In the News

Reading the Fine Print When Purchasing Malpractice Insurance

May 02, 2018

Unless you set up your own pathology practice or work as an independent contractor, you may not have first-hand knowledge of how to go about purchasing medical malpractice insurance. 

“A lot of pathologists get malpractice insurance through a group practice,” said ASCP Chief Legal Officer Lisa Simmons, JD. “Physicians have exposure. Whether they have to purchase their own insurance depends on the terms of where they work. If they are independent contractor, they may have to get their own.”

First, Simmons advises working with an insurance broker, who can help with the myriad factors that need to be considered in procuring medical malpractice insurance. Colleagues in your profession may be able to provide referrals.

You will want to know whether the insurance is occurrence or claims-made insurance. An occurrence policy protects you from any covered incident that “occurs” during the policy period, regardless of when a claim is filed. An occurrence policy will respond to claims that come in even after the policy has been canceled, as long as the incident occurred during the period in which coverage was in force.

Claims-made policies provide coverage when a claim is made against the insured during the policy period, regardless of when the wrongful act that gave rise to the claim took place.  (The one exception is when a retroactive date is applicable to a claims-made policy.)  

A broker will also make sure you purchase the right amount of insurance, based on your clinical specialty and the geographic region in which you practice. “You want to have the same amount of coverage as others in your practice. You don’t want too much or you’ll be a target,” Simmons said.

It’s also important to know whether the policy has a provision providing that the claim can be settled without the consent of the physician. “Insurance companies will make economic decisions to settle claims,” said Simmons. “In many instances, it may be in the interest of the doctor to settle the claim, but the doctor should be allowed to participate in that decision-making.”

A related matter is the policy’s limit to how much it will pay out to settle a claim. The doctor will want to know whether defense costs are included in that limit or outside that limit. “You don’t want to exhaust your policy limit with defense costs before you settle a case,” Simmons said, adding, “Make sure the insurance company has a good ranking so you know you‘re dealing with a financially-solvent institution.”

"While the majority of pathologists purchase their malpractice insurance through a group, this is important information to know about," advises ASCP President-Elect Melissa P. Upton, MD, FASCP.

Two final tips:  Remember to complete the insurance policy application thoroughly and accurately, and keep a copy of the insurance policy so you can find it when you need it.

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