Exhibit 10.73


 


COVERAGE SUMMARY

Physician Professional Liability Insurance Policy


 


NOTICE:
THIS POLICY IS ISSUED BY YOUR RISK RETENTION GROUP. YOUR RISK RETENTION GROUP MAY
NOT BE SUBJECT TO ALL OF THE INSURANCE LAWS AND REGULATIONS OF YOUR STATE.
STATE INSURANCE INSOLVENCY GUARANTY FUNDS ARE NOT AVAILABLE FOR YOUR RISK
RETENTION GROUP. THIS POLICY IS SUBJECT TO ARBITRATION IN ACCORDANCE WITH
THE SOUTH CAROLINA UNIFORM ARBITRATION ACT. SECTION 15-48-10.


 


INSURER


 


NATIONAL MEDICAL
PROFESSIONAL RISK RETENTION GROUP, INC.


7301 Rivers Avenue, Suite 230



North Charleston. SC 29406


 


Notice: The following
telephone numbers may be used to present inquiries or obtain information about
coverage and to provide assistance in resolving complaints: (888 ) 804-9556


 


FIRST NAMED INSURED- NAME AND ADDRESS


 


Radiation Therapy Services, Inc.
/21st Century Oncology, Inc.

2234 Colonial Boulevard

Fort Myers, FL 33907


 


POLICY AND ENDORSEMENTS ISSUED AT INCEPTION


 


Policy Number:
NMP-FL860013                                   Form: NMP 2006


 


Manuscript Endorsements: Endorsement
1 Cancellation; Endorsement 2 Consent to Settle; Endorsement 3 Limits of
Liability; Endorsement 4 Insured Persons and Organizations; Endorsement 5
General Changes; Endorsement 6 Exclusions; Endorsement 7 Definitions;
Endorsement 8 Physician Coverage Part; Endorsement 9 Hearing Costs; Endorsement
10: NMPRRG HIPAA Endorsement; Endorsement 11: Revised HIPAA Endorsement


 


Effective Date: October 14,
2009                                 Expiration
Date: October 14, 2010


 


Retroactive
Date: See page 2


 


PREMIUM


 


In consideration of the payment
of the premium and subject to all the terms and conditions of this policy, we agree with you to provide the
insurance as stated in this policy.  This policy
consists of the Physician Professional
Liability Policy,  NMP-FL860013, along with the coverage part(s) for
which a premium is indicated. Where no premium is shown, there is no coverage.


 


	
  Coverage Part

  	
   

  	
  Limits of Liability

  	
   

  	
  Premium

  
	
  Physician

  	
   

  	
  See
  Endorsement No. 3

  	
   

  	
   

  
	
  Professional Organization

  	
   

  	
  N/A

  	
   

  	
   

  



 


TOTAL PREMIUM:


 


1

















 


INSURED PERSONS AND ORGANIZATIONS


 


	
  Name

  	
   

  	
  Retroactive Date

  	
   

  	
  Termination Date

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  See Endorsement No. 4

  	
   

  	
   

  	
   

  	
   

  



 


LISTED PHYSICIANS/PHYSICIAN EXTENDERS

(See Section A.7 of Physician Professional Liability Coverage Part

and definition of covered person in Professional Organization Coverage Part)


 


	
  Name

  	
   

  	
  Retroactive Date

  	
   

  	
  Termination Date

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  See Endorsement No. 4

  	
   

  	
   

  	
   

  	
   

  



 


AGENT


 


Arthur J. Gallagher Risk
Management Services, Inc. 

9821 Katy Freeway, Suite 700 

Houston, TX 77024


 


The person to whom or in
whose name this policy is issued
is considered a member of the risk retention group with all rights and
obligations of membership.


 


The Coverage Summary, along
with policy form and endorsements
listed above, complete the above numbered policy.


 


	
  Date Issued:
  January 11, 2010

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
  /s/ Authorized Signatory

  	
   

  	
  /s/ Authorized Signatory

  
	
  Authorized
  Representative

  	
   

  	
  Authorized Representative

  



 


2

















 


NATIONAL MEDICAL PROFESSIONAL

RISK RETENTION GROUP, INC.

(NMPRRG)

North Charleston, South Carolina


 


PHYSICIAN PROFESSIONAL LIABILITY POLICY


 


POLICY NUMBER: NMP-FL860013


 


NOTICE: THIS POLICY IS ISSUED BY YOUR RISK RETENTION GROUP.
YOUR RISK RETENTION GROUP MAY NOT BE SUBJECT TO ALL OF THE INSURANCE LAWS
AND REGULATIONS OF YOUR STATE. STATE INSURANCE INSOLVENCY GUARANTY FUNDS ARE
NOT AVAILABLE FOR YOUR RISK RETENTION GROUP. THIS POLICY IS SUBJECT TO
ARBITRATION IN ACCORDANCE WITH THE SOUTH CAROLINA UNIFORM ARBITRATION ACT.
SECTION 15-48-10.


 


The policyholder has no contingent liability under this non
assessable policy.


 


Notice of Annual Meeting of Members


 


Pursuant to South Carolina
Code Section 38-19-40, the annual meeting of members of National Medical
Professional Risk Retention Group, Inc. will be held at: a day and time to
be determined.


 


Any change of the time and
place of the annual meeting of members will be made only at an annual meeting
of members, and notice of such change will be provided in accordance with the
bylaws of National Medical Professional Risk Retention Group, Inc.


 


FORM NMP 2006


 


1

















 


NATIONAL MEDICAL PROFESSIONAL

RISK RETENTION GROUP, INC.

(NMPRRG)


 


PROFESSIONAL LIABILITY POLICY


 


Introduction


 


This policy is written in plain language. Please
read it and familiarize yourself with what it says. If you have any questions, corrections or
changes, please contact us at the
telephone number or address listed on the Coverage Summary to this policy.


 


	
  Your Professional Liability Policy is made up of the following items

  	
   

  	
  Page Number

  
	
   

  	
   

  	
   

  	
   

  
	
  1.

  	
  Coverage
  Summary

  	
   

  	
  Separate Page

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  This is a page, which is
  typed or printed and inserted as the first page you see when you open the policy.  It will include a description of who
  is/are policyholder(s), insured(s),  applicable limits of liability, insured organizations,  which
  Coverage Parts and/or Endorsements are applicable, when coverage begins and
  ends, the Retroactive Date,  and other information required for you to understand the policy. If this page is missing or
  incorrect, please call or write us
  so we may send you a copy or
  issue any needed corrections.

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
  2.

  	
  Common
  Policy Conditions

  	
   

  	
  3

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  The conditions contained
  in this section apply to every Coverage Part and
  Endorsement(s) that is/are a part of this policy.  Rather
  than repeat them, we have
  consolidated them in this section.

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
  3.

  	
  Common
  Exclusions

  	
   

  	
  9

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  The exclusions contained
  in this section apply to every Coverage Part and
  Endorsement(s) that is/are part of this policy. Additional exclusions, if any, are contained in the
  applicable Coverage Part and any Endorsements that are a part of this Policy.Rather than repeat them, we have
  consolidated the common exclusions in this section.

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
  4.

  	
  Common
  Definitions

  	
   

  	
  12

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  The definitions contained
  in this section apply to every Coverage Part and applicable Endorsement
  that is part of this policy.

  	
   

  	
   

  



 


2

















 


	
   

  	
  Additional definitions, if
  any, are contained in the applicable Coverage Part or Endorsements that
  are part of this policy.  Rather than repeat them, we have consolidated the common
  definitions in this section.

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
  5.

  	
  Coverage
  Part(s)

  	
   

  	
  as applicable, Pages 14 and 20

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  The only applicable
  Coverage Parts are those shown on the Coverage Summary and that either has a
  premium shown or indicates the premium is “included”. Those applicable
  Coverage Parts provide you specific
  coverage agreements which detail the type of coverage(s) provided by
  this policy.  The policy
  may contain more than one Coverage Part, each providing different
  specific coverage agreements.

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
  6.

  	
  Endorsements

  	
   

  	
  Separate Pages

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  This policy may contain endorsements.
  Endorsements may be added to change policy terms
  and conditions that apply to you.  Endorsements to the policy at inception are listed on the
  Coverage Summary. Other endorsements may be added to the Policy during the policy period,  as described in Paragraph C of the Common Policy Conditions Section.

  	
   

  	
   

  



 


COMMON
POLICY CONDITIONS


 


A.                      The Policy Period


 


Coverage under this policy shall begin at 12:01 AM standard
time at the address and on the effective date shown in the Coverage Summary. If
this policy replaces a policy ending at noon, rather than 12:01
AM, coverage shall begin at noon when coverage under the old policy expires. Coverage shall expire at
12:01 AM, standard time, on the expiration
date shown in the Coverage Summary. If all or part of this policy is cancelled for any reason before
that date, the coverage will end at 12:01 AM standard time on the cancellation
date.


 


B.                      Premiums


 


1.                         All premiums
paid to us shall be computed in
accordance with our rules, rates,
rating plans, premiums and minimum premium applicable on the effective date of
the policy.


 


2.                         The first
premium is due at inception. Each renewal premium is due on or before the
beginning of the renewal period to which it applies. If any premium is not paid
when due, this policy will be
terminated in accordance with the cancellation provisions of this policy.


 


The policyholder must promptly notify us, in writing, of any change in the
information provided to us in any
application or other communication, including but not limited to: any change in
medical specialty; medical procedures performed; location of practice;
addition, substitution or termination of employees; partners, agents, or
independent contractors; and


 


3

















 


insureds or, changes in
the corporation, partnership or professional associations or affiliations of
the policyholder. Such changes may
result in a condition that would not be covered by this policy or additional premium due to us.


 


C.                      Policy Changes


 


This policy can only be changed by a written
endorsement to the policy. This
endorsement must be signed by one of our authorized
representatives. Notice to our agent
or knowledge possessed by our agent
or any other person shall not act as a waiver by us of any requirement under the policy or change any part of this policy. Any notice to any person will not prevent us from asserting any rights under the
provisions of the policy.


 


We make changes in
our standard policy from time to time. While your policy is in effect, we may make a
change in our standard policy which
may broaden or restrict coverage under that policy.
However your coverage
will only be changed in the following manner:


 


1.                         If the change
broadens your coverage and the
change can be added to your policy without
requiring a premium increase, you will
automatically receive the benefit of the broadened coverage;


2.                         if the change
restricts your coverage, it will
not become effective until and unless your
policy is renewed.


 


D.                      Renewal and Cancellation


 


Renewal: Neither we nor the policyholder is required to renew this policy. Any renewal will be on policy forms then in effect. We may renew by issuing a Continuation
Coverage Summary specifying a new policy
period or by offering a completely new policy. If you reject
our offer of renewal, either by failure to pay the premium on or before the
effective date of such renewal or by written notice received by us, then any coverage under a new policy period or a completely new policy shall be null and void as of its
effective date.


 


Cancellation: You can cancel this policy at any time. We have the same right


 


To cancel, you must mail or deliver to us the original policy or written notice stating when the coverage is to end.


