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
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
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.
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.