No matter how adept a physician is in their field, one key element to achieving and maintaining a successful career is investing in quality medical malpractice insurance. Physicians must do their due diligence when researching malpractice insurance options, as there are a variety of carriers, coverages, and policies in different states.

Aside from the fact that the law requires physicians to have malpractice insurance, President and CEO of EmPRO Insurance Company, Bruce Shulan, states that physicians need malpractice insurance for a number of additional reasons. For instance, medical malpractice insurance is required for hospital privileges. It also provides professional and personal protection to shield physicians from losing their medical licenses due to incidents occurring during treatment, surgery, and diagnosis.

Insurance Carriers Can Either be Admitted or Non-Admitted

According to Shulan, physicians should be aware that insurance carriers can be either admitted or non-admitted. Whereas the former is state-regulated and, to a certain extent, financially protected by the state, the latter does not have to operate in sync with state regulations and therefore lacks certainty that claims will be paid if the insurance company becomes insolvent. Shulan also notes various coverage types, including primary, occurrence, excess, and claims made.

Primary policies react to the first dollar of loss. New Jersey-based Business Credentialing Services defines occurrence policies as those that offer lifetime coverage for any incidents occurring within the policy timeframe, even if the claim is filed after the policy ends, whereas claims made policies (aka, tail coverage) only cover claims filed against the insured within the policy period. Excess policies offer limits that extend beyond those offered in the primary policy.

Did Physician Act Within State’s ‘Standard of Care’?

There are many factors that affect how medical malpractice insurers determine policy costs. Shulan suggests some considerations, including physician specialty, geographic location of the practice, and claims history. When it comes to deciding if a physician practiced “bad medicine,” Shulan notes that insurers boil it down to considering if a physician acted against the state’s “standard of care.”

Malpractice lawsuits can prove perilous and time-consuming for physicians. They negatively impact physicians both financially and reputationally. As such, it would behoove physicians to align themselves with trusted insurers and attorneys. According to Shulan, physicians can protect themselves against malpractice suits by taking measures such as contemporaneously documenting patient charts, using a productive patient-tracking systems, tying up any pending test results, and implementing an effective system for follow-up care. Shulan also suggests that physicians document any patient non-compliance, but that physicians should never change patient charts after-the-fact.