 


If we cancel the policy, we will mail or deliver to you written notice stating when the
coverage is to end. We will
ordinarily provide you ninety (90)
days notice of cancellation or non-renewal unless otherwise provided herein.
However, when the cancellation is due to any of the following reasons, we will only provide you ten (10) days notice of
cancellation:


 


1.                         Nonpayment of
premium under the terms of this policy;


2.                         The loss or
suspension of your license to
practice medicine;


3.                         The provision
by you of false or misleading
statements to us in our application or in the application
process;


 


After this policy has been in effect for ninety (90)
days or longer, we will not cancel the policy
except under the circumstances described in Paragraphs 1 through 3
above or Paragraphs 4 and 5 below:


 


4

















 


4.                         Failure to
comply with our underwriting
requirements within ninety (90) days of the date of effectuation of coverage;
and


5.                         Substantial
change of risk covered by the policy.


 


If we cancel the policy for any reason specified in Paragraphs 4 or 5 above, we will provide you with a ninety (90) day cancellation notice.


 


If  the policy is
cancelled during the policy period by
us for any reason, we will provide you with a pro rata refund of the unearned premium. If the policy is cancelled during the policy period by you for any reason, we will provide you with a pro rata refund of the unearned premium, less a
cancellation charge equal to ten percent (10%) of the annual premium. We will provide any premium refund due
either at the time cancellation is effected or as soon as administratively
practicable after cancellation becomes effective, but the cancellation will
occur as scheduled, regardless of whether you
have received the refund on the date of cancellation.


 


E.                        Policy Territory


 


This policy applies to a medical incident occurring in the United
States of America, including its territories and possessions, Puerto Rico and
Canada. A claim must be made and
suit must be filed within the United States of America only.


 


F.                        Assignments and Transfers


 


Neither the policyholder nor anyone else covered under
this policy can assign or transfer
your or their interest in the policy. If you die or are adjudged mentally incompetent, the coverage
under the policy shall be
automatically terminated as to you and
your interest in the policy shall be automatically transferred
to your duly appointed legal
representative. Any unearned premium shall be calculated on a pro rata basis
from the termination date and returned according to the provisions of this policy.


 


G.                      Consent to Settle a Claim or
Suit


 


We will not settle
any claim against you without the First Named Insured’s written consent. Once a judgment has
been entered against you, we may
settle the claim against you without consent. Upon your death or total disability, consent to
settle transfers to us.


 


H.                      Other Insurance


 


A loss that is covered under
this policy may also be covered
under another insurance policy or
risk transfer instrument, including but not limited to, self-insured
retentions, deductibles, or other alternative arrangements.


 


The coverage provided by all
Coverage Parts of this policy shall
apply as excess insurance to any coverage under another insurance policy or risk transfer instrument,
including but not limited to, self-insurance retentions, deductibles or other
alternative arrangements.


 


5

















 


We shall not be
liable under this policy for a
greater proportion of such loss than the applicable limit of liability under
this policy for such loss bears to
the total applicable limits of liability of all valid and collectible insurance
or risk transfer instruments, whether primary, contributory, excess, contingent
or otherwise.


 


These other insurance
provisions do not apply to any insurance policies
or risk transfer instruments written as specific excess insurance
over the limits of liability of this policy.


 


I.                           Recovering Damages from a Third Party


 


Any insured covered under this policy may be able to recover all or part
of a loss from a person or organization other than us; therefore, each insured must
do all that is reasonably possible to preserve any right of recovery. If we make a payment under this policy then the right of recovery shall
belong to us (on your behalf). If we recover more than we
have paid then the excess shall belong to the insured
that had the loss, but we
shall deduct our recovery expenses
first, including a reasonable attorneys’ fees.


 


J.                        Lawsuits Against Us


 


You may not bring
legal action against us concerning
this policy until:


 


1.                        You have fully complied with all the provisions of this policy, and


2.                        The amount of your obligation to pay has been decided.
Such amount can be set by court judgment or by written agreement between you, us and the claimant.


 


No person or organization
(including you) can join us in an action against you, and no one can sue us directly on a claim against you.


 


After liability against you has been determined by court judgment
or written agreement, the party making the claim
may be able to recover under this policy,
but only up to the limit of your coverage.
If you or your estate is adjudged bankrupt or becomes
insolvent, we will still be obligated under this policy.


 


K.                      Fraud and Misrepresentation


 


This policy shall be void if you or any insured covered under this policy
fail or refuse to disclose any relevant fact or information to us,
alter, conceal or destroy any relevant record or document, mislead us or defraud or lie to us about any relevant issue relating to
coverage under this policy, either
before or after a loss. Unintentional errors or omissions, however, will not
affect your rights under this policy.


 


L.                       Our Right to Inspect and Audit


 


You agree to let us inspect your property and business operations during normal business
hours while this policy is in
force. We are not, however,
required to make inspections. Nor will we
guarantee that your property or operations
are safe, or that they will conform to any laws, rules or regulations. You also agree to allow us to examine and audit your books and records that relate to this
insurance at any time up to three years after the policy ends. Any


 


6

















 


inspection, surveys, reports
or recommendations shall relate only to insurability under the policy and premium charged.


 


M.                    What To Do If You Have a Claim


 


Notification:


 


1.                        Tell us what happened as soon as possible after the
claim has been asserted


2.                        Notify the
police if any laws may have been broken.


3.                        Send us copies of all claims or demands or legal documents as soon as possible.


 


Notice to us shall be given to:


 


National Medical
Professional Risk Retention Group, Inc.

c/o Eugene Smith, Defense Counsel

1715 Monroe Street

Fort Myers, FL 33901

Phone: (888)804-9556

Fax: (239)334-4100


 


When providing information
to us, be sure to include the time
and place of the event, the persons involved, the specific nature of the incident,
including the type of claim that
may result, and the names and addresses of any witnesses and injured people.


 


Cooperation:


 


You are required to
fully cooperate with us or our designee in the making of settlements
within the policy limits of
liability, the conduct of suits or other proceedings and enforcing any right of
contribution or indemnity against another who may be liable to you because of injury, damage, loss or expense. If we ask, you shall
attend hearings and trials; assist in obtaining and presenting evidence, and
obtaining the attendance of witnesses.


 


Do not agree to any
financial obligations or make any payments of money without our authorization. Doing so will result in our not making reimbursement of any payment
or obligation even though it may have been covered by this policy.


 


Keep your records in a safe place. Do not alter,
cancel or destroy your medical
records or commit any act that would interfere with our ability to defend a claim
or lawsuit against you.  Create a separate litigation file for all
items relating to a medical incident, claim or
lawsuit separate and apart from any medical records pertaining to the treatment
provided.


 


N.                      Extended Reporting Period Endorsement


 


1.                         If either you or we
cancel or non-renew this insurance or if a physician
is no longer rendering professional
services on behalf of the First
Named Insured or if we
cancel or refuse to renew this policy for reasons other than for non-payment of
premium, upon the payment of an additional premium, you shall have the


 


7

















 


option to extend the period
during which claims can be made
against you and reported to us.  The
duration of the period under which claims can
be reported is unlimited. The offer of renewal terms and conditions or premium
different from those in effect prior to the renewal of this policy, shall not constitute failure or
refusal to renew.


 


2.                         Your right to
purchase optional Extended Reporting Period
Endorsement must be exercised by written notice to us not later than
thirty (30) days after the cancellation or termination date of the policy or the physician.  The
premium for the Extended Reporting Period
Endorsement will be based on the rules and rating plans we are using on the day the Extended Reporting Period Endorsement becomes
effective.


 


The Extended Reporting Period Endorsement will
not go into effect unless the First Named
Insured or the physician pay
the additional premium promptly when due. Once in effect, the entire premium
shall be fully earned, and the Extended
Reporting Period Endorsement may not be canceled.


 


3.                         The policy language that applied immediately
prior to the expiration date will
apply to all claims submitted
during the Extended Reporting Period
Endorsement. The broadening of coverage portion of the Policy Changes provision found in the
General Conditions section will not apply during the Extended Reporting Period Endorsement.


 


4.                         The Per Claim limit of liability that applied to you on the cancellation date will apply to
all claims submitted during the Extended Reporting Period Endorsement. The
Aggregate limit that applied to you on
the cancellation date is the maximum amount we
will pay for all claims covered
under this policy either prior to
the cancellation date or under the Extended
Reporting Period Endorsement


 


5.                         There will be
no charge for the Extended Reporting Period
Endorsement if any of the following events take place while the policyholder or insured physician are actively insured with us: if the insured physician


 


a.                          dies (we must
have a copy of the Death Certificate or other proof of death);


b.                         becomes disabled;
or,


c.                          fully retires from the practice of medicine at
age fifty-five (55) or more and has been continuously insured by us for the last five (5) years
immediately before retirement.


 


In the event you or the policyholder returns to the practice of medicine, the policyholder must notify us in writing. If you report a claim to us under
the Extended Reporting Period Endorsement and
we determine you were not fully retired from the
practice of medicine, no coverage will apply to the claim.


 


O.                     First Named Insured Responsibilities


 


By acceptance of this policy, the Insured named as the First
Named Insured in the Coverage Summary shall act on behalf of all Insureds for purposes including, but not
limited to, giving and receiving all notices and correspondence, the
cancellation or


 


8






 










 


non-renewal of this policy, the payment of premiums, and the
receipt of any return premiums that might be due under the policy. The First Named Insured shall exercise the Insured’s right to either reject or demand
the arbitration of any claim made
against the Insured in accordance
with our written instructions.


 


COMMON
EXCLUSIONS


 


We will not defend or pay
under this policy for:


 


A.                      Punitive or
exemplary damages unless coverage
for those types of damages are
required by the state where this policy is
issued.


 


B.                        Any injury or damages
resulting from an intentional tort, criminal act, or injury or damages
for acts or omissions while under the influence of intoxicants or
narcotics.


 


C.                        Any amounts
which you or any party must pay
under any unemployment or workers compensation, disability benefits or other
similar law.


 


D.                       Any injury or damages
to:


 


1.                         Your employee arising out of and in the course of
employment by you, or,


 


2.                         The spouse,
child, parent, brother or sister of that employee as a consequence of “1.”
above.


 


This exclusion applies to
any liability you have assumed
under any contract or agreement other than a contract covered by this policy. However this exclusion shall not
apply if you are providing
immediate medical or surgical care to an employee after an injury or there is a medical incident resulting from providing
of professional services to an
employee.


 


E.                        Any injury or damages
arising out of any:


 


1.                         Refusal to
employ;


 


2.                         Termination of
employment; or,


 


3.                         Coercion,
demotion, reassignment, defamation, harassment, humiliation, discrimination or
any other employment related practices, policies, acts or omissions.


 


F.                         Any injury or damages
arising out of claims asserting
any business or employment dispute, antitrust violations, unfair competition,
boycott, conspiracy, the independent tort of conspiracy, trademark, patent or
copyright infringement, misappropriation of trade secrets, breach of covenant
not to compete, non-competition agreement, interference with business relations
or contract, or any other act or omission which violates any statute, ordinance
or regulation imposing any fine, penalty or other sanction.


