Should I Carry Malpractice (Liability) Insurance? - page 13
This question comes up frequently and is asked of me quite often, "should I carry malpractice insurance?" Many nurses are covered under their own individual liability insurance carrier. Many more are not. I am ... Are you?? ... Read More
- 0Jun 2, '10 by reidobA 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.
- 1Jun 7, '10 by lamazeteacherQuote from Post# 120 by Reidob
"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. "
Right above the space for this reply, is an ad for liability insurance for massage therapists for $165/year. They don't usually make as much as nurses do, as they're on their own and have overhead.
The one economically reasonable insurance company for nurses has lower premiums, but I have heard that you get what you pay for, with them. In the thread about 2 nurses in Texas who were sued by a doctor who they reported, there was a post stating that the legal representation through that insurance company is sketchy.
I do know that malpractice lawyers generally sue everyone in sight of a medical maltreatment case, and they'd even sweep up the floor sweeper if they thought that might provide a larger purse. Doctors have lamented their legal vulnerability and the huge premiums they pay for coverage, but in all the years I've worked (about 50), none of the sincerely personable ones with insurance have been sued to any extent. It's the nasty types that get sued more. Communication skills and patient involvement in decisions, is key! Premiums are so high because there are too many incautious errors made, that damage patients considerably and are quite costly in human life and the quality of existance. Where there is no damage, there is no case.
A friend of mine who was an OB/GYN (now deceased) had a sign in his waiting room that said, "I have NO MALPRACTICE INSURANCE. If you sue me, you might get whatever my old, rundown house is worth. My children have college funds, which are untouchable, and my wife has one fur stole." He had a wonderful sense of humor and a very caring attitude (not so, his partners), and was never sued in 40 years of practice (his partners had lots of them).
I used to have the insurance that was available for $67/year, but it really never gave me peace of mind. What did give me that, was the knowledge at the end of each shift, that I'd performed the tasks assigned to me, to the best of my ability, gave the right medications in the correct dosage to the right patients, and showed them that I cared about their wellbeing, calling their attention to their well located call buttons, frequently. I never held back on pain meds as ordered, giving them in a timely and judicious manner; and called their doctors for higher doses of it, and/or a synergistic med when appropriate. If I thought a wound was supperating, I took VS and a culture of it, and got an order for that later, when antibiotics were ordered. I made sure that all tubes and wires were connected correctly, IVs dripped away through those newfangled pumps and that skin pressure areas were clear, etc., etc., etc. (as the King of Siam would say).
It's not what you do, but how you do it that will spare you considerable ire.
- 2Jun 7, '10 by elkpark"The one economically reasonable insurance company for nurses has lower premiums, but I have heard that you get what you pay for, with them. In the thread about 2 nurses in Texas who were sued by a doctor who they reported, there was a post stating that the legal representation through that insurance company is sketchy."
And the reason for that was discussed in that thread -- the charges against the two nurses had nothing to do with their nursing practice, so they were not covered for that by their professional liability insurance. Malpractice doesn't provide coverage for any legal charges/complaints that might ever happen to you -- it covers you for charges/complaints related to your clinical practice, just like your automobile insurance doesn't cover you for anything other than automobile accidents. That situation had nothing to do with the services provided by the insurance company being "sketchy." As with any kind of insurance, it's important to understand what the policy you're purchasing covers and what it doesn't.
- 0Jun 9, '10 by lamazeteacherResponse to Elkpark's post # 123
I didn't agree when someone posted the excuse given (? by the malpractice insurance company), that the event wherein a doctor's medical ethics were reported as objectionable, by 2 nurses (only the one who sent in a written complaint was sued by the doctor for doing that). The location at which that happened was in a remote part of west Texas, where there may not have been an attorney the insurance company could recommend/hire. I'd buy that, sooner than I'd believe that fulfilling a nurses' obligation to report aberrant practise of patients by another health care provider. That is something within the role of being a patient advocate, which nurses are.
Automobile insurance covers many things other than accidents: theft or vandalism to the car, theft of the car's contents or outer decorations (like the symbol/figure of the manufacturer on the hood), damage that occurs when a permitted, licensed person borrows a car with permission. Harm that occurs to anyone in the car, due to being kidnapped in it, crowds that rock the car, causing damage, cracks to the windshield caused by a stone (although if the policy's deductable is greater than the cost to repair/replace the windshield, the owner may elect not to report that), etc.
