Types of Medical Malpractice Insurance

One of the first elements attorneys consider in a malpractice case is the type of insurance the accused medical professional has and the liability coverage limits of the specific policy. Different insurance types and liability limits warrant different case strategies.

If you are considering filing a medical malpractice claim, you may find it helpful to know more about malpractice insurance and how it may impact your case. There are two primary types of medical malpractice insurance coverage: claims-made and occurrence coverage.

Claims-made medical malpractice coverage

Similar to home or auto insurance policies, claims-made insurance policies cover malpractice that takes place during the policy period. Unlike traditional home or auto insurance, however, for a claim to be covered, it must also be reported to the insurance company during the active policy period.

If a claims-made malpractice policy is switched to a new carrier or canceled for any reason without provisions to extend coverage beyond the coverage period, no benefits will be paid, even if the act of malpractice occurred while the policy was in force. Instead, a medical provider could be held personally liable for the costs associated with your claim, without a liability cap.

Your attorney knows to explore the insurance coverage of the accused medical provider in your claim to determine exactly how coverage-or lack of coverage-may impact your case.

Occurrence medical malpractice policies

An occurrence policy insures for any incident that occurs while the policy is in effect, regardless of when a claim is filed, even if the policy has been canceled since the act of malpractice occurred. Occurrence policies take into account current and future claims of malpractice, although the limits of liability are those in effect when the incident occurred.

Under an occurrence insurance policy, your medical malpractice lawyer knows going into the lawsuit what the liability limits will be in your case and plans the strategy of your case accordingly.

How does malpractice coverage work?

Imagine an incident of malpractice occurred on July 1, 2004. The treating physician became aware that there may be a possible claim on July 1, 2005 and notified the insurance carrier then. On July 1, 2006, a medical malpractice claim was filed.

  • An occurrence policy in effect on July 1, 2004 would cover the claim, despite when the actual lawsuit was filed or notification made to the insurance company.
  • A claims-made policy in effect on July 1, 2006 would cover the claim, as long as the retroactive date is no later than July 1, 2004.
  • A claims-made policy in effect on July 1, 2004, but terminated as of July 1, 2005 would deny the claim because the active coverage period ended before the claim was reported to the insurance company. If the physician did not purchase “tail” coverage to extend the provisions of his malpractice insurance of 2004, the physician may become personally liable for the costs associated with this malpractice claim.