 


G.                        Any injury or damages
due to any acts of war.


 


9

















 


H.                       Any injury or damages
due to your legal
responsibility resulting from the manufacturing, distributing, selling or
serving of alcoholic beverages, or if you are
the owner or lessor of locations used for such purposes.


 


I.                            Any required
return or withdrawal of fees or government payments to you;  the
payment of any fines, penalties, sanctions; or any multiplication of amounts
payable as penalties under this policy imposed
by law.


 


J.                           Any fees,
costs, expenses or other charges attributable to compensation of private legal
counsel you may retain to protect your personal interests, whether or not a
conflict of interest exists between you and
us.


 


K.                       Any damages based upon the Employee Retirement
Income Security Act of 1974, Public law 93-406 commonly referred to as the
Pension Reform Act of 1974, and amendments thereto or similar provisions of any
federal, state or local law.


 


L.                        Nuclear Energy Liability Exclusion


 


This policy shall not cover:


 


1.                         Under this policy or supplemental payments provision
for any injury,  sickness, disease, death or destruction;
or bodily injury or property
damage


 


a.                          with respect to
which an insured under the policy is also an insured under a nuclear
energy liability policy issued by Nuclear Energy Liability Insurance
Association, Mutual Atomic Energy Liability Underwriters or Nuclear Insurance
Association of Canada, or would be an insured under any such policy but for its termination upon
exhaustion of its limit of liability; or,


 


b.                         resulting from
the hazardous properties of nuclear material and with respect to which (a) any
person or organization is required to maintain financial protection pursuant to
the Atomic Energy Act of 1954, or any law amendatory thereof, or (b) the insured is, or had this policy not been issued would be, entitled
to indemnity from the United States of America, or any agency thereof, under
any agreement entered into by the United States of America, or any agency
thereof, with any person or organization.


 


2.                         Under any
Medical Payments Coverage Part, or under any supplementary payments provision
relating to (i) immediate medical or surgical relief; (ii) first aid
expenses incurred with respect to bodily injury, sickness, disease or death; or
(iii) bodily injury resulting from the hazardous
properties of nuclear material and
arising out of the operation of a nuclear
facility by any person or organization.


 


3.                         Under any
Coverage Part for any injury,  sickness, disease, death or destruction,
or bodily injury or property damage resulting from the hazardous properties of nuclear material,  if


 


a.                          the nuclear material is at any nuclear facility owned by, or operated by
or on behalf of, an insured or has
been discharged or dispersed there from, or


 


10

















 


b.                         the nuclear material is contained in spent fuel
or waste at any time possessed, handled, used, processed, stored, transported
or disposed of by or on behalf of an insured;  or


 


c.                          the injury, sickness, disease, death or
destruction, or bodily injury or property damage arises out of the furnishing
by an insured of services,
materials, parts or equipment in connection with the planning, construction,
maintenance, operation or use of any nuclear
facility,  but if such
facility is located within the United States of America, its territories or
possessions or Canada, this exclusion subsection (c) applies only to any injury to or destruction of property at
such nuclear facility,  or property damage to such nuclear facility and any other property
thereat.


 


4.                         As used in this
exclusion:


 


hazardous
properties include radioactive, toxic or explosive properties;


 


nuclear
materials means source
materials, special nuclear
material or byproduct material;  however, nuclear
materials do NOT include materials used in the provision of
professional services that are
otherwise covered by this policy


 


source
material, special nuclear
material, and byproduct material have
the meanings given them in the Atomic Energy Act of 1954 or in any law
amendatory thereof; spent fuel means
any fuel element or fuel component, solid or liquid, which has been used or
exposed to radiation in a nuclear reactor;


 


waste means any byproduct material other than tailings or
waste produced by the extraction or concentration of uranium or thorium from
any ore processed primarily for its source
material content and resulting from the operation by any person or
organization of any nuclear facility as
defined in subparagraphs a. and b. of the definition of nuclear facility.


 


nuclear
facility means:


 


a.                          any nuclear
reactor,


b.                         any equipment
or device designed or used for (a) separating the isotopes of uranium or
plutonium, (b) processing or utilizing spent fuel, or (c) handling,
processing or packaging waste,


c.                          any equipment
or device used for the processing, fabricating or alloying of special nuclear
material if at any time the total amount of such material in the custody of the
insured at the premises where such equipment or device is located consists of
or contains more than 25 grams of plutonium or uranium 233 or any combination
thereof, or more than 250 grams of uranium 235,


d                            any structure,
basin, excavation, premises or place prepared or used for the storage or
disposal of waste, and includes the site on which any of the foregoing is
located, all operations conducted on such site and all premises used for such operations;
“nuclear reactor” means any apparatus designed or used to sustain nuclear
fission in a self-supporting chain reaction or to contain


 


11

















 


a critical mass of
fissionable material; with respect to injury to
or destruction of property, the word “injury”  or “destruction” includes all forms of
radioactive contamination of property; “property damage” includes all forms of
radioactive contamination of property.


 


DEFINITIONS


 


Wherever used in this policy,  the
following words or phrases in bold type shall have these meanings:


 


Claim means any
expression of intent to hold you responsible
for damages arising from the
rendering or failure to render professional
services by you or by
someone for whom you are legally
responsible. If this policy is
terminated for any reason, we will
not accept as claims incident
reports that do not comply with the definition of claim.


 


Claim
expenses means the fees charged by an attorney we designate; and all other reasonable
fees, costs and expenses (including interest on that part of any judgment that
does not exceed the limit of your coverage)
which result from the investigation, adjustment, defense and appeal of a claim.  These
expenses must be incurred by us or
by you with our prior written consent. Claim expenses do not include awards of
attorney fees for a claimant.


 


Damages means all
amounts of money (legally recoverable) which are payable because of injury to which this insurance applies and
includes an award of attorney fees for a claimant.


 


Disabled means you have ceased your practice of medicine
as a result of your permanent,
complete and continuous inability to practice medicine, as certified by a
physician whose use we have
approved.


 


Expiration
date means the end of the policy period as
specified in the Coverage Summary or Continuation Coverage Summary, or if
earlier, the date this policy is
cancelled or terminated in accordance with Paragraph D (Renewal and
Cancellation) of the Common Policy Conditions
section of this policy.


 


Extended
Reporting Period Endorsement means the period of time
commencing immediately after the end of the policy
period for reporting claims arising
out of medical incidents which
occur on or after the Retroactive Date and
before termination date of the policy.


 


First Named
Insured means the first person or organization named in the
Coverage Summary of the policy.


 


Injury means bodily
injury, sickness, disease, mental or emotional distress sustained by a person,
or death resulting from such injury caused
by you.


 


Insured means any
person or entity covered under this policy.


 


Insured
organization means any partnership, professional corporation,
professional association, limited liability company, or other entity designated
as such on the Coverage Summary.


 


Insured
physician means any physician
designated as such on the Coverage Summary or Continuation Coverage
Summary.


 


12

















 


Medical
incident means any act, error or omission in the providing of
or failure to provide professional services by
you or by someone for whom you are legally responsible. For the
purposes of this definition, treatment of mother and fetus (or fetuses) from
conception through postpartum care constitutes a single medical incident,  and a continuing course of treatment or repeated exposure to
substantially the same general conditions constitutes a single medical incident.


 


Physician means a
licensed physician, surgeon or podiatrist.


 


Physician
extenders means certified nurse practitioners, certified nurse
midwives, certified registered nurse anesthetists, physicians assistants,
psychologists, optometrists and chiropractors.


 


Policy means the
Professional Liability Insurance Policy,  the Coverage Summary or Continuation
Coverage Summary, the applicable Coverage Part or Parts and any
Endorsements attached to the policy.


 


Policyholder
means the person or organization designated as such in the Coverage
Summary or Continuation Coverage Summary.


 


Policy
period means the date and time when the policy
begins and ends as set forth in the Coverage Summary or Continuation
Coverage Summary.


 


Professional
services means providing or failing to provide medical
services, including making or failing to make a medical diagnosis.


 


Retroactive
date, as specified in the Coverage Summary or Continuation Coverage Summary,
means the earliest date on or after which a medical
incident would be covered under this policy.  No
coverage exists for a medical incident that
occurred prior to the retroactive date.


 


Retire means you completely withdraw from the practice
of medicine.


 


Sexual
misconduct means any sexual act, intimacy, assault,
molestation, harassment, exploitation, or any treatment, procedure, conduct, or
behavior that is considered undue sexual familiarity.


 


You and your means (a) the policyholder; (b) an insured physician;  or (c) any approved locum tenens
employed or engaged by the policyholder while
acting within the scope of his or her duties as such.


 


We, us and our
means National Medical Professional Risk Retention Group, Inc.


 


This policy is signed by our authorized representative, but is not
valid unless a Coverage Summary signed by our
authorized representative is attached.


 


13

















 


PHYSICIAN PROFESSIONAL LIABILITY COVERAGE PART


 


This coverage applies only if indicated on the Coverage
Summary and a premium is shown.


 


This Coverage Part provides
protection against professional liability claims
that are brought against you by
or on behalf of a patient in your medical
practice. The coverage is written on a claims-made  basis which means that claims that are the result of medical incidents happening on or after the
retroactive date stated in the
Coverage Summary or Continuation Coverage Summary are covered, provided the claim is first made against you and reported to us while this Coverage Part is in
effect. We consider a claim to be made on the date you first notify us in writing regarding a claim
being made against you. No
coverage exists for claims first
made against you after the end of
the policy period unless, and then
only to the extent, an Extended Reporting
Period Endorsement applies as determined in the Conditions section
of the policy.


 


We will defend any
claim brought against you alleging damages covered under this Coverage Part. We will do this even if the claim is groundless and fraudulent. We will
not defend or pay a claim after
the applicable limits of liability of the Coverage Part have been used to
pay judgments or settlements.


 


A.                      Coverage Agreement


 


You are covered for
injury or damages arising from a medical incident resulting from:


 


1.                         Your providing or failure to provide professional services to a patient.


 


2.                         Your refusal to treat or to accept a person as a patient,
or for wrongful termination, transfer or abandonment of the care and treatment
of a patient.


 


3.                         Your providing or failure to provide professional services to any injured person
at the scene of an accident or emergency and/or failure to provide or arrange
for further medical treatment for the injured person.


 


4.                         Your providing or failure to provide professional services to anyone for and at
the request of a hospital, school, religious entity, non-profit organization,
or state or local governmental agency for which neither the requesting entity or
organization nor you expect,
charge, or receive any compensation.


 


5.                         Your service as a member of an insured organization, but that organization is only covered
for injury or damages resulting from the providing or
withholding of professional services to
a patient by you individually. The
organization is not protected for acts of any other members or employees of the
organization. There will be no coverage under this Physician Professional
Liability Coverage Part unless the organization is specifically named on
the Coverage Summary or Continuation Coverage Summary. The coverage under this
Paragraph 5 does not increase the limits of liability under this Coverage Part.
The insured organization shares your individual limits of liability under
this Coverage Part. However, if the policy also
provides coverage under the Professional Organization Coverage Part, then the insured organization will be provided
separate limits of liability under the Professional Organization Coverage Part.
Insurance provided under this Paragraph 5


 


14

















 


is excess of and payable
only after all other valid insurance and self-insurance limits of coverage have
been exhausted paying settlements and judgments.


