WELLDYNE/RX WEST INC. 1A-2008 - Laserfiche WebLink

Home Browse Search

Medical Staff Privileges This insurance does not apply to any "hearing" arising out of or resulting from the appointment or reappointment to medical staff or the revocation or restriction of medical staff privileges by any health care facility or managed care organization. Completion Or Alteration Of Medical Records This insurance does not apply to any "hearing" arising out of or resulting from disputes over timely completion or alteration of medical records. Fraud, Abuse, Or Non-Compliance This insurance does not apply to any "hearing" arising out of or resulting from fraud, abuse or willful non-compliance with the rules and regulations of Medicaid or Medicare or any other program of a local, state or federal agency. Substance Abuse This insurance does not apply to any "hearing" arising out of or resulting from allegations of substance abuse by the physician. Improper Prescriptions This insurance does not apply to any "hearing" arising out of or resulting from allegations of improper prescription of any medication. This includes prescriptions provided without an appropriate history or physical. For the purposes of Medical Board Licensing Hearing Cost Reimbursement Coverage only, the following changes are made: 1. Deductibles section does not apply; 2. Definitions section is changed to add the following "Hearings" means investigations conducted, or administrative proceedings or actions brought, by state medical licensing boards. "Hearing costs" means reasonable and necessary fees and expenses of legal counsel and expert consultants, including, without limitation, investigation, travel, costs of transcripts, and court fling fees, incurred in the defense of an administrative proceeding or action. "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 your "employees", "administrators" or agents, or any sanctions, penalties, fines or other monetary penalties imposed by a medical licensing board. COVERAGE TERRITORY CHANGE (Worldwide) The following is added to the "Coverage Territory" definition: c. For any "claims" or "suits" not addressed by paragraphs a. orb. above, we will only reimburse the named insured for: (1) Reasonable expenses incurred by your investigation and defense. (2) Damages for liability incurred or settlement(s) made that are otherwise covered by this policy. Any reimbursement made under paragraph c. for "claims" or "suits", shown below and the deductibles shown in the declarations page. You must notify us of all such "claims" or "suits" as soon as practicable. Aggregate Limit: $1,000,000 Each Medical Incident Limit: $1,000,000 The above limits are part of, and not in addition to, the each medical incident limit specified in the declarations. Notwithstanding the above, the coverage territory does not include any country or jurisdiction which is subject to trade or other economic sanction or embargo by the United States of America. 00 ML0207 00 11 03 Page 3 of 6