Vol. 8 Issue 17
Nursing Malpractice Insurance
Failing to purchase individual professional liability coverage can be risky business for nurses
Nursing malpractice or professional liability insurance policies are designed to help pay legal expenses and/or judicial awards associated with allegations of negligence in your nursing duties.
To help to make an informed decision of whether to purchase malpractice insurance, nurses should become familiar with the types of coverage, the cost and general benefits of having their own malpractice insurance. Also consider the type of nursing you practice, your practice setting and whether you feel better having added insurance coverage.
What Is Malpractice Insurance?
A nursing malpractice insurance policy is a contract. You agree to pay a premium to an insurer who promises to defend you if a claim is brought against you, and also to supply monies needed to settle any award against you within the limits of your coverage. Such insurance is typically purchased or renewed yearly for an agreed-upon amount of coverage. The coverage limits usually are presented on the policy application.
Current premium cost for staff nurses employed full time is less than $100. Self-employed nurses, staff in specialized areas or advanced nurse practitioners will find rates and coverage amounts are incrementally higher depending on the risk value associated with the area of practice. Self-employed nurses, midwives, CRNAs and nurses practicing in certain specialties like labor and delivery, APRNs and NPs often must pay more for coverage.
The written policy will define the type of coverage you've purchased, the amount of coverage, any special conditions and any limitations. The policy declaration page will outline the services purchased and steps required of the insured in the event of a claim (e.g., how soon the insurer must be contacted following the claim).
Some Types of Insurance
An occurrence-based policy usually includes coverage for defending complaints brought against your nursing license and claims made when you were in a volunteer role, (i.e.,while being a good Samaritan). The policy may offer benefits for non-work-related claims, such as medical payments for an injury that occurs to a visitor in your home, as well. This type of policy often covers legal expenses and settlements, and also may pay wages while the insured attends legal proceedings.
What's more, occurrence-based policies typically extend into retirement. So if a claim is brought against a nurse for an incident that occurred while still on the job, even though the policy was since cancelled, she would be covered. Most states have a 2-year statute of limitations for filing a malpractice claim. In cases involving a minor, the time limit typically extends until the claimant reaches age 20.
A claims-made policy protects the insured during a set time period. The insurer will not cover claims made after that time, even if the injury occurred during the time the policy was in effect. A claims-made policy is often purchased by a healthcare organization to cover a certain time period, and also to provide insurance for amounts greater than the organization is prepared to handle. For example, an organization may bear the burden of the first $1 million of a claim and then purchase additional insurance coverage for larger award amounts.
Things to Know
Legally, healthcare facilities are responsible for the acts of its employees, known as vicarious liability. As a component of this liability the term "Respondent Superior" offers legal definition that the employer must answer for the negligent acts or omissions of its employees that occur in the course of employment.
Employers do not routinely discuss the type of malpractice coverage available to nursing staff. As nurses, we traditionally "know the facility covers us." But exactly what that means may differ from what a nurse assumes it means. Will your employer provide legal representation for you? Will that lawyer work just for you or jointly for you and your organization? Will there be any limitations related to legal expenses? Will the facility continue to support you and provide legal assistance if it becomes evident there are conflicting opinions as to how to best defend you and the facility?
If a nurse conducts herself in a manner considered outside of the scope of the nursing license or parameters set by job description, the facility may deny responsibility for any harmful actions. If the nurse is found to be at fault, the facility may try to collect all of its expenses from the nurse. If the nurse has insurance, the facility may seek reimbursement (indemnification) from her insurance company.
Any nurse can get sued. When an injured patient consults a lawyer, all medical records are reviewed. If you are identified as being directly involved with an injury to a patient, it is likely you will be named as a defendant, whether you have insurance or not.
During discovery, you will be asked if you have insurance coverage applicable to the incident. Lawyers tend to name all the parties regardless of whether there is insurance coverage or not. If the claim is legitimate and the patient is awarded a settlement or a jury verdict, you may be held responsible. Your personal savings and future earnings could be subject to a lien, and, depe nding on where you live, your home and car may be, as well.
If you have no insurance, your employer may bear the burden of paying any damages awarded, even if the court finds you fully or partially responsible for the injury. But if the court awards an amount beyond the employer's insurance coverage, or if you are found grossly negligent, you may have to pay all damages.
Aiken, T. (2004). Legal, ethical, and political issues in nursing (2nd ed.). Philadelphia: F.A. Davis Company.
Bernzweig, E. (1996). The nurse's liability for malpractice. (6th ed.). St. Louis: Mosby.
Nurses Service Organization. (2003). What every policyholder should know. (Summary of benefits brochure).
Ann Zonderman has served as a medical malpractice defense attorney and is a licensed healthcare risk manager and legal nurse consultant. She has served as an expert witness and is an infusion therapy educator.