 


6.                         Your vicarious liability resulting from the providing or
failure to provide professional services by
your employees, leased employees
or loaned employees (other than physicians and
physician extenders) for whose
acts you are legally responsible.
This coverage is available only while these individuals are acting within the
scope of their employment by you. The
coverage under this Paragraph 6 does not increase the limits of liability under
this Coverage Part. However, if the policy also
provides coverage under the Professional Organization Coverage Part, then these
individuals will share the limits of liability provided under the Professional
Organization Coverage Part. Insurance provided under this Paragraph 6 is excess
of and payable only after all other valid insurance and self-insurance limits
of coverage have been exhausted paying settlements and judgments.


 


7.                         Your vicarious liability resulting from the providing or
failure to provide professional services by
physicians or physician extenders for whose acts you are legally responsible. This coverage
is available only when the physician or
physician extender is (A) employed
by you or the insured organization; (B) listed on
the Coverage Summary or Coverage Continuation Summary; and (C) individually
insured either by us or by another
company acceptable to us and you have furnished proof of such other
insurance (in the form of a Certificate of Insurance issued to us)  with
limits of liability acceptable to us. The
coverage under this Paragraph 7 does not increase the limits of liability under
this Coverage Part. . However, if the policy also
provides coverage under the Professional Organization Coverage Part, then these
individuals will share the limits of liability provided under the Professional
Organization Coverage Part. Insurance provided under this Paragraph 7 is excess
of and payable only after all other valid insurance and self-insurance limits
of coverage have been exhausted paying settlements and judgments.


 


8.                         Your vicarious liability for providing or failure to
provide professional services by
medical students and/or residents only when working in your medical practice, under your direct
supervision, while acting within the scope of a program approved by their
educational institution.


 


9.                         Your service on a formal hospital or professional society
board or committee. However, the coverage provided by this Paragraph 9 shall
not apply if you have other
insurance coverage or you are
covered under a self insurance plan, indemnity agreement or other agreement
providing some form of protection to you for
these services.


 


10.                   Your quality assurance activities when performed for the
purposes of evaluating and improving the quality of health care services and
for patient safety. We will cover you when you
participate as a member, a witness or a clinical practice advisor of
a formal credentialing, peer review, or quality assurance board or committee
formed by an organization for the purposes of improvement of patient safety or
the quality of health care services delivered to patients. Quality assurance
activities do not include your services
to an organization that reviews utilization, necessity and treatment issues
related to controlling health care costs unless that organization is added by


 


15

















 


endorsement or Coverage
Part. However, the coverage provided by this Paragraph 10 shall apply in excess
of other insurance coverage provided under a self insurance plan, indemnity
agreement or other agreement providing some form of protection to you for these services.


 


11.                   Your providing or failure to provide professional services that results in the
personal injury to a patient resulting from false arrest, detention,
imprisonment, libel, slander, defamation of character, violation of an
individual’s right to privacy, mental anguish, mental shock or humiliation.
Personal injury arising out of sexual
misconduct is not covered. The coverage provided by this Paragraph
11 shall apply in excess of other insurance coverage provided under a self
insurance plan, indemnity agreement or other agreement providing some form of
protection to you for these
services.


 


12.                   Your negligence in placing, or causing to be placed,
erroneous medical information in a medical chart or an electronic medical
record. You also will be covered
if you relied upon erroneous
medical information in a medical chart or an electronic medical record in
providing professional services.


 


13.                   Your wrongful or unauthorized disclosure of patient
confidential or privileged medical information to a person or persons who are
not otherwise entitled to it.


 


B.                      Limits of Liability


 


1.                         The Per Claim limit of liability stated on the
Coverage Summary or Continuation Coverage Summary is the maximum amount we will pay for all damages and all claims or causes of action of any kind against all
organizations and persons covered by this Coverage Part that have arisen
from an event or a series of events. The providing or failure to provide professional services to a patient, even
when seen on different occasions and by different persons covered by this
Coverage Part, shall be considered as having arisen from a series of events,
and only one Per Claim limit of
liability shall apply. If more than one person or organization is covered under
this Coverage Part, the Per Claim limit
of liability will still be the maximum amount we
will pay.


 


2.                         The Aggregate
limit of liability stated on the Coverage Summary is the maximum amount we will pay for all damages and all claims or causes of action of any kind arising from claims reported in any single policy period.


 


C.                      Additional Benefits


 


In addition to the limits of
liability:


 


1.                         We will pay premiums for appeal bonds or to release
property that is being used to secure a legal obligation, but only bonds valued
up to the limit of liability of the policy.
We have no obligation to apply for or to furnish the bond.


 


2.                         We will pay claim
expenses, including the interest on that part of any judgment that
does not exceed the limit of liability. We
will pay all reasonable costs incurred at our
request to investigate or defend a claim or suit against you. This includes loss of


 


16

















 


earnings not to exceed Five
Hundred Dollars ($500) per day for your attendance
at hearings or trials requested by us.


 


3.                         If you become subject to a state or federal
regulatory investigation, we will
pay the costs of defending the investigation up to, but not exceeding,
Twenty-Five Thousand Dollars ($25,000) in the annual aggregate for the policy period. We will not pay these costs
unless:


 


a.                          the
investigation is of a civil and not a criminal nature;


 


b.                         the
investigation is the outcome of injury or
damage resulting from a medical incident covered under this policy; and


 


c.                          you have informed us of
the investigation promptly after you received
notice of it and we receive your written notice of the investigation
during the policy period.


 


D.                      Exclusions


 


We will not defend
or pay under this Coverage Part for:


 


1.                         Any injury or damages
resulting from your liability
or administrative duties as a proprietor, superintendent, medical director,
administrative or executive officer of any of (but not limited to) the
following:


 


a.                          Hospital,
nursing home or sanitarium;


 


b.                         Clinic with bed
and board facilities,


 


c.                          Outpatient
surgery center, health care facility, laboratory, emergency medical service,
or,


 


d.                         Other business
enterprise.


 


This exclusion does not
apply to claims arising from
laboratory or health care facilities:


 


a.                          you maintain for testing of your own patients; or,


 


b.                         necessary to
the practice of your profession or
specialty.


 


2.                         Any injury or damages
for liability that you have
assumed under a contract or agreement. This exclusion does not apply to
liability you assume in a contract
with a health maintenance organization, preferred provider organization,
independent practice association or any other similar organization, if such
liability is attributable to your providing
or failure to provide professional services to
a patient and, as such, would be covered even in the absence of such a
contract.


 


17

















 


3.                         Any injury or damages
resulting from your liability
for the acts or omissions of any physician or
physician extender you employ or
engage except as specifically provided under Paragraph 7 of Section A of
this Coverage Part.


 


4.                         Any injury or damages
resulting from your liability
for the providing or failure to provide professional
services to a patient by any employee of:


 


a.                          a hospital,
nursing home or sanitarium;


b.                         a clinic with
bed and board facilities; or,


c.                          an outpatient
surgery center, health care facility, laboratory or emergency medical service
facility.


 


5.                         Any injury or damages
you are liable for while on active duty in the United States
Military Service or Reserve or any National Guard Unit.


 


6.                         Any injury or damages
in the event you or
someone you instruct fraudulently
alters, defaces or falsifies any records.


 


7.                         Any injury or damages
resulting from your liability
arising out of your own sexual misconduct or the sexual misconduct of those for whom you are legally responsible. This exclusion
applies whether the sexual misconduct is
done under the guise of treatment or otherwise and with or without the consent
of the individual. However, we
will defend any claim until such
time as there is an admission of such activity, relations or contact or they
have otherwise been adjudicated. This exclusion does not apply if any injury or damages
are caused by sexual misconduct of
employees who are not physicians or
physician extenders if you are legally responsible for such
employees when the sexual misconduct occurs
and the sexual misconduct occurs
without your actual or implied
knowledge.


 


8.                         Any injury or damages
for liability arising out of the manufacturing, selling, distribution,
disposing, altering or dispensing of any product by you, or to any person. This exclusion does not apply to
dispensing of pharmaceuticals or medical appliances to your own patients when such dispensing
arises out of the rendering of or failure to render professional services to a patient.


 


9.                         Any injury or damages
resulting from claims to
which you or any entity for which you are serving is entitled to sovereign
immunity defense or limitation. However, this exclusion does not apply if you are not entitled to sovereign immunity
defense or limitation.


 


10.                   Any injury or damages
resulting from claims or
lawsuits arising out of your rendering
or failing to render professional services while
your license to practice your
profession or license to prescribe controlled substances has been suspended,
revoked, restricted or voluntarily surrendered.


 


11.                   Any injury or damages:


 


a.                          arising out of
a medical incident that happened
either before the retroactive date or
on or after the retroactive date if
on the effective date


 


18






 










 


of this policy you knew or had been told that the medical incident would result in a claim; or


 


b.        arising out of any claim that on the effective date of this policy is a reported medical incident, a pending claim or proceeding; or a paid claim; or


 


c.         arising out of a medical incident disclosed on our application(s) or during the
application process.


 


12.      Any injury or damages
resulting from any individual hired or employed by or on behalf of your patient.


 


19

















 


 


PROFESSIONAL ORGANIZATION COVERAGE PART


 


This
coverage applies only if indicated on the Coverage Summary and a premium is
shown.


 


This Coverage Part provides
protection against professional liability claims
that are brought against the Professional Organization shown on the
Coverage Summary or Continuation Coverage Summary for damages resulting from the providing of or
failure to provide professional services to
a patient by a covered person.


 


For purposes of this
Coverage Part, covered person means


 


a.         the policyholder;


 


b.        an employee, leased employee
or loaned employee (other than a physician
or physician extender) of the
Professional Organization for whose acts the Professional Organization is
legally responsible, while acting within the scope of his or her employment by
the Professional Organization; and


 


c.         a physician or physician
extender for whose acts the Professional Organization is legally
responsible, but only when the physician or
physician extender is (A) employed
by the Professional Organization; (B) listed on the Coverage Summary or
Coverage Continuation Summary; and (C) individually insured either by us or by another company acceptable to us and the policyholder has furnished proof of such other insurance (in
the form of a Certificate of Insurance issued to us)  with limits
of liability acceptable to us.


 


The coverage is written on a
claims-made basis and applies to claims that
are the result of medical incidents happening
on or after the retroactive date stated
in the Coverage Summary or Continuation Coverage Summary are covered, provided
the claim is first made against
the Professional Organization and reported to us
while this insurance is in effect. We
consider a claim to be made on the date we are
first notified in writing regarding a claim against
the Professional Organization. No coverage exists for claims first made against the Professional
Organization after the end of the policy
period unless, and then only to the extent, an Extended Reporting Period Endorsement applies
as determined in the Conditions section of the policy.


 


We will defend any
claim alleging damages covered under this Coverage Part. We will do this even if the claim is groundless and fraudulent. We will not defend or pay a claim after the applicable limit of liability
has been used to pay judgments or settlements.


