The retroactive date of a medical malpractice policy.

In Puerto Rico, it is required by law to practice medicine to have medical malpractice insurance with limits of not less than $ 100,000 for each incident and $ 300,000 per aggregate.

Medical malpractice insurance has a particularity that makes it different from other lines of insurance: its coverage is “claims made” that is, it is activated when the claim is made (when the claim is made ), with the requirement that the event for which you are claiming occurred after the retroactive date. And it is that in a medical malpractice insurance you will find three dates on your declaration sheet:

  1. The effective date that defines the policy year: the day the policy year begins and
  2. The day the policy year ends, twelve months later
  3. The retroactive date that defines the date from when the policy is providing coverage. Usually this date is the same date the policy was first purchased.

The effective dates will change each anniversary, but the retroactive date does not change, and we do not want it to change because it defines the period that we have coverage.

For example, if we begin our practice of medicine today, May 21, 2018, and we purchase our medical malpractice insurance today, then we will have the effective dates of the beginning of the policy year on May 21, 2018, of the end of the policy year on May 21, 2019 and the retroactive date on May 21, 2018. On the anniversary (next year)  we will have the effective dates of the beginning of the policy year on May 21, 2019, and the end of the policy year on May 21 2020, but the retroactive date, May 21, 2018 will remain the same, and so on in subsequent years. The importance of the retroactive date in medical malpractice insurance is that it establishes the period of a physician’s practice that the policy is covering. In a claim of medical malpractice you will have two dates: 

  1. The date the doctor saw and treated the patient and
  2. The date the patient makes a claim for such treatment, either through a letter or a lawsuit in a court of law.

For a medical malpractice insurance to provide coverage to the insured doctor, the date on which the doctor treated the patient (date 1) must be after the retroactive date of the policy, and the date on which the patient makes the claim (date 2) must be between the effective dates. If these two matches do not occur, the policy does not provide coverage. Hence the importance of not losing the retroactive date in medical malpractice insurance.

There are several ways to lose the retroactive date.

If a policy is canceled for non-payment, the retroactive date is lost. If a medical malpractice policy is not renewed, the retroactive date is lost. Losing the retroactive date means losing coverage for the period that the medicine has been practiced, since as we mentioned earlier, the date on which the doctor treated the patient must be after the retroactive date, if it were before the date. retroactivity there is no cover. In image 1 below we show a covered claim. The retroactive and effective dates (beginning and end of the year) are marked in blue. The dates of the claim: date of the event and date of the claim are marked in red. Note that the date of the event, when the doctor attended the patient occurs after the retroactive date, thus fulfilling one of the requirements of the policy to provide coverage. The date of the claim is within the effective period of the policy, this period is also known as the reporting period or “reporting period” thus fulfilling the second requirement of the policy to provide coverage.