MALPRACTICE INSURANCE: FAQS

GreytNurse · Mar 30, 2002

I've always carried my own policy. That garbage about the 'facility providing coverage'..........:roll You know how long they will stay behind you if something happens???????? About 2.3 seconds. CARRY YOUR OWN INSURANCE.........

MarnnaRN · Mar 30, 2002

I carry my own insurance, even when the hospital says not too. It costs me a whole whopping $17 a year through state farm.

live4today, RN · Mar 30, 2002

I, too, always carried my own malpractice insurance during the years I worked as a nurse. I also encourage my daughter - who is also a nurse - to do the same. I would never depend on a hospital to cover me in times of a lawsuit. They will always take care of themselves FIRST! I believe in watching my own back! :)

James Huffman · Apr 1, 2002

For another take on malpractice insurance, check out my article "How Not to Get Sued For Malpractice" at

http://networkfornurses.com/how_not_to_get_sued_for_malpract.htm

nightingale, RN · Apr 1, 2002

Hi Jim:

I have heard both sides of the argument.. and I understand what you are saying.... I tend to agree with that philosophy as far as a financial loss.... the attorneys going after the big pockets etc.. but....

What about an attorney (paid by your insurance policy) giving you your legal protection to protect your reputation. Does not the policy protct you from that? Gee.. that would be my assumption so I guess I should read the fine print of the policy.

I do nto have liability protection... I know.. I know.... for those of you who have it... it is one of those things I have been on the fence post about....

My concern is when there is a lawsuit and the hospital uses you to dump on.. not to "just protect their financial interest" but to protect their reputation.

Jim please clarify...

Karen: I tried to get on but was stopped and needed a user name. Would you mind cut and pasting the article on this site?

B. :confused:

James Huffman · Apr 2, 2002

My basic point is trying to avoid lawsuits in the first place. While a good attorney (and contrary to my image, I have nothing against lawyers) can do lots to protect your reputation, a court trial can be nasty if you have prosecuting attorneys who double as pit-bulls. Also, if the case is juicy enough, it will receive AMPLE media coverage. Journalists being what they are, they are unlikely to do stories on what a good nurse you are ... instead, they will play up any errors or mistakes you might have made. As I pointed out in the article, if you are in a city the size of 90% in the US, the media will LOVE to have a nurse to pick on. My strategy would avoid the whole media circus of a trial altogether.

Jim Huffman, RN

http://www.networkfornurses.com

nightingale, RN · Apr 2, 2002

#@$% Happens.. I am all those "nice" things... I have a backround in customer service (how handy some days).. I can apologize without ever saying the S word.....

I have been involved in legal nightmares... nothing to do with healthcare but let me tell you.... I can say.. I do not like lawyers... they often only look out for their clients with little regard for the truth.... anyone one old enough to read the newspaper will attest to that....

So I guess, Jim, you do not offer a suggestion for self protection based on a hospital lawyer selling you out to protect HIS big pockets client..... ??

Forgive me if I sound condeming.. I am not.. I truly value what you have to say and I think it deserves merit as a base line.... Our reputation as a nurse is invaluable... without it.. we will get shut down as surely as there are long lines in an unemployment line....

B.

Home Health Columnist / Guide · Apr 2, 2002

Malpractice Insurance: FAQs

from The Gold Sheet

How much coverage do I need?

Nurse practitioners (NPs) need enough malpractice insurance to cover a damage award and attorney's fees for the defense. Several recent judgments against NPs have exceeded $1 million, though that is by no means the norm. Attorney fees average about $25,000 for a case which goes to trial.

An insurance policy will pay no more than its limits. Most nurse practitioners purchase policies which provide $1 million per occurrence. A missed lung cancer or breast cancer could easily lead to a damage award of over $1 million. A nurse practitioner carrying a $1 million policy and facing a damage award of $1.4 million and attorney's fees of $25,000 would owe $425, 000. Therefore, NPs may want to consider purchasing policies with limits higher than $1 million per occurrence.