 


20

















 


A.        Coverage
Agreement


 


The Professional
Organization is covered for injury or
damages arising from a medical incident resulting from:


 


1.        A covered person’s providing or failure to provide professional services to a patient.


 


2.        A covered person’s refusal to treat or to accept a person as a
patient, or for wrongful termination, transfer or abandonment of the care and
treatment of a patient.


 


3.        A covered person’s providing or failure to provide professional services to any injured person
at the scene of an accident or emergency and/or failure to provide or arrange
for further medical treatment for the injured person.


 


4.        A covered person’s providing or failure to provide professional services to anyone for and at
the request of a hospital, school, religious entity, non-profit organization,
or state or local governmental agency for which neither the requesting entity
or organization nor the covered person expects,
charges, or receives any compensation.


 


5.        A covered person’s providing or failure to provide professional services that results in the
personal injury to a patient resulting from false arrest, detention,
imprisonment, libel, slander, defamation of character, violation of an
individual’s right to privacy, mental anguish, mental shock or humiliation.
Personal injury arising out of sexual
misconduct is not covered. The coverage provided by this Paragraph 5
shall apply in excess of other insurance provided to or on behalf of the covered person by another or an agreement
providing some form of protection to the covered
person for these services.


 


6.        A covered person’s negligence in placing, or causing to be
placed, erroneous medical information in a medical chart or an electronic
medical record. The covered person also
will be covered if the covered person relied
upon erroneous medical information in a medical chart or an electronic medical
record in providing professional services.


 


7.        A covered person’s wrongful or
unauthorized disclosure of patient confidential or privileged medical
information to a person or persons who are not otherwise entitled to it.


 


B.        Limits of
Liability


 


1.        The Per Claim limit of liability stated on the
Coverage Summary or Continuation Coverage Summary is the maximum amount we will pay for all damages and all claims or causes of action of any kind against the
Professional Organization and all covered
persons that have arisen from an event or a series of events. The
providing or failure to provide professional
services to a patient, even when seen on different occasions and by
different covered persons, shall
be considered having arisen from a series of events, and only one Per Claim limit of liability shall


 


21

















 


apply. If more than one
person or organization is covered under this Coverage Part, the Per Claim limit of liability will still be the
maximum amount we will pay.


 


2.        The Aggregate limit of
liability stated on the Coverage Summary is the maximum amount we will pay for all damages and all claims or causes of action of any kind arising from claims reported in any single policy period.


 


3.        Claim
expenses are in addition to the limit of liability.


 


C.        Additional Benefits


 


In addition to the limits of
liability:


 


1.        We will pay
premiums for appeal bonds or to release property that is being used to secure a
legal obligation, but only bonds valued up to the limit of liability of the policy.
We have no obligation to apply for or to furnish the bond.


 


2.        We will pay claim expenses, including the interest on
that part of any judgment that does not exceed the limit of liability. We will pay all reasonable costs incurred
at our request to investigate or defend a claim
or suit against the Professional Organization. This includes loss of
earnings not to exceed Five Hundred Dollars ($500) per day for attendance by a covered person at hearings or trials by us.


 


D.        Exclusions


 


We will not defend
or pay under this Coverage Part for:


 


1.        Any injury or damages
arising from the acts or omissions of person who is not a covered person.


 


2.        Any injury or damages:


 


a.         arising out of a medical incident that happened either
before the retroactive date or on
or after the retroactive date if
on the effective date of this policy the
covered person knew or had been
told that the medical incident would
result in a claim; or


 


b.        arising out of any claim that on the effective date of this policy is a reported medical incident;  a pending claim or
proceeding; or a paid claim, or


 


c.         arising out of a medical incident disclosed on our application(s) or during the
application process.


 


3.        Any injury or damages
resulting from claims as
to which a covered person or any
entity for which a covered person is
serving is entitled to sovereign immunity defense or limitation. However, this
exclusion does not apply if the covered
person is not entitled to sovereign immunity defense or limitation.


 


22

















 


4.        Any injury or damages
resulting from a covered person’s liability
for providing or failure to provide professional
services to a patient by any employee of:


 


a.         a hospital, nursing home or
sanitarium;


 


b.        a clinic with bed and board
facilities; or,


 


c.         an outpatient surgery
center, health care facility, laboratory or emergency medical service facility.


 


5.        Any injury or damages
resulting from the Professional Organization’s liability for or
arising out of the sexual misconduct of
those for whom the Professional Organization is legally responsible. This
exclusion applies whether the sexual
misconduct is done under the guise of treatment or otherwise and
with or without the consent of the individual. However, we will defend any claim until such time as there is an
admission of such activity, relations or contact or they have otherwise been
adjudicated. This exclusion does not apply if any injury or damages are
caused by sexual misconduct of
employees of the Professional Organization who are not physicians or physician extenders if the Professional Organization is
legally responsible for such employees when the sexual misconduct occurs and the sexual misconduct occurs without the Professional Organization’s
actual or implied knowledge.


 


6.        Any injury or damages
for liability arising out of the manufacturing, selling,
distribution, disposing, altering or dispensing of any product by a covered person,  or to any person. This exclusion does not apply to dispensing
of pharmaceuticals or medical appliances to patients when such dispensing
arises out of a covered person’s rendering
of or failure to render professional services
to a patient.


 


7.        Any injury or damages
resulting from any individual hired or employed by or on behalf of a
patient of a covered person.


 


8.        Any injury or damages
resulting from a covered person’s liability
or administrative duties as a proprietor, superintendent, medical director,
administrative or executive officer of any of (but not limited to) the
following:


 


a.         Hospital, nursing home or
sanitarium;


 


b.        Clinic with bed and board
facilities,


 


c.         Outpatient surgery center,
health care facility, laboratory, emergency medical service, or,


 


d.        Other business enterprise.


 


This exclusion does not
apply to claims arising from
laboratory or health care facilities:


 


a.         a covered
person maintains for testing of patients of the covered person; or,


 


23

















 


b.        necessary to the practice of
the covered person’s profession or
specialty.


 


9.        Any injury or damages
for liability that a covered
person has assumed under a contract or agreement. This exclusion
does not apply to liability a covered person assumes
in a contract with a health maintenance organization, preferred provider
organization, independent practice association or any other similar organization,
if such liability is attributable to a covered
person’s providing or failure to provide professional services to a patient.


 


10.      Any injury or damages
in the event a covered person or
someone a covered person instructs
fraudulently alters, defaces or falsifies any records.


 


11.      Any injury or damages
resulting from claims or
lawsuits arising out of a covered person’s rendering
or failing to render professional services while
the covered person’s license to
practice his or her profession or license to prescribe controlled substances
has been suspended, revoked, restricted or voluntarily surrendered.


 


24

















 


NATIONAL
MEDICAL PROFESSIONAL RISK RETENTION GROUP, INC


 


Endorsement
No. 1 

Policy No. NMP-FL860G13


 


CANCELLATION ENDORSEMENT


 


This endorsement is attached
to and made a part of policy no. NMP-FL860013 and modifies the policy effective October 14, 2009.


 


The PROFESSIONAL LIABILITY POLICY COMMON POLICY CONDITIONS
D. Renewal and Cancellation is deleted and replaced by the
following:


 


D.       Renewal and Cancellation


 


Renewal: Neither we nor the policyholder is required to renew this policy. Any renewal will be on policy forms then in effect. We may renew by issuing a Continuation
Coverage Summary specifying a new Policy
Period or by offering a completely new policy.  If you reject our offer of renewal, either by
failure to pay the premium on or before the effective date of such renewal or
by written notice received by us, then
any coverage under a new policy period or
a completely new policy shall be
null and void as of its effective date.


 


If we non-renew the policy, we will mail or deliver to you written notice ninety (90) days prior to the expiration of
the policy.  The notice will state the reason for the
non-renewal.


 


Cancellation: You can cancel this policy at any time. We have the same right. To cancel, you must mail or deliver to us the original policy or written notice stating when the coverage is to end.


 


If we cancel the policy, we will mail or deliver to you written notice stating when the
coverage is to end. We will
ordinarily provide you ninety (90)
days notice of cancellation unless otherwise provided herein. However, then the
cancellation is due to any of the following reasons, we will only provide you ten
(10) days notice of cancellation.


 


1.         non-payment of premium under
the terms of this policy;


 


2.         the loss or suspension of your license to practice medicine.


 


After this policy has been in effect for ninety (90)
days or longer, or is a renewal of a prior policy, we will not cancel the policy
except under the circumstances described in #1 and #2 above.


 


Manuscript Endorsement


 


1

















 


If we cancel the policy for any reason specified below, we will provide you with a ninety (90) day cancellation notice:


 


1.      The provision by you of false or misleading statements to us in our
application or in the application process;


 


2.      Failure to comply with our underwriting requirements within ninety
(90) days of the effective date of coverage;


 


3.      Failure to comply with
written policy terms, conditions
or contractual duties; and


 


4.      Substantial change of risk
covered by the policy.


 


If  the policy is
cancelled during the policy period by
us for any reason, we will provide you with a pro-rata refund of the unearned premium. If the policy is cancelled during the policy
period by you for any reason, we
will provide you with a pro-rata
refund of the unearned premium, less a cancellation charge equal to ten percent
(10%) of the annual premium. We
will provide any premium refund due either at the time cancellation is effected
or as soon as administratively practicable after cancellation becomes
effective. The cancellation will occur as scheduled regardless of whether or
not you have received the refund on the date of cancellation.


 


All other terms, conditions
and exclusions of the policy remain
unchanged.


 


 


	
  Signed By:

  	
  /s/ Authorized Signatory

  	
   

  	
  January 11,
  2010

  
	
   

  	
  Authorized Signature or
  Countersignature 

  (In States where required)

  	
   

  	
  (Date)

  



 


2

















 


NATIONAL
MEDICAL PROFESSIONAL RISK RETENTION GROUP, INC


 


Endorsement
No. 2 

Policy No. NMP-FL860013


 


CONSENT TO SETTLE A CLAIM OR
SUIT ENDORSEMENT


 


This endorsement is attached
to and made a part of policy no. NMP-FL860013 and modifies the policy effective October 14,2009 as
follows:


 


The Professional Liability
Policy Common Policy Conditions G. Consent to
Settle a Claim or Suit is
deleted and replaced by the following:


 


G.       Consent to Settle a Claim or Suit


 


Except where prohibited by
statute, we will not settle any claim against
you without the First Named Insured’s written consent. Once
a judgment has been entered against you, we
may settle the claim against you
without consent. Upon your death
or total disability, consent to settle transfers to us.


 


All other terms, conditions
and exclusions of the policy remain
unchanged.


