Author: Chris Baxter

Tail coverage is integral to many insurance policies for businesses and professionals. We’ll explain everything you need to know about tail coverage in our guide, including how it works and the different types to consider.

Occurrence vs. Claims-Made Coverage

Before we get into the basics of tail coverage and the different policies it applies to, we should explain the differences between occurrence and claims-made insurance policy coverage. Tail coverage is for claims-made insurance policies that cover claims reported when the policy is active.

If a claims-made policy is inactive and a claim comes from a reported incident when the policy was active, it wouldn’t be covered. Occurrence is different, as it protects the insured from any covered incident when the policy was active, regardless of whether it’s expired. Tail coverage only applies to claims-made policies since it extends the time a claim can be reported against you. In contrast, the reporting time is irrelevant for occurrence coverage.

What Is Tail Coverage?

Now that you know about tail coverage for claims-made policies, you might wonder what exactly it does. Tail coverage is like an add-on to an insurance policy. It extends your coverage by giving you longer protection for claims reported after the insurance policy ends. This is also known as an Extended Reporting Period.

Tail coverage allows the insured to file a claim against the policy even though it’s expired or canceled. While it’s similar, don’t confuse tail coverage with nose coverage, which provides protection back to the first date of continuously maintained insurance coverage instead of extending reporting coverage of an expired policy.

Do I Need Tail Coverage?

While tail coverage is valuable and recommended, your need for it on top of your insurance policy depends on the policy. Tail coverage is especially common with medical malpractice insurance, as medical professionals may switch policies regularly, yet malpractice claims can come from incidents months or years in the past.

It’s quite common for medical malpractice claims to come from an incident years ago. If the target of the claim has since retired or changed policies, they could be vulnerable to the malpractice claim. If a medical professional retires, changes practices, leaves a practice for a hospital, or leaves their current work environment to start their own practice, they’ll likely have tail coverage for their malpractice insurance.

What Are the Alternatives to Tail Coverage?

While tail coverage is strongly recommended for many businesses and professionals, it’s not required. The alternatives to tail coverage include opting out (going bare) or choosing prior-acts coverage.

Going bare is just what it sounds like—the individual or business is left exposed without coverage for the gap in their coverage, but they save on monthly premiums. Prior acts coverage is similar yet different, as it applies coverage to the insured for any incidents that occurred to the policy’s purchase. Instead of extending the reporting of the previous policy, as with tail coverage, prior acts extend the reporting of the new policy.

How Long Does Tail Coverage Last?

While there are tail options for one, two or three years offered by some insurers, we recommend getting tail coverage for a term longer than that. Most of our tail policies and endorsements are unlimited and last a lifetime. Since malpractice claims can take a long time to be filed, we always recommend the longest tail your insurance company is offering.

Different Types of Tail Coverage

While we’ve mostly focused on tail coverage relating to medical malpractice insurance, our guide will now go over many different types of tail coverage. As mentioned previously, tail coverage is only for claims-made insurance coverage and applies to business and professional insurance.

Data Breach Insurance

Any business with an online presence or modern technology needs data breach cyber insurance. Data breach insurance protects businesses from cyber damage and other network-related issues, like a company computer getting a virus or customers suing the business because their personal information was stolen in a data breach.

Policy owners can add tail coverage to this policy to ensure protection if a claim comes forward months or years after the policy has expired. For cyber issues like data breaches and stolen private information, keep in mind that the victims may not notice they’ve been affected until months or years after the incident.

Employment Practices Insurance

Employment practices liability for businesses is another common type of insurance policy that includes tail coverage. This coverage protects businesses against claims regarding employment practices, like wrongful termination, discrimination, or harassment.

Practically every business with employees must have employment practices insurance to guarantee they’re protected if they terminate an employee and are faced with a wrongful termination lawsuit, which can be especially costly and damaging. Since these lawsuits and claims are so costly, it’s important to cover all gaps in their insurance, so tail coverage is necessary.

Management Liability Insurance

Management liability insurance, also known as directors and officers insurance, is another key business insurance policy. This policy protects the directors and officers of a business if they make mistakes or conduct wrongful acts while managing the company.

The claims against management may come from other employees, customers, competitors, or investors. Management liability is similar to employment practices but is limited to coverage for directors and officers instead of the business as an entity. As with employment practices, tail coverage is integral to the policy.

Professional Liability Insurance

Perhaps the most common version of tail coverage is for professional liability insurance. Professional liability policies are essential for many professionals, including doctors, CPAs, real estate agents, and lawyers.

This policy is ideal for professionals targeted for negligence, personal injury, malpractice, or other issues. Tail coverage is even more crucial for professional liability insurance because the individual could be left financially responsible for defending the claim with legal and court costs.

Where Can I Get Tail Coverage for My Insurance Policy?

If you require tail coverage for your professional liability or medical malpractice insurance policy, Baxter & Associates can help. As a renowned and experienced medical malpractice insurance agency, we can help you find the ideal policy and coverage, including tail coverage. Get a quote from our website online, or contact our staff if you have any questions.