I am a Family Nurse Practitioner. I am currently working with adult patients only. It is time to renew my malpractice insurance. I was told by a colleague that I can renew at the Adult Nurse Practitioner rate as opposed to the Family Nurse Practitioner rate (a savings of about $400) since I work exclusively with adults. The insurance company advises me to renew at the FNP rate (but of course, it would be to their advantage for me to do so). Can you offer me any advice?

Renew at the FNP rate. If you misrepresent your area of certification and are sued, the insurer may refuse to cover you.

My employer includes me in the practice's insurance policy. Should I have my own insurance? What kind?

There are several reasons why you should have your own policy rather than be covered under your employer's policy.

1) If you treat patients outside of the employment setting, or have a second part-time job, you definitely need your own policy. For example, many NPs are approached by neighbors, friends and relatives "for a prescription." An NP who undertakes the care of such individuals should have malpractice insurance to cover the possibility of a mistake.

2) If there is a malpractice action filed against several clinicians at the practice, and the clinicians are arguing among themselves as to liability, it may be wise to have your own attorney. A lawsuit fractures collegial alliances. Individual clinicians tend to deny their own liability and blame others. If your employer's insurer is covering all clinicians within the practice, that insurer may not want to pay for attorneys for each clinician. In a fractious environment, an NP will need an advocate--an attorney--to protect the NP's individual interests. If you have your own insurance, your insurer should hire an attorney who should have your interests, and only your interests, in mind.

3) Because it is your employer's policy, not yours, you have no control over selecting the level of coverage and other terms of coverage. If you plan to carry your own insurance, you can purchase the policy which you believe best serves your needs.

Now, the reasons for going with your employer's coverage:

1) If you have your own insurance policy, a plaintiff's attorney will see you as a source of additional dollars to cover a damage award. This could play out in the following way: A clinician at your employer's practice has been sued, and you and several other practitioners have been named as well. It is doubtful that you will be held liable for the mistake. However, because you have your own coverage, the plaintiff's attorney may work hard to keep you as a named defendant.

2) Your employer's policy may include a clause specifying that if an employee has his or her own insurance, the employer's insurance is secondary. This means that until the limits of your individual policy are exhausted, the employer's policy won't cover you. Or, your individual insurance policy may specify that it is secondary to any other insurance which may cover you. Having two policies could complicate matters. If you are covered under an employer's policy, ask your employer for a copy of the policy. Look for terms or conditions regarding other policies.

3) Policies which cover physician groups often are "claims made" policies. Occurrence policies are preferable. See "Should I get a "claims made" or "occurrence" policy?" below.

Should I get a "claims made" or "occurrence" policy?

Occurrence policies are highly preferable to claims made policies. An occurrence policy covers any incident which occurred when the policy was paid up. In contrast, a claims made policy covers an NP only if the NP keeps the policy continuously paid up. So, if an NP retires, leaves the profession, leaves the employer's practice, or no longer has need for active insurance, the NP covered by a claims made policy must keep paying premiums, possibly for life, in order to ensure coverage for incidents that happened in years past but for which no lawsuit has yet been filed. (The statute of limitation can vary, and can, in some cases, be longer than 15 years.) A claims made policy can be extended by purchasing a "tail" policy. Tail policies are expensive.

Will I be more likely to be sued if I have malpractice insurance?

Many NPs purchase insurance because they have greater peace of mind when they know they and their patients are covered in the event of a mistake. These NPs will want insurance whether or not it will increase their attractiveness to litigious patients. Most patients and attorneys probably assume that NPs have malpractice insurance. The decision to sue or not to sue is unlikely to be influenced by the presence or absence of insurance coverage, because no one but the NP and the NP's employer should know the details of the coverage.

However, an NP who discusses his or her malpractice coverage with patients may inspire litigious patients, or may relieve a reluctant patient from any feelings of guilt over suing a care giver. The wise NP will have insurance, but not discuss it.

Which company's policy is best?

There is little data or commentary available from NPs who have utilized the services of malpractice insurers. Understandably, those who have been sued remain quiet about the experience and don't discuss the pros and cons of the customer service of the insurer. The author knows of no word-of-mouth reports that would indicate that any of the professional Liability Insurance companies currently advertising in the nursing journals are unsatisfactory.

