Medical Liability Mutual Insurance Company

News Update!

MLMIC Joins Berkshire Hathaway Family of Companies

MLMIC has announced the official completion of its conversion from a mutual company to a stock company and its acquisition by National Indemnity Company, a subsidiary of Berkhire Hathaway.  The cash consideration resulting from the conversion will be paid out to eligible policyholders as promptly as practicable.  >>Read More

Record Date Policyholders Vote to Approve MLMIC Plan of Conversion

By a vote of 6,679, the Plan of Conversion and Amended and Restated Charter were approved by the Record Date Policyholders in accordance with Section 7307 of the New York Insurance Law.  >>Read More

Clarification of the Description of the Extraordinary Dividend in the Policyholder
Information Statement

On page 2 (Important Information) and page 9 (Question 23) of the Policyholder Information Statement
(the “PIS”) that was sent to Record Date Policyholders, it sets forth the following:

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NYACP continues to endorse MLMIC as a membership benefit because, for over 40 years, the Medical Liability Mutual Insurance Company (MLMIC) has put the interests of policyholders first. Their mission has always been to provide the highest quality liability insurance at the lowest possible cost consistent with long term viability.

MLMIC charges premiums that are specialty and territory specific, without a profit motive or high operating expenses.  When MLMIC’s financial results turn out better than expected, dividends are shared with policyholder holders. To help the insured avoid claims, effective risk management programs are developed that provide CME credits, a 5% premium discount, and the opportunity to qualify for free excess insurance funded by New York State.  For policyholders that get a claim, MLMIC vigorously defends the standard of care, closing the vast majority of cases without a loss payment.

Today, MLMIC is the leading medical and dental liability insurer in New York State, and they insure approximately 15,000 physicians, 5,000 mid-level and allied health practitioners, 4,000 dentists, and 40 hospitals. MLMIC remains a mutual insurer owned by their policyholders.  If you want an insurance carrier that truly looks out for you, please visit or call (800) ASK-MLMIC.

The MLMIC News Digest e-newsletter

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Subscribe today, and each month MLMIC  will send you links to valuable insights and expert opinion on important liability issues.


MLMIC Risk Management Tip of the Month:

Tip #21:  The Use of Computers in Examination Rooms

The Risk:  The presence of laptops/tablets in examination rooms has become commonplace as more providers implement electronic health records.  This method of documentation may place a barrier between the provider and the patient.  Providers may miss non-verbal cues and patients may perceive an electronic device as a hindrance to communication.  In several recent medical malpractice cases, plaintiffs testified that the provider spent too much time entering information into the computer and not enough time listening.  Utilizing effective communication skills to engage the patient while using a computer will enhance the integration of this technology into healthcare and improve the patient experience.

>> Read More

Upon the completion of the proposed transaction, the issuance by [Medical Liability Mutual Insurance Company (“MLMIC”)] of an extraordinary dividend to [National Indemnity Company (“NICO”)] in the amount of $1.905 billion, after which MLMIC commits to maintain at least the capital and surplus necessary to maintain MLMIC’s company action level risk-based capital ratio (a financial metric used in New York Insurance Law Section 1324) above 350%.

The basis upon which the $1.905 billion dividend amount was determined was on MLMIC’s authorized control level risk-based capital and not its company action level risk-based capital.  As a result, the reference to “company action level” should be deleted and the relevant sentences on page 2 and page 9 of the PIS should be revised to reflect that change.  It is also being revised to clarify that NICO not MLMIC intends to keep sufficient capital in MLMIC so that its risk-based capital ratio does not fall below 350%.  The revised language for page 2 and page 9 is as follows:

Upon the completion of the proposed transaction, the issuance by MLMIC of an extraordinary dividend to NICO in the amount of $1.905 billion, after which NICO intends to keep sufficient capital in MLMIC so that MLMIC has at least the capital and surplus necessary to maintain its risk-based capital ratio (a financial metric used in New York Insurance Law Section 1324) above 350%.