Medical malpractice suits are always a concern for medical professionals. Below, we explain the four “Cs” of medical malpractice prevention that each medical professional should know to avoid malpractice cases.

Compassion

Compassion or caring should be self-explanatory for anyone in the medical profession who wants to help people. Doctors and nurses must sympathize with and show concern for their patients to help create a bond of trust.

One of the most common complaints and catalysts of medical malpractice claims against nurses or doctors is that the patient felt ignored or that the medical professional didn’t care about them. Take the time to go the extra mile with a patient and be honest with them to create a more compassionate yet professional relationship.

Communication

Communication is another critical factor in medical malpractice prevention. Communication encompasses verbal and non-verbal contact between medical professionals and between the medical professional and the patient.

Communication with a patient is critical, as the patient must feel their doctor or nurse is listening and giving them plenty of opportunities to ask questions as they review the problem and course of treatment, so they understand what’s happening. Communication between staff is also critical, as miscommunication or delayed communication can cause a domino effect that negatively impacts the patient’s health and causes harm.

Competence

Obviously, a medical professional must be competent if they want to avoid medical malpractice claims. A doctor or nurse should realize when a situation is outside their purview and recommend a patient to someone more competent when needed.

But the competence of malpractice prevention is also about staying capable in their position. The medical industry changes so often that doctors and nurses must constantly stay up-to-date with their training and education, so as not to use outdated practices and technology on the patients, potentially causing harm.

Charting

Charting is perhaps the most important factor in malpractice prevention and can be the easiest strategy. Proper documentation is critical to competent treatment and provides a detailed written record of the patient’s medical history.

A doctor needs quality documentation to adequately treat a patient, as it can cause significant harm if something’s missing or incorrect. The chart is often a key piece of evidence, so it’s crucial to ensure it’s accurate and up-to-date if a medical malpractice case goes to court.

Even if you follow every strategy of malpractice prevention, you may still be hit with a malpractice claim. Baxter & Associates can help medical professionals find specialized policies, like CRNA liability insurance. Contact our staff if you have medical malpractice questions or need a professional liability policy today.

Malpractice cases are an unfortunate part of the job of every health-care provider, including nurse practitioners. Below, we’ll explain the elements of medical malpractice and discuss some common examples of malpractice suits brought against nurse practitioners.

The Elements of Medical Malpractice

Before we get into examples of professional liability cases against nurse practitioners (NPs), we’ll discuss what it takes for a court to find a nurse practitioner liable. In the courts, four elements of malpractice liability must be present for the courts to find an NP or other medical professional professionally liable for harm to a patient.

Duty Owed to Patient

The first element the plaintiff must prove against the defendant is that the NP had a professional responsibility to care for the patient. This element is pretty basic and rarely contested by the defendant.

All the patient or the patient’s family must do is prove that the NP had a duty of care toward the patient. They can prove this if there’s any basic documentation or witnesses that prove the NP cared for the patient. The defendant can contest this if they claim that there was some miscommunication regarding who was responsible for the patient’s care, but such cases are rare.

Breach of Duty

After establishing the responsibility of care, the plaintiff must prove that the NP neglected or violated that responsibility. This is the most difficult element to prove, and the defense will usually contest it.

The breach of duty can come in many forms, like medication errors or absent patient monitoring, but another medical expert witness must corroborate this claim. It often requires medical expertise to decipher documentation and offer testimony about how the NP made an error.

Causality of Breach to Patient Injury

After the breach of duty, the plaintiff must also prove that the breach of duty directly caused the patient injury. Every malpractice case must include an injury to the victim; otherwise, there’s no basis for malpractice and no recourse that the courts can take.

Several things can cause the patient’s injury other than malpractice, including a worsening condition, a new injury/illness, or emotional distress. This element is often straightforward, and the plaintiff or defense can prove or disprove it with simple medical records or victim testimony.

Damages

Lastly, for the plaintiff to receive compensation for their injuries or injuries to their loved ones, they have to show the value of their case in damages. If there are no damages to the individual, the court cannot reward compensation.

Again, this element is often easy to prove if the plaintiff has already proved the breach of duty. Damages can include additional medical bills, lost wages, or out-of-pocket expenses related to the breach of duty. Often, the defense doesn’t contest the existence of damages but only the extent of them.

Examples of Medical Malpractice for Nurse Practitioners

While malpractice cases can come in all forms, there are many ways that NPs can receive a claim. Below, we’ve compiled a list of common malpractice suits brought against nurse practitioners.

Improper Documentation

One of the most common reasons an NP can receive a malpractice claim is errors in the documentation or a failure to document altogether. Documentation is a large aspect of an NP’s responsibilities, like documenting when they administered treatment or medication.

If there are errors in the documentation, like an NP forgetting to document how much medication they administered, that lead to harm, they could be liable for malpractice. Even something as simple as having illegible handwriting can lead to miscommunications and harm to the patient, so always write legibly!

