1. Forms
2. PR
3. PR-00-06

What the form is

The Allied Health Care Providers Professional Liability Coverage Form PR 00 06 is an Insurance Services Office (ISO) claims-made policy designed to provide professional liability coverage for a variety of allied healthcare professionals and entities. This form protects insureds against claims alleging errors, omissions, or negligent acts in the rendering of or failure to render professional services. Being a claims-made form, coverage is triggered when a claim is first made against the insured during the policy period or any applicable extended reporting period, provided the act giving rise to the claim did not occur before the retroactive date stated in the Declarations.

Classes of business it applies to

This form is intended for a diverse group of healthcare providers who are not typically covered under more specific medical professional liability forms (like those for physicians or hospitals). Examples of professionals and businesses that may be covered under this form include, but are not limited to:

• Chiropractors
• Dental hygienists
• Emergency medical technicians (EMTs) and paramedics
• Physical and occupational therapists
• Radiological technicians
• Optometrists
• Veterinarians
• Blood banks
• Diagnostic testing laboratories
• Nurses (employed by entities other than hospitals or physicians)
• Medical or X-ray laboratories
• Physiotherapists

For instance, a physical therapy clinic could use this form to cover its liability exposures related to the treatment services provided by its employed therapists. Similarly, an independent diagnostic imaging center could secure coverage under this form for potential errors in performing or interpreting medical scans.

Special considerations

• Claims-Made Basis: It is crucial for both the insured and the agent to understand the implications of a claims-made policy. This includes the importance of maintaining continuous coverage to avoid gaps and the function of the retroactive date, which typically aligns with the inception date of the first claims-made policy for the insured.
• Retroactive Date: Claims arising from incidents that occurred prior to the retroactive date shown in the Declarations are not covered.
• Extended Reporting Periods (Tail Coverage): The form includes provisions for purchasing an extended reporting period if the policy is canceled, non-renewed, or if the insurer renews or replaces coverage with a later retroactive date or on an occurrence basis. This allows for the reporting of claims that arise from incidents that occurred after the retroactive date and before the end of the policy period, but are not made until after the policy has terminated.
• Consent to Settle: Professional liability forms often contain clauses regarding the insurer's right to settle claims, sometimes requiring the insured's consent. The specifics of this should be reviewed in the policy.
• Defense Costs: The form typically covers the costs to defend against claims, which may be within the limits of liability or in addition to them, depending on the policy provisions.

For example, if an EMT service covered under PR 00 06 faces a lawsuit alleging negligence during a patient transport that occurred during the policy period, the claim would be considered under this policy if it is first made during the policy period or an applicable tail period, and the incident occurred after the retroactive date.

Key information for agents and underwriters

• Underwriting Focus: Underwriters will assess the specific types of professional services being rendered, the qualifications and experience of the professionals, risk management procedures in place, and prior claims history. The term "Allied Health Care Providers" is a broad catchall, so a thorough understanding of the applicant's specific operations is essential.
• Pricing: Pricing will vary significantly based on the profession, the scope of services, geographic location, limits of liability, deductible, and the insured's risk profile.
• Coverage Gaps: Agents should be vigilant about potential coverage gaps when an insured switches from an occurrence form to a claims-made form, or between claims-made carriers. Ensuring the correct retroactive date is established is critical.
• Endorsements: Various endorsements may be available to tailor the coverage, such as those to add or exclude specific services, modify limits, or add additional insureds (e.g., PR 20 03 for employees). A deductible is often part of professional liability policies and can be implemented using an endorsement like PR 03 02.
• Limits of Liability: Policies will have an aggregate limit for all claims during a policy period and often a per-claim limit. Understanding how defense costs impact these limits is important.

An agent working with a new optometry practice would explain the claims-made nature of the PR 00 06 form, the importance of selecting an appropriate retroactive date (likely the practice's start date), and discuss the availability of extended reporting period options should the practice ever cease operations or change coverage significantly.