Confused by all the different types of medical malpractice insurers out there? Wondering if regulatory changes and the ongoing evolution of coverage products have rendered your current policies obsolete? Concerned that you may have made your coverage choices based on the wrong critical factors? You're not alone.

The good news: The specifics of how an insurance company is set up, incorporated and operated likely don't matter as much as the specifics of what kind of coverage the firm offers and how well it takes care of policyholders. And you can determine those things by knowing what to ask when you go looking for coverage. Here are experts' tips for navigating the jungle of indemnity insurers, risk retention groups and mutual corporations that represent modern medmal.

"It may not be appropriate to state that there is a drawback to a particular type of insurance company," says Larry Laster, senior medical malpractice underwriter at Fairway Physicians Insurance Co., Westlake Village, "just that there are differences that a doctor must be aware of. ... [Doctors] should evaluate all the aspects of the coverage they need in addition to the premium, and then evaluate which type of carrier provides the best combination. Many times, the type of company is not a big factor in a doctor's decision."

So, what should be the big factors? Details about coverage, pricing and customer service matter most, says Summer Nagano Gray, assistant vice president, communications, at The SCPIE Companies, Los Angeles. "As with any important decision in life," she says, "potential insureds should do their homework--in this case, on the variety of medmal carriers offering coverage in their region."

Nagano Gray advises potential insureds to ask these questions:

1. How long has your company been writing medmal insurance in this region?

2. Are you an admitted carrier or non-admitted carrier according to the California Department of Insurance?

3. What limits of liability do you offer?

4. Do you offer prior acts coverage?

5. Do you offer a discount for new-to-practice physicians? Do you have a step-level rating plan? How does it work?

6. Are you endorsed by any medical associations or specialty societies?

7. Do you have just one type of medical liability policy or do you offer alternatives?

8. What are your policy benefits?

9. Do you offer free locum tenens coverage days? How many a year?

10. Do you provide compensation for insureds attending a trial? How much?

11. Does the coverage allow the doctor to report an incident while the policy is in force and still be covered if the incident turns into a claim after the policy has expired?

12. Do you require a membership contribution upon enrollment?

13. Do you pay defense expenses in addition to liability limits, or do you deduct defense expenses from them?

14. What payment options are available? Can I pay using a credit card? Can I pay online?

15. Do you require an insured's consent before settling a claim?

16. How financially stable is your company?

17. Do you provide legal defense reimbursement for disciplinary proceedings by state licensing authorities, such as the Medical Board of California?

18. When do you provide free tail coverage?

19. Do you offer a claims-free discount?

20. Is your Web site user-friendly and content-rich?

21. Do you have a 24-hour toll-free risk management hotline?

22. What kind of results do you get at trial?

23. Do you offer opportunities to earn continuing medical education credits?

Whether the company offers what Nagano Gray calls "personal service" should be considered as well. No matter what type of insurance company you're dealing with, the level of red tape you experience can be the make-or-break factor in your coverage decision. "All carriers say they provide high-quality personal service," Nagano Gray says. "So you should test it for yourself. Call the carrier and see how you are treated." Ask yourself these questions:

24. Did you end up maneuvering through an automated phone tree?

25. Did that work out well or make you more confused?

26. Did you speak to a helpful representative or did you get the runaround?

Intentionally low on Nagano Gray's list is the actual amount of cash the coverage costs. "Obviously, the price of a policy is an important factor for most physicians," she explains. "But they need to remember that it's just one part of the equation." Ask these questions:

27. Does the less-expensive policy provide you less coverage?

28. Will the coverage offer you peace of mind in the event of a lawsuit?

Choosing an insurer probably won't ever be fun. It's insurance, after all, not a trendy restaurant or a new car. But knowing what to consider and how to evaluate a carrier's responses to your questions can make the process less intimidating.