March 21, 2017
Beyond a medical liability claim, nothing can threaten your livelihood more than a disciplinary proceeding. For this reason, every TMLT policy includes Medefense —coverage for legal expenses, fines, and penalties associated with disciplinary actions (such as an investigation by the Texas Medical Board).
In 2017, we’ve enhanced our Medefense coverage and now offer higher limits for purchase when you renew your TMLT policy.
Current limits — included with every TMLT policy
- $50,000 per claim
New limits for purchase*
- $100,000 per claim — for $250
- $200,000 per claim — for $350
- $500,000 per claim — for $550
Medefense covers expenses related to:
- actions by a state medical licensing authority;
- a professional review action regarding clinical privileges;
- a proceeding instituted by a state department of insurance, state workers’ compensation commission, state department of health and human services, the U.S. Department of Health and Human Services, or Centers for Medicare and Medicaid Services alleging medical services were performed in violation of guidelines;
- Medicare billing audits conducted by Recovery Audit Contractors (RAC) or other private contractors as well as allegations of non-compliance with Medicare/Medicaid regulations or procedures;
- proceedings alleging violations of EMTALA, HIPAA, Stark law; and
- a tax practitioner's fees to assist a policyholder in an IRS audit of a federal tax return.
Medefense claims are subject to a $1,000 deductible per claim.
Policyholders can choose their own attorney. However, we will waive the deductible and pay legal expenses directly if you hire an attorney from a panel provided by TMLT.
New limits can be purchased when you renew your policy. For more information, please contact your underwriter at 800-580-8658 or visit www.tmlt.org.
* Subject to approval by the Underwriting Department.