Bought NSO Insurance.. but worried about a particlar point....

RiskManager · Feb 21, 2016

https://allnurses.com/general-nursing-discussion/one-healthcare-risk-999441.html

Your question is addressed in my article and the subsequent comments. You are correct that your individual policy and the hospital policy likely both have an 'other insurance' clause. It varies by the statutory, regulatory and case law of a given state, but generally speaking, the insurance of your employer is primary even with the 'other insurance' clause, and since your individual policy is written as excess coverage, your individual policy will likely not be triggered for any malpractice claims that you are involved in. In some states, your own individual policy will be primary meaning that you will be named as a defendant to trigger your coverage, and in other states, your individual policy and your employer's insurance will divide up coverage. It all depends on what the appellate courts in your state have ruled on this. In those states without explicit case law, the insurance of your employer is primary, and your coverage will not be triggered to provide you coverage.

sallyrnrrt, ADN, RN · Feb 21, 2016

I have absolutely no faith in NSO, which I have been covered with, paid my premium for over a decade.....this past renewal period, when they invoiced me for renewal of MYPOLICY, I kid you not after submitting my payment, I was told that they were having problems "locating my account". My frustrated questions, that if they could not locate my account when I submitted payment for "my policy renewal".....how would they ever represent me in a claim?, went unanswered......Since they did not answer me, I don't think I have coverage....I demanded refund of payment, so I could purchase alternate coverage.....that request also was ignored....... I am very suspect of NSO.

Libby1987 · Feb 21, 2016

With the who's going to be primary/secondary question in mind, can I piggy back a couple of questions?

What about having/using prepaid legal for those, "you should check with your attorney" type situations? Whether clinical or HR related.

If you're in a DON or administrative position, how necessary and/or strategic is carrying individual malpractice insurance?

RiskManager · Feb 21, 2016

As a disclaimer, I know very little about pre-paid legal plans, but as a risk manager, I know that the contract/policy should spell out the details of what is covered and what is not. https://sites.legalshield.com/pdf/contractProvisions/V2ST25LAL.pdf is the contract for the LegalShield brand of prepaid legal plans for individuals. I see that section N on page 8 lists various policy exclusions, such as business matters or interests or any matters covered by any insurance policy. This makes me think that utilizing your pre-paid legal benefits to ask clinical or HR related questions would not work and the company will take the position that such questions are not covered under the plan benefits. Not to mention that the lawyers who sign up for these plans are usually general-practice lawyers and I would certainly not be asking a generalist for an opinion on specialty-specific matters such as clinical or HR issues. You would probably have a better chance of finding coverage for questions under a prepaid legal plan for businesses, but again, you would want to read the policy/contract to get a sense of what is covered.

In terms of getting an individual liability policy from CNA if you provide no clinical services, I wonder if there is a compelling argument to do so. http://www.hpso.com/Lists/CommonFormStateList/Attachments/3/cmcov3.pdf primarily provides coverage for liability claims resulting in injury arising out of a medical incident or professional services, all of which are defined in the policy. If you are not providing actual clinical care, I would think that coverage would not be triggered. Further along in the policy, you see an actual exclusion for any employment liability matters. So any employment claims against you by a staff member as a DON or administrator would not be covered. Any healthcare facility should have, however, D&O, commercial general liability or employment practices Liability Insurance that would provide coverage for your administrative or employment related issues. There are other coverages in the CNA individual liability policy that may appeal to you and make it worth the nominal cost per year.

Let me also make a plug that the current insurance carrier of your facility no doubt has people like me on staff who would be happy to answer questions and serve as a resource to you, probably making the entire issue of prepaid legal plans, etc. a moot point. You should always think about calling your insurance company for help or with any questions.