If you have any questions about this clarification, please call 1-888-467-9074 from 9 a.m. to 4 p.m., Eastern Time, Monday through Friday.

MLMIC Provides Clarification of Ability to Make Assignments of Cash Consideration

For eligible policyholders who have previously appointed a policy administrator or an EPLIP employer (as defined in the Policyholder Information Statement) to act on its behalf, MLMIC has initiated a process of notifying such eligible policyholders and their policy administrator or EPLIP employer that the previous appointments do not extend to the distribution of the cash consideration. MLMIC has provided consent forms to such eligible policyholders for use should they choose to designate their policy administrator or EPLIP employer to receive such distribution.

Nevertheless, MLMIC has always recognized that eligible policyholders have the right outside the plan of conversion to assign their right to receive their allocable share of the cash consideration.  MLMIC will honor any properly drafted and signed assignments that it receives from eligible policyholders on a timely basis, recognizing that the record date policyholder vote is scheduled for September 14, 2018.  Unless the signature of the eligible policyholder is notarized, the assignments should come directly from the eligible policyholders in order to mitigate concerns about the validity of the assignments.  In addition, it would be administratively difficult to honor assignments of less than the entire amount that has not otherwise been designated to be paid to a policy administrator or EPLIP employer.

The receipt of multiple forms of assignment may delay the distribution of cash consideration allocable to eligible policyholders who have made assignments as MLMIC reviews the forms of assignment. In order to streamline the process, MLMIC has prepared a form of assignment that may be used by eligible policyholders who did not previously appoint a Policy Administrator or EPLIP Employer. The form of assignment can be accessed by clicking here.

If we receive a properly completed consent form or other assignment form that designates a previously appointed policy administrator or EPLIP employer to receive the cash consideration, that designation will take precedence over any other assignment.  Also, an assignment will only be operative as to the amount due the eligible policyholder.  If there is a notice of dispute filed by a previously appointed policy administrator or EPLIP employer in accordance with the process set forth in the Policyholder Information Statement that disputes the eligible policyholder’s entitlement to cash consideration, MLMIC will hold the amount allocable to the particular eligible policyholder in escrow pending the resolution of the dispute.  As clarification, the dispute process only applies in the case of disputes by policy administrators or EPLIP employers, as defined in the Policyholder Information Statement, who were previously appointed to act on behalf of Eligible Policyholders during the Eligibility Period.

Completed assignment agreements should be sent to MLMIC by PDF to or by mail to:

Medical Liability Mutual Insurance Company
Two Park Avenue, Room 2500
New York NY 10016
ATTN: Conversion Coordinator.

If you have any questions about this clarification, please call 1-888-467-9074 from 9 a.m. to 4 p.m., Eastern Time, Monday through Friday.

MLMIC Provides Clarification to Consent Form Instructions Contained in Policyholder Information Statement

An important clarification on the designation by an eligible policyholder for a policy administrator or EPLIP employer to receive cash consideration upon approval of the proposed transaction with Berkshire Hathaway is as follows:

MLMIC recently sent notices to eligible policyholders who, according to MLMIC’s records, had a policy administrator or an employer on an Employee Professional Liability Insurance Policy (EPLIP Employer) in effect at any time from July 15, 2013, through July 14, 2016.  The notices explained how cash consideration allocable to eligible policyholders upon completion of the Proposed Transaction with Berkshire Hathaway could be designated to such policy administrators or EPLIP employers by completing a consent form and returning the executed consent form to MLMIC’s tabulation agent, Computershare Inc., in the envelope provided with each notice.

In the Policyholder Information Statement that was sent to record date policyholders (see page 8, item A13), it states that the consent form should be returned to the policy administrator or EPLIP Employer who should then return the consent form to MLMIC.  At this time, you are advised to disregard those instructions in the Policyholder Information Statement, which have been superseded by the process in the notices, and instead send the executed consent form directly to MLMIC’s tabulation agent – Computershare Inc., at Proxy Services c/o Computershare Investor Services, P.O. Box 505008, Louisville, KY 40233-9814 – using the prepaid envelope that was included with the notices. Important -  do not return the consent form to the policy administrator, the EPLIP Employer or MLMIC.

