Physicians Regulatory Defense Insurance

APS offers a comprehensive, stand-alone regulatory defense solution that reimburses legal costs and related expenses when a physician, practice, or covered provider is subject to regulatory inquiry or administrative action. The program is underwritten through various admitted and non-admitted markets, giving brokers flexible placement options for a wide range of physician and small-group practice risks.

• Individual physicians, small group practices, and medical directors
• Practices with prior billing complexity or that participate in government and commercial payor programs
• Providers using contractors or vendors who handle billing and claims
• Accounts concerned about network security/privacy incidents and patient notification costs

APS is best for accounts that need a stand-alone defense policy to protect licensure and regulatory standing. Accounts with active criminal allegations, ongoing license denials, or extensive prior disciplinary history will require detailed underwriting and may have limited options.

• Defense reimbursement for alleged or actual billing errors, including investigations by governmental payors
• Covers Qui Tam/whistleblower actions and associated defense costs
• Protection for contractors working on behalf of government or commercial payors
• Coverage for privacy and network security events, including patient notification and credit monitoring costs
• Data recovery and related expense coverage following cyber incidents
• HIPAA compliance incident coverage and assistance
• Focus on rapid response to protect professional licenses and limit exposure to suspension or revocation

As an MGA, Advanced Professional Services works with multiple carriers to match risk profiles to appropriate markets. Underwriting will typically request prior loss history, claims and investigation details, scope of practice, billing volume, and use of third-party billers or vendors. Minimum premiums and specific terms vary by carrier and state—expect pricing and available limits to depend on specialty, claims history, and whether the placement is admitted or non-admitted.

Minimum premium: Varies by carrier and state.

This program is available in most U.S. states and the District of Columbia: AK, AL, AR, AZ, CA, CO, CT, DE, FL, GA, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WI, WV, WY, DC. APS places business with various carriers and can consider both admitted and non-admitted options where appropriate.

APS combines targeted underwriting expertise for regulatory exposure with access to multiple markets, allowing brokers to secure tailored terms for complex physician exposures. The program emphasizes early defense and license protection—critical when investigations begin—plus practical coverages for privacy events and data recovery that many professionals lack in standard malpractice policies.

Example scenarios you might place with APS:

• A small cardiology practice facing a government audit over billing codes where early defense reimbursement prevents license jeopardy.
• An independent physician whose practice experienced a vendor data breach requiring patient notification, credit monitoring, and forensic recovery.

For placement, submit complete underwriting details including prior claims, billing volume, use of third-party billers, and any ongoing investigations. APS underwriters will work with you to identify the best carrier fit and structure for each account.