No matter which part of the world you live. Medical practices need malpractice insurance. If you work for an institution, then this is usually covered. Most physicians will look for this information when a problem arises. However, if you are in a small group, your own practice or a big hospital, there are some things you must know about the malpractice insurance covering you or if you’re looking for one.

What is the Type of Policy covering you & your practice?

Malpractice insurance policies come in two forms. Claims-made policies and occurrence policies. The majority of them tend to be claims made policies.

Claims-made malpractice insurance

These provide coverage for any incidents that occur or are reported while you are insured. So the incident and its filing takes place while your policy is ongoing. If you discontinue this policy, there’s no coverage for later suits unless you have “tail coverage.” This is usually 3x the premium but provides future coverage as well. You can also have what is called nose coverage. This is where your new insurance policy covers liability from a previous claims-made policy.

Tip: Always negotiate or get it written in your employment contract about tail coverage if you leave a group and who pays for it.

Occurrence Policies

These policies cover all occurrences while the policy is in effect. It is kind of a lifetime policy so claims filed years later are all covered if the policy was in effect.

When you compare claims made policies are cheaper and premiums climb as the years pass by.

Matching Coverage

The policy coverage must match the size of your practice, the specialty you practice in and the geographical area. Normally, it ranges from from $100,000 to $300,000 and $1 million to $3 million. What do these numbers mean? The first is the maximum payout per claim during a year. The second is the maximum payout for all claims in a year.

These differ from country to country, state to state and specialty to specialty. Some states like California, Florida, and Texas have caps on payments.

Tip: Include your staff and all clinical activities. If you fly solo, try to get a locum tenens coverage.

Compare Malpractice Insurance Coverage

This is a very competitive market. You have to shop around and understand the technicalities. Check if you have assessable coverage. This means that the insurance company can add a surcharge if they see some claims. You want to avoid the ones that keep adding surcharges. If there are low premiums, ask why. Read the finer points.

Consent to Settle

This is a clause that allows a company to settle an insurance claim without your written consent even if you are not fault. Try to ensure this doesn’t happen. Any settlement made by an insurance company gets reported to the National Practitioner Data Bank. This can affect your future insurance, managed-care group participation, and hospital privileges.

Tip: Always negotiate to include the consent to settle clause and find out who will pay for defense costs.

Key Criteria

Before choosing a company, look at a few key criteria. The fiscal health of the company, how well they handle claims, and how responsive they are. Consider the premiums and talk to other doctors served by them. Get details about their process and customer satisfaction.

How long has the company been in business? Do they offer risk management advice? For fiscal health, research their A.M. Best rating. You want them to be at least A minus.

Tip: Get more information from the state insurance commissioner’s office once you have finalized your top two choices.

Insurance Type

Insurers differ bases on who owns them and their organization. The most common types of insurance carriers are commercial, mutual, trust, risk retention and captive. Another fact is if a carrier is physician owned. These tend to insure more than half of the doctors in the US buying their own insurance. They tend to be well liked by physicians because they advocate for their doctors and are fairer.

Tip: Choose a carrier that will listen to you and not just shoehorn you without hearing what you have to say.

Are There Endorsements?

Are there any endorsements or policy extras? Is there coverage for cyber liability for patient records? Are they covering Medicare and Medicaid? Is there administrative/ medical board defense coverage? These are features of high-quality policies. If you are a procedure heavy specialty, is there coverage for those procedures and are all the locations of those procedures added to the policy. Are there exclusions for certain medications or procedures?

Tip: Ask about the exclusions and endorsements.

Maintain Good Records

Record keeping is important. Keep a copy of your insurance coverage for every year during your training and later. The carrier is not required to have a copy that they covered you but you should. Maintain a record of all work activities, shared practice, moonlighting, dates you worked, where you worked, timings, and which malpractice insurance covered you, Keep a copy of your Certificate of Insurance for every malpractice insurance policy you have ever had.

Tip: If your employer hasn’t given you your Certificate of Insurance, ask for a copy.

How do you deal with malpractice insurance. What are your tips for individual doctors and smaller practices especially in a post COVID world?