Administrative Defense Coverage (ADC)

Administrative Defense Coverage (ADC)

An administrative defense claim can be more damaging to a podiatrist's practice than a lawsuit.

Every podiatrist knows, he or she may be sued for malpractice. However, having an administrative claim may not only cost you your reputation, but also your livelihood. The good news is PICA includes $100,000 Administrative Defense Coverage per policy period, and in the aggregate, as part of our policy.

 

What is Administrative Defense Coverage (ADC)?

Administrative Defense Coverage (ADC) is insurance for legal expenses incurred defending actions such as:

  • Administrative disciplinary actions
  • Hospital peer review actions or attempts to restrict or revoke privileges
  • MCO de-certification or contract terminations
  • Actions brought by government payers such as Medicare or Medicaid
  • Actions by state licensing boards
  • Investigations involving billing and coding practices
  • HIPAA complaints - actions by the Office of Civil Rights
  • Potential HIPAA matters - lost or stolen medical records

 

How is PICA's Administrative Defense Coverage special?

At some point in his or her career, a podiatrist will be audited. Did you know, in most instances, the first appeal of an administrative claim will fail? But did you also know you could be able to appeal an administrative claim up to five times? Some medical professional liability insurance may cover only the first appeal. Because we know how devastating an ADC claim can be to a podiatrist's practice, PICA will be there for you for each of the five levels of appeal allowed.*

 

When you receive any notice - legal or other - please call
PICA Risk Management ASAP for a confidential consultation
at (800) 251-5727, ext. 2052.

We will be with you, every step of the way.

 

*An appeal from a final disposition of an administrative action against the covered insured shall be considered part of an administrative disciplinary proceeding, provided that the covered insured has the right of appeal under any applicable law, statute, or regulation.

ADC does not include legal actions instituted by the podiatric physician, criminal actions or initial applications for licensure, participation in MCO networks or hospital staff privileges.

Terms and Conditions: The descriptions do not include all terms, conditions, and exclusions in the policy. Please refer to the actual policy and endorsements for complete details of coverage. Policy terms may vary based on individual state requirements. Issuance of coverage is subject to underwriting review and approval.

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