For ophthalmologists, Ophthalmic Mutual Insurance Co. (OMIC) is the only liability insurance company endorsed and sponsored by the American Academy of Ophthalmology.
Prior to OMIC’s formation in 1987, insurance was not always guaranteed in all states, and ophthalmologists were sometimes forced to move or modify their practice to obtain or maintain coverage.
Today, OMIC is available nationally and portable if an ophthalmologist moves between states. This is important as medicine transitions to larger multistate groups. The number of OMIC’s insured solo practices increased 75% from 1992 to 2023. Meanwhile, the number of ophthalmologists affiliated with insured group practices increased 825% during the same period. As of July, 2024, OMIC covers more than 6,300 ophthalmologists.
OMIC’s Board of Directors and committees are made up of ophthalmologists who are well-known around the country, many of whom also serve in Academy leadership roles.
OMIC’s Role in the Profession
OMIC protects Academy members and other eye care professionals and their patients by providing comprehensive, affordable liability insurance and risk management and claims defense services. In addition to pricing stability and coverage, OMIC supports the profession in other ways.
Support for Young Ophthalmologists. In order to support those who are establishing their initial practice, OMIC provides heavily discounted premium rates for ophthalmologists who are in their first three years of private practice upon completion of education and training or military service.
Defending the profession. OMIC vigorously defends many non-meritorious claims against ophthalmologists. Settling these otherwise defensible claims (which some insurers do as a cost-savings tactic) only encourages more claims. OMIC’s longest-defended case lasted 20 years and cost more than a million dollars to successfully defend (there was no payment to the plaintiff). Money is well-spent to defend our ophthalmologist members.
Patient safety and risk management. In the interest of patient safety and the successful defense of ophthalmic malpractice lawsuits, OMIC carefully analyzes its closed claims to determine medical-legal vulnerabilities that exist for ophthalmologists.
By studying the impact effective risk management strategies have on the successful resolution of claims (i.e. without payment to the plaintiff) OMIC strives to continually improve the quality of care, which is also good for its business. OMIC’s process for identifying trends and creating and refining patient education materials and informed consent documents remains unique within the insurance industry. These resources help protect insureds. OMIC shares information and recommendations with the broader community through courses at meetings around the country.
Research and support. OMIC provides significant funding to the Academy and its foundation and maintains partnerships with most state, subspecialty, and special interest ophthalmic societies in the United States. Financial support has been crucial to the production and dissemination of resources in multiple languages. OMIC issues approximately $2 million in premium credits each year to insured organizations through its society partnership program and provides additional annual financial support for ophthalmic organizations around the country.
Fiscal responsibility. Ophthalmologists have benefited from relative price stability during the same period. The average national mature rate for $1 million in coverage for a full-time full surgery ophthalmologist was $9,398 in 1992. In 2024, it was $9,892, despite an increase in the consumer price index of 220% during the same period.
Although technically OMIC is not a “nonprofit,” it essentially operates like one for its insureds. It regularly returns to its physician policyholders any premium above what is necessary to prudently run the company. OMIC has returned $102 Million to policyholders through dividends since inception — an average of 8% per insured per year. This cumulative return from 1992 to 2023 was approximately $25,250 per insured, or equal to two and a half years of coverage at the average annual premium during the same period referenced above. Only about a third of malpractice carriers issue dividend returns.
Further Resources
About the author: Robert Widi has held various positions on OMIC’s senior executive team since 1994. He is currently vice president of marketing and sales.