Frequently Asked Questions About Medical Malpractice Insurance

Medical malpractice insurance is essential for healthcare professionals to protect against potential lawsuits and claims. Below, we answer the most frequently asked questions to help you understand coverage, costs, and legal protections.
What is medical malpractice insurance?
Medical malpractice insurance is a type of professional liability insurance that protects healthcare providers from lawsuits alleging negligence, errors, or omissions that result in patient harm.
Why do healthcare professionals need medical malpractice insurance?
Lawsuits in the medical field are common, and legal defense costs can be substantial. Malpractice insurance helps cover legal fees, settlements, and judgments, preventing financial ruin.
What does medical malpractice insurance cover?
It typically covers:
• Legal defense costs
• Settlements and judgments
• Court fees
• Attorney fees
• License protection for board investigations
What is the difference between claims-made and occurrence policies?
• Claims-made policies cover claims only if the incident and the claim both occur while the policy is active.
• Occurrence policies cover incidents that happened during the policy period, regardless of when the claim is filed.
How much does medical malpractice insurance cost?
Premiums vary based on specialty, location, coverage limits, and claims history. Physicians in high-risk specialties (e.g., surgeons, OB/GYNs) typically pay higher premiums than those in lower-risk fields.
What factors affect the cost of medical malpractice insurance?
• Type of medical specialty
• Geographic location
• Policy type (claims-made vs. occurrence)
• Coverage limits
• Claims history
• Experience and training
Do all medical professionals need malpractice insurance?
Yes, doctors, nurses, dentists, chiropractors, and other healthcare providers should have malpractice insurance to protect their careers and finances.
Is medical malpractice insurance required by law?
It depends on the state. Some states require malpractice insurance by law, while others do not. However, hospitals and employers may require coverage regardless of state laws.
What is the difference between professional liability and medical malpractice insurance?
Medical malpractice insurance is a type of professional liability insurance specifically designed for healthcare providers. Professional liability insurance applies more broadly across various industries.
How do I choose the right medical malpractice insurance policy?
Consider factors like coverage limits, policy type, reputation of the insurer, additional features (e.g., tail coverage), and cost. Consulting an insurance specialist can help you make the right decision.
What is tail coverage in medical malpractice insurance?
Tail coverage extends protection after a claims-made policy ends, allowing claims to be reported even after coverage has expired. It is crucial for professionals changing jobs or retiring.
How does prior acts coverage work?
Prior acts coverage (or nose coverage) protects against claims for incidents that happened before a new claims-made policy started, as long as they fall within the retroactive date.
What happens if my policy lapses?
If a claims-made policy lapses and you don’t have tail coverage or a new policy with prior acts coverage, you will not be protected against any claims filed for past services.
Does medical malpractice insurance cover telemedicine services?
Most modern policies offer coverage for telemedicine, but it’s important to confirm with your insurer, as some states have specific regulations.
Are legal defense costs included in medical malpractice insurance?
Yes, most policies cover attorney fees, court costs, and expert witness expenses. Some policies have defense costs inside policy limits, while others have separate limits for legal fees.
What are policy limits, and how do they affect coverage?
Policy limits determine the maximum amount the insurer will pay per claim and per policy period. Common limits are $1 million per claim / $3 million aggregate per year.
Can I switch malpractice insurance providers easily?
Yes, but make sure to arrange for tail coverage or a new policy with prior acts coverage to avoid gaps in protection.
How do I know if my policy meets my state’s requirements?
Check with your state’s medical board or consult an insurance specialist to ensure compliance.
Does my employer’s malpractice insurance fully protect me?
Not always. Employer-provided policies may not cover independent work, moonlighting, or lawsuits that target you personally.
What is vicarious liability, and does malpractice insurance cover it?
Vicarious liability means you could be held responsible for another provider’s negligence (e.g., an employee under your supervision). Most malpractice policies cover this risk.
What should I do if a patient files a malpractice claim against me?
• Notify your insurance provider immediately.
• Avoid discussing the case with anyone other than your insurer and attorney.
• Gather relevant medical records and documentation.
How does the claims process work?
1. Claim filed – A patient or attorney files a lawsuit.
2. Investigation – The insurer reviews medical records and facts.
3. Legal defense – Your insurer assigns a defense attorney.
4. Resolution – The case may be dismissed, settled, or go to trial.
How long do I have to report a malpractice claim?
The statute of limitations varies by state, but most claims must be reported within 2-3 years from the date of the incident or discovery of harm.
What happens if I am sued after I retire?
If you had a claims-made policy, you need tail coverage to be protected. If you had an occurrence policy, you are covered automatically.
How can I reduce my risk of a malpractice lawsuit?
• Maintain clear and thorough patient records.
• Communicate effectively with patients.
• Follow best practices for informed consent.
• Stay updated on medical guidelines and training.
Does malpractice insurance cover board investigations or disciplinary actions?
Some policies include license defense coverage, which helps cover legal costs if you face an investigation from a state medical board.
What are the most common reasons for medical malpractice claims?
• Misdiagnosis or delayed diagnosis
• Surgical errors
• Medication mistakes
• Birth injuries
• Failure to obtain informed consent
How does medical malpractice insurance help if I’m falsely accused?
Even if the claim is groundless, your policy covers legal defense costs, protecting your reputation and finances.
How long does a malpractice claim take to resolve?
Some claims are dismissed quickly, while others can take months or years if they go to trial. The average length of a malpractice lawsuit is around 2-5 years.
Can my premiums increase after a malpractice claim?
Yes, insurers may raise premiums based on claims history, especially for severe cases with large payouts. However, risk management programs can help minimize premium increases.