1. What is Personal Counsel?

Your Personal Counsel is a lawyer that represents YOUR – and ONLY YOUR – interests. Your Personal Counsel helps you understand and negotiate the malpractice claims process.

2. Why do I need Personal Counsel in a malpractice claim?

  • Your insurance company selects defense counsel to represent you. Your Personal Counsel can help you if the lawyer selected by the insurance company doesn't have the appropriate training and experience.
  • Your Personal Counsel attends your pre-suit statement and deposition to protect YOUR interests.
  • If the insurance company denies coverage or covers you under a reservation of rights, your Personal Counsel navigates these issues and fight for the coverage you deserve.
  • Your insurance company controls the defense of the lawsuit and directs the defense lawyer. Personal Counsel assists you in communicating YOUR preferences to the appointed lawyer.
  • If the insurance company establishes defense guidelines which restrict the extent and level of legal services being provided to you, your Personal Counsel assists you in understanding the restrictions and obtaining authorizations from the insurance company when needed.
  • Matters may exist which could jeopardize your coverage under the policy. You can discuss these issues in complete confidence with your Personal Counsel. Your Personal Counsel will help you navigate without putting the appointed counsel in a compromising position.
  • Insurance companies are required to act in good faith when defending your claim. Your Personal Counsel helps ensure the insurance company acts good faith.
  • Excess verdicts can and do occur. Your Personal Counsel will act on your behalf to protect you from a verdict in excess of your policy limits.
  • Have you sold or are you thinking of selling your practice? Someone else buying your malpractice policy for you? Is your insurance being provided through their '"Preferred Insurer" or by the hospital? Are these insurers really looking out for your interests, or do they answer to the group or hospital? Your Personal Counsel will ensure your interests are being protected.

3. Will this policy defend me if I'm uninsured?

No. This policy only provides for an attorney to monitor the insurance company's assigned attorney and your claim. If you have this policy and don't have malpractice insurance coverage, if you hire a plan attorney you'll receive a 20% discount off their regular hourly rate.

4. Can I select anyone to represent me?

We will assign a plan attorney to represent you as your Personal Counsel. If you don't like them, we'll assign another plan attorney, or you can select any attorney licensed in the State of Florida. If you select an attorney outside our plan, we will pay 80% of the attorney's usual and customary rates, up to a maximum of $125 per hour. Note that if you select an attorney outside the plan, we cannot provide a preferred member discount nor coverage for optional medical malpractice claims services, as we do not have a provider agreement with your attorney.

5. Who pays my attorney's legal fees - Gulf Atlantic or me?

If you utilize panel counsel, they will bill us directly. If you select an attorney outside our panel, you either pay the bill directly and seek reimbursement from us or authorize the attorney to bill us directly.

6. Is there a limit on my coverage?

Your policy contains an annual cap for Personal Counsel services of 75 hours for malpractice claims and 10 hours for governmental entity claims.

7. How will I know how much time my attorney has spent on my case?

We will pay the attorney's bills and provide you with a periodic summary of the amounts (and hours) paid to date. You may also call us any time for an update as to how much we have paid on your behalf.

8. What happens if I exceed a coverage cap?

Once the annual cap is exhausted, you are responsible for your Personal Counsel's fees thereafter. For medical malpractice claims using panel counsel, your Personal Counsel's rate will be equal to our panel counsel rate. For non-covered services, the panel counsel's hourly rate will be reduced by a discount equal to 20% of the attorney's usual hourly rate. When it appears that you will be close to exhausting your limits of liability under your policy, you will need to discuss billings and payment issues with your selected attorney.

9. Can I purchase Prior Acts coverage under this policy?

Prior acts coverage is not necessary. Gulf Atlantic will provide Personal Counsel coverage for claims made against you and reported during our policy period, regardless of when the act or omission giving rise to the claim occurred, as long as you don't know about the claim when you first obtain coverage with us.

10. Does the Gulf Atlantic policy provide Personal Counsel for AHCA investigations? What about legal expenses associated with Medicare / Medicaid audits?

Our policy provides you with Personal Counsel for these and other Governmental Claims to assist you through the claims process. If you are not covered for these claims, you can individually retain a Plan Attorney to represent you at a discount of 20% off the attorney's usual hourly billing rate.

11. Can I purchase an extended reporting endorsement, or "tail coverage" when I end coverage under my Gulf Atlantic policy?

No. Your Gulf Atlantic Personal Counsel Policy only provides Personal Counsel while coverage is in force.