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7 Dos and Don’ts of Medical Malpractice Insurance for RNs, NPs and PAs

As a medical professional, you may’ve encountered a horror story or two involving an RN, NP or PA who owed millions of dollars following a medical malpractice suit. The first thing that likely crossed your mind after hearing such a tale: How can I make sure this doesn’t happen to me?

The blunt answer is that it’s impossible to eliminate all risk of being named in a malpractice suit. And as RNs, NPs and PAs become more autonomous in their practice, their statistical risk of being sued increases.

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That’s why, with every employer or work setting you take on, you should assess what insurance coverage you’re provided and decide whether to pay for an additional plan from your own pocket. Here are some tips to help you make this call.

Do not assume you are less liable than the physician(s) with whom you collaborate.

Many RNs, NPs and PAs mistakenly believe they can’t be sued for malpractice if they work under an MD. And while physicians are certainly sued more often, the truth is: Working within a collaborative practice agreement that identifies a collaborating MD does not immunize you from a liability risk to a patient — unless the MD actually told you what to do, and even that circumstance or setting is not absolute.

Do ALWAYS have malpractice insurance of some kind.

“Mid-level providers absolutely need to have insurance coverage for the work they do, but it can come in a variety of ways,” Michael Paul Ringwood, Esq., equity partner at Smith Sovik law firm of Syracuse, New York, who’s defended healthcare providers for the past 35 years, tells Florence Health. “Most mid-level providers who work for somebody else, say, a private practice group, will likely have a contract … indicating whether malpractice insurance coverage for you is provided, in what amount and who will pay the premiums.”

A standard example of such an arrangement, Ringwood says, would be that your employer pays the premium for medical malpractice insurance, and the coverage would be at a maximum of $1 million per incident. But you can also purchase your own individual plan for additional peace of mind.

Do not assume your employer’s insurance plan will prioritize your needs.

Many employer plans have policy gaps or exclusions that can prompt your employer to refuse to defend you, according to American Nurse Today, the official journal of the American Nurses Association. What’s more, if your employer believes you may responsible for the liability it’s facing, it could even bring a counterclaim against you.

Do find out the details of the insurance coverage included in your employment contract.

If you do decide to seek out your own coverage, the first thing you should do is find out what exactly your employer’s plan addresses. For example, it may include excess and umbrella coverage. If so, in a situation where you’re found liable for $1.5 million in damages but the primary insurance only covers $1 million, the excess and umbrella insurance will likely cover the rest.

Your employer-provided insurance also probably does not include license protection benefits, which cover legal fees if you face an investigation or disciplinary charges by your licensing board, according to American Nurse Today. You can find out the details on your employer’s policy by contacting the insurance agency that wrote it.

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If it’s not included, your employer may purchase a rider to cover it, Ringwood says, or you can purchase a policy on your own to provide this coverage. Just keep in mind that this type of coverage is usually limited to a fixed maximum amount of $25,000 that can only go toward attorney fees.

Do secure liability insurance coverage on your own for any professional work outside the work you do for your main employer…

…unless you are certain your employer-provided insurance actually covers that other work. For example, many medical professionals moonlight, and as a result they decide “to purchase an additional insurance policy on their own” because their supplementary work “isn’t in the scope of their employment,” Ringwood explains. Also, if you do any volunteer work, you need to have an individual policy to be covered. Good Samaritan laws only protect you in emergency situations.

Do familiarize yourself with the risk of malpractice for your specialty.

Certain medical specialties — like orthopedics, obstetrics and gynecology, and radiology — have a higher risk of complications and poor outcomes and therefore a statistically increased risk of lawsuit, Ringwood stresses. The average judgement for such specialties will also be greater on average. “When you are dealing with patients who have greater risk of complications, the more likely it is statistically for non-perfect patient outcomes and therefore a greater statistical risk of lawsuits,” he adds.

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Do contact local insurance agencies as part of your research.

“Insurance companies providing malpractice insurance coverage are not unlike the auto insurance industry,” Ringwood says. “They work through agents, so find out what local insurance agents sell malpractice coverage and consult with them regarding your needs.” Do try to keep your research local because laws that govern malpractice insurance and suits vary from state to state.


What is Medical Malpractice?, American Board of Professional Liability Attorneys.

Why you need your own malpractice insurance, American Nurse Today.

Last updated on 8/23/19

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