Medication Errors

Another significant reason someone may bring up a malpractice case against NPs is medication. NPs must prescribe and administer medication, and even the slightest errors in prescribing or administering drugs can cause significant harm to a patient.

If an NP administers the wrong medication or the incorrect amount, they could be professionally liable. The same is true if they prescribe a medication that the patient is allergic to. With the opioid crisis, there’s also been a rise in NPs receiving cases due to overprescribing opioids to patients and causing opioid dependence. NPs must always look for the signs of addiction in their patients when prescribing powerful opioids.

Failure To Provide Care

One of the most basic examples of an NP breaching duty of care is failing to provide proper care altogether. This area of malpractice is vague and can relate to many responsibilities of NPs, like failing to diagnose a patient or not providing adequate medical intervention in an emergency.

If an NP neglects simple responsibilities, like helping a patient out of their bed, helping them move around for exercise, and preventing bed sores, they can be professionally liable.

Absent Monitoring

Another key part of the job as an NP is monitoring and observing patients. It’s often an NP’s responsibility to monitor the well-being of their patients and identify any signs of distress or harm, report those signs, and act immediately.

If a patient suffers a medical event, like a cardiac arrest, while under the supervision of an NP, and that NP doesn’t act quickly enough, causing greater harm or death to the patient, the patient could hold them responsible.

Treatment Error or Failure To Provide Standard of Care

NPs also have many responsibilities for treatment, which is another area of malpractice cases. NPs often perform hands-on treatment and perform medical procedures for patients. They could be liable if they make a mistake during these treatments that cause bodily harm or emotional distress.

Not every error is malpractice, but if the error results from an NP not following the standards of care, like failing to implement necessary safety protocols, they’d be vulnerable to a malpractice claim.

Conclusion

Malpractice suits are something that every NP must prepare for in case they make an error. Baxter & Associates helps NPs find insurance and even nurse practitioner student liability insurance for those working while still studying. If you’re a nurse practitioner who needs insurance, contact our helpful staff at Baxter & Associates and ask about malpractice insurance today.

A common reason for a malpractice lawsuit against a medical practice is unethical conduct from the clinic or a staff member. Below, we explain some of the most significant ethical breaches that can occur in medical practice.

Confidentiality Breach

Confidentiality is a significant concern for patients, so any breach of that confidentiality by a doctor or clinic is a serious form of unethical conduct. The Health Insurance Portability and Accountability Act (HIPAA) strictly prohibits the disclosure of sensitive health information without the patient’s consent.

Disclosing sensitive health information can sometimes occur accidentally, but it’s still a significant ethics violation that could expose the doctor and clinic legally.

Discrimination

Discriminatory behavior is obviously a major unethical conduct in medical practice—whether it’s discrimination of a patient’s gender, race, sexual orientation, or other protected category. Discrimination in health care can come in many forms, from doctors selectively choosing the patients they want to treat to being dismissive about specific gender issues.

Discriminatory conduct can also come in the form of verbal abuse if a doctor or clinic staff is inappropriate or abusive to a patient based on race, gender, or other criteria. This conduct is why diversity training and seminars can be valuable resources for clinics to avoid malpractice and discrimination lawsuits.

Covering Up a Mistake

Sometimes in medical practice, it’s not the mistake but the actions of the doctor and clinic afterward that are unethical. We’re all human, and we make mistakes. Still, if a doctor/clinic is deceitful about that mistake and withholds information from the patient regarding their medical condition, that’s a severe ethical and legal breach.

Patients have a legal and ethical right to information about their medical conditions—mistakes and all. If a patient later learns that a previous doctor/clinic made a mistake in their treatment and covered it up, they would have a strong case for malpractice and violation of informed consent.

Deceptive Billing Practices

An, unfortunately, all too common ethical breach in the health-care industry has little to do with doctors and patients and revolves around billing practices. The insurance billing system is complex and difficult for many to understand, which makes it a rife opportunity for shady medical billing professionals and clinics to dupe patients and insurance providers.

There are many examples and types of shady billing practices in health care, including:

• Upcoding (overbilling)
• Duplicate charges
• Phantom charges (billed for services never rendered)
• Unbundling (separation of charges that the insurance company should bill together)
• Incorrect quantities (inflating total items/medications received by the patient)

Any of these billing practices are an ethical breach for a clinic and could lead to legal action from the patient and the insurance provider.

Conclusion

There are clearly many opportunities for a clinic to face legal action due to unethical conduct, which is why group malpractice insurance is essential for any medical clinic. If you have questions about unethical conduct or malpractice insurance, contact our expert team at Baxter & Associates.

Insurance agents help professionals and ordinary people get the insurance coverage they need. You might wonder if professional insurance agents need malpractice coverage themselves. They do, and we’ll explain policies every insurance agent needs, like errors and omissions coverage.

