Should I Carry Nursing Malpractice (Liability) Insurance?

[sirI]

This question comes up frequently and is asked of me quite often, "should I carry malpractice protection?"

What is Malpractice?

Simply put, it is a failure to adhere to a standard of care or conduct by a professional such as a Physician, Nurse, Attorney, etc. Malpractice occurs when it can be proven that the professional had a duty to provide a standard of care/conduct, breached that duty, an injury or damage resulted, and the injury/damage was caused by the breach.

No matter how educated, confident, and careful the Nurse is, unintentional mistakes can and will happen. Accidents will occur. And, unfortunately, willful neglect can be an issue. Injury and death very often are the results of mistakes, accidents, and neglect. Families want to know what happened. Even in the best scenario, the Nurse feels embarrassed and ultimately fears what the damage could do to a perfect professional reputation. Nurses must have the option of protecting their professional reputations and personal assets. Having individual Liability Insurance is a smart solution.

Nurses will often make the following statement

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My employer covers me so I don't need my own malpractice/liability policy.

Yes, your employer's policy may cover you, but only up to a point. Remember: Your employer's policy is created to fit their specific needs and protects them first. You may even be told (by your employer HR) that you do not need your own policy. What they do not tell you is that they want you to be represented by their attorneys. They do not want "outside" representation for they know that their best interests will not be first and foremost.

All malpractice liability insurance policies have limits of liability. If you are only covered by your employer's insurance, other defendants employed at your entity may and probably do share your liability limits under the same policy. If you, as well as others, are named in a suit, your legal costs, including any settlement, could exceed your employer's shared liability limits. This would mean out-of-pocket expenses for you.

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What type of policy and how much coverage do I need as a Nurse?

These are questions that are very important when considering a policy.

Two Popular Policies

• Occurrence-based - any covered incident occurring while the policy is in effect even if the policy is now canceled and/or you have retired
• Claims-made - any covered incident only while the policy is in effect

The cost of a policy is economical and reasonable. For example, the annual premium could cover the first hour billed by Attorney. $1,000,000/$6,000,000 coverage premiums are approximate $100/year in most states for the Registered Nurse (RN) as well as for the Licensed Practical/Vocational Nurse (LPN/LVN).

Links of Interest

• CM&F Nursing Medical Malpractice Program
• American Nurses Association
• Nurses Service Organization

One major benefit of an individual policy that is often overlooked or taken for granted when considering coverage is license protection. Nurses need to be aware that this will extend beyond their employer's coverage and includes discipline issues that can be brought up by the individual Nurse's Board of Nursing (BON). Many Nurses do not have the financial ability to go against the BON, therefore, license protection is a must.

Another all-important beneficial consideration is that policies normally will include coverage regarding libel, slander and patient confidentiality, including HIPAA issues. These issues can be troublesome and include a great cost for the Nurse.

Finally, a common statement that is incorrect and based on myth ...

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Malpractice liability insurance will make me a target and I'll be named in a lawsuit.

When being named in a lawsuit, no one knows you have your own personal policy unless you have revealed this information. Only after a lawsuit is filed and only during the period of the discovery phase is this information available.

So, do you carry your own individual malpractice/liability insurance? In the end, the question of whether or not the Nurse should carry malpractice/liability insurance is a personal one and should be seriously considered.

The peace of mind knowing that you are covered is overwhelming.

The peace of overwhelming reassurance.

[mgrtype]

From your screen name, I am going to leap and assume you are an L&D nurse or women's health specialists. I can appreciate your comments, as I too have this background. I still believe if you are doing the best to provide care based on AWHONN, ACOG standards, and have done a thorough documentation of events, ultimately, the hospital insurance should cover you in the event, even if the outcome was not as good as you would have liked. I have been a nurse for 25 years, and, although I do not have the additional 25 years of knowledge to fall back on, I do believe (from personal experience), knowing what the scope of practice is, and knowing the standards for the professional organizations that support your practice as well as hospital policy will be what is necessary to protect a nurse from liability. It is true that others have selective memory, and physicians are not your friend if it's us vs. them.

[sirI, MSN, APRN, NP]

mgrtype said:

If a nurse is following hospital policy, and an event occurs, the hospital liability insurance would cover her and any costs associated with a lawsuit.

It is important to check the type of liability coverage you have through your employer, and to evaluate whether you should purchase an additional professional Liability Insurance policy because defending an allegation of malpractice can be financially draining. Your employer's policy may cover you, but only up to a point.

Your employer's policy is designed to fit their own needs and protect their interests first. If you have your own individual protection, you will have the benefit of your own representation, when needed, that is concerned specifically with your interests.

Remember...

All malpractice insurance policies have limits of liability. If you are only covered by your employer's insurance, other defendants employed at your entity may and probably do share your liability limits under the same policy.

If you, as well as others, are named in a suit, your legal costs, including any settlement, could exceed your employer's shared liability limits. This would mean out-of-pocket expenses for you.

[mgrtype]

Much would depend on the organizaton a nurse works for. I think we will agree to disagree here. I do not want to carry an additional policy, just more for the lawyers to go after............

[Birdbr]

Question: Should certified nursing assistants get covered?

Thanks.

[sirI, MSN, APRN, NP]

Birdbr said:

Question: Should certified nursing assistants get covered?

Thanks.

