Malpractice Insurance

MunoRN, RN · Feb 12, 2016

https://allnurses.com/general-nursing-discussion/one-healthcare-risk-999441.html
Read the article and let me know if you have any followup questions. Pay careful attention to the part about how it is excess coverage over your employment, and thus it will probably never be triggered to provide you coverage. TL;DR: I recommend the CNA policy sold by NSO and others but there are significant coverage limitations such that you will probably not have coverage under the policy for a malpractice claim or BON investigation. Everyone thinks that if they are peripherally involved in a malpractice claim or named in a BON investigation that the insurance company will provide them with their own attorney to look out for their interests, and this is simply wrong. If you call NSO and ask them this very question, they will confirm your policy will likely not be triggered and you will not have counsel representing you. Your own individual policy will very rarely be triggered, and this is why the coverage is so cheap: relatively few claims are paid out. But read the entire article.

NSO does actually cover attorney costs for license defense as well as related costs such as lost wages, there of course limitations to this coverage ($10,000 for the attorney's fees), but it's certainly better than nothing. If you've got 20 years of potential career left then protecting your license is worth about $1.4 million, paying $100 a year to help protect that $1.4 million makes sense to a lot of people.

RiskManager · Feb 12, 2016

You need to read the CNA policy language on license defense: the policy is only triggered for reimbursement if the BON files actual charges against your license. Board investigations do not trigger coverage and no legal fee reimbursement is provided. Typically, the actual amount of the legal fee reimbursement under the CNA policy is $ 25,000. Depending on your state, relatively few charges are filed as opposed to complaints or investigations done. So yes, the CNA policy does provide reimbursement for license defense, but just like the coverage trigger for malpractice claims, the policy is written so that coverage is not often triggered.

Hancock330 · Feb 13, 2016

I've never been without my own malpractice insurance. I'm now retired and I still pay $114/year for my policy.

1. If you EVER give one bit of health care advice away from your job, and if the person who got the advice has a bad outcome for any reason and decides to sue you, your malpractice insurance will pay for a lawyer to defend you. You employer's insurance won't. While such lawsuits are very rare, how fond are you of the house you're buying, your kid's college fund, your IRA, etc.? You could lose all of those if you lost that kind of law suit, and you could lose a lot in legal fees even if you won.

2. Your employer's attorneys will decide who to protect in a law suit. If it's a choice between you and the hospital, guess who gets offered up for the sacrifice? I've known one nurse who swore she always followed every single policy and procedure at the hospital where she worked. I was never quite able to do that. If you might occasionally slip in that regard the hospital can shift blame for a bad outcome onto you -- even if, for instance, totally inadequate staffing was the reason you weren't able to follow the policy or procedure (consider the psychic B/Ps you know some of your nursing assistants take when they're overwhelmingly busy, for instance. Do you always retake them when you think that might have happened?). Having YOUR malpractice insurance company's lawyer for you in court helping to defend against any kind of accusation may be very important for protecting your license and your financial stability. Such lawsuits may also be rare, but the same questions apply.

3. Make sure that any policy you buy protects you based on whether you were insured at the time of the incident not just if you have been continuously insured by the same company. That is, if you moved and had to change policies, you don't want to be vulnerable to a lawsuit for an event that happened several years ago when you were covered by a different company -- you want that company to still protect you.

I've never been sued but the cost of the protection has been well worth the peace of mind I've had for all of these years.

Trusting to the good will of ANY employer when it comes to threats to the "bottom line" of the employer is seldom wise. Choose carefully and do what you can to protect yourself.

LadysSolo · Feb 13, 2016

I teach part-time in an LPN school, and have always carried (and will always carry) malpractice insurance. If your employer has insurance on you, but you and your employer are insured (the most likely scenario,) who is going under the bus? YOU! The one paying the bill gets the best defense. I want someone defending ME. And just be sure it is a "claims occurred" policy, not "claims made." An Occurrence policy means when it happened, a Claims made policy means after you retire you have to keep paying premiums until the statute of limitations of any occurrence is over.

MunoRN, RN · Feb 13, 2016

You need to read the CNA policy language on license defense: the policy is only triggered for reimbursement if the BON files actual charges against your license. Board investigations do not trigger coverage and no legal fee reimbursement is provided. Typically, the actual amount of the legal fee reimbursement under the CNA policy is $ 25,000. Depending on your state, relatively few charges are filed as opposed to complaints or investigations done. So yes, the CNA policy does provide reimbursement for license defense, but just like the coverage trigger for malpractice claims, the policy is written so that coverage is not often triggered.

I have read their policy language and it's quite clear; their license defense coverage activates the moment you are made aware of an investigation.

