General FAQs

About TMLT

Joining TMLT

Type of Coverage

About TMLT

What is TMLT?

Texas Medical Liability Trust (TMLT) is a not-for-profit health care liability claim trust led by a Board of Governors who are elected by TMLT policyholders. TMLT is not an insurance company, but a self-insured trust created by the Texas legislature in 1979 to provide medical malpractice insurance to members of the Texas Medical Association.

What is an insurance trust?

In reference to TMLT, it is a medical liability trust led by a Board of Governors who are elected by TMLT policyholders. TMLT was created by the Texas Legislature to provide medical liability insurance to members of the Texas Medical Association. In general, trusts are not regulated by state insurance departments, but TMLT complies voluntarily with the rules and regulations for commercial insurance companies.

What are your business hours?

Our business hours are Monday through Friday, between 8am and 5pm.

Where are you located?

TMLT headquarters are located…
901 South Mopac Expressway
Barton Oaks Plaza Building V - Suite 500

Austin, Texas 78746

Why is TMLT no longer collecting surplus?

When TMLT was formed, policyholders were required to make a "contribution to surplus." This amount provided capital for the company to operate and to be in compliance with financial guidelines of the Texas Department of Insurance.

At this time, TMLT has accumulated sufficient surplus to meet all statutory requirements and to be assigned an "A" rating by AM Best. This rating stands for having "an excellent ability to meet our ongoing obligations to policyholders." Therefore, it is not necessary for TMLT to collect surplus.

Joining TMLT

How do I obtain a quote?

You can request a quote from the TMLT web site or you can contact a sales representative by calling 800-580-8658. You can also email sales.

How do I apply for coverage?

You can apply for coverage using our online application or you can download an application, fill it out, and return it to TMLT. A representative from TMLT will contact you once your application has been received.

Why do I have to be a member of Texas Medical Association to purchase TMLT coverage?

TMLT was created by the Texas legislature in 1979 to provide medical liability coverage for physician members of the Texas Medical Association. The legislation that created TMLT included the provision that policyholders must be members of the TMA. Therefore, by law, policyholders must also be members of the TMA.

How long does it take to process an application?

The average time to process an application is approximately 10 business days. Please make sure that your application is filled out completely, as incomplete information may delay the underwriting process.

When is coverage effective?

For coverage to begin, we must have confirmation of pending TMA membership and your completed application underwritten and approved. You must also provide a current CV and proof of any previous or current medical liability coverage.

Are my ancillary staff (nurses, medical assistants, technicians) covered under my TMLT medical liability policy?

TMLT policies do not cover ancillary staff. However, if the physician is named in a claim or a lawsuit due to the actions of a staff member for whom the physician may be considered "legally responsible," coverage may be provided for the physician. Please be aware that coverage for a claim is ultimately determined after a thorough investigation by the TMLT Claims Operations Department.

Ancillary staff working with TMLT policyholders can obtain medical liability coverage through Texas Medical Insurance Company, our subsidiary.

Does my TMLT policy cover me for my activities as a medical director?

Yes, all TMLT policies include coverage for your administrative activities as a medical director. This coverage is at a sublimit of $100,000 of your existing policy limit. You may contact TMLT at 800-580-8658 to decline this coverage.

How is my premium determined?

Premium is based on geographic location, specialty, procedures performed, limits of liability, number of years of exposure covered, and claims experience.

What are limits of coverage?

Limits of coverage spell out the maximum amounts your policy will pay. In professional liability policies, there are typically two limits. One limit states the maximum per claim, while the second limit spells out the maximum amount that will be paid during the policy period. The first limit is called an "each claim" limit and the second one is called an "all claims" limit.

How much coverage is right for me? What limits of liability do you recommend?

We cannot advise you about what limits to carry, but we recommend that you speak with colleagues who practice in your specialty and location to see what limits of liability they carry. You may also contact your local county medical society; often their legal counsel is available to advise you. Your personal financial advisor may also have recommendations in consideration of your personal assets.

What is a declarations page?

The declarations page is the first page of the insurance policy that contains information specific to the policyholder. The declarations page contains the policyholder's name, address, specialty, limits of liability, premium amount, policy effective date, endorsements, etc.

What is an endorsement?

An endorsement is a document that changes the terms of the insurance policy.

What is vicarious liability?