Hello, Birdbr and thank you for your question.

It is my opinion that yes, CNAs should be covered. You can get free online quotes from Healthcare Providers Insurance Coverage . Premiums are around $50/year.

LTC is a highly litigious area and CNAs are found there in large numbers. The liability for CNAs in that environment is one that having adequate coverage is a must.

[lamazeteacher]

mgrtype said:

From your screen name, I am going to leap and assume you are an L&D nurse or women's health specialists. I can appreciate your comments, as I too have this background. I still believe if you are doing the best to provide care based on AWHONN, ACOG standards, and have done a thorough documentation of events, ultimately, the hospital insurance should cover you in the event, even if the outcome was not as good as you would have liked. I have been a nurse for 25 years, and, although I do not have the additional 25 years of knowledge to fall back on, I do believe (from personal experience), knowing what the scope of practice is, and knowing the standards for the professional organizations that support your practice as well as hospital policy will be what is necessary to protect a nurse from liability. It is true that others have selective memory, and physicians are not your friend if it's us vs. them.

Your capability to perform tasks perfectly can be altered when rushed!! Not having malpractise insurance for yourself, is like going to work blindfolded and nude!! You're anything but objective, if/when you have participated in an "incident". The lawyers for patients, facilities, etc. aren't looking out for you, believe me (not that I've had to experience such a thing, thank goodness).

You need a professional with knowledge of how laws work, how Judges see circumstances, and what's best for YOU. It says a lot for nurses, that the premium for our protection by the most utilized insurance program is so low. But don't rest back on others' laurels! You need your own representation in legal maneuvers; and you can bet hospitals pay big bucks for theirs.......

I think that nurses who believe that hospitals/employers will protect them in very costly lawsuits, is mistaken and implies a need to place them in a parental role - NOT!!

[P_RN, ADN, RN]

I am nowhere as eloquent as the former nurses who have posted.

All I can say is..................yes........always have had it and will have it till they take my stethoscope out of my cold dead hands.

[NCFlyGirl]

Hummmm interesting topic. I do not and have never had my own malpractice insurance and have been a nurse for 30 years. I've never been named in a patient legal suit despite having worked in a large trauma center. I say never named in patient legal suit but did have an "interesting" suit brought against me as well as 2 of the nurses I worked with. Another nurse who was assigned to me (I was the OR Evening Coordinator) brought a civil suit against us for the sum of 30 million dollars! Not that's not a typo. We were in report, she stood up and said "you didn't wish me a Happy Hanukkah". I said, "Oh, I'm sorry, Happy Hanukkah" and went on with our report. Some months later she was terminated after compiling a number of safety infractions. I was not involved with her termination process as she'd left the evening shift by then. Shortly after that we were investigated for anti-semitism. After the investigator gathered the facts the suit was rejected. No real point here just something that comes to mind when someone mentions malpractice insurance.

[lamazeteacher]

I'd like to apologize to NCFlyGirl, for the rudeness of the (possibly) Jewish person with whom she once worked. Since you may not know many Jewish people, I'd like you to know that most of is don't expect to be wished a "Happy Hannukkah". It is really a less important celebration, but due to the Christmas lavishness, Jewish families try to make it special so their children won't resent being Jewish. I discovered that I was Jewish when I was 8 years old, and a neighborhood child called me a "dirty" Jew. That was during WW II.

Anti-semitism does exist, but the incident you describe is definitely not indicative of it. Usually it is hidden, but causes prejudicial treatment, such as being excluded from membership of a social club. I wish prejudice didn't exist, and that people were accepted on their own merit, but that is an ideal that isn't likely to happen in my lifetime.

When I announced that I would teach the nurses I supervised at a Home Health agency in VA, I was discouraged from doing that. My superior administrative nurse finally said, "They can't learn". I replied, "They are learning. You should see their charting now". After it was shown to her, the response she gave was, "Now they'll want more money!" I was flabbergasted..... You can guess what population it was that I taught....... a real southern experience.

I've not thought of my religion as a persecuted group in this country, since then. Others have it far worse!

[scoochy]

When choosing malpractice insurance, carefully examine coverage. I have carried it for 28/30 years of my career. When I was examining fees, attorney fee reimbursement was less than 50% of the going hourly rate for attorneys in the area in which I live. Pay a little more for better protection!

[reidob]

A very interesting string. I have been practicing for 20 years, including 10 in an ICU in a major trauma center, and I have never carried my own malpractice insurance. Not that I can bring any great evidence to bear to why I have chosen not to do so, but most of the best informed opinions I have been able to garner have said that it is not needed if you work at a major instituion (I work for the state), and may in fact open you up to being named when you might not have been otherwise. I know, I know, all of this has been discussed here already, but I am left no less confused than when I started. But in reading every single one of the 119 posts before this one (oh, yes, I did!), I find not a single instance where anyone has any personal experience with using the insurance, or even knows anyone who has! So, how am I to know that it is valuable or worthwhile to have? How am I to know if the insurance company will be the one to "throw me under the bus", as opposed to my employer? Yes, it's a small price to pay for peace of mind, but I hate the idea that I am paying even a dime for something that is not worthwhile. I have been perplexed on this question for my entire career.

[nurse2033, MSN, RN]

I heard that if you carry your own insurance it's more likely you will be sued because they know they can get more out of you. Does anyone know if this is true?