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.

[elkpark]

A number of people here have also posted that they have coverage as a rider on their homeowner's insurance. I don't know the details of how that would work; I have always been more comfortable dealing with a company that specializes in Liability Insurance for nurses.

[employeeadvocate]

It seems like such a small price to pay for such a large amount of protection. There would be no reason not to have it. Do you find that most nurses also have income replacement insurance provided through their employer or privately? That way they still have income in the event of being temporarily removed from their position?

[Libby1987]

I just searched and found this thread.

I'vc been having this conversation for the last 24 hrs.

I don't have a high probability of huge med type errors in the home setting. What am I going to do, put a wound vac on backwards? But with the higher acuity patients being sent home, some that are on the fence for being appropriate for at home care, it's the documentation and/or action or lack of action when they start to deteriorate.

It's tricky these days in HH with fewer dr's taking call on night/weekends with the trend for 3-4 office days/week and the pressure to avoid unnecessary ER visits. Re-admission rates have never been higher it seems and no it's not because of some harm I caused. But what might seem like perfect logic based on experience can look like poor judgement in hindsight after the patient is sitting in ICU and you're not the one who called for ambulance transport.

On top of that just transitioning onto EMR and not being 100% confident with the charting.

I'm signing up for the insurance.

[Rose_Queen, BSN, MSN, RN]

In the hopes of bumping this thread up since so many people ask about malpractice insurance, I have my own policy and am of the opinion that every nurse should have his/her own policy so that they have someone looking out for their best interests, not the best interests of the facility/group paying the premium. At around $100/year, it's worth the peace of mind and added benefits of representation in front of the BON and coverage for such things as HIPAA violations (not that I intend to be involved in either situation).

[smartnurse1982]

Does anyone think it would be silly to purchase 2 malpractice insurance policies?

I have had NSO ever since i became a nurse,which was 11 years ago.

[JustBeachyNurse, LPN]

smartnurse1982 said:

Does anyone think it would be silly to purchase 2 malpractice insurance policies?

I have had NSO ever since I became a nurse,which was 11 years ago.

Why would you want two policies? Who would issue duplicate coverage?

[EternalFeather]

I have a question: would the insurance protect a nurse from accusations to the board from other nurses?

I'm a new nurse and I've been told that I need to watch out cause there are other nurses that for reason are jealous and they are going to find even the littlest mistake and make it into a big issue, then try to bring a complaint to the state board of nursing so you will lose your license.

[JustBeachyNurse, LPN]

EternalFeather said:

I have a question: would the insurance protect a nurse from accusations to the board from other nurses?

I'm a new nurse and I've been told that I need to watch out cause there are other nurses that for reason are jealous and they are going to find even the littlest mistake and make it into a big issue, then try to bring a complaint to the state board of nursing so you will lose your license.

Yes any accusation whether by a BoN, patient, colleague, facility, family

[PS0812]

As a clinical nurse I always thought that I should have my own malpractice insurance. I knew - as I was told - that the hospital covered all their nurses for malpractice. Once I left the clinical setting and started working for an insurance company my opinion changed. I was asked to review a case (at my former hospital) in which it was my opinion the nurse was negligent (short story, she failed to recognize impending signs of increased intracranial pressure). The patient died and the family sued the hospital, the neurosurgeon and the nurse. The hospital under the doctrine of respondeat superior (let the master answer), the neurosurgeon (who had his own insurance) and the nurse who felt she had coverage not only through the hospital but her own malpractice policy were all sued. When you look at a malpractice policy, under the conditions section, there is wording to the effect that "If any other coverage is enforce at the time of the occurrence, this policy is secondary". Both the hospital's policy and the nurse's policy had that statement (as they all do). Well, when the nurse was asked (by the hospital's risk manager) if she had malpractice insurance - which she did, the hospital denied coverage based upon the "If any other coverage is enforce......." clause. So she put the claim under her coverage only to find out she had no coverage for the exact same reason. She had to, at her own expense, hire two attorneys. One to defend her in the malpractice action and one to sue both insurance companies for coverage. After much and costly litigation (at her expense), she eventually won coverage (by court order) under the hospital's insurance policy. The defense attorney for the hospital told me that if I worked for a hospital to never have my own policy as I would find myself in the same boat should I be sued while in the course/scope of my employment. I learned a valuable lesson at someone else's expense. I caution all of you to read and understand all aspects of your personal malpractice policy, should you have one.

[RiskManager]

The above scenario by PSO812 is not unusual. Your Liability Insurance from CNA or Liberty Mutual has an 'other insurance' clause and the hospital's insurance also usually has an 'other insurance' clause. You may be stuck in the middle with each insurance company denying coverage for a claim. Many states have appellate court decisions in which this issue has been previously considered and a legal decision handed down that specifies which insurance company responds. Sometimes it is the hospital insurance, sometimes it is the nurse's insurance, and sometimes they both respond on a 50/50 basis.

There is a reason why nursing liability insurance for the typical nurse is so cheap. It is because they rarely pay any claims. And the reason they rarely pay claims is that coverage is denied under the 'other insurance' or 'excess insurance' clause. Generally speaking, the hospital is on the hook for your liability as an employee.

There may be good reasons for you to purchase your own liability coverage, which I have discussed elsewhere, but you need to purchase it with your eyes open after researching the issue, and not just assume that the insurance company is going to always cover you and fight vigorously for you, in exchange for your $ 200/year premium.

[BIGT68]

Yes, I have malpractice insurance, u hope u never need it, but it is a nice thing to have in the event u ever have to use it

[Pancheta]

Yes you Should. It is inexpensive.