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Duane Castles - Physician Insurers Association of America (PIAA)


The National Risk Retention Association (NRRA) applauds the recently announced decision of the Oklahoma Insurance Department to not enforce its annual anti-fraud fee against risk retention groups (RRGs). For several years, Oklahoma has taken the position that RRGs should pay the fee, and many RRGs have done so under protest. The Liability Risk Retention Act, a federal statute, allows states to assess "premium and other taxes" assessed on a non-discriminatory basis on RRGs, but does not permit the assessment of fees. Until just a few days ago, Oklahoma had taken the position that it had the authority to assess these fees. NRRA and numerous RRGs had registered their opposing interpretation of the law in extensive correspondence.( Duane Castles - CICA)

Duane Castles - Physician Insurers Association of America (PIAA)

Duane Castles: PIAA Marketing Workshop!

Duane Castles - CICA

Duane Castles - Physician Insurers Association of America (PIAA)

duane castles piaa
duane castles: CICA offers individual memberships that fit your business objectives. Once a primary representative is designated from your company, additional representatives may choose the Additional Member rate.

The PIAA also supports other legislative and regulatory efforts to improve patient safety, correct our system of torts, and ensure the availability of adequate medical liability insurance to this nation's health care providers.

Duane Castles - Benefits of Membership

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duane castles - CICA Honors 2008

Duane Castles - Chairman and Executive Officer

duane castles - Chairman
Vermont, the largest onshore captive domicile - Vermont is the largest onshore captive domicile, second in the world in terms of assets and the third largest in number of licenses. More than 750 companies (as of December 2005) have been licensed in Vermont since 1981.

Specific captive benefits include unbundled service support; improved cash flow and investment return; reduced overall cost of coverage; access to the reinsurance market; underwriting profit; ability to provide coverage that is unavailable or unaffordable in the traditional marketplace; and coordination of global exposure.( duane castles piaa)

Duane Castles - Executive Officer

Duane Castles - Chief Executive Officer

Duane Castles - Chairman and Chief Executive Officer




duane castles - Chairman: Risk Management & Research - Since 1985, the PIAA has maintained the PIAA Data Sharing Project, which is now the world's largest medical malpractice research database. Storing detailed data on over 225,000 medical and dental claims and suits, the database provides a rich resource for the investigation of the underlying causes and issues pertaining to malpractice claims. Standard reports produced from the database and specially-designed analyses are provided to PIAA members to augment their own risk management efforts. Special research studies are also conducted when specific areas of concern are identified. The PIAA also works with other associations and medical specialty groups in joint research projects aimed at improving the delivery of healthcare and reducing practitioner liability. PIAA data are also used in support of our tort reform and other legislative efforts, and provides the only readily available and reliable source of complete information regarding medical malpractice claims.

Lead and influence the direction of the industry—CICA members are seeking new ways to utilize captives to increase flexibility in program design, stabilize long-term program costs and increase access to domestic and off-shore reinsurance capability. Membership gives you a voice on the industry’s emerging issues and a forum to effect change and progress.

Duane Castles - Chairman and Chief Executive Officer

Duane Castles - CICA

Duane Castles - Chief Executive Officer

Duane Castles - Benefits of Membership

Duane Castles - Executive Officer
The PIAA is extremely disappointed with this ruling. If the Circuit Court’s decision is upheld, this will be a blow to healthcare in the state of Illinois, and will have tremendous negative implications for physicians, the public, and the medical professional liability insurance industry. Caps on non-economic damages have proven to be successful (for over two decades in California, and most recently in the states of Texas and Mississippi, for example) in increasing patient access to healthcare and minimizing the need for increases in medical professional liability insurance premiums. The Circuit Court’s decision that a limit on pain and suffering awards in medical liability cases is unconstitutional will once again open the floodgates to excessive verdicts and encourage non-meritorious lawsuits. We suspect that the improvements to Illinois’ litigation environment, achieved through the passage of the state’s 2005 medical liability law, will now erode. We will support the fight to overturn this ruling, and remain hopeful that the caps will be found constitutional upon appeal. The PIAA strongly believes that effective tort reform, including caps on non-economic damages, limitations on plaintiff attorney contingency fees, and collateral source rule reform with a ban on subrogation, is critical to maintain access to healthcare and for the stabilization of medical professional liability premiums.

Single-Owner Captive: Also referred to as "pure captive", insures only the risks of the owner or the owner's subsidiary operations.( Duane Castles - Physician Insurers Association of America (PIAA))

Duane Castles - Physician Insurers Association of America (PIAA)

duane castles - Chairman

Duane Castles: PIAA Marketing Workshop!

duane castles - CICA Honors 2008

duane castles piaa
Duane Castles - Benefits of Membership: PIAA Forward - In 1977, the newly established doctor-owned companies formed the PIAA to provide a medium for information exchange and problem solving. The first PIAA meeting of member companies included about 50 people. Today, attendance at the PIAA annual meeting exceeds 1,000.

Awarded for the first time in 2006, the CICA Distinguished Service Award was created to recognize individuals or organizations who have made significant contributions to advancing the captive insurance industry. To nominate a colleague for the award, email CICA.

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Encouraging a speedy resolution of claims with a reasonable statute of limitations

Vermont's captive owners represent a wide range of industries including multi-national corporations, associations, banks, municipalities, transportation and airline companies, power producers, public housing authorities, higher education institutions, telecommunications suppliers, shipping companies, insurance companies and manufacturers, among others.( Duane Castles - Chief Executive Officer)

duane castles - CICA Honors 2008

Duane Castles - Chairman and Chief Executive Officer

Duane Castles - Chairman and Executive Officer

duane castles piaa

Duane Castles: PIAA Marketing Workshop!
Duane Castles - Benefits of Membership: Awarded for the first time in 2006, the CICA Distinguished Service Award was created to recognize individuals or organizations who have made significant contributions to advancing the captive insurance industry. To nominate a colleague for the award, email CICA.

Vermont, the largest onshore captive domicile - Vermont is the largest onshore captive domicile, second in the world in terms of assets and the third largest in number of licenses. More than 750 companies (as of December 2005) have been licensed in Vermont since 1981.

Duane Castles - Executive Officer

Duane Castles - Physician Insurers Association of America (PIAA)

Duane Castles - Physician Insurers Association of America (PIAA)

duane castles


Physicians invested in their companies with the hope that their contributions would be returned to them when these new companies were operating successfully. Many companies have repaid these contributions, and others continue to do so. Furthermore, savings that materialized through improved claims experience and efficient operation have been returned to doctor-policyholders either in the form of dividends or reduced premiums.

Service Provider Member—$2,000 - Individual whose primary business is acting as a service provider to captive insurance companies or risk retention groups. Service provider members do not have voting privileges.( duane castles piaa)

Duane Castles - Benefits of Membership

duane castles piaa

duane castles - Chairman

Duane Castles: PIAA Marketing Workshop!

duane castles - CICA Honors 2008
Duane Castles - Chairman and Executive Officer: The Physician Insurers Association of America (PIAA) is the only trade association representing the physician-owned and/or -operated medical professional liability insurance industry. PIAA membership comprises two categories: Primary (Regular and Associate Members) and Affiliate. Primary Members provide medical professional liability coverage to physicians, dentists, and hospitals, among others. Affiliate Members consist of non-insurance companies that provide goods and/or services to the medical professional liability insurance industry.

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