Insights
Field notes from a senior care insurance practice.
Your building is priced by its courthouse
Two facilities forty miles apart, same operator, same acuity, same incident, can carry materially different expected claim values. Underwriters price that. Very few operators are told it is happening.
The tail you did not price
The cost of an extended reporting period is fixed in your policy at binding, not negotiated when you need it. Most operators discover the multiple during a sale, which is the moment it cannot be changed.
Three clocks and a closed file
The limitations period on a senior care claim is longer than most operators assume, because discovery rules, incapacity and a separate wrongful death clock all extend it. That has consequences for record retention and for the policy that will eventually respond.
The entity that funds its own defense
Corporate negligence reaches decisions made above the building, which means the plaintiff names the manager and the parent. On most programs at least one of those entities is not a named insured, and nobody notices until it is.
Development is the submission
Above a certain size an operator stops being class rated and starts being loss rated. At that point how your claims mature against reserves is not one input among several. It is the input.
The agreement nobody rescinds
Underwriters ask about arbitration agreements on nearly every senior care submission. The agreement itself is close to worthless. What has value is an execution practice that survives challenge, and most do not.
What you buy when you buy a building
An asset purchase is supposed to leave the liabilities behind. In licensed care that comfort is weaker than it looks, and the insurance decision that matters belongs in the purchase agreement rather than in the week after closing.
The excess that cannot be reached
A tower is only worth what it attaches to. Two clauses decide whether the layers above your primary respond at all, and neither of them appears on a proposal.
One hundred and fifty days
Ninety days is the conventional renewal runway and it is too short for this class. The reason is structural, and a late submission does not produce no quote. It produces a defensive one.
Immediate jeopardy is a revenue event
The sanction that follows a serious survey finding rarely closes a building. It stops the money while the building keeps operating, and the coverage most operators assume responds to that does not.
The quiet defect at a carrier change
When a senior care program moves markets, the retroactive date sometimes moves with it. Nothing on the declarations page indicates the problem, and it creates an uninsured tail that grows more expensive the longer it goes unnoticed.
The number under the number
Your declarations page shows a limit. Somewhere below it sits a schedule of sublimits, and for the claims most likely to be brought against a senior care operator, the smaller number is the real one.
Four words that move a memory care claim
Resident on resident altercation is a professional liability claim in substance. Whether it is one for insurance purposes depends on a phrase in the assault and battery endorsement that most operators have never read.
The record the plaintiff already has
Before a complaint is filed, opposing counsel can pull your staffing history, your survey findings and your quality measures from public federal data. Most operators have never read their own file the way it will be read.
The limit that is not there
Most senior care liability is written with defense costs inside the limit. Here is what that actually does to the number on your declarations page, and the one question to ask at renewal.