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]

kriziabrown said:

That is a pretty interesting topic to think about. When I think of malpractice I automatically think of a doctor. I didn't know nurses need to have malpratice insurance. Do the hospitals cover that or how does that work??? I guess i would not get it either hearing that story makes me think about it. But if a nurse makes the error would you get sued as a person or would they just sue the hospital directly??? This is a bit of a confusing topic to me that I would like to know more about.

Have you read the rest of this thread? All those issues are discussed earlier in the thread. There are also several other threads on this site discussing the pros and cons of personal professional liability ("malpractice") insurance.

[sirI, MSN, APRN, NP]

kriziabrown said:

That is a pretty interesting topic to think about. When I think of malpractice I automatically think of a doctor. I didn't know nurses need to have malpratice insurance. Do the hospitals cover that or how does that work??? I guess i would not get it either hearing that story makes me think about it. But if a nurse makes the error would you get sued as a person or would they just sue the hospital directly??? This is a bit of a confusing topic to me that I would like to know more about.

Hello and Welcome to the Medical-Legal Argot Blog.

elkpark is correct. Please review the first post of this thread and your questions will be answered.

[RkfdNurse1]

Absolutely YES, get malpractice insurance!!! I had been a nurse for over a year when a fellow nurse stopped me in the hallway and asked me what I thought about the whole lawsuit business. When I asked "what lawsuit business" she gasped and said "follow me". I followed her into the locker room where she proceeded to pull a subpoena out of her bag. At the top of the document, listed under defendants.....there was my name. I immediately felt sick to my stomach. I hadn't been served yet so she suggested I go home and buy insurance before it's too late. I got the insurance and it helped with a little piece of mind. I called the company attorney defending us and was told I was on the defendants list because I made 1 entry into the nurses log since I floated to that unit for the one day. It has been 3 months since I saw the subpoena and I have yet to be served. The other nurse that originally told me about this found me the other day to see if I had been served yet. When I told her no, she said she had heard the family amended the lawsuit to include just the doctor. I would have NEVER expected to see my name on a subpoena for malpractice because I really try to cover all my bases when at work. I love having the piece of mind that this insurance gives. Besides I found out the companies we work for are always being sued for malpractice. It's just kept very hush hush. To me it is very much worth the $99 a year I pay. Don't work without it.

[wvgi]

I have had malpractice insurance since a student over 30 years ago. We were required to have it before we could step foot on the hospital floor for clinical rotations. I have never let it slip. I have had it with the same carrier all these years. I pay about $90 a year for mine.

I agree you can be sued just like the MD and the hopsital/facility may cover you at the time but can also come back and sue you to get the money back. Better to be safe thatn sorry.

[elkpark]

Also, again, it's not just about being sued. For nurses, the risk that you will ever be sued for malpractice is quite slim. However, most insurance policies for nurses also cover you (pay for legal representation) if you're called as a witness in a lawsuit against someone else or have to appear before the BON to defend your license. Either of those situations is more likely to happen, over the course of your career, than being sued; in either case, you'd certainly want to have an attorney; and, in either case, paying for an attorney out of pocket would likely cost you quite a bit more than the sum of your insurance premiums over your career.

[Kittyfeet]

I really want to get insurance.. we purchased it through the school as students and I feel like if we had to do it then, there was probably good reason and we should still do it. However I heard someone say something like "if you have nothing to go after the lawyers won't try to go after you because it's not worth it to them, but if you have insurance they will know and they will go after it". Any thoughts on that? Regardless of that though, I think I would feel better with it, I already checked out a quote on NPO and it looked pretty good.

[sirI, MSN, APRN, NP]

Kittyfeet said:

I really want to get insurance.. we purchased it through the school as students and I feel like if we had to do it then, there was probably good reason and we should still do it. However I heard someone say something like "if you have nothing to go after the lawyers won't try to go after you because it's not worth it to them, but if you have insurance they will know and they will go after it". Any thoughts on that? Regardless of that though, I think I would feel better with it, I already checked out a quote on NPO and it looked pretty good.

