PNP Insurance Questions

Do I need individual malpractice/liability insurance?


It is important to ask your future or current employer whether or not you will be covered under the practice’s or hospital’s malpractice insurance plan.  If so, you must find out the following information:

  • What are the limits of liability?
  • Are there any exclusions (i.e. negligence)?
  • Is the policy enforced 24 hours a day/7 days per week?
  • Does the policy cover out of pocket expenses  (i.e. lost wages to attend court hearings, depositions, meetings with attorneys, etc)?
  • Does coverage continue if you are no longer employed with that practice or orgranization? (i.e. Is there tail coverage?)


However, as a pediatric nurse practitioner, carrying your own malpractice policy can protect you by providing assistance in preparation for a deposition, paying for your defense and working to settle a judgment against you. Although you may be discouraged from purchasing malpractice insurance by your risk manager or hospital attorney, it is likely that this individual does not wear both hats of nurse and lawyer. Some lawyers set forth the argument that getting your own liability insurance will make you a “deep pocket” and more likely to be sued. Unfortunately, if you are directly involved with any injury to a former patient who is now a plaintiff (e.g. the individual suing you for damages), it is highly unlikely that the injured plaintiff will care whether or not you have malpractice insurance. In most cases, the information regarding insurance is not available prior to the filing of a lawsuit anyway, and the plaintiff will name any party who may have contributed to his/her injury. Remember that claims can be filed against you even if you have not committed any negligence.

A major reason a pediatric nurse practitioner may need to have individual malpractice coverage is because of the liability attached to every nursing act or nursing service provided when you are beyond the “scope of employment.” This phrase simply means that you are not on the job as an employee or as an independent contractor, and you have not formed the PNP – patient relationship. This covers all volunteer situations, emergency situations off the job, and any other time you respond as a nurse. Your employer’s malpractice insurance provides a defense only when you are in your capacity as an employee.


Does having my own individual professional liability insurance policy make me a more likely target for a lawsuit?

No. When you are named in a malpractice lawsuit, no one knows, not even the patient’s lawyer, whether you have your own professional liability insurance. Your insurance provider cannot confirm your policy’s existence to anyone other than you without your expressed written consent. So you won’t be named in a lawsuit just because you have coverage. Rather, if you do have your own coverage, your policy can protect you by preparing you for a deposition and paying for your defense and any settlement or judgment against you (NSO, 2010).


When looking for a policy, it is important to know what type of coverage your policy includes. There are many different options and benefits.  For a glossary of terms related to malpractice, see

To read NSO’s Malpractice Claim Study, go to


What is the difference between claims-made coverage and occurrence coverage?

Claims-made and occurrence are the two primary types of policy forms. An occurrence policy form covers losses that occur during the policy period, while a claims-made policy covers losses that occur during the policy period only if the claim is filed during the active policy period.


For example, suppose you carry a policy from January 1, 2012 to January 1, 2013 and subsequently fail to renew the policy. On September 30, 2013, you receive notice that you have been named in a malpractice lawsuit citing an incident that occurred on March 3, 2012. If your policy was an occurrence policy, it would provide protection for the claim, even though you received notice after the policy period ended. However, if it was a claims-made policy, you would not have coverage because the policy was not active at the time the claim was made.


To continue coverage of a claims-made policy after the policy period, you must purchase a “tail” from that policy’s carrier. Tail coverage extends the claims reporting period after the policy has ended. However, the incident will still need to occur while the policy was active. (Courtesy of NSO, 2/25/10)


There are three national liability providers to choose from: Nurses Service Organization (NSO), Cotterell, Mitchell & Fifer, Inc (CM&F Group), and Marsh Affinity Group Services.   Additional smaller state-based firms (e.g. Princeton Insurance Company in NJ) or hospitals that provide self-coverage are also available. NAPNAP has a relationship with:

Nurses Service Organization (NSO)

159 E. County Line Road
Hatboro, PA 19040-1218
Phone: 1-800-247-1500
Fax: 1-800-739-8818

Other Malpractice Insurance Companies:

Marsh Affinity Group Services, a service of Seabury & Smith
1440 Renaissance Drive
Park Ridge, IL 60068-1400
1-847-803-3100; 1-800-503-9230
Fax: 1-847-493-4401
Hours: Mon-Fri, 8:15 a.m. – 5:00 p.m. Central Time


CM&F Group
99 Hudson Street
12th Floor
New York, NY, 10013