If you have any questions about the designation process, please call 1-888-467-9074 from 9 a.m. to 4 p.m., Eastern time, Monday through Friday.

MLMIC's Summer 2018 Case Review Publication

A review of case studies, for MLMIC insured physicians and facilities, is available for online reading.  There are two case studies in this issue, and both cases are followed by a legal and risk management perspective.

(1)  Case Study #1:  The Importance of Protocols for Dealing with Noncompliant Patients - This case details what happens when an internist and a psychiatrist fail to communicate with each other to coordinate their patient's care.

(2)  Case Study #2:  Lack of Communication Between Treating Physicians is a Serious Detriment to Patient Care -   In this case, failure to file a discrepancy report results in a delayed diagnosis of breast cancer.

To access the Summer 2018 Case Review, click HERE.

MLMIC Distributes Policyholder Information Statement on Berkshire Hathaway Transaction

MLMIC has prepared and distributed a Policyholder Information Statement to Record Date Policyholders with detailed information about the proposed conversion and acquisition by National Indemnity Company, a subsidiary of Berkshire Hathaway, Inc.  To view important information contained in the document, click HERE.

Notice of a Public Hearing on MLMIC's Plan of Conversion and Acquisition by Berkshire Hathaway

A public hearing has been scheduled by the NYS Superintendent of Financial Services to consider the Plan of Conversion that was recently adopted by MLMIC's Board of Directors.  To view a digital copy of the entire notice of public hearing, click HERE.  To view a digital copy of the Plan of Conversion, click HERE.  For additional information about the transaction, visit MLMIC's FAQ or call 1-888-7871.

MLMIC Announces New CME Modules Addressing Diagnostic Errors

MLMIC has recently announced that a new series of CME modules addressing diagnostic errors is now available online.

High Exposure Liability: Errors in Diagnosis – Parts I & II feature a physician expert and a defense attorney discussing high exposure liability claims associated with errors in diagnosis. The top medical factors that contribute to diagnostic errors are reviewed, and strategies to prevent claims are outlined. A case study analysis illustrates the key medical and legal issues that impact the outcome of a diagnostic error claim. Risk management strategies to help physicians improve the quality of patient care and reduce their potential liability risk are also provided.

To learn more about MLMIC’s CME modules, including how to register and view them, please click here or contact MLMIC.

MLMIC Reports Progress on Berkshire Hathaway Transaction

For an update on MLMIC's acquisition with National indemnity Company, a subsidiary of Bershire Hathaway, Inc., click HERE.

MLMIC's New "Risk Protect"

Risk Protect is a proactive initiative designed for practices to actively address and aggressively manage specific areas of risk, at no cost to MLMIC policyholders.  By providing unique services such as on-site risk management surveys/audits and tailored/targeted risk management educational programs, Risk Protect enables MLMIC insureds to undertake self-protective measures to manage their risks, reduce exposures and prevent adverse outcomes.  For more information, contact MLMIC at 1-800-275-6564.

MLMIC Shares Latest Development in Berkshire Hathaway Transaction

On February 23, 2018, MLMIC and Berkshire Hathaway agreed to an acquisition price.  Completion of the acquisition is expected in the third quarter of 2018. >>Read More

MLMIC's November 2017 Case Review Publication

This issue of MLMIC's Case Review newsletter features the following cases: 

(1)  Case #1 - Systemic Failures and Poor Care Lead to Death in the PACU - this case highlights the results of multiple deviations from the standard of care.

(2)  Case #2 - Inadequate Staffing Leads to Post-Treatment Disaster - unsafe patient conditions make a physician's case indefensible.

>>Read More

MLMIC's Fall 2017 Dateline Newsletter

The Fall 2017 issue of Dateline contains several articles, including:

  • a cover story about the use of unlicensed medical assistants in the physician’s office;
  • a case study about a dermatologist who was sued for an employee’s negligent laser treatment;
  • an underwriting update related to legal defense cost coverage endorsements;
  • recommendations for responding to unflattering online reviews;
  • a risk management tip on proper use of patient portals; and
  • notes on additions to MLMIC’s Research Library.

