Malpractice for locum clinicians.

What malpractice insurance covers

Professional liability insurance, which most clinicians call malpractice coverage, responds to claims that your professional services caused harm. It pays settlements and judgments up to a per-claim limit and an annual aggregate limit, and it pays for your defense.

Some policies pay defense costs on top of the limits and some count them against the limits.

Claims-made vs occurrence

A claims-made policy covers a claim only if the incident happened after the policy's retroactive date and the claim is reported while the policy is in force. If a patient files two years after the visit and the policy ended last month, the claim isn't covered unless tail coverage is in place.

An occurrence policy covers incidents that happened while it was in force, whenever the claim arrives, so it needs no tail.

Tail coverage (extended reporting)

Tail is an extended reporting period. It covers claims reported after a claims-made policy ends, for incidents that happened while the policy was in force. Without it, ending a claims-made policy leaves no coverage for a claim that arrives later.

Who pays for tail depends on the policy and the contract: sometimes the prior carrier's policy includes it, sometimes a new carrier covers prior acts (called nose coverage), and sometimes the clinician buys it.

NPDB reporting

The National Practitioner Data Bank (NPDB) collects reports of malpractice payments and of adverse actions on licenses and clinical privileges. Any malpractice payment made on a practitioner's behalf, in any amount, is reported by the insurer or entity that paid it.

Hospitals are required to query the data bank, and other eligible health care entities can. What you disclose in a credentialing file can be compared with what's been reported.

What credentialing looks at

When a facility credentials you, the malpractice part of the file usually covers three things.

• Coverage for the shiftThe named insured, the limits, and the form (claims-made or occurrence).
• Claims historyA clean record or a complete disclosure of past claims, settlements, and judgments.
• Loss-run report, if requestedA summary from prior carriers of claims paid or pending against you.

What to ask about any coverage

The same four questions apply to a policy you buy yourself and to coverage an agency, platform, or facility arranges.

• Who is the named insured?The person or entity the policy is written for, and whether you're covered by name or as part of a group.
• What are the limits?The per-claim limit, the annual aggregate limit, and whether defense costs count against them.
• Is it claims-made or occurrence?For a claims-made policy, the retroactive date sets how far back covered incidents go.
• Who pays for tail?If the coverage is claims-made, someone covers the period after it ends: the prior carrier, a new carrier, or you.

This is not legal or insurance advice

This guide explains how malpractice coverage generally works. It isn't legal or insurance advice. Your carrier or a healthcare insurance broker can tell you how it applies to a policy you hold.