NPs should choose a company located in the United States (in case the NP has to sue the insurance company), and which has been in business at least ten years. NPs should obtain a copy of the policy, read the policy carefully and ask questions about any exclusions which seem unreasonable.

If I work part-time, do I still need insurance?

Yes. Look for a company which is willing to issue a policy for part-time clinicians. Some companies will issue a policy for part-time NPs for a lower premium than that for full-time clinicians.

The Gold Sheet is published monthly by the Law Office of Carolyn Buppert, 1419 Forest Drive, Suite 205, Annapolis, MD 21403. Monthly subscription is available. Carolyn's report is part of the Medscape.com newsletter I receive weekly. She has much NP legal advice at Medscape especailly on billing practices for NP's, setting up employer contracts what are NP's services worth.etc. I've saved many of her columns for the future...if I make it thru graduate school that is, LOL. Karen

maggiemae · Jun 25, 2005

Malpractice Insurance: FAQs
from The Gold Sheet
How much coverage do I need?
Nurse practitioners (NPs) need enough malpractice insurance to cover a damage award and attorney's fees for the defense. Several recent judgments against NPs have exceeded $1 million, though that is by no means the norm. Attorney fees average about $25,000 for a case which goes to trial.
An insurance policy will pay no more than its limits. Most nurse practitioners purchase policies which provide $1 million per occurrence. A missed lung cancer or breast cancer could easily lead to a damage award of over $1 million. A nurse practitioner carrying a $1 million policy and facing a damage award of $1.4 million and attorney's fees of $25,000 would owe $425, 000. Therefore, NPs may want to consider purchasing policies with limits higher than $1 million per occurrence.
I am a Family Nurse Practitioner. I am currently working with adult patients only. It is time to renew my malpractice insurance. I was told by a colleague that I can renew at the Adult Nurse Practitioner rate as opposed to the Family Nurse Practitioner rate (a savings of about $400) since I work exclusively with adults. The insurance company advises me to renew at the FNP rate (but of course, it would be to their advantage for me to do so). Can you offer me any advice?
Renew at the FNP rate. If you misrepresent your area of certification and are sued, the insurer may refuse to cover you.
My employer includes me in the practice's insurance policy. Should I have my own insurance? What kind?
There are several reasons why you should have your own policy rather than be covered under your employer's policy.
1) If you treat patients outside of the employment setting, or have a second part-time job, you definitely need your own policy. For example, many NPs are approached by neighbors, friends and relatives "for a prescription." An NP who undertakes the care of such individuals should have malpractice insurance to cover the possibility of a mistake.
2) If there is a malpractice action filed against several clinicians at the practice, and the clinicians are arguing among themselves as to liability, it may be wise to have your own attorney. A lawsuit fractures collegial alliances. Individual clinicians tend to deny their own liability and blame others. If your employer's insurer is covering all clinicians within the practice, that insurer may not want to pay for attorneys for each clinician. In a fractious environment, an NP will need an advocate--an attorney--to protect the NP's individual interests. If you have your own insurance, your insurer should hire an attorney who should have your interests, and only your interests, in mind.
3) Because it is your employer's policy, not yours, you have no control over selecting the level of coverage and other terms of coverage. If you plan to carry your own insurance, you can purchase the policy which you believe best serves your needs.
Now, the reasons for going with your employer's coverage:
1) If you have your own insurance policy, a plaintiff's attorney will see you as a source of additional dollars to cover a damage award. This could play out in the following way: A clinician at your employer's practice has been sued, and you and several other practitioners have been named as well. It is doubtful that you will be held liable for the mistake. However, because you have your own coverage, the plaintiff's attorney may work hard to keep you as a named defendant.
2) Your employer's policy may include a clause specifying that if an employee has his or her own insurance, the employer's insurance is secondary. This means that until the limits of your individual policy are exhausted, the employer's policy won't cover you. Or, your individual insurance policy may specify that it is secondary to any other insurance which may cover you. Having two policies could complicate matters. If you are covered under an employer's policy, ask your employer for a copy of the policy. Look for terms or conditions regarding other policies.