>>Read More

MLMIC - Risk Management Tips for Today's Medical Practice (Volume II)

Volume II of MLMIC's Risk Management Tips for Today's Medical Practice contains 10 tips on basic office procedures that promote patient safety and reduce exposure to liability.  Each tip is is designed to address a common issue in the office practice and provide practical guidance on how to employ best practices.  Tip topics include:  Using Chaperones During Physician Examinations, Promoting Communication Between Referring and Consulting Physicians, Handling Patients' Complaints Properly, Managing Drug Seeking Patients, Communicating and Following-Up Critical Test Results, Promoting Adherence to a Medication Regimen, Communicating with Low Health Literacy Patients, Discontinuing the Physician-Patient Relationship Properly, Treating Patients with Whom You Have a Close Relationship and Reducing the Risk of the "Copy and Paste" Function in Electronic Health Records. >>Risk Management Tips Brochure

MLMIC's Summer 2017 Case Review Publication

(1) Poor Medical Care Contributes to Death of Nursing Home Patient and (2) Nerve Injury from a Femoral Block Under General Anesthesia  >>Read More

MLMIC's Winter 2017 Case Review Publication

MLMIC's Winter 2017 Case Review Newsletter is available online.  The Case Review is published twice a year (summer and winter) and focuses on two medical malpractice lawsuits and the medical and risk management issues involved in each case.  The Winter 2017 issue of Case Review features the following cases:

MLMIC Asks the Question:   What's Your Security Worth?

Recent news stories are shining a spotlight on the dangers of unstable medical liability insurers.  Many healthcare professionals are rightfully concerned and are switching carriers. 

Choose MLMIC and stop worrying about what might come next. 

As New York's #1 medical liability insurance provider, MLMIC has been supporting physicians, hospitals and dentists in the area for more than 40 years.  MLMIC has a proven reputation for stability.  Find peace of mind at a reasonable price.  Sign up or renew by May 1st and you may even qualify for a 20 percent savings (applies to policyholders insured on 5/1/17 and who maintain continuous coverage through 7/1/17 and is based upon the annual rate of premium in effect on 5/1/17.  The dividend will be paid as a credit on your 7/1/17 renewal policy invoice). 

Learn more about what MLMIC can do for you.  Call (888) 690-2393 to speak with a MLMIC representative today.

Dealing with Patients Who Have Compromised Driving Ability

One of the most difficult decisions an individual faces is whether and when to surrender his/her driver's license and stop driving.  In addition, physicians are often in a quandary regarding the extent to which they are obligated to report to the New York State Department of Motor Vehicles when they believe a patient should not be operating a motor vehicle.  It is recommended that you take a few minutes to read this important and informative article.  >> Read More

What to Do When Patients Record Conversations with Their Patients

The use of cell phones by patients and families for the purpose of recording conversations with their healthcare providers is a topic of serious concern to many physicians.  >>Read More

Medical Liability Mutual Insurance Company (MLMIC) was formed in 1975, in cooperation with the Medical Society of the State of New York (MSSNY).  It is a mutual professional liability insurance company, which means that it is owned by the healthcare providers it insures. Headquartered in New York City, MLMIC has field representatives throughout the State, as well as three regional offices located in Syracuse, East Meadow, and the Albany area.

Management and direction of MLMIC is accomplished through a Board of Directors, comprised of physicians, dentists, and hospital administrators.  Policyholders have full voting rights on management issues. MLMIC is an active participant in the national organization, Physician Insurers Association of America (PIAA), and has been a leading force in development of risk management programs and systems, cause of loss identification, and patient safety education.                                         

Last Updated: 11.1.18

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New York Chapter of the American College of Physicians
744 Broadway, Albany NY 12207
Tel: 518-427-0366
Fax: 518-427-1991