Yes, Insurance Agents Need Liability Coverage

Every professional insurance agent should have liability policies to protect themselves and their business. Professional liability insurance is especially important. An insurance agent who runs their own business will need basic business coverage, like a business owner’s policy, worker’s compensation, and cyber liability insurance.

Insurance agents offer advice and counsel to clients, but that counsel doesn’t always work out. When this happens, the client may seek retribution against the agent. Every insurance agent needs malpractice coverage for protection in these cases, primarily errors and omissions (E&O) insurance.

Errors & Omissions Insurance

E&O insurance is a specialized policy to protect the insured against the legal cost of errors not traditionally covered by standard liability insurance. Insurance agents are people, too, and can make mistakes in the counsel or recommendations of their clients. Errors that E&O covers include the following:

• Giving the wrong advice accidentally
• Missing a deadline
• Failing to recommend coverage
• Not explaining policy provisions
• Errors made by the agent, team, or subcontractor
• Inadequate work

If a client feels that any of these errors by their insurance agent cost them a substantial sum or payout from the insurance provider, they may file a malpractice claim to force the agent to make up the difference.

What Errors & Omissions Insurance Covers

If the claim falls under one of the protected acts in E&O insurance, the policy will cover most of the costs of defending the agent in court. That includes attorney fees, court costs, and unfavorable judgments or settlements up to the policy’s limits.

Judgments and settlements regarding liability and malpractice can reach hundreds of thousands or millions of dollars, depending on the situation. Without liability insurance, the agent could be left on the hook for that payment themselves.

Conclusion

Now you understand why insurance agents need malpractice coverage and some policies the average agent needs. Baxter & Associates is a trusted malpractice insurance agency that connects professionals with suitable providers and can offer a liability policy. Learn more on our website or contact our staff to get started on a policy today.

Opening a medical clinic, like any small business, is a massive undertaking that’s difficult for many people—especially for those who know only the medical side of a practice. If you’re thinking of starting a medicine practice, our key tips below will help your clinic begin on the right foot toward becoming functional and profitable.

Obtain Funding

The first concern when building a medical clinic from scratch is securing the cash to get it up and running. Dollar amounts for how much a medical practice needs to get started depend on the situation and the practice itself.

There are two main considerations for securing funding: the startup costs, such as the medical and office equipment, and the initial operating expenses for overhead costs, staff, vendors, and more. It takes months or years for a medical practice to come close to earning a profit and generating a stable revenue stream. So until then, keeping the lights on will require additional funding. Unless you’re independently wealthy, the best way to secure funding is to get investors and loans from banks, and to do that will require a business plan.

Create a Business Plan

Like any other business, a key tip for starting a functional medicine practice is to create an informative and detailed business plan. A business plan acts as a pitch for banks and investors to secure funding and a roadmap for the medical clinic’s first couple of years of operation.

Most medical professionals launching a practice are more concerned about the medical side of the business. However, the operational and administrative side of things requires much of the thought and resources. There are many aspects of a business plan, so we’ll touch on some key elements below and how they relate to medical practice.

Executive Summary

The executive summary is the first section of a business plan and the first thing banks and investors will read. As the name suggests, this section is all the big ideas and plans of the other sections boiled down to a concise and attractive summary.

While it appears as the first section in the document, you should write it last to summarize the rest of the business plan accurately. The summary should be around a page or two long and feature the plan’s general information and best points, including who you are, what your practice offers, the competition, etc.

Problem and Solution

The core of any profitable business, whether a medical practice or a hot dog stand, is the problem and solution. What is the problem that the business is solving, and how will it solve the problem?

This section for a new medical clinic generally concerns the lack of specialty care in the practice area. For example, the problem may be that the aging population in such-and-such areas doesn’t have reliable chiropractic care within 50 miles, which this new chiropractic clinic will solve.

Target Market

Every business has a target market, which comprises the people the business will market toward and who will make up the core of its customer base. The target market section will relate to the problem and solution section. For example, if there aren’t enough gynecological or pediatric services in the area that a gynecology or pediatric clinic is proposing to solve, target market research will support the claim.

The target market section of a medical business plan should also include an ideal patient profile. This profile should include information like the patient’s income, health problems, where they live, their insurance, etc. It’s also wise to include a list of competitors for this target market and how this new practice will offer something different.

Marking and Sales Plan

After outlining the target market of the new practice, it’s time to explain how the practice will attract and retain this target market. A new practice has the disadvantage of not being known in the community and industry, so the marketing and sales plan is crucial for reaching the target market.

Will the clinic focus on direct mail campaigns or advertise more online? What areas will the advertising budget be most focused on and why?

Incorporate the Practice

Assuming you secure funding for your medical practice, it’s time to start the legal proceedings of starting the business, which include incorporating the practice. In many states, medical clinics can only operate as professional medical corporations, so it’s not much of a choice.

Incorporation provides many benefits to the owner—mainly, it protects the owner from personal liability for the business. So if it fails or faces problems, the business—not the owner—is liable. But owners who operate as medical professionals, like a chiropractor who runs their own clinic, would still be liable professionally for malpractice or negligence.

