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.

[ivy1]

Yes I agree it's good to have it, but I don't flaunt it. A few pts in my career have hinted on the subject, however I just mention that the hospital covers us, because I do NOT want them to know that I have it, otherwise they might think I could be sued personally for any wrongdoing, or think that the hospital has deep pockets with an extra back pocket (my pocket!!) So I keep it under my cap.

[Elvish, BSN, DNP, RN, NP]

I mentioned earlier that I have it, but I don't advertise the fact either. First, because it's really none of anyone else's business. But beyond that, I don't want anyone forming any theories about why I have it or why I'd need it, or anything. I do my best every day but have no illusions about the hospital being my friend should something awful happen. If they stuck up for me, it would be a most welcome, pleasant surprise, but I surely won't count on it to the point of not insuring myself.

[KeepingItRealEeyore]

One should carry malpractice insurance. I had malpractice insurance for student nurse when I was in nursing school, and definitiely got it once I became an RN. It doesn't matter where you work , when the crap hits the fan, it is everyone for themseleves. make sure you are protected, because the company only protects the company, not its people. That is just my .

[starletRN]

I was told recently from a student that their instructor told them they didn't need to have it when they got their jobs because the hospital would cover them. I immediately let her know that was not the best advice.

I'm not sure if that's happening a lot in NS, but my school definitely advised us to get it.

[letarn2b]

I thought you needed mal insurance once you start nur school.our school requires it.

[GiGiOm]

I carry it. Better to have it and not need it than need it and not have it. It's cheap. NSO has a good program. That's what I carry. But DON'T tell anybody you've got it!

[starletRN]

letarn2b said:

I thought you needed mal insurance once you start nur school.our school requires it.

It probably depends on the school. Ours didn't require it.

[DManAZRN]

I refuse to pay another insurance company that prolly won't honor their word anyway!

Know what you are responsible for, respond to it, notify MD's and document, they can't touch you.

If they know you have it, the prosecuting party is MORE LIKELY to go after YOU personally.

If you do not, they are more likely to go after the hospital/Dr. because they are required to have it.

If you are not confident in your abilities, go for it, and buy more than average.

Have your OWN lawyer subpoena the staffing records for that shift.

I dont think any jury of my peers would say my hospitals staffing is "Reasonable and Prudent" Failure to listen to your own medical professionals is NEGLIGENCE!!!!!!!!

[sirI, MSN, APRN, NP]

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DManAZRN

Failure to listen to your own medical professionals is NEGLIGENCE!!!!!!!!

Medical professionals are not always correct and make errors (intentional or not) resulting in harm. When engaging in patient care and one realizes a certain practice is potentially harmful; against evidenced-based practice/SOP, the nurse has an ethical duty/obligation to question authority.

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DManAZRN

I dont think any jury of my peers would say my hospitals staffing is "Reasonable and Prudent"

If a nurse continues to work for a facility and knows they are not "reasonable and prudent", said nurse better secure his/her own personal Liability Insurance policy.

[elkpark]

DManAZRN said:

I refuse to pay another insurance company that prolly won't honor their word anyway!

Know what you are responsible for, respond to it, notify MD's and document, they can't touch you.

If they know you have it, the prosecuting party is MORE LIKELY to go after YOU personally.

If you do not, they are more likely to go after the hospital/Dr. because they are required to have it.

If you are not confident in your abilities, go for it, and buy more than average.

Have your OWN lawyer subpoena the staffing records for that shift.

I dont think any jury of my peers would say my hospitals staffing is "Reasonable and Prudent" Failure to listen to your own medical professionals is NEGLIGENCE!!!!!!!!

Suit yourself -- however, the courts have firmly established long ago that inadequate staffing is not an excuse or rationalization for a nurse's failure to provide safe, appropriate care. If the staffing is so low that you can't provide appropriate care to all your assigned clients, the only protection you have is to refuse the assignment (and get fired for doing so, in many cases :)). If you, as an independent professional, accept the assignment, you are accepting the responsibility and you don't have an excuse for any shortcomings.

Physicians and hospitals are not "required" to carry liability coverage (some physicians (not many) don't) -- they carry it because it's the smart thing to do.

[PennStudent]

I recently graduated (LPN) and got a job in LTC. We weren't required to have insurance in school (quite frankly, that's not even something I knew existed) but one of our instructors stressed very strongly that we get insurance once we're employed. Since this was the same woman who was well-studied on litigation in nursing, and taught us how to document in such a way that we don't get sued...yeah, I'm going to listen to her.

I start next week, and I just went to the NSO site for a quote. I can get max coverage (w grad discount) for $50/year. My question is... why are there different limits? The lower limit was $42. Should I just get the max coverage?

[sirI, MSN, APRN, NP]

pennstudent said:

I start next week, and I just went to the NSO site for a quote. I can get max coverage (w grad discount) for $50/year. my question is... why are there different limits? The lower limit was $42. Should I just get the max coverage?

Good question.

There really isn't a magic formula to use in determining just how much Liability Insurance you need to carry. One single question you might ask yourself when determining your limits is, "how important are my assets?"

"Limits of liability" is the maximum amount of coverage agreed upon in the insurance contract that the company would pay in the event of a loss. Example:

A $1,000,000/$6,000,000 limit means that the most that would be paid on any one claim is $1,000,000 and the number of $1,000,000 claims that could be paid on your behalf in a year is 6, for a total annual aggregate of $6,000,000.

As professionals, we are held to a higher standard and therefore considered to hold greater liability towards our patients.

I carry $1,000,000/$6,000,000.