Not every new insurance idea is a roaring success out of the gate, but a change in delivery model helped jumpstart the success of one of NAS Insurance Services many specialty programs, the firm's leader reports.

Richard Robin, chief executive officer of NAS Insurance Services, described the evolution of MEDEFENSE, a policy covering physicians and health care entities for defense costs and fines and penalties resulting from various types of regulatory investigations, including probes of Medicare and Medicaid billing errors and fraud allegations.

Mr. Robin explained that the concept was developed in the 1980s, when some physician groups and associations approached the Encino, Calif.-based managing general underwriter to develop a product to cover defense costs associated with peer reviews, hospital credentialing and state board proceedings.