Invest in Quality Equipment and Staff

It may be tempting to cut corners regarding initial expenses and equipment to reduce costs at your new clinic. And while there are plenty of areas where you can make compromises, the equipment and staff are worth investing more money into for greater long-term value to the medical clinic. For example, for a chiropractic clinic, high-quality treatment tables and experienced chiropractors are well worth the investment over shoddy equipment and new staff.

New owners should also want to invest in experienced professionals for their front-office team, if they have one. An experienced front-office team will help clinic operators navigate the tumultuous waters of the first months and provide a clear delineation between the administrative and treatment side of the business.

Purchase Medical Business Insurance

Like any other business, a medicine clinic needs quality insurance coverage to protect management, employees, and the incorporated business. The following is coverage that every medical clinic requires:

• General liability insurance
• Business income insurance
• Commercial property insurance
• Workers compensation insurance

Medical clinics also have specialized insurance that caters to the unique circumstances of medical practices, such as medical malpractice insurance and medical office business insurance. Overall, quality insurance coverage is as critical to a business’s survival as the management and employees are.

Conclusion

We hope our guide on creating a medical clinic has been informative and helpful. If you’re starting a practice and need insurance coverage, Baxter & Associates can help you find medical malpractice insurance quotes that suit your business and situation. Contact our staff to learn more and find the right insurance policy for you.

Risk assessment is an integral part of insurance. Insurance carriers categorize potential policies by risk, affecting premiums, coverage, and all other parts of the policy. In this guide, we’ll examine the risk classifications for malpractice insurance, explain the elements of a successful malpractice lawsuit, and more.

How Risks Are Classified in Malpractice Insurance

When attaining malpractice insurance for an individual or group, the insurance carrier will place the policy into one of their risk categories. Below, we’ll highlight the main risk classifications for malpractice insurance and what they mean, so individuals can better understand their policy.

Preferred Risk

The best risk category for a policy to be in is preferred risk. A preferred risk individual or group policy is a medical professional or practice with a lower risk than average of filing a claim.

Medical malpractice liability Insurance providers use stats to determine these classifications—certain specialties and practices are more or less likely to be sued for malpractice than others. Examples of low-risk practices and professions include pediatrics, psychiatry, and general family practice. These aren’t guaranteed risk-free, but they come with the least risk statistically.

Standard Risk

As one could guess, the standard risk classification is the average risk for most malpractice policies. These individuals and groups are not significantly risky or low-risk and constitute the majority of medical malpractice policies.

Most medical professionals would fall into this category—typically registered nurses to physicians and specialists. But while an individual may work in a standard risk job, if they have a history of malpractice or prior lawsuits, they may be bumped into the impaired risk category.

Impaired Risk

Lastly, the policies considered the riskiest are placed in the impaired category. The insurance carrier considers an impaired risk to be an individual or practice that is riskier than the average but not such a liability that they’re not worthy of a policy.

Those that fall in the impaired risk category are typically those that work in specialties with the highest rate of malpractice claims, which include:

• • Plastic surgeons
• • Cardiovascular surgeons
• • OB-GYNs
• • Urologists

Surgeons are often classified as impaired risks because they’re common targets for malpractice claims.

The Elements of a Successful Malpractice Claim

Along with understanding the risk classifications, it’s also wise to understand the basic elements of a malpractice claim. For a malpractice lawsuit to be successful, it must prove four elements—a duty owed to the patient, a breach of that duty, injury caused by the breach, and damages.

These elements are sometimes called the four Ds: Duty, Dereliction, Direct Cause, and Damages.

Duty Owed to Patient

The first element that a malpractice lawsuit must prove is that the defendant had a duty of care to the patient (plaintiff). A primary physician has a duty to provide competent and careful treatment and diagnosis to the patient, and a surgeon has a duty to perform the surgery competently to the best of their abilities.

A patient who suffers injury can’t simply sue whoever they want to and expect them to be held responsible if they did not have a duty of care. This element is typically the easiest part of the malpractice suit to prove and is generally uncontested by the defendant.

Breach of Duty

Once the defendant’s duty of care to the plaintiff is proven, the lawsuit must also establish that there was a breach (otherwise known as dereliction) of duty. This element is much harder to prove as it must show the defendant deviated from their duty and failed to fulfill their obligations.

Examples of breach of duty include misdiagnosing a patient, prescribing the wrong type of medication, or making surgical mistakes. Since understanding the core duties of medical treatment requires a lot of education and skill, expert witnesses and testimony are typically needed to establish whether the defendant breached their duty.

Injury Caused by Breach

If the breach of duty is proven, then the case can move to prove that the plaintiff suffered an injury due to the cause of the breach. In medical malpractice, it’s not enough that there was a mistake, but it must be proven that the mistake caused harm.