3) Policies which cover physician groups often are "claims made" policies. Occurrence policies are preferable. See "Should I get a "claims made" or "occurrence" policy?" below.
Should I get a "claims made" or "occurrence" policy?
Occurrence policies are highly preferable to claims made policies. An occurrence policy covers any incident which occurred when the policy was paid up. In contrast, a claims made policy covers an NP only if the NP keeps the policy continuously paid up. So, if an NP retires, leaves the profession, leaves the employer's practice, or no longer has need for active insurance, the NP covered by a claims made policy must keep paying premiums, possibly for life, in order to ensure coverage for incidents that happened in years past but for which no lawsuit has yet been filed. (The statute of limitation can vary, and can, in some cases, be longer than 15 years.) A claims made policy can be extended by purchasing a "tail" policy. Tail policies are expensive.
Will I be more likely to be sued if I have malpractice insurance?
Many NPs purchase insurance because they have greater peace of mind when they know they and their patients are covered in the event of a mistake. These NPs will want insurance whether or not it will increase their attractiveness to litigious patients. Most patients and attorneys probably assume that NPs have malpractice insurance. The decision to sue or not to sue is unlikely to be influenced by the presence or absence of insurance coverage, because no one but the NP and the NP's employer should know the details of the coverage.
However, an NP who discusses his or her malpractice coverage with patients may inspire litigious patients, or may relieve a reluctant patient from any feelings of guilt over suing a care giver. The wise NP will have insurance, but not discuss it.
Which company's policy is best?
There is little data or commentary available from NPs who have utilized the services of malpractice insurers. Understandably, those who have been sued remain quiet about the experience and don't discuss the pros and cons of the customer service of the insurer. The author knows of no word-of-mouth reports that would indicate that any of the professional liability insurance companies currently advertising in the nursing journals are unsatisfactory.
NPs should choose a company located in the United States (in case the NP has to sue the insurance company), and which has been in business at least ten years. NPs should obtain a copy of the policy, read the policy carefully and ask questions about any exclusions which seem unreasonable.
If I work part-time, do I still need insurance?
Yes. Look for a company which is willing to issue a policy for part-time clinicians. Some companies will issue a policy for part-time NPs for a lower premium than that for full-time clinicians.
Gold Sheet 4(2), 2002. © 2002 Carolyn Buppert
The Gold Sheet is published monthly by the Law Office of Carolyn Buppert, 1419 Forest Drive, Suite 205, Annapolis, MD 21403. Monthly subscription is available. Carolyn's report is part of the Medscape.com newsletter I receive weekly. She has much NP legal advice at Medscape especailly on billing practices for NP's, setting up employer contracts what are NP's services worth.etc. I've saved many of her columns for the future...if I make it thru graduate school that is, LOL. Karen

I was wondering what you can tell me about tailgate coverage for CNSs and NPs. I have this in my contract and am thinking about leaving the practice I am currently in

mydesygn · Jun 25, 2005

#@$% Happens.. I am all those "nice" things... I have a backround in customer service (how handy some days).. I can apologize without ever saying the S word.....
I have been involved in legal nightmares... nothing to do with healthcare but let me tell you.... I can say.. I do not like lawyers... they often only look out for their clients with little regard for the truth.... anyone one old enough to read the newspaper will attest to that....
So I guess, Jim, you do not offer a suggestion for self protection based on a hospital lawyer selling you out to protect HIS big pockets client..... ??
Forgive me if I sound condeming.. I am not.. I truly value what you have to say and I think it deserves merit as a base line.... Our reputation as a nurse is invaluable... without it.. we will get shut down as surely as there are long lines in an unemployment line....
B.

One other point, you are more likely to be reported to the Board than sued for malpractice. I would lok for a policy that would cover you for expenses related to defending your nursing license.

PeachyOrthoRN, RN · Jun 25, 2005

I think that one should definitely carry coverage. I have coverage through my home owners insurance which costs me about 17$ a year for about 500,000$, and I could go higher if I wanted to.