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  • #16
    TBE protects only when there is a suit against one of the members of a couple. If someone sues both of them, then TBE does nothing.

    Be careful. There are states that PERMIT TBE titles for things other than real estate, but that only provide ASSET PROTECTION to the primary residence. In such a state, a couple could have everything they own as TBE, but have protection only for their home, if they owned it.

    TBE would not protect against divorce. The TBE property would be fair game for a settlement or judgment.

    DAPT, if it works, would protect the assets inside it, no matter who was sued. As the ACTEC article briefly mentions, the real life protection of a DAPT is not assured. Maybe it will work. Maybe the plaintiffs will get a judge to ignore it. That is apparently more likely when the judge is not in an asset protection state.

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    • #17
      Originally posted by afan View Post
      https://casetext.com/case/ellis-v-cl...NUMBER_GROUP=P

      massive judgment upheld at appeal.

      Summary of Medscape malpractice survey

      https://www.medscape.com/slideshow/2...ort-6009206#20
      Medscape 2017 malpractice survey. Survey of 4100 physicians. Of cases that resulted in payments, 11% were above $1M and 5% were above $2M.
      On the first point, yes, there are anecdotes. It's not 0%, but it certainly rounds there.

      On the second point, that survey doesn't distinguish from when there are multiple defendants, like the doc and the hospital. So if the judgment is $4 million, $3M to the hospital and $1M to the doc, it would be reported in that survey as $4M, but the doc would not have been out any personal assets.
      Helping those who wear the white coat get a fair shake on Wall Street since 2011

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      • #18
        Exactly. We don't know how many, if any, of those larger settlements or judgments included a hospital or other defendants. Some, unknown, fraction may have. But hardly a basis for concluding that this is typical or that large judgments against individual docs are so rare as to ignore.

        "What Is the Average Value of a Medical Malpractice Lawsuit?

        The average settlement value for a medical malpractice lawsuit in the U.S. is somewhere between $300,000 to $380,000. The median value of a medical malpractice settlement is $250,000. The average jury verdict in a malpractice cases won by the plaintiff is just over $1 million. The value of an individual case will vary greatly depending on what state its in and the severity of the plaintiff’s injuries." Interpret with caution, as this is from a group of plaintiff's attorneys looking for business.

        on the other hand, the study below was derived from data in the national practitioner databank, written by physicians and published in JAMA Internal Medicine.


        ...Of 280 368 paid claims, 21 271 (7.6%) exceeded $1 million (4304 of 69 617 [6.2%] in 1992-1996 and 4322 of 54 081 [8.0%] in 2009-2014),...
        Between 1992 and 2014, the rate of malpractice claims paid on behalf of physicians in the United States declined substantially. Mean compensation amounts and the percentage of paid claims exceeding $1 million increased, with wide differences in rates and characteristics across specialties.

        ...From 1992 to 2014, a total of 280 368 malpractice claims (for 175 667 physicians) were reported to the NPDB as paid on behalf of physicians...

        ...Paid malpractice claims exceeding $1 million (ie, catastrophic claims)9 comprised 7.6% (21 271 of 280 368) of paid claims, and accounted for 6.2% (4304 of 69 617) of paid claims in 1992-1996 and 8.0% (4322 of 54 081) in 2009-2014 (eTable in the Supplement). The percentage of catastrophic claims increased over time in 23 of the 24 specialties, and the increase was significant in 13 specialties. Neurosurgery had the highest percentage of catastrophic payments (13.0% [838 of 6468]), followed by obstetrics and gynecology (12.4% [4946 of 39 897]) and neurology (11.8% [353 of 2986]); pediatrics, pathology, and anesthesiology were also above 10%. Plastic surgery had the lowest percentage of catastrophic payments (2.7% [198 of 7352])....
        Claims paid by hospitals or other entities. The authors note that these would NOT be included in the figures they cite. The data concern only payments reported to the databank on behalf of physicians.

        because the NPDB contains only claims that result in payment on behalf of a physician in response to a written claim, we were unable to count claims for which no payment was made, that were settled without a written demand, or those in which payment was made solely on behalf of an institution.
        I cannot tell from this language whether a claim made against several physicians would be reported individually for each (although considering the purpose and data in the databank, I suspect this is the case), or whether some may have reflected aggregate amounts for multiple physicians (which would defeat the goal of identifying individual risky docs).


        Rates and Characteristics of Paid Malpractice Claims Among US Physicians by Specialty, 1992-2014
        Adam C. Schaffer, MD1; Anupam B. Jena, MD, PhD2,3,4; Seth A. Seabury, PhD4,5,6; et alHarnam Singh, PhD7; Venkat Chalasani, PhD7; Allen Kachalia, MD, JD1
        Author Affiliations Article Information
        JAMA Intern Med. 2017;177(5):710-718. doi:10.1001/jamainternmed.2017.0311
        So over the second period-2009 to 2014- paid claims of more than $1 million were 8% of total paid claims overall and were 13% of paid claims against neurosurgeons.

        This table from the supplement lists the percent of cases in which the payment was >$1 million by specialty. The rates vary across fields but by eyeball, the lowest rate was for general internal medicine at 3.0%. A lot lower than neurosurgery, but hardly vanishingly rare.
        ioi170009supp1_prod.pdf (jamanetwork.com)

        I would not assume that large malpractice settlements and judgments are so rare as to be ignored. The more important issues would be one's field, the laws of your state and the malpractice climate in your location.