A plaintiff may claim that a misdiagnosis caused injury, but the defendant may point to pre-existing conditions or other circumstances that caused the injury, not the breach of duty. In some cases, though, this element can be obvious—like if a surgeon leaves a surgical instrument in the patient (which happens more than you think), that’s a clear line from breach of duty to injury.

Damages

Lastly, the plaintiff must prove that damages resulted from the injury caused by the breach of duty. In some cases, a mistake was made and caused injury, but the damages weren’t significant enough to reward compensation.

Damages are placed into two groups: special and general. Special damages include lost pay or the cost of corrective surgery when needed. General damages are vaguer and include pain and suffering or loss of quality of life. If a malpractice claim can prove these four elements, they will likely be successful and be rewarded compensation or a settlement with the defendant.

The 4 Cs of Medical Malpractice Risk Reduction

Naturally, its in the best interests of medical professionals and practices to reduce risk as best they can. There are many strategies for reducing risk in healthcare, but the core elements are sometimes called the four Cs: compassion, communication, competence, and charting.

Compassion & Communication

Compassion is vital in developing the doctor-patient relationship and avoiding strife that can result in a malpractice lawsuit. One of the most common reasons patients and families pursue litigation is that they felt mistreated or disrespected by the individual—so if a doctor shows compassion and understanding, they’re more likely to receive it from patients and families if a negative result occurs.

Communication is also crucial in avoiding malpractice litigation. For one, proper communication with staff helps avoid mistakes like delayed diagnosis and incorrect prescription drug administration. Communicating with patients and families also helps them understand better what’s happening and why and makes them feel heard instead of ignored.

Competence & Charting

Of course, healthcare professionals must be competent if they want to avoid malpractice litigation. But competence also refers to physicians not going past their area of expertise—consulting with colleagues and referring patients to specialists when needed.

Lastly, charting (or documentation) helps to improve communication and is useful in potential litigation. For one, it provides a written record of everything that’s happened to the patient and gives healthcare professionals the most up-to-date information regarding the patient for quality and safe care.

Conclusion

If you’d like to learn more about medical malpractice liability risk for individuals and practices, our helpful staff is eager to answer all your questions and can help you find the ideal malpractice insurance policy for you.

When it comes to insurance, especially malpractice insurance, there are many aspects of the policy that the insured individual should be familiar with. One of the most important components of any insurance policy is the deductible.

Malpractice insurance deductibles are different than the typical deductibles found in other policies, such as those for home or car owners. Below, we’ll explain everything you need to know about malpractice insurance deductibles, from how they’re structured to the options available.

What Is an Insurance Deductible?

First, consider the basics of deductibles and insurance policies. Deductibles are common parts of many insurance policies, whether healthcare, homeowner’s, or auto insurance. An insurance deductible is the specified amount an insured pays toward their insured loss.

The deductible is a lump sum the insured pays the insurer if the policy and coverage are activated. To use the example of auto insurance, if the insured has a $500 deductible insurance policy and gets in an accident that causes damages in the amount of $5,000, the insured would be responsible for paying the $500 before the repairs can be made or reimbursed for $4,500 for the repairs minus the deductible.

Does Every Malpractice Insurance Policy Carry a Deductible?

While deductibles are standard on most homeowner’s and auto insurance policies, they’re not typical with malpractice and professional liability policies. Since malpractice insurance differs from other types of insurance and covers different costs, most policies don’t include a deductible.

Many policies will carry a deductible option, but it’s not mandatory unless the individual is joining a group malpractice insurance policy where the deductible is required. Those seeking individual malpractice insurance policies will likely have the option of having a deductible. And while the deductible may be a substantial lump sum, a higher deductible could mean lower premiums, so it is worth considering.

How Are Malpractice Insurance Deductibles Different?

Malpractice insurance is already quite different from other forms of insurance regarding deductibles, but they’re also structured differently. While deductibles for most insurance policies, like auto and home coverage, must be paid immediately to activate policy coverage, malpractice deductibles are slightly different.

Individuals looking for malpractice insurance have two options regarding deductibles—indemnity-only or indemnity and expense. Both deductible types are fairly common, but they do have distinct characteristics.

Indemnity-Only Deductibles

An indemnity-only deductible, otherwise known as loss-only, is a deductible that is only required when the insurance provider pays an indemnity. An indemnity is compensation for damages or losses agreed upon in a settlement or levied on the defendant by the court.

If there is no indemnity, where the claim is either dismissed or resolved in favor of the insured defendant, then the insured wouldn’t have to pay the deductible at all. An indemnity-only deductible is only required when a settlement is agreed to or the lawsuit is resolved.

Consent-to-Settlement Clause & Deductibles

Those with an indemnity-only deductible should also consider a consent-to-settlement clause in their insurance policy. A consent-to-settlement clause is a provision that requires the insurer to seek the insured’s approval before settling a claim. While this clause is common in many policies, it’s not standard and shouldn’t be assumed by the insured.

Those with an indemnity-only deductible would naturally want to consent to a settlement, as that’s when the indemnity-only deductible would activate and they’d have to pay a large sum. Without the clause, there’s an incentive for the insurer to agree on a settlement to resolve the claim and activate the indemnity-only deductible.

