Malpractice Insurance

Sun0408, ASN, RN · Jan 9, 2016

I like having my own period. I would rather have it and not need it then the other way around. I'm not sure of the cost if your working as a NP but for me as a RN, I will continue to spend that 100.00 a year.

MesaRN · Jan 9, 2016

This question nearly always results in the following replies:

1. Don't rely on your employer's coverage as it is designed to cover them not yourself. Some may offer to pay for your individual insurance, but it needs to be a individual policy for you, not a group coverage.

2. Some will say there is a risk of insurance as you now become a target for malpractice since you have insurance money to go after. This argument is often cited for RN's but is not as valid for NPs. As an NP you are assuming the same risks as a physician in many instances.

Policies for NP are more than RN but far (far far far) less than physicians. RNs can often get Liability Insurance via there homeowners insurance, but I have not heard of this yet for NPs. Two companies that come well recommend are Proliabilty and NSO.

My recommendation is that I would look to the physician world for guidance on liability insurance as the liability of the NP compared to an RN is very different.

RiskManager · Jan 10, 2016

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

Read the linked article and let me know if you have any questions. Buying your own Liability Insurance is almost exclusively a RN phenomenon. I do not know of any physicians, dentists, nurse practitioners or physician assistants who buy their own liability insurance to supplement the insurance provided by their employer. Only if you work as an independent contractor or if the employer did not provide liability insurance would you need to buy your own. I do malpractice, liability and insurance for a living.

Trauma Columnist · Jan 10, 2016

I have my own malpractice insurance (have been an APRN for almost 10 years). I have been sued and yes, while your company's malpractice insurance will cover the suit, they do NOT cover license protection.

And yes, it is more expensive than RN coverage but in my mind at least, its well worth it and its tax deductible.

Mookiepsychnp · Jan 10, 2016

I definitely have my own no matter what the company provides. They may decide to settle a case, which would have my name attached even if innocent. I always feel better safe than sorry.

RiskManager · Jan 10, 2016

I definitely have my own no matter what the company provides. They may decide to settle a case, which would have my name attached even if innocent. I always feel better safe than sorry.

I trust that you realize that having your own insurance has no bearing to what settlement decision is made by your employer's insurance. So if your employer's insurance decides to settle a case and you are reported to the NPDB, your own insurance has nothing to do with this. By the same token, if your own individual policy does not have a 'consent to settle' clause in it, your own individual policy may very well decide to settle a case regardless of your wishes.

Mookiepsychnp · Jan 10, 2016

I trust that you realize that having your own insurance has no bearing to what settlement decision is made by your employer's insurance. So if your employer's insurance decides to settle a case and you are reported to the NPDB, your own insurance has nothing to do with this. By the same token, if your own individual policy does not have a 'consent to settle' clause in it, your own individual policy may very well decide to settle a case regardless of your wishes.

Yes my policy does have a consent to settle clause, however I was unaware it had no bearing on my employer. What protection do you have if you are named with a group of people and you may have had contact with the patient but did not directly contribute to their bad outcome but you are named with others and they settle?

RiskManager · Jan 10, 2016

Yes my policy does have a consent to settle clause, however I was unaware it had no bearing on my employer. What protection do you have if you are named with a group of people and you may have had contact with the patient but did not directly contribute to their bad outcome but you are named with others and they settle?

Just as with so many clinical issues, the short answer is it depends. I have lots of malpractice claims in which many individuals are named as defendants, but any settlement is made on behalf of the organization as the employer or legally-responsible entity for the named defendants. Ideally, plaintiff counsel can be persuaded or compelled to drop those defendant names from the case that have little or nothing to do with the case. Sometimes this works and sometimes it does not. If the case settles, I will have all of the named defendants listed in the settlement paperwork to ensure that the case is over for everybody. The key issue is for whom a payment was made in settling the case.

There was a loophole in the NPDB reporting requirements such that many corporate entities such as Kaiser, Henry Ford, Sharp, etc. would settle a case on behalf of the organization and take the position that nothing had to be reported to the NPDB since payment was not made on behalf of an individual provider but for the organization as a whole. The Feds have gotten snippy about that and now if you make a payment because of the negligence of Dr. Lopez, ARNP Chang or RN Smith, you have to report them specifically to the NPDB, even if the settlement is made on behalf of the organization.

In the settlement paperwork, I try to make it clear which named defendants are having a payment made on their behalf to settle the case and those are the people reported to the NPDB and/or the state disciplinary/licensing agency. If ARNP Chang is a listed defendant but I paid no money based on his/her negligence, I take the position that ARNP Chang does not have to be reported to the NPDB and/or the State.

ARNP Chang does have to report for future credentialing/privileges/insurance that he/she was named in a malpractice claim, but can say that no money was paid on their behalf. The defense side has no control over whom the plaintiff chooses to name as a defendant.

So the short answer to your question is that you likely have no protection against being named as a defendant, but if no money is paid on your behalf, the paperwork can be written to make this clear such that it will not count against you.

If you are ever involved in a situation like this, print out this message and give to the defense attorney, insurance claims manager or risk manager running the defense of the case, and they will know exactly what this means and hopefully can do the paperwork accordingly. I point out that my comments are general statements and there may be unique statutory, regulatory or case law in your jurisdiction that may make these comments more or less applicable to your situation.

Mookiepsychnp · Jan 10, 2016

@riskmanager Thank you so much for this information! I'm sure many others will benefit from it as well.

RiskManager · Jan 10, 2016

I try to be a full-service risk manager.

DeeAngel · Jan 11, 2016

I always have carried my own because I have no faith in hospital employers. They will do what they need to do to cover themselves but have no interest in protecting the nurse herself or her license. They will always act in their best interests, never in yours and if they can force blame onto you to make themselves less culpable they will do it in a heart beat. With my own policy, (which is only $100.00 a year) I have someone who will represent just me and my interests and who cares nothing about the hospital's interests. It is important if you retire to keep the policy in force until the statute of limitations for lawsuits expires in your state.