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What does your Malpractice expense look like?

If you work in health care, you have the possibility of a malpractice lawsuit. A malpractice suit can set your practice back quite a bit or even devastate your practice without malpractice insurance. 

Malpractice insurance, also known as medical professional liability insurance, is your protection when (not if) patients suffer bodily injury or harm. “Bodily injury or harm” could include medication mishaps, surgical mistakes or even misdiagnosis. 

Malpractice insurance is a federal requirement for almost all healthcare professionals including the following:

  • Physicians
  • Surgeons
  • Chiropractors
  • Anesthesiologists
  • Nurses
  • Pharmacists
  • Dentists
  • MedSpa or Skin Clinic Technicians

Who pays for malpractice insurance?

Typically, all healthcare professionals employed by a hospital will be covered by said hospital. Doctors who operate their own practices typically pay for their own malpractice insurance, and larger groups may or may not pay for the expense. 

Medical professionals who work for federal agencies do not pay for malpractice insurance: the federal government is the insurer. 

The cost of malpractice insurance depends on factors, such as:

  • Your specialty. If you’re an ENT doctor versus an ER doctor, your rates will be completely different.
  • Your state. This is impacted by state laws and cost of living.
  • Whether you work full or part time.
  • The type of coverage package you purchase.
  • The policy’s dollar limit per claim.
  • The policy’s aggregate limit on claims.

What does a malpractice insurance policy cover?

Though your specific package may come with a different amount of coverage than someone else, the following are typically on a malpractice insurance policy:

  • Court costs.
  • Attorney fees.
  • Settlement costs.
  • Medical damages.
  • Arbitration fees.
  • Punitive and compensatory damages.

Malpractice insurance does NOT typically cover:

  • Sexual misconduct (that’s a criminal case).
  • Criminal activity.
  • Inappropriate alteration of records.
  • Cyber liability. (You’ll likely need to have a conversation with your representative if you think you have this one.)

For the time period of the insurance plan, you’ll need to go through that insurance. So that includes anything that is filed after your coverage has ended but occurred during the time of coverage. Be sure to call your representative if you have any questions regarding a specific lawsuit.

How “defensive medicine” becomes a crux

Many doctors order unnecessary tests or make unnecessary referrals to avoid malpractice trouble. In fact, Excellus estimated that $45.6 billion was spent on malpractice defensive medicine compared to $10 billion in insurance payments, administrative expenses and other costs back in 2010.

It’s an interesting argument, but what is labeled defensive medicine can be construed as legitimate practice, so the amount of money found may or may not be entirely accurate. It’s safe to say that many doctors perform tests and make unnecessary referrals, but how many and when are difficult to determine. 


What is Rivet?

Rivet is a software solution that integrates with your EHR for up-front patient cost estimates (that comply with the No Surprises Act), as well as denied claim and underpaid claim tools.

Download this PDF to see more information about Rivet's products.