MEDEFENSETM PLUS 

  • Coverage is on a reimbursement basis
  • This coverage pays regulatory fines and penalties, claims expenses, and shadow audit expenses
  • There is no duty to defend in this coverage only reimbursement of claims expenses, shadow audit expenses, and regulatory fines and penalties
  • There is a $1,000 retention in this coverage and coverage is in excess of any underlying coverage (built-in coverage in an MDIC policy is an example of the underlying coverage)

How it Works:

Upon receiving notice of a claim by the insured the company provides name(s) of panel counsel. If insured retains panel counsel then company reimburses 100% of covered claims expenses in excess of retention and to the limit of liability. If non-panel counsel is retained then company pays 75% of claims expenses, shadow audit expenses and regulatory fines and penalties. There is a $250 per hour maximum rate for non-panel attorney.

Exclusions:

Any act committed on purpose in violation of regulatory statute; any act or omission which was committed in whole or in part prior to the applicable retro date.

Definitions:

Regulatory Proceedings include: Billing Errors (Qui Tam or Government or Commercial entity); EMTALA; and Stark

Coverage Details

Defense of Medical Board Action/Disciplinary Action

Coverage for legal expenses.

HIPAA/EMTALA Action

Coverage for legal expenses.

Allegations of Medicare/Medicaid Fraud and Abuse

Coverage for legal expenses arising out of Medicare or Medicaid investigations due to alleged billing errors and omissions.

e-MD® Cyber 

Coverage Details

Multimedia Liability

Coverage for claims alleging copyright or trademark infringement, libel or slander, or plagiarism. Covers both online and offline media.

  • Coverage is paid on behalf of Named Insured
  • Multimedia perils is the release or display of any electronic media on the named insured’s (or any affiliate’s) website or print media for which the named insured is solely responsible
  • The coverage pays for damages and claim expenses

Security & Privacy Liability

Coverage for damages, expenses and claims resulting from a breach of third party’s privacy as a result of:

  1. Unauthorized access or use of your computer system
  2. Failure to disclose a security breach in a timely manner
  3. Failure to prevent transmission of malicious code
  4. Failure to prevent your computer system from participating in a denial of service attack

Coverage is paid on behalf of Named Insured

Privacy Regulatory Defense and Fines and Penalties
  • Coverage is paid on behalf of Named Insured
  • Covers regulatory compensatory awards and regulatory fines and penalties as well as claims expenses resulting from a privacy regulatory proceeding
  • Compensatory awards include any money that is awarded to a third-party due to an adverse judgment or settlement as well as any money that the insured is legally obligated to pay to a fund for affected individuals
  • Regulatory fines and penalties include civil fines and penalties imposed by governmental entity
  • None of the above include any criminal fines, penalties or sanctions

Privacy Breach Response Costs

Coverage for costs associated with a privacy breach response, including:

  1. Patient notification expenses
  2. Patient call center support and credit monitoring

Network Asset Protection

Coverage for amounts incurred to recover and/or replace data that is compromised, damaged, lost, erased or corrupted due to accidental damage or destruction of electronic media or computer hardware, administrative or operational mistakes in the handling of electronic data, or computer crime/attacks.

  • Coverage is a reimbursement basis
  • Covers digital assets loss and special expenses defined as data and computer programs that exist in the computer system at the time of loss
  • Does not include computer hardware
  • Covers reasonable and necessary expenses to replace, re-create or restore digital assets to the same state prior to damage
  •  This coverage also includes nonphysical business interruption and extra expense loss during the period of restoration not to exceed 120 days and on a reimbursement level

Cyber Extortion

Coverage for extortion expenses and extortion monies as a direct result of a credible cyber extortion threat.

  • With Underwriting approval prior to payment of threat

Cyber Terrorism

This coverage pays income loss, interruption expenses, and special expenses during the period of restoration because of total or partial interruption due to computer system damage or failure as a result of an act of terrorism

  •  Coverage is on a reimbursement basis