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        • #19
          When I was still practicing one thing we did when we set up our revocable trusts was to put the house title into my wife's trust so that if there was a malpractice issue it wasn't owned by me. Obviously you need to be sure you're not at risk of divorce before doing that. That's a fairly painless way to keep the house safe and we wanted the trusts anyway for estate planning.

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          • #20
            Originally posted by dennis View Post
            When I was still practicing one thing we did when we set up our revocable trusts was to put the house title into my wife's trust so that if there was a malpractice issue it wasn't owned by me. Obviously you need to be sure you're not at risk of divorce before doing that. That's a fairly painless way to keep the house safe and we wanted the trusts anyway for estate planning.
            I have heard of people who have all assets held by their spouse. Would be prudent to make sure to have plenty of umbrella, auto insurance etc for your spouse in that case.

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            • #21
              If your state permits it, TBE is better than putting all assets in the name of the lower risk spouse.
              For those in states that do not recognize the TBE protections, some couples will wait long enough after retirement for the statute of limitations to expire and then put the house back into joint ownership. Still at risk if a divorce comes up while it is in one name. And at risk if someone brings a case against the lower risk spouse.

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              • #22
                I'd hope the people who put everything in the name of lower income spouse are very sure of their relationship, with a track record to show. I see many surgeons on their third wives at my current hospital...

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                • #23
                  Originally posted by billy View Post
                  I'd hope the people who put everything in the name of lower income spouse are very sure of their relationship, with a track record to show. I see many surgeons on their third wives at my current hospital...
                  Does it actually make a difference in the event of divorce? If the surgeons you know had put everything in their name instead, would the surgeon have gotten to keep everything? I thought in the event of divorce everything is split assuming it was acquired during the marriage.

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                  • #24
                    Depends on the law. Varies by state.

                    Comment


                    • #25
                      Originally posted by afan View Post
                      Exactly. We don't know how many, if any, of those larger settlements or judgments included a hospital or other defendants. Some, unknown, fraction may have. But hardly a basis for concluding that this is typical or that large judgments against individual docs are so rare as to ignore.

                      "What Is the Average Value of a Medical Malpractice Lawsuit?

                      The average settlement value for a medical malpractice lawsuit in the U.S. is somewhere between $300,000 to $380,000. The median value of a medical malpractice settlement is $250,000. The average jury verdict in a malpractice cases won by the plaintiff is just over $1 million. The value of an individual case will vary greatly depending on what state its in and the severity of the plaintiff’s injuries." Interpret with caution, as this is from a group of plaintiff's attorneys looking for business.

                      on the other hand, the study below was derived from data in the national practitioner databank, written by physicians and published in JAMA Internal Medicine.




                      Claims paid by hospitals or other entities. The authors note that these would NOT be included in the figures they cite. The data concern only payments reported to the databank on behalf of physicians.



                      I cannot tell from this language whether a claim made against several physicians would be reported individually for each (although considering the purpose and data in the databank, I suspect this is the case), or whether some may have reflected aggregate amounts for multiple physicians (which would defeat the goal of identifying individual risky docs).




                      So over the second period-2009 to 2014- paid claims of more than $1 million were 8% of total paid claims overall and were 13% of paid claims against neurosurgeons.

                      This table from the supplement lists the percent of cases in which the payment was >$1 million by specialty. The rates vary across fields but by eyeball, the lowest rate was for general internal medicine at 3.0%. A lot lower than neurosurgery, but hardly vanishingly rare.
                      ioi170009supp1_prod.pdf (jamanetwork.com)

                      I would not assume that large malpractice settlements and judgments are so rare as to be ignored. The more important issues would be one's field, the laws of your state and the malpractice climate in your location.
                      I agree the data is less than ideal to answer the question(s) we all really want answered--what is our individual risk of an above policy judgment that is not reduced to policy limits on appeal. The ONLY study I've seen that actually addresses that issue is fairly old. It looked at ALL of the above policy limits judgements over a fair number of years. The interesting thing about the data (aside from how few there were) was that most of the payouts were only $50-100K over policy limits, not amounts that would bankrupt the docs. Plaintiff attorneys basically said they were just trying to send a message on egregious cases that should have been settled that the docs didn't settle.
                      Helping those who wear the white coat get a fair shake on Wall Street since 2011

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                      • #26
                        Originally posted by tailwind225 View Post

                        I have heard of people who have all assets held by their spouse. Would be prudent to make sure to have plenty of umbrella, auto insurance etc for your spouse in that case.
                        You are FAR more likely to lose assets to your spouse in divorce than to a patient. How many docs do you know who have lost assets to a spouse? How many to a patient? I rest my case.
                        Helping those who wear the white coat get a fair shake on Wall Street since 2011

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                        • #27
                          Originally posted by afan View Post
                          Depends on the law. Varies by state.
                          Handy tool.
                          https://www.maritallaws.com/laws/property-division
                          It has tons of other info. Not recommended for financial well being.

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                          • #28
                            The relevant question is not how community property would be divided at divorce. The question is whether one spouse can gift their share to the other spouse. Can spouse A convert community property to property owned solely by spouse B? This would need to happen in order for holding the house in spouse B's name alone to work for malpractice protection. If it would work, then it would be difficult to claim that the house remained community property come a divorce.

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