Understanding Medical Malpractice Insurance for Nurses
Medical malpractice coverage, sometimes called professional liability insurance, provides financial protection to nurses if they are sued for an actual or potential error, omission, or negligence in their practice. Registered nurse roles are extending the boundaries of practice to include more independent decision-making and procedures that have traditionally been performed by physicians. As a result of these professional changes, nurses are more vulnerable to personal liability risks.
The truth is alarming: According to industry leaders, the average settlement cost for a malpractice suit against a nurse can exceed $150,000, with some claims settled in the millions of dollars. Without appropriate insurance coverage, you would have to pay these costs from your assets.
Why Employer Coverage May Not Be Enough
Many nurses believe their employer’s malpractice policy shields them from liability. Although employer protection provides some level of safeguard, it often does not provide adequate coverage:
- Employer policies are designed to prevent risk to the institution’s interests, not necessarily your interests.
- There may be limits on coverage for your situation.
- Coverage may not extend to activities outside of your primary job.
- You may not be covered for prior acts if you have switched employers.
- The policy may not allow for legal representation for your defense.
Insurance for personal medical malpractice gives you a safeguard for coverage and legal representation that is focused on defending your interests and your career.
What is the Best Medical Malpractice Insurance for Nurses?
The “best” medical malpractice insurance depends on your particular nursing specialty, where you practice, and any unique circumstances. However, superior policies typically offer:
Key Features to Look for
- Occurrence vs Claims-Made: Are you covered for an incident that occurred during the policy term, no matter when the claim is expressed? Occurrence policies would cover you if the incident occurred while on this policy. Claims-made policies cover you for claims made while the policy is active. When you cancel your claims-made policy, you will need to purchase “tail coverage”.
- Proper Limits of Coverage: Most nursing professionals should be looking for policies that have at least $1M per occurrence and $3M aggregate limits.
- License Protection Coverage: This would include the costs of defense if you received a complaint from the state board, and a complaint investigation of your license is ongoing.
- Consent to Settle: Policy should require you to agree to the settlement.
- Legal Defense Costs: Coverage for attorney fees, court fees, expert witnesses, etc., that do not reduce liability limits on the policy.
- Changes and flexibility: Changes in practices, working in multiple practice settings, and flexibility in changing policy if your career changes.
- Deposition representation: Legal representation when asked to testify, even if you are not named in the lawsuit.
Considerations Related to Specialty
Nursing specialties involve different levels of risk, and coverage must be tailored:
- Nurse practitioners and CRNAs: Typically insured for higher limits ($2M/$6M) because of more autonomy and higher risk procedures
- Labor and delivery nurses: Increased coverage because of the riskiness of obstetrical care and possible large damages
- Critical care and emergency nurses: Added protection in fast-paced, high-acuity environments
- Home health nurses: Coverage that follows the nurse, regardless of the care site, and covers travel between locations.
State-Specific Requirements and Considerations
Malpractice insurance requirements and healthcare environments vary significantly by state. Understanding the specific landscape in your state helps ensure you have appropriate coverage.
Medical Malpractice Insurance for Nurses in Florida
Florida has an unusual legal climate surrounding healthcare professional. Where nurses are not required to obtain malpractice insurance, Florida’s litigation-friendly nature makes it a necessity.
Florida allows plaintiffs two years from the date of discovery of an injury (or four years from the date of the injury) to file a claim, which puts the healthcare professional’s long-tail liability risk at considerable lengths.
It is essential for Advanced Practice Registered Nurses (APRNs) in Florida, especially those with prescriptive authority, to have extensive coverage based on the increased scope of practice outlined in new legislation. Florida APRNs should ensure their policies have limits of at least $1M/$3M and cover Florida’s unique regulatory environment.
No matter if you work in the medical centers of Miami, the growing healthcare systems of Orlando or with other rural communities, Florida nurses would benefit from policies that contain strong legal defense components given the complex medical liability environment within the state.
Medical Malpractice Insurance for Nurses in New York
New York maintains one of the highest levels of medical malpractice insurance premiums in the country. Physician legal liability cases do litigate, contributing to the active environment that characterizes New York. As opposed to single and several liability, New York follows a joint and several liability policy. This means that any defendant found liable even partially, could be responsible to pay the entire judgement amount if the other defendants are unable to pay their judgement.
For nurses working and living in New York city and the Metropolitan area, increased coverage limits should be considered due to the higher claim amounts and settlements in this region. The statute of limitations in New York is generally 2.5 years past the date of the alleged malpractice event, except for issues related to foreign bodies left after a surgical procedure and continuous treatment.
