Physician-built captive insurance
Your practice already carries the risk. Start keeping the return.
Every dollar of premium lives on someone’s balance sheet. The only question is whose.
Why
Why physicians build captives
The Independence Tax
An independent practice pays more than a system for the same things. Malpractice, property, reinsurance, administration, capital. Every one is priced for a buyer of one. That premium is paid every year, in cash, to someone else.
Whose balance sheet
Premium is collected, held for years, and invested the whole time. Premium that is not spent on claims stays inside and compounds. Today both belong to the carrier.
In a captive they belong to the physicians who carry the risk.
You have done this before
A multi-specialty group in New York built a surgery center together in 1997 and sold it to a health system in 2018.
10x
Still the largest financial event of any of their careers. Expense to asset. A captive is the same shape of trade.
Where the premium goes
Same dollars. Different balance sheet.
What you pay today for malpractice, property and casualty, you pay every year to a commercial carrier. The same dollars, paid into a captive you take part in, build reserves the physicians carry.
| Item | Commercial carrier | Your captive |
|---|---|---|
| Premium paid | Becomes the carrier’s reserves | Becomes reserves held for the physicians who carry the risk |
| Investment income | Kept by the carrier | Added to the physicians’ surplus |
| Unspent premium | Kept as the carrier’s profit | Credited to the physicians as surplus |
| At renewal | The slate is wiped | The surplus carries forward and compounds |
What
What DrCaptives offers
Live
Medical malpractice
Cornerstone Indemnity. Domiciled in Anguilla and reinsured at Lloyd’s.
- Admission is decided by the Standards Group, four practicing physicians
- Priced for your specialty and state
- Consent to settle belongs to the physician
- For physicians, PAs, NPs and physical therapists
Opening 2027
Property
A property captive for practice owners with buildings, equipment and contents to insure.
- What a property captive retains and what it reinsures
- What a practice can prepare now: locations, equipment, current policies, five years of losses
- Interest list open
The platform
What a captive is
A licensed insurance company formed to insure the people who fund it.
- Float and surplus
- Where premium goes
- Reinsurance
- How a captive year runs
- What a captive is not
Practicing physicians lead the platform and carry the same risk the members do. Four of them, the Standards Group, write the standards and decide who is admitted.
-
James McAtee, MD
Orthopedic surgery
Leads the Standards Group
-
Paul Slosar, MD
Orthopedic spine surgery
Standards Group
-
Jay Gilbaugh, MD
Urology
Standards Group
-
Trevor Gaskill, MD
Orthopedic sports medicine
-
Hank Doering, MD, FACS
General surgery
-
Luis Tumialán, MD
Neurosurgery, spine
Standards Group
-
Steven Siwek, MD
Interventional pain