Indemnity & Expense Deductibles

The other type of deductible in malpractice insurance is indemnity and expense. While the deductible covers the indemnity—should any be paid—it also covers other expenses, like court and legal fees.

It doesn’t matter if an indemnity has been reached yet; most indemnity and expense deductibles are required immediately once the claim is filed. The indemnity and expense deductible is typically more common than an indemnity-only deductible if the policy has any deductible at all.

Which Malpractice Deductible Is Best for Me?

Choosing which deductible is best for you and your insurance policy will primarily come down to your preferences. Each deductible type has its advantages, as an indemnity-only deductible is paid only when the claim is resolved and may not be paid at all if the claim is dismissed or resolved in favor of the defendant.

However, indemnity-only deductibles are typically higher than indemnity and expense deductibles, which must be paid immediately to cover legal costs like lawyer and court fees. One type of deductible may also yield a lower policy premium, so you should carefully weigh each deductible’s pros and cons before deciding.

How Much Should I Pay for My Malpractice Insurance Deductible?

One of the most common questions that many searching for new malpractice insurance policies ask is how much they should pay for a deductible. The price of a malpractice policy deductible depends on numerous factors, including the individual’s risk factor. Some medical professions have inherently higher risk factors and are more likely to have higher premiums or deductibles for coverage.

Some malpractice deductibles are as low as $1,000, while some are as high as $25,000 or more. Keep in mind, a higher deductible typically means a lower premium and vice versa. Those shopping for a new malpractice policy should decide if they’re more financially capable of paying a higher monthly premium or greater lump sum for their coverage.

How Do I Find Suitable Malpractice Insurance?

If you’re ready to find a malpractice insurance policy that best fits you, Baxter & Associates can help. Baxter & Associates provides professional liability insurance for many medical professions, from CRNA medical malpractice insurance to group insurance policies for healthcare facilities.

Some examples of the medical professions we serve as malpractice insurance brokers include:

• Doctors
• Dental professionals
• Podiatrists
• Chiropractors
• Nurse practitioners
• Physician assistants and more

As a national insurance broker with decades of experience, we’ll help connect you with a policy that’s ideally tailored to your situation, whether you know exactly what you want or if need help finding the right policy. Contact our helpful staff at Baxter & Associates, and we’ll ensure that you’re sufficiently covered in the case of a medical malpractice claim.

Informed consent is one of the most fundamental principles of healthcare. If you plan on working in the industry or want to learn more, we explain what every healthcare worker should know about informed consent below.

Informed Consent, Defined

First, let’s define informed consent and why it is important. Informed consent is the communication process between the patient and healthcare provider—whether a surgeon, primary physician, or chiropractor—that leads to an agreement of permission for care and services, signed by the patient.

Informed consent is also a legal right for the patient or their picked surrogate to have autonomy and choice regarding their treatment and the potential risks involved. If the patient can mentally make their own decisions, medical treatment and services cannot be performed without their consent. Their consent must include full knowledge of the treatment and potential complications.

The Purpose of Informed Consent

Those who work in healthcare should know that informed consent satisfies a legal, ethical, and administrative compliance purpose for both the patient and healthcare provider.

Legal

Informed consent is typically a legal document that a patient signs that states they understand the treatment and risks involved and consent to it. For one, this protects the patient from assault, as the document is also binding—healthcare providers are not allowed to overstep the purview of treatment in the form unless in life-threatening, time-sensitive emergencies.

It’s also a form of protection for the doctor as it states the potential complications of the treatment or procedure. The patient states on the form that they understand and consent to such treatment. This signature doesn’t completely shield the healthcare provider from potential malpractice should complications arise, but it’s valuable documentation that shows the patient understood the potential risks.

Ethical

Informed consent also has a moral purpose—to protect the patient’s autonomy. Through legal court cases, an ethical standard has gotten crafted that guarantee’s a patient the right to have autonomous decision-making for their treatment if they have the mental capacity to make such decisions.

For example, the ethical purpose of informed consent is that a patient can refuse treatment or procedures based on religious grounds, like a Jehovah’s Witness refusing a blood transfusion and not having autonomy or mental capacity questioned. It also has the moral purpose of ensuring that the patient has the right to set their own goals for treatment, not the healthcare provider.

Administrative Compliance

As the informed consent process is typically finalized with the signature on a written document, it also has an administrative compliance purpose. The informed consent form is a written document showing both parties’ consent regarding treatment and complications.

This simple document provides safeguards to fulfill the legal and ethical purposes of informed consent we discussed.

The Origins of Informed Consent

While it may seem obvious now, informed consent was not a legally binding concept until the 1950s. The origins of the legal concept as we understand it today were born out of multiple malpractice cases in the early twentieth century from patients against providers, and a standard legal concept got crafted out of these decisions.