Your question has been addressed in this blog. Please read through this blog and you will see what we've said about this very thing.

[DJ71]

Be cautious about where you get your malpractice insurance. I have had NSO since 1998 and in past year have had very frustrating experiences with them. I'm an independent contractor, legal nurse consultant, and company I was contracting with required changes in my coverage to include them before I could do any work for them. It took several months and numerous emails, faxes, and mailings to finally get it taken care of. Later I took an online CE course they provided with promise of 10% credit on policy cost. Again, I have sent numerous emails, faxes and mailings requesting this credit and recently made partial payment of my premium including complete rendition of the events. Today I got a letter from them asking for the remainder of the premium without any referral to my letter and reason for partial payment. I am currently looking for a different company and will change my policy ASAP. I'm sure I will never get a refund on what I've paid but I am very concerned about what will happen if I ever have a malpractice claim.

[deidreparkinson]

Has anyone else had problems with NSO insurance? I will be a first time buyer.

[starletRN]

deidreparkinson said:

Has anyone else had problems with NSO insurance? I will be a first time buyer.

I haven't had any problems with them so far.

[mgrtype]

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. If a nurse carries personal liability insurance in addition to the hospital liability insurance, the plaintiff can and will seek out the nurse individually, and often the company from which a nurse is insured is in a different state from where he/she is currently practicing, thus complicating any involvment from the private attorneys. The plaintiff wants the deep pockets, and if the nurse is carrying personal liability insurance, I believe they are more likely to be sought out personally. If you talk to an attorney that is in the business to make money off of a nurse's anguish, then they will strongly urge you to carry personal liability insurance. If you talk with corporate attorneys, they do not beleive this is additional protection for the nurse (unless they were practicing outside of the scope of practice, or hospital policy during the event). This would definitely have to be a personal decision, and evaluation of one's own practice patterns.

[lamazeteacher]

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.

The coverage for the hospital, a much more lucrative client will be the priority of their insurance company. When "Push comes to shove", especially in these economic times, nurses without their own policy could find themselves the scapegoat.......

If a nurse carries personal liability insurance in addition to the hospital liability insurance, the plaintiff can and will seek out the nurse individually, and often the company from which a nurse is insured is in a different state from where he/she is currently practicing, thus complicating any involvement from the private attorneys.

Reading the policy regarding legal representation is an essential part of the private insurance policy (yet you only get the policy to read, after paying for the insurance, unless you can read the policy of a colleague who has that insurance), to see if attorneys from any state in which the trouble happened, are covered.

The plaintiff wants the deep pockets, and if the nurse is carrying personal liability insurance, I believe they are more likely to be sought out personally. Not necessarily, most lawsuits sweep everyone up, and if the nurse has no private insurance and the hospital's insurance company's legal representation isn't helping him/her, you may find yourself having to pay for your own legal representation, which could require a huge "Up front" fee you don't have, called a "Retainer fee".

If you talk to an attorney that is in the business to make money off of a nurse's anguish they don't think or talk anguish, unless they're pleading in court for a victim of malpractice - most attorneys don't care about nurses' anguish at all....., then they will strongly urge you to carry personal liability insurance. If you talk with corporate attorneys, they do not believe this is additional protection for the nurse (unless they were practicing outside of the scope of practice, or hospital policy during the event).Sometimes that happens in a crisis, without being realized. Perfection is nearly impossible to achieve, even in the best of circumstances. This would definitely have to be a personal decision, and evaluation of one's own practice patterns.

Good, appropriate practice patterns during a calm time are usually great, but when a patient "Crashes", and everyone is yelling at each other, it's harder, if not impossible to achieve. Also, when the dust clears, the others involved in the crisis will have "Selective" memory to save their own hides.

I hate to be so pessimistic, but I've been in nursing just about 50 years, covered cpr responses to critique them, and heard the fallout. It's not pretty, as most of us have self serving instincts.