Automobile insurance also covers the cost of a rental car for the owner, usually while repairs of damage caused by an accident or other occurence such as those above, occurs. There's usually a period of time given for renting a car, based on the extent of repairs needed, and how long the repair should take. The tax and extra insurance offered by the car rental company, isn't paid by the insurance company.
I refused the extra insurance (it comes at a high price) when I rented a car while my car was repaired after an accident, and I was rear ended by an uninsured motorist. There were only scratches on the back bumper (which is quite flimsy) and the rental company insists that their body shop with which they have a contract - which involves a monthly minimum number of cars brought to that shop (I went there to get some idea of what their charge might be). They said that since it was their car, the had the right to choose where the repair is done. The cost of the repair done at their choice of body shops was over 3 times that of another body shop. The car rental company also charged a $100 "executive fee", in the bill I was sent.
I'm sharing the above, although this thread is certainly not about insured car repairs, because nurses rely heavily on their vehicles, especially when working in Home Health. Perhaps my experience will forewarn other nurses of the excessive charges that can occur despite insurance coverage.
- 2Jun 9, '10 by NRSKarenRN, BSN, RN Admingreat ana series:take control: a guide to risk management
the importance of professional liability insurance in managing risk
all professionals incur the risk of being sued and of losing a substantial judgment. often guilt or innocence has less to do with the outcome than does the public's perception of a plaintiff's needs. risk is real. the issue is how one should efficiently manage risk, including its transfer to institutions skilled at managing it. and healthcare professionals' risk is increasing because of a number of factors...
to purchase or not to purchase, that is the question
many nurses believe that if they purchase professional liability insurance, they will increase their chances of being named in a malpractice suit. many employers encourage this notion, as it is easier and more economical for an employer to manage a liability claim if the interests of individual employees are not being individually protected. the fact is, however, that most. lawsuits are filed before a plaintiff's attorney has any knowledge of whether a defendant has insurance or not. it is only during the discovery phase that this information is learned. and, in today's world, the plaintiff's attorney will name everyone who is remotely connected to a patient's care in order to have the largest sum of money available as possible to satisfy a damage award. if you have signed the chart, you will probably be named, even if the care provided is tangential to the events which actually caused the injury.
other nurses believe that their employer's professional liability insurance provides all of the coverage needed. while this is certainly true in the majority of cases, there may be instances in which the interests of an individual may be in conflict with that of the employer. in fact, if the event leading to a malpractice claim was contrary to the policies and protocols established by the employer and the employer is sued, the employer can file a claim against the practitioner to recover awarded damages and attorney fees.
a third reason for considering the purchase of personal professional liability protection is for acts performed outside of the scope of employment. as an example, if a nurse accepts a moonlighting position, a full-time employer's insurance plan will not cover any adverse events. nurses are commonly called upon by friends, neighbors, and relatives to assess a medical situation and to provide care or to suggest a course of action. if erroneous advice or care is given, the nurse can be sued for the resulting injury. again, the employer's policy would not respond as the event did not occur in the course of employment activities; the nurse would be personally liable for all resulting expenses. and what about good samaritan acts such as stopping to assist in an automobile accident or attending to a person who falls on the street? while most states have good samaritan statutes which prevent making a claim against an individual who assists another without being remunerated for care given in an emergency situation, individual events such as a claim for gross negligence could waive the protection afforded by such a statute. and, furthermore, these statutes, although providing some protection against loss, do not protect against being sued and incurring the cost of defense.
if, after understanding the limitations of employer supplied liability insurance, a nurse makes an informed decision to rely on this risk transfer vehicle, he/she should investigate the nature of the policy/plan affording the protection. it might also be advisable to request a copy of your employer's policy/plan and have it reviewed by an insurance professional.
- 2Jun 9, '10 by elkparkLamazeteacher -- you are certainly correct that auto liability insurance covers all those things, in most cases. However, all those things are still related to owning and operating your car. Professional liability (malpractice) insurance covers you for issues related to your professional practice. In the case of the two nurses in Winkler, TX, while they were certainly advocating for the hospital's clients and we all agree that advocating for clients is part of nursing's role, in this particular case, they were charged with a felony (criminal charges) -- misusing medical information, specifically -- not sued for malpractice by anyone. As sirI noted already, no insurer's malpractice coverage covers you for criminal charges. (Likewise, most automobile liability policies include an exclusion for criminal acts -- if you have an automobile accident while using your car to commit a criminal act, you're not covered). Certainly, when considering purchasing any kind of insurance, it's v. important to be aware of the policy covers and what it doesn't.