Nurses working in New York should be mindful if their policies provide coverage for punitive damages because New York is one of a few states that can have these awards covered. Additionally, given New York’s high litigation costs, it’s important to ensure your policy has a reasonable amount of legal defense coverage.
Individual RN, LPN, and nurse practitioners will find that individual policies provide a benefit to employer provided coverage by providing individual legal representation and protection that spans multiple practice settings.
Medical Malpractice Insurance for Nurses in Texas
In 2003, Texas instituted major tort reform that capped non-economic damages in medical malpractice cases at $250,000 for each health care provider, with an overall cap of $750,000. This reform has not entirely removed unpredictability from the liability environment, but it has created a somewhat more predictable one, and full coverage is critical.
Nurses in Texas are not required to carry individual malpractice insurance. However, patient complaints or incidents can result in an investigation by the Texas Board of Nursing. Because of this, the license defense coverage is an invaluable piece of coverage for nurses in Texas.
Nurse practitioners in Texas, especially those practicing under physician supervision in prescriptive authority agreements, are afforded important protections by policies that specifically address scope of practice issues and collaborative practice arrangements.
Texas nurses should make sure their policies address coverage for regulatory and administrative proceedings because the Texas Board of Nursing has broad disciplinary jurisdiction. Furthermore, the variability in practice settings, ranging from urban centers, such as Houston and Dallas, to rural areas, creates different risk profiles to consider for coverage.
Medical Malpractice Insurance for Nurses in Georgia
Georgia’s medical liability scene has a two-year statute of limitations for most claims and a five-year statute of repose (absolute deadline). Georgia has attempted to limit non-economic damages to $350,000, but the state Supreme Court found the cap to be unconstitutional, opening up the potential for higher settlements and verdicts.
Georgia nurses, mainly those with independent practice authority, should keep in mind Georgia’s relatively plaintiff-friendly legal environment when deciding what coverage limits to carry. For advanced practice nurses in Georgia, policies that included prescriptive authority and expanded scope of practice offered important protections.
The different healthcare delivery systems in Georgia – from the major medical centers in Atlanta to rural community hospitals – result in different risk exposures to you, the insured, and will help you in making your insurance decisions. There are policies written for Georgia nurses that provide consent-to-settle provisions which means that you get a say in how claims brought against you are settled.
As Georgia grapples with a shortage of nurses, especially in rural areas, nurses who practice in multiple facilities or settings, should ensure that their policies provide coverage for all geographies and settings of practice.
Medical Malpractice Insurance for Nurses in California
California’s Medical Injury Compensation Reform Act (MICRA) caps non-economic damages in medical malpractice cases at $350,000 for non-death cases and $500,000 for wrongful death claims (these caps will gradually increase to $750,000 and $1 million respectively by 2033). In addition, this allows for some predictability of claims even in California’s highly regulated health care system.
California has strict licensing requirements and scope of practice laws. Individual malpractice policies specifying regulatory defense coverage provide an immense asset to nurses dealing with Board of Registered Nursing investigations.
New legislation in California that expands nurse practitioner practice authority means that comprehensive coverage is more imperative for these practitioners. When you gain practice autonomy, you also increase your exposure to personal liability and have to purchase coverage that is specifically designed to protect you.
California’s work environment for nurse practitioners is multifaceted, with urban centers like Los Angeles and San Francisco, as well as rural communities, which all bring about certain unique risk factors. If your scope of practice includes multiple settings, you want to make sure that your policies cover adequate immediacy and settings, and there are no exclusions that could create blind spots in your protection.
Frequently Asked Questions
1. Do nurses really need their own malpractice insurance if they’re covered by their employer?
Yes. Employer policies often prioritize the institution, may not cover all scenarios, and may not include personal legal representation.
2. What’s the difference between occurrence and claims-made policies?
Occurrence policies cover incidents during the policy period, even if claims arise later; claims-made policies only cover claims made while the policy is active.
3. How much malpractice insurance coverage should a nurse carry?
Most nurses should carry at least $1M per occurrence and $3M aggregate; advanced practice nurses may need higher limits.
4. Does malpractice insurance cover legal defense during board investigations?
Yes, many policies include license protection, covering legal defense during board complaints or investigations.
5. How much does malpractice insurance cost for nurses?
Costs vary by role and location – RNs typically pay $100–$500 annually, while nurse practitioners may pay $600–$3,000.