New Grads: 5 Questions to Ask About Your Group Malpractice Coverage

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A lot is happening when physicians are looking for their first professional position: They are finishing training, taking the boards, and trying to decide where they may want to live and practice medicine.  As overwhelming as that may be, don't skimp on your due diligence as you decide which practice is the right fit for you - and make sure you know how you'll be protected from malpractice risks in the future. Here are 5 questions to ask about your group’s medical malpractice insurance coverage.

Question #1: What type of policy is it?

It’s important for you to know what type of malpractice insurance policy is being provided for you – Occurrence or Claims-Made?  Claims-Made coverage triggers based on when the claim is made against the provider; so a physician must carry the insurance while they are actively practicing and then obtain tail insurance (or nose/prior acts coverage from a new carrier) after the policy is cancelled to continue the coverage in the event that a claim is made after the termination date. Occurrence coverage triggers based on when medical incident actually occurred, even if the claim is filed after the policy has been cancelled.  Tail insurance is not necessary for Occurrence policies.

If your group is providing a Claims-Made policy for you, it’s important to find out who is responsible for purchasing the tail coverage when you leave.  This is an often-overlooked item that needs to be decided early in your contract negotiations and ideally written into your employment agreement so there is no confusion when you leave.  Tail insurance can be expensive (typically 1.5 – 2 times an annual premium), so you’ll need to be prepared for that expense if it will be your responsibility.

Question #2: Who is paying for your policy?

Ask your potential employer who will be paying for your malpractice insurance policy. It may be covered by the group, it may be deducted from your pay, or you may be individually responsible for paying the premium. If you are not satisfied with the coverage that is being provided, you may want to ask about obtaining your own separate policy.

Question #3: Are you covered on a shared limits basis? Or do you have your own individual policy limit?

Be sure to understand how much coverage you have in the event that you are named in a medical malpractice claim.  If you are covered on a shared limit policy, that means that you (and all the other named individuals) will be sharing the same policy limit, which potentially reduces the amount of coverage available to you.  It is generally recommended that physicians and higher-level practitioners have their own individual policy limits.    

Question #4: Is coverage limited to your scope & duty as an employee of X medical group?

As previously discussed, most employed physicians’ malpractice policies are not written on a broad form; they are limited scope & duty policies. This means that your policy only covers you for claims related to the work that you do for that employer. If the incident that led to a complaint falls outside the scope of your job description or falls within a policy exclusion, you may not have coverage.

If you provide professional medical services outside the scope of your employment, even if it’s as a volunteer or a favor to your neighbor, you need to have a separate policy in order to be covered. Good Samaritan laws protect you only in emergency situations. Many carriers offer moonlighting policies or part-time malpractice insurance policies at discounted rates, so obtaining additional coverage is generally affordable.  

Question #5: Do you have consent to settle?

Individual physicians and their employers may have different views when it comes to the impact of large verdict cases. Consent to settle becomes a key issue in these instances.  When your malpractice insurance policy contains a consent provision, the carrier must obtain your direct written consent before settling a claim on your behalf.

Consent to settle is important because it allows you to play an active role in the handling of your case. It gives you a voice in your defense.  Make sure you've read your malpractice insurance policy to know your rights when it comes to matters of individual consent or engage with a knowledgeable insurance agent to help.