Malpractice Insurance

As nurse practitioners (NPs) assume more autonomy and take on more responsibility, they increase their legal liability. NPs are now being held accountable to their scope of practice. The resulting dilemma is that as scope of practice and autonomy increase so does susceptibility to malpractice exposure.

Professional liability insurance (PLI), also known as malpractice insurance, is an insurance policy that provides financial protection in the event of a malpractice claim. PMI is sold in two forms:

Claims-made policy – covers claims made while the policy is in force but not if a claim is made after the policy expired.

Claims-occurrence policy – covers claims made at the time the policy was in effect regardless of when the claim is made.

How much malpractice insurance is enough?

The best answer is: As much as you can get and afford.

To Avoid a Malpractice Lawsuit

• Do not establish a duty to a patient when you do not have to
• Do not offer advice, diagnosis, or treatment outside of your scope of practice and expertise
• Base your diagnosis and therapy on guidelines and references commonly accepted in your area of practice
• Order a consultation or refer a patient if the history and examination suggest a differential which includes a deadly condition, and you have not ruled out or treated that condition
• If you order a test or consultation, follow through to be sure it was done and that the results were dealt with appropriately
• If the standard of care calls for screening for disease due to your patient’s age, gender, or risk facts, conduct the screening and follow through if the results are positive
• Document carefully so that your actions are justified and your process for medical decision making is discernable to an outside evaluator
• If you cannot practice safely in your current work situation, for whatever reason, leave that situation and find somewhere you can practice safely
• Purchase your own “occurrence” malpractice insurance policy

Picking a Policy

• Ask these questions of companies from which you are considering purchasing malpractice insurance:
• What does the policy cover?
• What is excluded from coverage?
• What are the policy limits?
• How long have you been in business?
• How long have you been writing policies for NP’s?
• What is your financial stability rating?

What questions should I ask my employer about their policy?

• Am I protected individually under the policy? (i.e., am I specifically named as an insured?)
• Does my insurance include License Protection to help defend me in an administrative or disciplinary situation
• If I leave my employer, will its policy cover me for an incident that occurred while I was still employed? (i.e., is my employer’s policy “Occurrence”?)
• Do I have my own individual limits of liability?
• What level of coverage do I have?
• May I see the policy?
• Do I have coverage 24 hours a day

References

ACNP (2012). Frequently Asked Questions about NP Liability Insurance. Retrieved from

http://www.acnpweb.org/frequently-asked-questions-about-np-liability-insurance

Buppert, C. (2008). Frequently asked questions, and answers, about malpractice insurance. Dermatology Nursing, 20(5), 405-406.