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Accrued Professional Liability
 12 Months Ended
Dec. 31, 2013
Health Care Organizations [Abstract]  
Accrued Professional Liability

9.    Accrued Professional Liability:

At December 31, 2013 and 2012, the Company’s total accrued professional liability of $158.7 million and $137.0 million, respectively, includes incurred but not reported loss reserves of $110.3 million and $90.6 million, respectively, and loss reserves for reported claims associated with self-insured retention amounts through the Company’s wholly owned captive insurance subsidiary of $48.4 million and $46.4 million, respectively.

The activity related to the Company’s total accrued professional liability for the years ended December 31, 2013, 2012 and 2011 is as follows (in thousands):

 

     Years Ended December 31,  
     2013     2012     2011  

Balance at beginning of year

    $ 137,036      $ 122,847      $ 111,662   

Provision (adjustment) for losses related to:

       

Current year

      41,235        35,441        33,031   

Prior years

      (8,100 )      (8,119 )      (10,099 ) 
  

 

 

    

 

 

    

 

 

  

Total provision for losses

      33,135        27,322        22,932   

Claim payments related to:

       

Current year

      (741 )      (569 )      (221 ) 

Prior years

      (10,739 )      (12,564 )      (11,526 ) 
  

 

 

    

 

 

    

 

 

  

Total payments

      (11,480 )      (13,133 )      (11,747 ) 
  

 

 

    

 

 

    

 

 

  

Balance at end of year

    $ 158,691      $ 137,036      $ 122,847   
  

 

 

    

 

 

    

 

 

  

The net increases in the Company’s total accrued professional liability for the years ended December 31, 2013 and 2012, are primarily attributable to increases in the current year provision for losses as a result of the increase in the number of physicians insured due to acquisitions and internal growth, offset by claim payments and adjustments to the provision for losses related to prior years resulting from favorable trends in the Company’s claims experience.