Vicarious liability is when a policyholder can be held legally responsible for the actions of another person. Typically in medical liability claims, physicians can be found vicariously liable for the actions of nurses, medical assistants, employed physicians, or other people for whom they are legally responsible.

What does claims frequency mean?

Claim frequency refers to the number of claims filed. Claim frequency is one factor used to determine insurance premiums.

What is claim severity?

Claim severity refers to the dollar value of a claim as determined by a jury verdict or settlement agreement. Claim severity is another factor used to determine insurance premiums.

What is reinsurance?

It is a transfer of risk by one insurance company (the insurer) to another (the reinsurer).

What are reserves?

Reserves are funds set aside by insurance companies to pay estimated future losses. A company's claim department typically specifies a reserve amount for every claim filed, which can be modified as the claim proceeds to resolution.

Types of Coverage

What does claims-made mean?

A claims-made policy is designed to protect you during the active policy period, usually one year. If you do not renew your claims-made policy when it expires, you no longer have coverage for any claims that may arise in the future that are alleged to have occurred during the time your policy was in force.

Physicians who wish to continue coverage under a claims-made policy must purchase supplemental coverage, such as tail coverage or prior acts coverage. If neither tail coverage nor prior acts coverage are purchased when a claims-made policy expires, any future claims that might arise from services performed during the policy period will not be covered.

What is an occurrence policy?

An occurrence policy provides ongoing insurance protection for events that occur during the policy period, even if they are reported after the policy is cancelled.

Occurrence policies are generally more expensive, but it is not necessary to buy supplemental coverage like tail or prior acts coverage after an occurrence policy expires.

What is prior acts coverage?

A supplement to a claims-made policy, prior acts coverage is purchased from a new carrier when you change insurance companies. This coverage, also known as nose coverage, covers claims from unknown incidents that occurred before the beginning of your new policy. Prior acts coverage is an alternative to tail coverage, which is purchased from the original carrier when a change in insurance companies is made.

Companies typically require new policyholders to purchase either prior acts from them, or tail coverage from their prior carrier, to protect against claims arising from prior acts.

What is tail coverage?

Tail coverage, also called a reporting endorsement, is available for purchase when your claims-made policy is cancelled or non-renewed. Tail coverage continues insurance protection under your claims-made policy for claims reported in the future but arising from incidents that occurred while your policy was in force. Tail coverage payment is due within 60 days of policy cancellation.

TMLT offers free tail coverage to physicians who:

  • are 50 years of age or older;
  • have been continuously insured with TMLT for 5 years or more on a claims-made policy; and
  • the cancellation of the policy is due to retirement from the practice of medicine.

In addition, TMLT waives the tail premium at any time if the physician should stop practicing due to medical disability or death.

What is per-patient based coverage?

Per-patient based coverage is designed for emergency physicians and urgent care groups, as well as other groups that are structured on a per-encounter basis.

This type of coverage is more cost effective because pricing is based on the number of visits rather than rated on the number of physicians in the group.

What is cyber liability coverage?

Cyber liability coverage provides coverage for privacy-related claims that occur as a result of lost laptops, theft of hardware or data, improper disposal of medical records, hacking or virus attacks, and disgruntled employees.

Cyber liability coverage is included with all TMLT policies.

What is Medefense coverage?

Medefense covers legal expenses, fines, and penalties arising out of medical board and other disciplinary proceedings.

Medefense coverage is included with all TMLT policies.

What is employment practices liability (EPLI) coverage?

EPLI covers claims that arise from alleged wrongful employment practices, such as discrimination, harassment, and retaliation.

EPLI coverage is included with all TMLT policies.

What coverage is available for my entity?

Entities, which are defined as an incorporated formation of two or more shareholder physicians practicing under the group's "DBA" name, are eligible for a separate entity policy. The policy provides defense and indemnity coverage when the entity is held legally responsible for the actions of the member physicians. Physicians that are incorporated as a Solo Professional Association or Solo PLLC are provided coverage under their Individual policy on a shared-limit basis.

What does assessable mean?

Some policies will ask that you pay an assessment in addition to the yearly premiums. Assessments can occur if a company experiences higher claims costs than anticipated. In some cases, assessments can be as much as the full premium. All TMLT medical liability policies are non-assessable.

What is general liability insurance?

General liability insurance refers to a type of business liability insurance other than automobile, workers' compensation, or employer's liability that covers property damage or bodily injury. In a health care setting, general liability insurance would cover such incidents as a visitor slipping on a wet floor of a hospital or office.