Claims Paid

What is the Difference in Coverage?

Having collected additional reserve money, a Claims-Made carrier charges an annual premium for all claims that are expected to be reported. For this reason, once a member reports a claim, and hence the claim is made, the carrier may now resolve it using the funds already collected. Once the carrier assumes liability for a claim, the member may leave and secure retroactive coverage from a new carrier.

The Claims Paid approach is different. Since Continuing Care Risk Retention Group, Inc. (CCRRG) does not collect reserves, the Members pay less on average from year to year. In return for typically lower premium costs, the Member agrees either to remain with CCRRG until all pending claims are resolved, or purchases an extended reporting period (ERP) coverage or Member assumes outstanding balance of any claim at time of termination of coverage and membership.

CCRRG Claim Paid​ Insuring Agreement Definition:

We will “Pay” amounts within policy limits for “Damages” because of “Bodily Injury” or “Property Damage” to which this insurance applies, on behalf of a “Member” who incurs a legally binding obligation to “Pay” that has been determined by a court, arbitrator or other administrative tribunal during the time they were a CCRRG “Member”.

A “Claim” “Occurring” during the “Policy Period” and reported during “Policy Period” for which the company will “Pay” such amounts;

1. When it becomes a legally binding obligation for the “Member” during the time the “Claim” is asserted during the “Policy Period; and
2. While the “Member” remains a “Member” at such time as the “Member” becomes legally obligated to “Pay” the “Claim”.

CCRRG and Magnolia LTC Management Services, Inc. have been granted exclusive use of the patent pending Claims Paid PL/GL form by Cooperative of American Physicians (CAP) for all institutional long term care facilities in the U.S.

WHY PAY FOR CLAIMS THAT MAY NEVER OCCUR?

As an alternative to CCRRG’s Claims Made policy form, CCRRG also offers a unique Claims Paid Alternative. 

Under its unique Claims Paid policy, you will appreciate premium savings while maintaining the same stable, competitive and consistent coverage enjoyed under Claims Made coverage.

How Does CCRRG Do It?

• Contrasting with traditional insurance companies, Claims Made form, whose premium pricing formulas add estimates of potential future losses which increase company operating expenses, CCRRG Member / Insureds who elect the Claims Paid policy never pay for reserves on incidents that may not develop into a claim. 
• CCRRG Claims Paid premium is based on the projected costs of current and anticipated claims, per program year, plus the cost of running CCRRG. 
• If a Member / Insured choses to leave the program with open Claims Paid claim(s), they may purchase an extended reporting period (ERP) endorsement or make the decision to take the claim(s) with them.
• If the Member / Insured leaves the program and decides not to purchase additional coverage for an ERP, CCRRG will support the defense cost on the open Claims Paid claim(s) for a period of thirty (30) days after the last day of coverage. This allows the former Member / Insured ample time to obtain its own defense counsel.