In one case, a patient agreed to undergo an ear operation, but after they got anesthetized, the doctor changed plans and operated on the other ear, causing hearing loss. The patient sued the doctor for changing plans without her consent. Other cases involving doctors unintentionally and intentionally misleading or withholding information from patients or even performing different procedures than agreed to helped create the legally-binding foundation of informed consent as we know it today.

Elements of Informed Consent

An informed consent form and agreement must incorporate a few elements to get deemed truthful and legally binding.

Patient Competency & Explanation of Risks

For one, the patient must get deemed competent to understand and make healthcare decisions. In cases of mental health ailments, the patient and the healthcare provider can scrutinize and challenge this element.

If deemed competent, the informed consent form must also provide a sufficient explanation of the treatment, its benefits, and the risks. This explanation of treatment is the informed element of the form—if the healthcare provider withholds or includes misleading information regarding the treatment, they’ve violated the patient’s informed consent.

Patient Understands & Authorizes Treatment

The patient or the appointed decision-maker for the patient must understand the treatment, its benefits, and its risks fully. In healthcare, this can be difficult with such complex terminology and treatments, but it’s paramount for providers to feel they’ve explained it in detail and informed the decision-maker.

Once the patient or decision-maker understands, they must authorize the treatment plan, typically with a signature. Without a signature on the form, the healthcare provider can get found to have violated patient autonomy and be legally exposed.

What Chiropractors Must Know About Informed Consent

Informed consent is also an essential part of chiropractic healthcare. Since chiropractic care is an alternative treatment to other methods like drugs or surgery, the patients who visit chiropractic clinics are typically enthusiastic and willing to receive treatment.

Even so, it’s paramount that chiropractors explain the risks and details of every treatment and receive written authorization for treatment via an informed consent form.

Chiropractic Malpractice Issues Arising From Informed Consent Violations

While the risks associated with chiropractic treatment are relatively low compared to other types of treatment, malpractice issues can arise from informed consent violations. The most common complication that occurs from spinal manipulation treatment is muscle soreness.

Muscle soreness may not seem like a big deal, but if it debilitates the patient enough to where they can’t work, or their quality of life gets reduced, they may seek compensation. And without a signed informed consent form explaining that muscle soreness is a potential complication of chiropractic treatment, a chiropractor could get left exposed to a malpractice claim.

Conclusion

This shows the importance of understanding informed consent and having malpractice insurance for chiropractors. Every chiropractor should be intimately familiar with the legal parameters of informed consent and have forms ready for every patient about to undergo spinal manipulation treatment.

If you’d like to learn more about informed consent or need to find malpractice insurance for yourself or your practice, Baxter & Associates can help you learn more about medical malpractice and help find a policy plan that fits your situation.

 

Informed consent is a part of the job that all CRNAs need to know. Below, we’ll explain the basics of informed consent, its elements, and how it relates to the duties of CRNAs.

What Is Informed Consent?

Informed consent is one of the fundamental ethical principles in modern medicine and guarantees a patient’s right to self-determination. The medical-legal concept of informed consent as we know it first came about through various court cases in the mid-20th century that stated patients have the right to informed consent.

Basically, informed consent is the communication process between the patient and physician that leads to an agreement or permission for care, treatment, or services. The patient (or their legal representative) has the right to obtain all the information regarding a procedure or treatment and the risks involved before treatment can begin.

What Are the Elements of Informed Consent?

First, the physician must identify an appropriate person to provide informed consent to if the client is incapacitated or mentally unfit to receive and act on the information. Then, the physician will describe the treatment or procedure and provide written materials when possible.

The physician will also describe the risks involved, give their professional opinion on the patient’s options, and answer any questions. The patient can ask questions and obtain a second opinion if they want. If the patient consents to the treatment, they (or their representative) will sign a written letter of informed consent stating their approval.

Can a CRNA Obtain Informed Consent?

While we’ve mentioned physicians obtaining informed consent, can CRNAs obtain it? Yes, a CRNA or nurse will often take on the task of obtaining informed consent. Still, the physician or anesthesiologist will typically be the one to explain the gist and details of the treatment and risks involved.

Usually, the CRNA is the one who returns to the patient later to obtain and witness the written informed consent and answer further questions from the patient. For many CRNAs, it’s one of the basic parts of their responsibilities.

What Are Considered Violations of Informed Consent?

Informed consent is also an area where malpractice cases can occur due to a perceived or real violation of the patient’s rights regarding it. CRNAs need to know that failure to obtain informed consent or withholding pertinent information regarding the treatment or procedure and risks is a significant form of negligence and malpractice.

The most common violation of informed consent is inadequately warning a patient of the risks associated with the medical procedure. If complications arise, it’s not uncommon for patients or their representatives to feel deceived or insufficiently informed regarding the risks. For this reason, CRNA malpractice insurance is essential for all CRNAs.

If you’re a CRNA that needs malpractice insurance, Baxter & Associates is here for you. We will help you find a plan that ensures you’re covered should a malpractice claim arise from an alleged breach of informed consent.