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Smart Practice

Malpractice Insurance

As a nurse practitioner, you should never be without malpractice insurance. Even so, your chances of being sued can be greatly diminished by accurate, thorough documentation and good systems and risk management in your practice. If you see unsafe activities in your office, and your employer refuses to make any changes, it is time for a change of employers.

But sometimes you can't avoid being sued. That's why you need malpractice insurance. Purchasing malpractice insurance can be confusing, and finding the best rate can be challenging. Rates vary among companies, and the same company may have different rates for NPs in different parts of the country, for NPs in different specialties, for full-time and part-time NPs, and for NPs who own their practices.

The cost of malpractice insurance has been rising. More lawsuits and higher awards against nurse practitioners have been a factor in the price hikes. And as the number of NPs increases and our scope of practice widens, lawsuits against NPs will increase. NPs perform many of the procedures that physicians perform, and in many states, we can practice independently.

Even with the premium increases, malpractice insurance is still a bargain when you consider that a physician may pay $10,000 while a nurse practitioner pays $1,200 for the same coverage.

Below are some points to consider when you're shopping for the best policy.

Occurrence vs. Claims Made
Malpractice insurance policies are available in two major types: occurrence and claims made. Occurrence policies cover you if you had insurance when the alleged malpractice occurred. For example, an NP has an occurrence malpractice insurance policy and then retires and drops her malpractice coverage. She is sued for malpractice 3 years later for an act she committed while she was working. The insurance would cover her for that act because when the act was committed, she was insured.

Claims-made policies cover you only if you have insurance when the act is committed and when the claim is made. If that same NP had a claims-made policy and then retired with no insurance, she would be personally liable for her actions.

A supplemental type of malpractice policy - tail insurance - is designed to extend claims-made policies. Often expensive, a tail policy covers you for past acts. An occurrence policy is typically your best choice.

Employer's Insurance
If your employer purchases your malpractice insurance, ask to see the policy to determine whether you are covered for administrative claims. Administrative claims are complaints filed with the board of nursing. When a plaintiff files a malpractice claim, he or she usually files a complaint with the board of nursing, which will investigate. An unhappy patient or disgruntled employee can file a complaint for unprofessional behavior or negligence with the nursing board, and the complaint may be investigated even though it's not true. Many insurance carriers do not cover administrative defense.

Many large institutions are self-insured, which means they bear the costs for any malpractice claims. Employees are covered only during working hours. If you give advice to anyone outside your practice and are sued for malpractice, you must pay for your defense yourself.

You should also consider that when your employer is your only insurer, your best interest may not be your employer's best interest. Your employer wants the best settlement overall, not necessarily the best settlement for you. Consider purchasing your own malpractice policy even if your employer supplies malpractice insurance. With personal malpractice coverage, you have an attorney who represents you, not your employer.

Malpractice Insurance

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