RiskManager · Feb 14, 2016

@MunoRN, I am sorry to tell you that you are simply wrong. http://www.hpso.com/Lists/CommonFormStateList/Attachments/3/cmcov3.pdf This is the policy language interpreted by CNA to determine coverage. You need to read carefully the License Protection section under the Coverage Extension part, and even more importantly, read the definition of a License Protection Incident in the Definitions section. I suspect you have read the first part but not the definition of the triggering event.

I have been on the phone with the CNA underwriters and received coverage denial letters from them, and they interpret the License Protection clause as only being triggered if an actual complaint with charges is filed against your license by the disciplinary authority. This is the circumstance that meets the definition of a License Protection Incident. If you have something in writing from CNA that says differently, by all means send it along to me so I can take a look at it.

RiskManager · Feb 14, 2016

For @Hancock and @LadysSolo, my article addressed your common misperceptions: that the employer will throw you under the bus and that you will have your own attorney representing you in a claim. Both of your contentions are likely wrong for the typical case in which you are an employee of a healthcare facility.

It is so important to be aware of the circumstances that trigger your coverage. No coverage trigger, no lawyer for you. The policy language goes into great detail over what circumstances trigger your coverage.

MunoRN, RN · Feb 14, 2016

@MunoRN, I am sorry to tell you that you are simply wrong. http://www.hpso.com/Lists/CommonFormStateList/Attachments/3/cmcov3.pdf This is the policy language interpreted by CNA to determine coverage. You need to read carefully the License Protection section under the Coverage Extension part, and even more importantly, read the definition of a License Protection Incident in the Definitions section. I suspect you have read the first part but not the definition of the triggering event.
I have been on the phone with the CNA underwriters and received coverage denial letters from them, and they interpret the License Protection clause as only being triggered if an actual complaint with charges is filed against your license by the disciplinary authority. This is the circumstance that meets the definition of a License Protection Incident. If you have something in writing from CNA that says differently, by all means send it along to me so I can take a look at it.

I would only expect the coverage to be triggered if "an actual complaint with charges is filed against your license by the disciplinary authority", I don't expect them to cover license defense costs if there is no reason to defend my license.

RiskManager · Feb 14, 2016

I would only expect the coverage to be triggered if "an actual complaint with charges is filed against your license by the disciplinary authority", I don't expect them to cover license defense costs if there is no reason to defend my license.

You are spot on. The common confusion is that many people who buy the policy thinks they will have a lawyer assigned for a BON investigation. The CNA legal reimbursement under the License Protection is not triggered for just an investigation. It has to be actual charges filed by the BON. In some states, there are many investigations by the BON and few charges. In other states, there are few investigations and many charges. In other states, it starts out as an investigation and then turns into charges, if necessary. Each nurse should know the approach of their state's BON, since that should be a factor in your decision to purchase your individual policy.

rzyzzy · Feb 14, 2016

You are spot on. The common confusion is that many people who buy the policy thinks they will have a lawyer assigned for a BON investigation. The CNA legal reimbursement under the License Protection is not triggered for just an investigation. It has to be actual charges filed by the BON. In some states, there are many investigations by the BON and few charges. In other states, there are few investigations and many charges. In other states, it starts out as an investigation and then turns into charges, if necessary. Each nurse should know the approach of their state's BON, since that should be a factor in your decision to purchase your individual policy.

In AZ, NSO fully covered the cost of an attorney after I was notified of a complaint (investigation). As part of the investigation, I was required to answer questions by the board's investigators, and anything you said could be used against you - so attorney review of these communications is critical.

My complaint was ********, but I don't think the board likes it when you write that in your response. In any case, the investigation was closed without even going before the board, my attorney got a couple grand, and I only paid my premium.

Kris10lp · Feb 15, 2016

Our instructors advised us to get it and keep it to yourself. For the reason, the hospital will say they will defend you but who do you think will get thrown under the bus if somebody has to. That is exactly what happened to me. NSO paid the huge lawyer bill I would not have been able to for license defense, and he went back and forth with the investigator and asked questions of me that I would have probably been too nervous to think about. In the end it really helped because they tried to give some story about how I was responsible because of XYZ but turns out they were lying. Had I been doing things on my own I probably would have been so mortified and nervous I wouldn't have thought to even question the things they said like timing and such. I ended up keeping my license with only an administrative warning and the hospital looked bad because even the investigator felt they clearly scapegoated me. The lawyer said unfortunately many nurses don't get legal counsel at that time because they make it seem like it is very laid back. I ended up not even having to interview in person because my lawyer negotiated a written statement detailing the entire issue. I have never been so happy to spend....yes $109 a year to be exact.