Physicians Are Insurance Consumers, Too

Since taking office less than two months ago, Insurance Commissioner Dave Jones has made it clear he wants to protect consumers from insurers — and he made moves to get the authority to curb excessive insurance rate hikes and enforce new federal medical loss ratios.

Jones still doesn’t have the rate-regulation authority he said the California Department of Insurance needs, but he does have the enforcement power to go after insurers who don’t meet medical loss ratio standards.

Now Jones’ office is targeting a new type of insurance: medical malpractice.

“Based on an examination of 2009 data, we found that loss ratios for some medical malpractice insurers were low,” Ioannis Kazanis of the CDI said. “That’s why we contacted some of them and explained they may have to re-file.”

It’s not an issue brought up by physician groups such as the California Medical Association, Kazanis said. But physicians are like any other consumer group, in that they are entitled to protection against high rates on their insurance, in this case malpractice insurance, Jones said in a statement.

“Unlike health insurance, where I do not have the authority to reject excessive rates, the Insurance Commissioner does have the authority to regulate the rates of medical malpractice insurance paid for by doctors, surgeons, clinics and other health providers,” Jones said.

“We have found that recent loss ratios — the percentage of every premium dollar the insurer spends on claims — of many medical malpractice insurers are low,” he said. “And that’s why I have directed my staff to carefully examine the rates of medical malpractice insurers. Low loss ratios are one indication that premiums may be too high.”

Kazanis said more-recent 2010 data should be available next month. It’s possible, based on the new figures, she said, “that not all of the companies we contacted will have to re-file.”

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