Am I covered for malpractice under my personal lines homeowners' policy?

Nurses General Nursing

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Specializes in Healthcare risk management and liability.

Copied and pasted from the discussion in correctional nursing. I was asked to repost this so a wider audience could see it. I was responding to some comments about nursing staff being covered for professional liability under their homeowners' policies or an endorsement or rider on that policy.

Anyone who thinks that they have healthcare professional liability insurance under their standard personal homeowner's policy or personal umbrella policy is probably wrong. There is an exclusion in the policy that applies. Almost all insurance policies written in the USA are based upon ISO standard forms. The Insurance Services Office (ISO) writes template insurance policies for insurance companies. This means that most insurance policies have pretty standard language, although an individual insurance company can and does modify the language to suit their needs or the legal or regulatory requirements of a given jurisdiction.

The typical homeowner's policy is written on ISO HO-3 forms. This form is designed to provide property and liability coverage for the homeowners so if your house burns down or someone trips on your sidewalk you are covered. There are other HO forms used in special circumstances but a sample HO-3 form can be found below:

http://www.google.com/url?sa=t&rct=j...,d.cGU&cad=rjt

The ‘exclusions' section is what you want to look at, and you can find the pertinent part on page 18 of the sample policy. ‘Coverages E and F do not apply to the following: 3. Professional services: ‘Bodily injury' or ‘property damage' arising out of the rendering or failing to render professional services.' This exclusion means that any malpractice claims for you causing bodily injury to someone are not covered by this insurance. This exclusion of healthcare professional liability has been so interpreted pretty consistently by appellate courts across the country. A number of healthcare professionals over the years have sued their homeowners' insurance company in an attempt to get coverage and have been unsuccessful. This has also applied to other professionals, like accountants, lawyers or engineers who have tried to get their homeowners' policy to pay for a liability claim arising out of their profession. If your homeowners' insurance is written on a different form, it probably has similar language.

Now, having said all of that, this is a big country, and it is possible that a particular insurance company may issue an endorsement or rider on the standard personal homeowners' policy that provides some level of healthcare professional liability coverage and modifies or removes the standard exclusion, but I would have to see the policy language with my own eyes to believe it. Professional Liability Insurance Definition | Investopedia on the no coverage under a homeowners' endorsement.

You can get healthcare professional liability coverage on certain types of business policies or a business umbrella, but we are talking about personal lines here. The other issue that would come up is the standard 'other insurance' clause in the policy that would make your homeowners' excess over any other policy that covers you, such as your healthcare employer's professional liability policy that covers you for your negligence as a healthcare employee.

If anyone thinks that they have healthcare professional liability coverage via their personal homeowners' policy, then I would urge them to immediately write the underwriting department of that insurance company, with a copy to their insurance agent, asking for something in writing confirming that healthcare professional liability is a covered exposure under your personal lines homeowners' policy or any endorsements or riders. You cannot rely on your insurance agent or broker, since they generally do not have the authority to bind the insurance company to how the policy is interpreted. Only the insurance company can do that. You could also print out this message and ask your agent to comment.

Specializes in Healthcare risk management and liability.

I was asked for a sample letter or email to the insurance company about coverage. Here is what I would write:

Date

Your name

Your policy number

TO: XYZ insurance company, Underwriting department

To Whom It May Concern:

I purchased a personal lines homeowners' insurance policy from your company. Part of the reason that I purchased the policy (or rider or endorsement) was the representation that it would provide me healthcare professional liability coverage for my work as a nurse. I would like to find out if this is correct. Can you please confirm for me in writing that if I am named in a healthcare professional liability claim or suit from my actions as a nurse that I will have primary first-dollar indemnity and expense liability coverage under the policy (or rider or endorsement). Thank you for your help.

Your name

And I would copy this to my insurance agent, broker or whomever sold me the policy.

I will tell you as a licensed insurance agent (yes I have 2 licenses!) that professional liability is NOT covered under a homeowners policy. You need a separate policy.

To that end, I'd suggest anyone who travels between work sites during the work day or otherwise uses their personal car for work purposes inquire if their auto insurance covers you.

It probably doesn't.

Specializes in Healthcare risk management and liability.
To that end, I'd suggest anyone who travels between work sites during the work day or otherwise uses their personal car for work purposes inquire if their auto insurance covers you.

It probably doesn't.

Typically, your personal auto policy insurance company does not get too worked up in terms of using your personal auto for incidental business purposes such as traveling between sites or the like. They are likely not going to exclude coverage for any accidents.

They would get worked up for using your personal vehicle for hire (taxi, Uber, etc.) or as a courier vehicle for work, which is usually defined as a business purpose that would likely not be covered under the personal auto policy.

Specializes in PACU, pre/postoperative, ortho.

I carry NSO, but also use the same insurance co mentioned in that thread (I believe). They actually do offer a specific policy for nursing liability but it was more expensive so I never checked into it further.

Specializes in Healthcare risk management and liability.

NSO is actually an insurance agency that is owned by Aon Affinity, a very large insurance company. All, or almost all, of the nursing liability policies placed by NSO are with a subsidiary of CNA, so CNA is the actual insurance company. ProLiability, another insurance agency that places a lot of nursing policies, uses Liberty Mutual as the actual insurance company. So NSO and ProLiability sell the insurance, but the actual policies are written by CNA or Liberty Mutual.

Specializes in MICU, SICU, CICU.

Very informative. This should be on the article page.

Specializes in Emergency & Trauma/Adult ICU.

Thank you for this thread. I'm surprised to hear that anyone would leap to the conclusion that a typical homeowner's policy intended to cover damage to property and, to a limited extent, the personal actions of the homeowner, would also cover professional liability. But it's good to have factual information spelled out.

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