 


 


	
  Signed By:

  	
  /s/ Authorized Signatory

  	
   

  	
  January 11, 2010

  
	
   

  	
  Authorized Signature or
  Countersignature 

  (In States where required)

  	
   

  	
  (Date)

  



 


1

















 


NATIONAL
MEDICAL PROFESSIONAL RISK RETENTION GROUP, INC


 


Endorsement
No. 3 

Policy No. NMP-FL860013


 


LIMITS OF LIABILITY
ENDORSEMENT


 


This endorsement is attached
to and made a part of policy no. NMP-FL860013 and modifies the policy effective October 14, 2009 as
follows:


 


The Limits of Liability on
the Coverage Summary are amended as follows and apply to each physician based
on the physician’s primary practice location:


 


Limits of Liability for Physicians Excluding “Stand-In” Physicians:


 


All states except North
Carolina, Nevada and Pennsylvania:

$250,000 per Claim per Physician / $750,000 annual aggregate per Physician


 


North Carolina and Nevada:

$1,000,000 per Claim per Physician / $3,000,000 annual aggregate per
Physician


 


Pennsylvania:

$500,000 per Claim per Physician / $1,500,000 annual aggregate per
Physician


 


Limits of Liability for “Stand-In”
Physicians:  Physicians engaged to provide physician supervision coverage for purposes
only as required by law on behalf of the Named
Insured are provided the following limits:


 


AH states including North
Carolina, Nevada and Pennsylvania:

$250,000 per Claim per Physician / $750,000 annual aggregate per Physician


 


Limits of Liability for
Professional Organization(s):


 


Not Applicable


 


All other terms, conditions
and exclusions of the policy remain
unchanged.


 


 


	
  Signed By:

  	
  /s/ Authorized Signatory

  	
   

  	
  January 11,
  2010

  
	
   

  	
  Authorized Signature or
  Countersignature (In States where required)

  	
   

  	
  (Date)

  



 


1






 










 


NATIONAL
MEDICAL PROFESSIONAL RISK RETENTION GROUP, INC


 


Endorsement
No. 4

Policy No. NMP-FL860013


 


INSURED PERSONS &
ORGANIZATIONS ENDORSEMENT


 


This endorsement is attached
to and made a part of policy no. NMP-FL860013 and modifies the policy effective October 14, 2009 as
follows:


 


The complete listing of Insured Physicians and Retroactive Dates as amended from time to
time is on file with the Risk management Department of the First Named Insured.


 


It is understood and agreed
that there is no coverage provided under the Professional
Organization Coverage Part of this policy.


 


All other terms, conditions
and exclusions of the policy remain
unchanged.


 


 


	
  Signed By:

  	
  /s/ Authorized Signatory

  	
   

  	
  January 11,
  2010

  
	
   

  	
  Authorized Signature or
  Countersignature 

  	
   

  	
  (Date)

  
	
   

  	
  (In States where required)

  	
   

  	
   

  



 


1

















 


NATIONAL
MEDICAL PROFESSIONAL RISK RETENTION GROUP, INC


 


Endorsement
No. 5 

Policy No. NMP-FL860013


 


GENERAL CHANGE ENDORSEMENT


 


This endorsement is attached
to and made a part of policy no. NMP-FL860013 and modifies the policy effective October 14,2009 as
follows:


 


The following sections of
the PROFESSIONAL LIABILITY POLICY are
amended as follows:


 


COMMON
POLICY CONDITIONS — Sections E. Policy Territory and N. Extended Reporting
Period Endorsement are deleted and replaced with the following:


 


A.                      Policy
Territory


 


Policy
Territory means anywhere in the world, but only if the suit
for damages is brought within the United States of America (including its
territories and possessions), Puerto Rico and Canada.


 


N.                      Extended
Reporting Period Endorsement


 


1.                          If either you or we
cancel or non-renew this insurance or if a physician is no longer rendering professional services on behalf of the First Named Insured or if we cancel or refuse to renew this policy
for reasons other than for non-payment of premium, upon the payment of an
additional premium, you shall have
the option to extend the period during which claims
can be made against you and
reported to us. The duration of
the period under which claims can
be reported is unlimited. The offer of renewal terms and conditions or premium
different from those in effect prior to the renewal of this policy, shall not constitute failure or
refusal to renew.


 


2.                          The premium for
the Extended Reporting Period Endorsement will
be based on the rules and rating plans we
are using on the day the Extended
Reporting Period Endorsement becomes effective.


 


The Extended Reporting Period Endorsement will
not go into effect unless the First Named
Insured or the physician pays
the additional premium when due. Once in effect, the entire premium shall be
fully earned, and the Extended Reporting
Period Endorsement may not be canceled.


 


3.                          The policy language that applied immediately
prior to the expiration date will
apply to all claims submitted
during the Extended Reporting Period. The
broadening of coverage portion of the Policy Changes
provision found in the General Conditions section will not apply during the Extended Reporting Period Endorsement.


 


4.                          The Per Claim limit of liability that applied to you on the cancellation date will apply to
all claims submitted during the Extended Reporting Period Endorsement unless


 


1

















 


otherwise endorsed. The
Aggregate limit that applied to you on
the cancellation date is the maximum amount we will pay for all claims covered under this policy either prior to the cancellation
date or under the Extended Reporting Period unless
otherwise endorsed.


 


5.                          There will be
no charge for the Extended Reporting Period
Endorsement if any of the following events take place while the policyholder or insured physician are actively insured with us: if the insured physician


 


a.                         dies (we must
have a copy of the Death Certificate or other proof of death);


b.                        becomes disabled; or,


c.                         fully retires from the practice of medicine at
age fifty-five (55) or more and has been continuously insured by us for the last five (5) years
immediately before retirement (inclusive of the Lexington Insurance Company policy
numbers on file with the First Named Insured for
the policy periods shown below):


 


1.          10/01/03-10/14/04


2.          10/14/04-10/14/05


3.          10/14/05-10/14/06


4.          10/14/06-10/14/07


 


In the event you or the policyholder returns to the practice of medicine, the policyholder must notify us in writing. If you report a claim to us under
the Extended Reporting Period Endorsement and
we determine you were not fully retired from the
practice of medicine, no coverage will apply to the claim.


 


All other terms, conditions
and exclusions of the policy remain
unchanged.


 


 


	
  Signed By:

  	
  /s/ Authorized Signatory

  	
   

  	
  January 11,
  2010

  
	
   

  	
  Authorized Signature or
  Countersignature 

  	
   

  	
  (Date)

  
	
   

  	
  (In States where required)

  	
   

  	
   

  



 


2

















 


NATIONAL
MEDICAL PROFESSIONAL RISK RETENTION GROUP, INC


 


Endorsement
No. 6 

Policy No. NMP-FL860013


 


EXCLUSIONS ENDORSEMENT


 


This endorsement is attached
to and made a part of policy no. NMP-FL860013 and modifies the policy effective October 14, 2009 as
follows:


 


The following sections of
the PROFESSIONAL LIABILITY POLICY are
amended as follows:


 


COMMON
EXCLUSIONS — The following are added:


 


M.                   Property
Damage. Any claim that arises out
of or results from property damage.


 


N.                      Personal
Injury. Any claim that arises out of or results from personal injury.


 


O.                      Harassment,
Unfair Discrimination, or Wrongful Discharge. Any claim that arises out of or
results from:


 


a.                          Harassment,
sexual or otherwise;


b.                         Unfair
discrimination; or


c.                          Wrongful
discharge


 


However, this exclusion does
not apply to claims brought by an insured’s patient against an insured who did not take part in harassment
or unfair discrimination. With respect to such claims brought by your patients,
we will provide a defense.
However, if an insured took a
direct part in harassment or unfair discrimination and intended to cause harm, we will have no further obligation to
defend.


 


P.                        Abuse or
Molestation. Any claim that arises
out of or results from actual or threatened abuse or molestation. However, this
exclusion does not apply to claims brought
by your patients against an insured who did not take direct part in the
abuse or molestation. With respect to such claims
brought by your patients,
we will provide a defense.
However, when it is determined an insured took
a direct part in the abuse or molestation; we
will have no further obligation to defend.


 


Q.                      Restraint of
Trade. Any claim that arises out
of or results from alleged violations of any law that prohibits the
monopolization or unlawful restraint of trade, business or profession.


 


R.                       Violation of
Law. Any claim that arises out of
or results from an act for which an insured is
convicted of a violation of any law or regulation that imposes criminal
penalties. However, this exclusion does not apply to the civil liability of an insured who has not taken part in the act
which gave rise to the conviction.


 


1

















 


S.                        Pollution.


 


a.          Bodily injury which would
not have occurred in whole or part but for the actual, alleged, or threatened
discharge, dispersal, seepage, migration, manifestation, appearance, presence,
reproduction, release or escape of pollutants
at any time; or


 


b.         Any loss, cost expense,
charge, fine or penalty arising out of any:


 


i.             Request, demand or order
that any insured or others test for, monitor, clean up, remediate, remove,
contain, treat, detoxify or neutralize, rehabilitate or in any way respond to,
or assess the effects of pollutants;  or


ii.          Claim,  suit or administrative or regulatory
action by or on behalf of a governmental authority for damages because of testing for, monitoring,
removing, containing, treating, detoxifying or neutralizing, or in any way
responding to, or assessing the effects of pollutants.


 


T.                       Substance
Abuse. Any claim that arises from professional services performed while an insured is under the influence of alcohol,
narcotics, hallucinogenic agents or which involves any other substance abuse.


 


U.                      License
Suspension or Revocation. Any claim that
arises from professional services performed
while an insured’s license to
practice medicine or any other healthcare discipline is suspended or revoked.


 


V.                       Non-FDA
Approved Medication or Device. Any claim that
arises from the design, manufacture, use, distribution, promotion or sale of
any non-FDA approved medication, device, equipment or protocols.


 


W.                  Guarantee of Results. Any
claim that arises out of an insured’s guarantee
of results of any professional services or
professional committee services.


 


All other terms, conditions
and exclusions of the policy remain
unchanged.


 


 


	
  Signed By:

  	
  /s/ Authorized Signatory

  	
   

  	
  January 11,
  2010

  
	
   

  	
  Authorized Signature or
  Countersignature 

  	
   

  	
  (Date)

  
	
   

  	
  (In States where required)

  	
   

  	
   

  



 


2

















 


NATIONAL
MEDICAL PROFESSIONAL RISK RETENTION GROUP, INC


 


Endorsement
No. 7 

Policy No. NMP-FL860013


 


DEFINITIONS ENDORSEMENT


 


This endorsement is attached
to and made a part of policy no. NMP-FL860013 and modifies the policy effective October 14, 2009 as
follows:


 


The following sections of
the PROFESSIONAL LIABILITY POLICY are
amended as follows:


 


DEFINITIONS
— The DEFINITIONS of Claim, Insured Physician, Medical Incident and
Professional Services are deleted and replaced with the following:


 


Claim means a written
demand in which damages are alleged
or:


 


1.                         Cross claims,
lawsuits, screening panel proceedings; or


2.                         An arbitration
proceeding in which damages are
alleged and to which you must
submit or do submit with our consent;
or


3.                         Any other
alternative dispute resolution proceeding in which damages are alleged and to
which you submit with our consent.


 


Insured
Physician means any physician designated as such on the
Coverage Summary or Continuation Coverage Summary while acting within the
course and scope of their duties for you. Coverage
applies to insured physician administrators
while acting within the course and scope of their administrative duties for you.  Coverage
applies to insured physicians performing
committee or board services on or for your formal
review boards or committees. Coverage applies to insured physicians acting as your supervisors, teachers or proctors.
Coverage is included for physicians authorized
and appointed as locum tenens of any insured
physician.  Locum Tenens
share in the applicable limit of insurance with the insured physician and is
covered only for professional services provided
on your behalf.


