Understanding Your Declarations Page and Certificate of Insurance
Starting and running your own medical practice comes with a host of administrative tasks, one of the most crucial being securing medical malpractice insurance. As a healthcare provider, understanding insurance documents is essential to ensure you have the right coverage and can provide the necessary proof of that coverage when it is required. Two key documents you will encounter in your medical malpractice insurance policy are the Declarations Page and the Certificate of Insurance (COI). While both provide information about your policy, including whether or not it is for a group or solo policy, they serve distinct purposes and knowing when to use one over the other can save you time and prevent unnecessary disclosure of sensitive information. Even if you aren’t running your own medical practice, you’ll still find the distinction between these two documents integral to maintaining credentials and proving coverage is in place.
What Is a Declarations Page?
A Declarations Page, often referred to as the "Dec Page," is issued by your insurance carrier as part of your policy. Typically, this is page 1 of your policy document, summarizing crucial details about your coverage. Here’s what you’ll find on a Declarations Page:
The insurance carrier’s name
Your coverage limits (per claim and aggregate)
Your policy number
Effective and expiration dates of your policy
The premium you paid
Named insured (policyholder)
Additional insureds (if applicable)
Practice locations (if applicable)
Basic information about the coverage provided
A Declarations Page Guide
The Declarations Page is most useful when you need to review the specifics of your policy. It’s essential for internal record-keeping and should be kept on file as proof of coverage. It is also commonly used when you need to confirm coverage for additional insureds or practice locations.
When Not to Use the Declarations Page
While the Dec Page is comprehensive, it contains more information than is needed for credentialing. It typically lists additional insureds or specific practice locations, which can lead to unnecessary back-and-forth with credentialing departments. Additionally, because it includes premium details, it is not always the best document to share externally.
What Is a Certificate of Insurance (COI)?
A Certificate of Insurance (COI) provides evidence of coverage in a simplified format. Unlike the Declarations Page, which is part of the policy, a certificate of insurance for medical practice can be issued either by the insurance carrier or by your broker. Here’s what you’ll find on a COI:
The insurance carrier’s name
Your policy number
Coverage limits
Effective and expiration dates
A statement indicating whether the recipient, a certificate holder, has rights to be informed of policy changes
One key difference from the Declarations Page is that a COI never includes the premium paid. This is because a COI is intended only to provide the necessary information for credentialing, vendor agreements, and other professional verifications.
When to Use the Certificate of Insurance for Medical Practice
The COI is the preferred document for credentialing purposes, as it includes only the relevant details without disclosing sensitive financial information. It is also commonly used when:
A hospital, clinic, or facility requires proof of malpractice coverage
A third party (e.g., a landlord or business associate) needs evidence of insurance
When Not to Use the Certificate of Insurance
While the COI is useful for verification, it does not provide the full scope of your policy details. If you need to review all policy specifics or confirm exclusions, the Declarations Page (or full policy) is the more appropriate document.
Why Providing Too Much Information Can Be a Problem
Many healthcare providers make the mistake of submitting the Declarations Page when a Certificate of Insurance would suffice. Here’s why that could be a problem:
Sensitive Information Exposure – The Dec Page includes your premium amount and possibly other private details that credentialing organizations do not need to see.
Confusion Over Coverage – Because Dec Pages may list additional insureds or locations, this can lead to unnecessary follow-ups and delays.
Unnecessary Requests for Additional Documentation – Providing more information than required can prompt further scrutiny and additional documentation requests, slowing down your credentialing process.
Differences by Carrier and Policy Type
Not all Declarations Pages and Certificates of Insurance look the same. Differences can occur based on:
Carrier Formatting – Some carriers may include more details on a COI than others, and certain insurers might format their Dec Page differently.
Standard vs. Non-Standard Insurance Policies – If you are insured under a policy issued by an excess and surplus lines (E&S) carrier, your COI might contain additional disclaimers about regulatory oversight, exclusions, or information about your deductible, if one applies to your policy.
Conclusion
Understanding insurance documents like the Declarations Page and the Certificate of Insurance for your medical practice is essential for efficiently managing your professional liability coverage. Knowing when to use each document can prevent unnecessary complications and ensure smooth credentialing and compliance processes.
By staying informed about your policy documents, you can safeguard your practice and avoid unnecessary administrative hurdles. If you have further questions, consulting with an experienced medical malpractice insurance broker can ensure you have the right coverage and documentation in place. For more guidance on understanding insurance documents and managing your medical malpractice coverage, reach out to L&J.