Corporation Professional Liability.

Classes of Business It Applies To

This form is specifically designed for:

• Physicians
• Surgeons
• Dentists

It can apply to these professionals whether they are practicing as individuals, or as part of a partnership, limited liability company (LLC), professional association, or corporation. For example, an individual surgeon in private practice, a dental group organized as an LLC, or a multi-specialty physicians' partnership could all be insured under this form.

Special Considerations

• Occurrence vs. Claims-Made: Being an occurrence form is a key feature. This contrasts with claims-made policies (like the PR 00 02 form), which cover claims first made against the insured during the policy period, provided the incident occurred after any retroactive date. Occurrence forms can provide longer-term certainty for incidents happening during the policy year, as claims can be reported years later.
• Exclusions: The form contains various exclusions. Common exclusions may include liability arising from criminal acts, contractual liability (unless specifically related to the rendering of professional services as defined), and injuries covered under workers' compensation laws. It's crucial to note that this policy is for professional services; commercial activities, such as a physician selling medical appliances, would typically require a separate Commercial General Liability (CGL) policy.
• Defense Costs: The policy usually states that the insurer has the right and duty to defend the insured against suits seeking damages covered by the policy. However, this duty may end once the applicable limit of insurance has been exhausted by payment of judgments or settlements.

Key Information for Agents and Underwriters

• Definitions are Critical: Terms like "medical incident" and "business entity incident" are defined within the policy and are fundamental to understanding the scope of coverage. Agents should ensure clients understand these definitions.
• Limits of Insurance: The policy will have specific limits of insurance, often an aggregate limit for all claims during a policy period and a per-medical incident limit. Underwriters will assess the appropriate limits based on the insured's specialty, location, and claims history.
• Risk Assessment: Underwriters will carefully evaluate the physician's, surgeon's, or dentist's specialty, procedures performed, patient load, risk management practices, and prior claims history. Certain specialties (e.g., surgery, obstetrics) are generally considered higher risk.
• Application Accuracy: The policy is issued in reliance upon the representations made by the insured in the application. Agents must stress the importance of accurate and complete information.
• Related Endorsements: Various endorsements can modify the PR 00 01. For example, PR 03 02 is a deductible endorsement specifically for use with this form. Agents and underwriters need to be aware of how endorsements alter the base coverage.