Dr. Michael Brisman on Captive Success

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Dr. Michael Brisman on Captive Success

Dr. Michael Brisman on Captive Success

Setting up a captive insurer—a licensed insurance company created by a parent group to provide coverage for itself—can provide great benefits, but it’s not for everyone. PRI is proud to have partnered with Michael Brisman, M.D., F.A.C.S., for the past four years on the captive of Neurological Surgery, P.C., a leading neurosurgery practice based on Long island. We sat down with him so he could share his experience with our insureds.

What interested you and Neurological Surgery, P.C. in setting up a captive?

We determined that our practice had the scale and risk profile that made a captive attractive in terms of the economic benefit and greater control it could provide. It aligns our liability premium, loss results and net cost of insurance, and we receive income from the investment of the premiums. Importantly, we also had the capital required to take on some of the risk normally carried by the insurer.


Why did you choose to partner with PRI?

PRI has a Bermuda-based captive, Futuro Insurance Company, Ltd., that they established to afford a turn-key, cost efficient vehicle to facilitate risk sharing with PRI policyholders in these situations. Since we take some of the risk through the captive, we believe it is also important to partner with a seasoned malpractice insurer with demonstrated New York expertise. Our ongoing partnership with PRI has met our expectations in that regard, and we believe that PRI’s comprehensive claims support services plays an instrumental role in our successful captive program.


What are the challenges of maintaining a captive and how have you been successful?

You need to really be committed to the plan and make someone accountable for the program’s success. That person needs to be deeply involved in every step of the process. For us, that’s me. In addition to overseeing normal operational captive needs and logistics, I make sure needed action is taken before, during and after any potential claim.


What does this encompass?

If we have a difficult procedure coming up, we huddle and talk through the risks in advance so we are all aligned. After a claim, I’ll bring a team together to do a deep dive on the case, discuss lessons learned and determine whether any corrective action needs to be taken. As a result, we have fewer claims, and when we do, the severity is quite low relative to similar practices.


Do you have advice for other physician groups considering the captive route?

Attention to detail is critical. You need to designate a leader to ensure the continuous commitment required to keep everyone up to date, and to do the work on risk mitigation up front, every time.


For more information to learn if a captive insurer is right for you, please contact Dawn Thomas Lewis at d.lewis@medmal.com