 


Medical
incident means any act, error or omission in the providing of
or failure to provide professional services by
you or by someone for whom you are legally responsible. For the
purposes of this definition, treatment of mother and fetus (or fetuses) from
conception through postpartum care constitutes a single medical incident,  and a continuing course of treatment or repeated exposure to
substantially the same general conditions constitutes a single medical incident.  All damages arising from wrongly calibrated equipment and for
one specific individual performing the same specific procedure incorrectly
every time, are considered to arise out of a single medical incident.  Such
medical incident will be deemed to
have first taken place at the time the first claim seeking such damages is made
and reported in accordance with the What to
Do if You Have a Claim section of this policy form.


 


Professional
Services means the diagnosis of, treatment or medical care
for, or medical consultation regarding, a patient’s medical condition. Professional Services also includes
Professional Committee Activities including the performance of any of the
following by an insured acting on your behalf:


 


1

















 


1.                         Peer review or
quality assurance; or


2.                         Utilization
review on behalf of your patients
or on behalf of a state or county medical society.


 


The
following additional DEFINITIONS are added to the PROFESSIONAL LIABILITY
POLICY:


 


Employee means a person:


 


1.                         whose service
or labor is supervised by you; and


2.                         Who is on your payroll and subject to the withholding
of taxes, whether working on a full or part time basis. Independent contractors
are not employees.


 


Hearing means
investigations conducted by or administrative proceedings or actions brought by
state medical licensing departments.


 


Hearing
Costs means reasonable and customary fees and expenses of legal counsel and
expert consultants, including their costs and expenses of investigation and
travel, costs of transcripts, court filing fees and other reasonable costs and
expense incurred in the defense of an administrative proceeding or action.
However, the hearing costs associated
with appeals are considered part of those incurred during the original
proceeding. Hearing costs do not
include salary, charges or incidental expenses of the insured’s employees, officials or agents,
or any sanctions penalties, fines or other monetary penalties imposed upon physicians by a regulatory agency.


 


Personal
Injury means injury, other than bodily injury, arising out of one or more of
the following offenses:


 


1.                         False arrest,
detention or imprisonment;


2.                         Malicious
prosecution;


3.                         The wrongful
eviction from, wrongful entry into, or invasion of the right of private
occupancy of a room, dwelling or premises that a person occupies by or on
behalf of its owner, landlord, or lessor;


4.                         oral or written
publication of material that slanders or libels a person or organization or
disparages a person’s or organization’s goods, products or services; or


5.                         Oral or written
publication of material that violates a person’s right of recovery.


 


Pollutants mean any solid,
liquid, gaseous or thermal irritant or contaminant. The term includes but is
not limited to smoke, vapor or soot, fumes, acids, alkalis, chemicals,
asbestos, lead, waste, mold, mildew, spores, myotoxins, fungi, organic
pathogens or other micro organisms of any type, nature or description. Waste
includes medical waste from your operations
and materials to be recycled, reconditions or reclaimed.


 


Property
Damage means:


 


1.                         Physical harm,
including all resulting loss of use of that property. All such loss of use
shall be deemed to occur at the time of the physical harm that caused it; or


 


2

















 


2.                         Loss of use of
tangible property that is not physically harmed. All such loss shall be deemed
to occur at the time of the occurrence that
caused it.


 


Unfair
Discrimination means the illegal treatment of persons based on
their race, color, creed, religion, age, sex, sexual preference, physical
disability, marital status, pregnancy or national origin.


 


Wrongful
Discharge means the unfair or unjust termination of an
employment relationship:


 


1.                         Which breaches
an implied agreement to continue employment;


2.                         Which inflicts
emotional distress upon the employee, invades
his or her privacy, or is the result of fraud; or


3.                         Which
retaliates for:


 


a.                          A refusal by
the employee to participate in
acts that violate public policy; or


b.                         The employee’s exercise of legal rights.


 


All other terms, conditions
and exclusions of the policy remain
unchanged.


 


 


	
  Signed By:

  	
  /s/ Authorized Signatory

  	
   

  	
  January 11,
  2010

  
	
   

  	
  Authorized Signature or
  Countersignature

  	
   

  	
  (Date)

  
	
   

  	
  (In States where required)

  	
   

  	
   

  



 


3

















 


NATIONAL
MEDICAL PROFESSIONAL RISK RETENTION GROUP, INC


 


Endorsement
No. 8 

Policy No. NMP-FL860013


 


PHYSICIAN PROFESSIONAL
LIABILITY COVERAGE PART ENDORSEMENT


 


This endorsement is attached
to and made a part of policy no. NMP-FL860013 and modifies the policy effective October 14, 2009 as
follows:


 


The following sections of
the PHYSICIAN PROFESSIONAL LIABILITY COVERAGE
PART are amended as follows:


 


C.                      Additional
Benefits is deleted and replaced with the following:


 


We will pay the
following benefits in addition to the limits of liability. However, these
benefits end when we have eroded the applicable limit of liability in the
payment of judgments or settlements of claims.


 


a.                          We will pay
prejudgment and post-judgment interest only on that part of any judgment we pay. We won’t pay any prejudgment
interest that accrues after we offer
to pay the limit of insurance that applies. We won’t pay any post judgment
interest that accrues after we pay
or offer to pay our share of the
judgment.


 


b.                          We will pay premiums for bonds that are required in a claim we defend. These include appeal bonds
and bonds to release property that is being used to secure a legal obligation.
However, we will only pay for
bonds valued up to the limit of insurance that applies. We have no obligation to apply for or
furnish these bonds.


 


c.                          Claim
expenses will be paid in addition to the limits of liability.
We will pay all reasonable costs incurred at our request to investigate or
defend a claim. This includes up
to $250 a day for actual loss of earnings by a covered person.


 


All other terms, conditions
and exclusions of the policy remain
unchanged.


 


 


	
  Signed By:

  	
  /s/ Authorized Signatory

  	
   

  	
  January 11,
  2010

  
	
   

  	
  Authorized Signature or
  Countersignature 

  	
   

  	
  (Date)

  
	
   

  	
  (In States where required)

  	
   

  	
   

  



 


1

















 


NATIONAL
MEDICAL PROFESSIONAL RISK RETENTION GROUP, INC


 


Endorsement
No. 9 

Policy No. NMP-FL860013


 


HEARING COSTS ENDORSEMENT


 


This endorsement is attached
to and made a part of policy no. NMP-FL860013 and modifies the policy effective October 14, 2009 as
follows:


 


The following sections of
the PHYSICIAN PROFESSIONAL LIABILITY COVERAGE
PART are amended as follows:


 


C.                      Additional Benefits
is amended by adding the following:


 


2.                         Reimbursement
of State of Federal Regulatory Investigation Hearing Costs


 


Limits applicable to this
coverage:

$25,000 Per Hearing per Physician 

$75,000 Aggregate Limit per Physician


 


We will reimburse hearing costs which arise out of hearings against insured physicians by any state or federal regulatory agency.
The limits shown above are the most we will
pay for hearing costs under this
endorsement.


 


Additional exclusions
applicable to this hearing costs coverage:


 


A.           Medical Staff Privileges. Hearings arising out of or resulting from
the appointment or reappointment to medical staff or revocation or restriction
of medical staff privileges by any healthcare facility or managed care
organization.


B.             Completing or Alteration of
medical Records. Hearings arising
out of or resulting from disputes over timely completion or alteration or
medical records.


C.             Fraud, Abuse, or
Non-Compliance. Hearings arising
out of or resulting from fraud, abuse, or willful non-compliance with the rules and
regulations of Medicaid/Medicare or any other program of a local, state or
federal agency.


D.            Substance Abuse. Hearings arising out of or resulting from
allegations of substance abuse by the physician.


E.              Improper Prescriptions. Hearings arising out of or resulting from
allegations of improper prescription of any medication. This includes
prescriptions provided without an appropriate history and physical.


 


All other terms, conditions
and exclusions of the policy remain
unchanged.


 


 


	
  Signed By:

  	
  /s/ Authorized Signatory

  	
   

  	
  January 11,
  2010

  
	
   

  	
  Authorized Signature or
  Countersignature

  	
   

  	
  (Date)

  
	
   

  	
  (In States where required)

  	
   

  	
   

  



 


1














 


NATIONAL
MEDICAL PROFESSIONAL RISK RETENTION GROUP, INC


 


Endorsement
No. 10 

Policy No. NMP-FL860013


 


HIPAA ENDORSEMENT


 


This endorsement is attached
to and made a part of policy no. NMP-FL860013 and modifies the policy effective October 14, 2009 as
follows:


 


NATIONAL MEDICAL PROFESSIONAL RISK RETENTION GROUP, INC.

PHYSICIAN PROFESSIONAL LIABILITY INSURANCE POLICY

HIPAA BUSINESS ASSOCIATE ENDORSEMENT


 


Obligations
of the Company


 


Pursuant to the Standards
for Privacy of Individually Identifiable Health Information issued under the
Health Insurance Portability and Accountability Act of 1996 (the “Privacy Rule”),
we shall:


 


1. Not use or further
disclose protected health information (“PHI”), as defined by the Privacy Rule,
other than:


 


a.                         To administer
this Policy or reinsurance agreements to which the Company is a party relating
to this Policy;


 


b.                        To analyze
coverage and/or liability issues;


 


c.                         To evaluate
claims for purposes of defense or settlement;


 


d.                        To set,
evaluate or adjust reserves;


 


e.                         To set, raise
or refund any current or future insurance or reinsurance premiums;


 


f.                           To underwrite
this Policy or future insurance coverage;


 


g.                        To evaluate
your risk management, loss prevention and quality assurance activities;


 


h.                        As otherwise
provided in this Endorsement or in connection with this Policy or as permitted
or required by the Policy;


 


i.                            For the proper
management and administration of our operations and to carry out our legal
responsibilities, provided in each case that the disclosure is required by law,
or reasonable assurances are obtained from the person to whom the information
is disclosed that it will be held confidentially and used or further disclosed
only as required by law or for the purpose for which it was disclosed to such
person and that the person notifies us of any instances of which it is aware in
which the confidentiality of the information has been breached;


 


1

















 


j.                            To provide data
aggregation services relating to the health care operations of our insureds;
and


 


k.                         As required by
applicable law.


 


2.
Use appropriate safeguards to prevent use or disclosure of PHI other than as
provided by this Endorsement.


 


3. Report to you any use or
disclosure of PHI you provided us which are not permitted by this Endorsement
of which we become aware.


 


4. Ensure that any of our
agents or subcontractors to which we provide PHI received from you or created
or received on your behalf agrees to the same restrictions and conditions that
apply through this Endorsement to us with respect to PHI.


 


5. To the extent we maintain
PHI in a designated record set (as defined by the Privacy Rule) and at your
request, make such PHI available for access to you except for:


 


a.                         PHI maintained
by us which is a copy of PHI held by you; or


 


b.                        Information
that is protected by the Privacy Rule or other applicable law from
disclosure.


