Should I Carry Nursing Malpractice (Liability) Insurance?

Malpractice (liability) insurance provides essential legal and financial security. Many Nurses go "bare" and never really consider Liability insurance as important. Be sure you are well informed before you make any final decisions about your future. Nurses Career Support Video Knowledge

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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 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

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.

Specializes in Complex pedi to LTC/SA & now a manager.
sallyrnrrt said:
I do not know about NSO...I have had malpractice with them since maybe 2007.... This past year when I attempted to renew...... And paid from their invoice..... I kid you not....they told me they were "trying to locate my account".... I have very little faith in a malpractice insurance company.....that I have had policy with for nine years, who all of a sudden, "can not find my account".....how can they represent me, if they can not find a tenured client's account.... Multiple emails, went unanswered.... So if they could not find my account after three months... I demanded refund... Not only was that request not responded to.... So when it comes to NSO...."buyer beware"...I am seeking private malpractice ins...coverage, they took my money for nine years, and all of a sudden...."can't find my account "...glad I really did not need them....

Happened to me. I'm still waiting for a response

Specializes in Certified Med/Surg tele, and other stuff.

So, we really don't need insurance?

NSO holds my claim because I've always heard of them by instructors. Which company, if we need insurance, should we go with?

Specializes in Healthcare risk management and liability.
tokmom said:
So, we really don't need insurance?

NSO holds my claim because I've always heard of them by instructors. Which company, if we need insurance, should we go with?

Bear in mind that NSO is just the insurance agent. CNA is the insurance company that writes the actual policy. NSO just collects the premium, passes it along to CNA minus the commission, and does some servicing of the policy. You have two real choices for the insurance, CNA or Liberty Mutual. You can buy the policies from other insurance agents, and you need not go through NSO or ProLiability, the agent for Liberty Mutual.

Specializes in Certified Med/Surg tele, and other stuff.
RiskManager said:
Bear in mind that NSO is just the insurance agent. CNA is the insurance company that writes the actual policy. NSO just collects the premium, passes it along to CNA minus the commission, and does some servicing of the policy. You have two real choices for the insurance, CNA or Liberty Mutual. You can buy the policies from other insurance agents, and you need not go through NSO or ProLiability, the agent for Liberty Mutual.

So can we just google CNA an go straight through them an leave out the middleman?

Specializes in Healthcare risk management and liability.
tokmom said:
So can we just google CNA an go straight through them an leave out the middleman?

I am pretty sure that for individual nursing coverage, CNA is not a direct writer. This means that you cannot buy CNA insurance directly from CNA, you have to go through an agent. If you already have an insurance agent that handles your auto, renters or homeowners, etc., I would ask that agent if they can place the coverage for you.

Specializes in Family Practice, Med-Surg.

Absolutely. I have for 40 years.

I work in mental health and recently arrived on the unit as the only nurse for 17 patients. Therefore I'd like to be protected. I just have a few questions:

How do you know if the insurance is occurrence based or claims made? I've been going to different sites getting quotes but they don't mention which type they provide only the limits. Also what limits do you recommend?

I have Liberty Mutual for my car and home insurance.

I had no idea CNA and Liberty Mutual were the same company.

If that is the case i could have signed up for coverage through my homeowner's policy(Umbrella policy)

Specializes in Healthcare risk management and liability.
smartnurse1982 said:
I have Liberty Mutual for my car and home insurance.

I had no idea CNA and Liberty Mutual were the same company.

If that is the case i could have signed up for coverage through my homeowner's policy(Umbrella policy)

CNA and Liberty Mutual are two different insurance companies. NSO is the major broker for CNA and ProLiability is the major broker for Liberty Mutual. You cannot get healthcare professional for malpractice through your homeowners' or a personal umbrella policy. A personal umbrella provides you with an additional layer and additional liability coverages for your homeowners' and auto policy. It does not provide any liability coverage for professional or business activities. There has been much litigation over the years in which people have sued to have their umbrella policy cover them for professional malpractice, such as architect, engineer, lawyer, physician, etc, and they have all failed.

Specializes in Healthcare risk management and liability.
Tiffany, RN said:
I work in mental health and recently arrived on the unit as the only nurse for 17 patients. Therefore I'd like to be protected. I just have a few questions:

How do you know if the insurance is occurrence based or claims made? I've been going to different sites getting quotes but they don't mention which type they provide only the limits. Also what limits do you recommend?

Most individual nursing liability policies are occurrence, but you are indeed wise to check. If it does not say on the website, look for a sample policy on the site. The policy language, right at the beginning of the policy, will say if it is occurrence or claims made. In terms of policy limits, I generally recommend $ 1 million. If someone asks me for a recommendation on where to place the coverage, I tell them to go to NSO for the CNA policy or to ProLiability for the Liberty Mutual policy. CNA is by far the largest writer of nursing policies in the country.

Geico has on their page that Umbrella insurance can work in conjunction with your standard .

Specializes in Healthcare risk management and liability.
smartnurse1982 said:
Geico has on their page that Umbrella insurance can work in conjunction with your standard malpractice insurance.

You are referring to this page: Umbrella Insurance is for Professionals too! | GEICO

A personal umbrella policy is over your personal auto and homeowners policies. It is not a substitute for, nor does it provide any professional liability coverage. You will note that the Geico page does not say that the personal umbrella provides any professional liability coverage but instead refers to an additional layer of coverage for your personal assets for personal liability such as auto and homeowners. When you read the personal umbrella policy language, you will find there is a specific exclusion for business and professional activities.