Nearly 10,000 doctors of chiropractic throughout the United States have turned to Chiropractic Benefit Services (CBS) for the most comprehensive and reliable malpractice coverage available in the profession.

Now, with a new A-rated underwriting company and a list of added benefits and extended coverage, the program expects to attract an even greater portion of the chiropractic community.

"Every month, we add more doctors who want the peace of mind of being with CBS," said Timothy Feuling, CBS vice president. "They are tired of seeing other chiropractic insurance programs going bankrupt, expanding into the ultra-risky medical fields, and using scare tactics to attract business. They want to be with the only chiropractic-owned and operated insurance program in the world, one that is backed by an A-rated underwriter and one that turns around and puts a portion of its profits back into the profession."

"We don't want our doctors having to subsidize the higher-risk medical doctors," Feuling explained. "Many D.C.s justifiably have a problem when they see a so-called chiropractic insurance program also catering to M.D.s, physical therapists, and other competing health care providers. They know that excessive claims by one category of insured can endanger the health of the entire insurance company, and cause their own premiums to increase. It's one thing to have to pay higher premiums because of the general economy. It's another to have to pay them because medical doctors are being sued for malpractice in record numbers."

The "D.C.s-only" rule is an added benefit for chiropractic, said Feuling, since a portion of CBS profits is used to fund programs, research and efforts that support chiropractic. "If a chiropractic program also insures medical doctors, they're not going to be giving their full attention or resources to helping D.C.s"

To make matters worse, some companies that insure chiropractors are actually owned and/or run by medical doctors. Given the long history of antagonism between the two professions, it is unlikely that these companies will provide the kind of defense needed to truly protect chiropractors.

"D.C.s must make a choice. Do they want to support the medical machine that continues to discriminate against chiropractic? Can they depend on medical companies to defend, rather than settle, their case? It bothers me to see chiropractors writing checks to these companies, indirectly helping fund the AMA's discrimination campaign against the profession. As long ago as the 1950s, the group declared a war on chiropractic that continues today, although more covertly. D.C.s need to ask themselves whether they really want to help this organization reach its goal — the elimination of chiropractic."

There is yet another CBS benefit to insureds. Since CBS actually owns the program (as opposed to serving solely as a broker), it can react to market changes quickly, and offer the broadest possible policy coverage, competitive pricing and aggressive defense.

In addition, CBS has gained a widespread reputation for excellent customer service, with direct access to the highest levels of management to resolve problems or provide personalized assistance.

Among the most important is sexual misconduct coverage. This is one of the fastest- growing issues in risk management and Feuling has written extensively on the problem in his monthly columns for The Chiropractic Journal, as well as in CBS' free online newsletter, the CBS Report (www.cbsmalpractice.com/report).

Although many women have legitimate complaints against doctors, these suits are often the result of misunderstanding or greed. A completely sham accusation is often an easy way to collect several thousands of dollars from a doctor whose malpractice policy doesn't cover such claims. Some experts say the problem is becoming so widespread that one out of every six doctors will be accused of sexual misconduct during their career. Increasingly, female doctors — once thought immune from such accusations — are being sued by male patients.

Although successful lawsuits can bankrupt a doctor — even though he or she is completely innocent of all charges — many policies now being offered to D.C.s do not cover sexual misconduct accusations. A few, like NCMIC and Princeton, offer limited coverage, but only if the patient also alleges malpractice, which is rare.

"It is common knowledge in the insurance industry that people who sue for sexual misconduct and people who sue for malpractice are not one in the same," Feuling explained. "I am continuously getting calls from doctors who have been wiped out by these allegations and out-of-pocket costs. They often end up settling the cases — actually pleading guilty to something they never did — because they can't afford to defend themselves."

Afterwards, these doctors often have difficulty finding a company to insure them since most companies won't insure/take on the risk, of a doctor who has lost or settled a sexual misconduct case. They also may have trouble enrolling as an HMO provider, finding employment as an associate, or getting a job at a college because of the accusation on their record. All because their malpractice policy didn't cover sexual misconduct cases the way CBS does.

Another important reason chiropractors are overwhelmingly choosing CBS is that it has a "Consent-to-Settle" agreement — without the punitive "hammer clause" that appears in other policies.

A Consent-to-Settle agreement is considered absolutely essential for doctors of chiropractic, since it protects their right to refuse to settle a bogus charge out of court. Too often, insurance companies will settle cases in order to save themselves the cost of defending the doctor. This, however, can be a problem for the D.C. who was falsely accused of malpractice.

One expert (writing in Medical Economics, Jan. 12, 1998) warned, "stable premiums are no bargain if rising legal costs mean you could end up with a weaker defense or be pushed into a settlement you don't want. And that's exactly what's happening, according to malpractice defense attorneys. As one of them puts it, 'It's a dirty little secret in the industry, and doctors don't know anything about it.'"

Although CBS doctors can choose to settle out of court if they prefer, they make that vital decision based on what's best for them. They are not forced to settle by the insurance company merely to save money on defense costs.

Even when a policy does have a Consent-to-Settle agreement, doctors have to be wary for it may also contain a "hammer clause" that can cost them hundreds of thousands of dollars.

With a hammer clause, if you refuse the settlement offer recommend by the insurer, the insurer's liability is limited to the amount of the recommended settlement offer.

For example, if your insurance company wants to settle a claim out of court for $50,000 but you want to fight the claim, the insurer will pay a maximum of $50,000 if you lose the case. If the plaintiff is awarded $100,000, you would have to pay $50,000 plus any deductible — even if the policy is supposed to have $1 million coverage. This clause is often referred to as a "blackmail provision."

Attorney Kenneth S. Meyers added: "Some hammer clauses also eliminate the insurer's liability for defense expenses incurred after the date of refusal, and some even allow the insurer to tender the defense back to the insured at that point. Thus, although the insured might be afforded the right to refuse to consent to a settlement, that right comes with a significant cost attached to it." ("Professional Liability Insurance: Beware of the Hammer Clause" Association of Business Trial Lawyers, February 1999)

The CBS policy includes a full Consent-to-Settle agreement with no hammer clause or other restrictions.

The Consent-to-Settle agreement isn't the only advantage of the CBS policy, Feuling is quick to point out. CBS is also able to provide even more benefits while maintaining extremely competitive rates. Among the advantages of CBS are:

*** Professional Board Dispute Defense expenses, up to $30,000 per year for cases regarding patient care.

*** Sexual Misconduct Defense expenses, with no limit and no payback clause.

*** Personal Assault Expense Reimbursement — if you and/or your staff are ever assaulted in your office, office parking lot, screening room, etc.

*** Property Damage Payment — if a patient's personal property is damaged in your office.

*** First Aid Reimbursement — if a patient is injured as a result of your care.

*** Free Vacation Relief coverage for up to 90 days each year.

*** Free Tail Coverage on Claims-made policy after just one year with current underwriter, and 52 years of age at retirement.

*** New graduate discounts up to 75% off.

*** A 50% discount for doctors who work 20 hours or less per week

*** Generous discounts for experience, risk management, patient forms.

"Doctors can't wait until they they're sued and encounter a problem with their policy," Feuling warned. "By then, they already may face financial ruin or a reputation that has been irreparably damaged. At the very least, they'll end up with a black mark against them and find it difficult to get good coverage elsewhere. They need to get proper coverage before they have a problem or lawsuit. They need to get a CBS policy."