 


6. To the extent we maintain
PHI in a designated record set (as defined by the Privacy Rule) and at your
request, make available to you such PHI for amendment and incorporate any
amendments to PHI provided by you.


 


7. At your request, provide
documentation of disclosures of PHI made by us other than for purposes
described in Paragraph 1 above and provide the following information related to
each such disclosure for purposes of enabling you to provide an accounting of
disclosures of PHI as required under the Privacy Rule:


 


a.                         The date of the
disclosure;


 


b.                        The name of the
entity or person who received PHI and, if known, the address of such entity or
person;


 


c.                         A brief
description of PHI disclosed; and


 


d.                        A brief
statement of the purpose of the disclosure that reasonably informs the Insured
of the basis for the disclosure.


 


The foregoing is subject to
all of the exceptions to an accounting of disclosures of PHI provided in the
Privacy Rule (e.g., no accounting is required for disclosures of PHI made
in connection with health care operations as defined by the Privacy Rule).


 


8. Make its internal
practices, books, and records relating to the use and disclosure of PHI
received from or by us on your behalf available to the Secretary of the United
States Department


 


2

















 


of Health and Human Services
for purposes of determining your compliance with the Privacy Rule.


 


Obligations
of  the Insureds


 


You shall:


 


1.
Not request us to use or disclose PHI in any manner prohibited under the
Privacy Rule.


 


2. Notify us of any
limitations in or changes to your Notice of Privacy Practices to the extent
that such limitation or change may affect our use or disclosure of PHI.


 


3. Notify us of any
restriction on the use or disclosure of PHI that you have agreed to in
accordance with the Privacy Rule to the extent that such restriction may
affect our use or disclosure of PHI.


 


Material Breach
Involving PHI


 


Upon your knowledge of a
material breach by us of the provisions of this Endorsement involving the use
or disclosure of PHI, you shall provide us with written notice of such breach,
including a description of the manner in which the circumstances leading to
such breach can be cured. You shall provide us with an opportunity to cure by
taking steps to change such circumstances within the sixty-day period following
the notice. If the breach is not cured within such sixty-day period, you may
terminate this Policy, if feasible. We acknowledge that if termination under
those circumstances is not feasible, you are obligated to report the violation
to the Secretary of the United States Department of Health and Human Services.


 


Effect of
Termination or Cancellation


 


We both acknowledge and
agree that PHI will be needed by us following the termination or cancellation
of the Policy for purposes described herein, and that it therefore is not
feasible for us to return or destroy all PHI received from you or on your
behalf. Therefore, we shall extend the protections of this Endorsement to such
PHI and limit further uses and disclosures of such PHI to those purposes that
make the return or destruction infeasible for so long as we maintain such PHI.
These provisions shall survive termination of this Policy.


 


Applicability


 


This Endorsement applies to
you only if and to the extent you are a covered entity or a member of the
workforce of a covered entity within the meaning of the Privacy Rule. This
Endorsement is being provided solely for the purpose of enabling you to comply
with your obligations as a “covered entity” under the Privacy Rule and
does not constitute an agreement by us to be subject to any federal or state
law to which we are not otherwise subject.


 


All other terms, conditions
and exclusions of the policy remain
unchanged.


 


 


	
  Signed By:

  	
  /s/ Authorized Signatory

  	
   

  	
  January 11,
  2010

  
	
   

  	
  Authorized Signature or
  Countersignature 

  	
   

  	
  (Date)

  
	
   

  	
  (In States where required)

  	
   

  	
   

  



 


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NATIONAL
MEDICAL PROFESSIONAL RISK RETENTION GROUP, INC


 


Endorsement
No. 11 

Policy No. NMP-FL860013


 


REVISED HIPAA ENDORSEMENT


 


This endorsement is attached
to and made a part of policy no. NMP-FL860013 and modifies the policy effective February 17, 2010 as
follows:


 


This endorsement replaces
Endorsement No. 10 effective February 17, 2010:


 


HIPAA BUSINESS ASSOCIATE ENDORSEMENT


 


Obligations
of the Company


 


Pursuant to the Standards
for Privacy of Individually Identifiable Health Information and the Health
Insurance Reform Security Standards issued under the Health Insurance
Portability and Accountability Act of 1996 and subsequent modifications thereof
(the “Privacy Rule” and the “Security Rule,” respectively), the Company shall:


 


1.                         Not use or
further disclose protected health information, as defined by the Privacy Rule (“PHI”),
other than:


 


a.                          To administer
this Policy or reinsurance agreements to which the Company is a party relating
to this Policy;


 


b.                         To analyze
coverage and/or liability issues;


 


c.                          To evaluate
claims for purposes of defense or settlement;


 


d.                         To set,
evaluate or adjust reserves;


 


e.                          To set, raise
or refund any current or future insurance or reinsurance premiums;


 


f.                            To underwrite
this Policy or future insurance coverage;


 


g.                         To evaluate the
Insured’s risk management, loss prevention and quality assurance activities;


 


h.                         As otherwise
provided in this Endorsement or in connection with this Policy or as permitted
or required by the Policy;


 


i.                             For the proper
management and administration of the Company and to carry out the legal
responsibilities of the Company, provided in each case that the disclosure is
required by law, or reasonable assurances are obtained from the person to whom
the information is disclosed that it will


 


1

















 


be held confidentially and
used or further disclosed only as required by law or for the purpose for which
it was disclosed to such person and that the person notifies the Company of any
instances of which it is aware in which the confidentiality of the information
has been breached;


 


j.                             To provide data
aggregation services relating to the health care operations of the Insureds;
and


 


k.                          As required by
applicable law.


 


2.                         Use appropriate
safeguards to prevent use or disclosure of PHI other than as provided for by
this Endorsement. Additionally, the Company agrees to implement administrative,
physical and technical safeguards that reasonably and appropriately protect the
confidentiality, integrity and availability of the electronic PHI that it
creates, maintains or transmits on behalf of the Insured.


 


3.                         Report to the
Insured who provided such PHI any use or disclosure of PHI not provided for by
this Endorsement, any Security Incident (i.e., the attempted or successful
unauthorized access, use, disclosure, modification or destruction of
information or interference with system operations in an information system)
and any “breach” of “unsecured PHI” (as those terms are defined in the Health
Information Technology for Clinical Health Act (the “HITECH Act”)) of which the
Company becomes aware.


 


4.                         Ensure that any
of its agents or subcontractors to which the Company provides PHI received from
or created or received on behalf of Insured agrees to the same restrictions and
conditions that apply through this Endorsement to the Company with respect to
PHI, including without limitation, the obligation to implement reasonable and
appropriate safeguards to protect electronic PHI.


 


5.                         To the extent
the Company maintains PHI in a designated record set (as defined by the Privacy
Rule) and at the request of the Insured, make such PHI available for access to
the Insured except for:


 


(a)                     PHI maintained by the
Company which is a copy of PHI held by the Insured; or


 


(b)                    Information that is
protected by the Privacy Rule or other applicable law from disclosure.


 


6.                         To the extent
the Company maintains PHI in a designated record set (as defined by the Privacy
Rule) and at the request of an Insured, make available to the Insured such PHI
for amendment and incorporate any amendments to PHI provided by the Insured.


 


7.                         At the request
of an Insured, provide documentation of disclosures of PHI made by the Company
other than for purposes described in Paragraph 1 above and provide the
following information related to each such disclosure for purposes of


 


2

















 


enabling the Insured to
provide an accounting of disclosures of PHI as required under the Privacy Rule:


 


(a)                     The date of the disclosure;


 


(b)                    The name of the entity or
person who received PHI and, if known, the address of such entity or person;


 


(c)                     A brief description of PHI
disclosed; and


 


(d)                    A brief statement of the
purpose of the disclosure that reasonably informs the Insured of the basis for the
disclosure.


 


The foregoing is subject to
all of the exceptions to an accounting of disclosures of PHI provided in the
Privacy Rule as modified by the HITECH Act.


 


8.                         Make its
internal practices, books, and records relating to the use and disclosure of PHI
received from or by the Company on behalf of the Insured available to the
Secretary of the United States Department of Health and Human Services for
purposes of determining the Insured’s compliance with the Privacy Rule.


 


Obligations of the Insureds


 


An Insured shall:


 


(1)                    Not request the Company to
use or disclose PHI in any manner prohibited to the Insured under the Privacy
Rule.


 


(2)                    Notify the Company of any
limitations in or changes to its Notice of Privacy Practices to the extent that
such limitation or change may affect the Company’s use or disclosure of PHI.


 


(3)                    Notify the Company of any
restriction on the use or disclosure of PHI that it has agreed to in accordance
with the Privacy Rule to the extent that such restriction may affect the
Company’s use or disclosure of PHI.


 


Material Breach Involving
PHI


 


Upon the Insured’s knowledge
of a material breach by the Company of the provisions of this Endorsement
involving the use or disclosure of PHI, the Insured shall provide the Company
with written notice of such breach, including a description of the manner in
which the circumstances leading to such breach can be cured. The Insured shall
provide the Company with an opportunity to cure by taking steps to change such
circumstances within the sixty-day period following the notice. If the breach
is not cured within such sixty-day period, the Insured may terminate this
Policy with respect to the Insured, if feasible. The Company acknowledges that
if termination under those circumstances is not feasible, the Insured is
obligated to report the


 


3

















 


violation to the Secretary
of the United States Department of Health and Human Services (the “Secretary”).


 


If the Company reports a
breach of unsecured PHI (as defined in the HITECH Act) to the Insured, the
Insured shall provide any notices required by the HITECH Act to (i) the
individuals whose PHI was involved in the breach, and (ii) the Secretary.
Upon request of the Insured and subject to applicable law, the Company shall
provide the Insured with information in its possession required for such
notices.


 


Effect of Termination or
Cancellation


 


The Company and the Insured
acknowledge and agree that PHI will be needed by the Company following the
termination or cancellation of the Policy for purposes described herein, and
that it therefore is not feasible for the Company to return or destroy all PHI
received from or on behalf of Insured. Therefore, the Company shall extend the
protections of this Endorsement to such PHI and limit further uses and
disclosures of such PHI to those purposes that make the return or destruction
infeasible for so long as the Company maintains such PHI. These provisions
shall survive termination of this Policy.


 


Applicability


 


This Endorsement applies to
a particular Insured only if and to the extent such Insured is a covered entity
or a member of the workforce of a covered entity within the meaning of the
Privacy Rule. This Endorsement is being provided solely for the purpose of
enabling the Insured to comply with its obligations as a “covered entity” under
the Privacy Rule and does not constitute an agreement by the Company to be
subject to any United States federal or state law to which the Company is not
otherwise subject.


 


All other terms, conditions
and exclusions of the policy remain
unchanged.


 


 


	
  Signed By:

  	
  /s/ Authorized Signatory

  	
   

  	
  January 11,
  2010

  
	
   

  	
  Authorized Signature or
  Countersignature 

  	
   

  	
  (Date)

  
	
   

  	
  (In States where required)

  	
   

  	
   

  



 


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