Employed CRNA Toolkit
The Importance of Supplemental Malpractice Insurance
Questions You Should Ask Your Employer
For CRNAs who rely solely on the malpractice insurance provided by their employer or facility, the information below will help you understand why it’s important to get answers to the following questions:
- Are you provided with your own separate limits of liability or are you sharing limits of liability with everyone else insured under your employer’s policy?
- What happens if there is a claim?
- If there is a claim, will you, your interests and your professional reputation be protected?
- Will you have any say in how the claim is settled or what’s reported to the National Practitioner Data Bank?
- What happens if you’re sued for something that occurred when you were working for a previous employer?
- What’s not covered by your employer’s policy?
- Should you have a policy of your own to supplement the coverage provided by your employer?
FAQs: Supplemental Malpractice Insurance for CRNAs Employed by Hospitals or Groups
The answer is "yes"! As long as you are provided coverage by an employer or a facility, the Supplemental Policy will also provide coverage on your behalf - even if you are working for multiple facilities or employers.
2. My employer provides my malpractice insurance. I’m concerned that if I’m ever involved in a claim that my interests will not be protected, and I will have no say in how the claim is handled. Is there anything I can do to protect myself?
Developed with the input from our members, AANA Insurance Services has designed the first malpractice policy of its kind to supplement the coverage provided by your employer or facility. Not only does this policy provide you with your own attorney and unlimited defense costs, no settlement can be paid out under this policy without your consent. The policy even provides coverage for licensing board or regulatory issues.
3. My husband and I are both CRNAs. We work for the same company, and both of us are covered on its group malpractice policy. We recently purchased policies from AANA Insurance Services to supplement the malpractice coverage provided by our employer. I receive a W-2 from our employer but my husband receives a 1099. Does his 1099 status disqualify him from being able to purchase the supplemental policy?
The answer is "no". Employment status is not an eligibility factor for the supplemental malpractice policy. As long as the employer or facility provides you with malpractice coverage, you are eligible to buy the supplemental policy from AANA Insurance Services.
4. Does this policy cover self-employed individuals, independent contractors, that have their own policy outside of AANA?
If by “own” policy you mean that you have purchased your own individual policy, and not one provided by an employer or a facility, there wouldn’t be any need to purchase our Supplemental policy; it wouldn’t really provide you with any additional value over what you already have.
If you have your own policy, you’d have your own limits of liability and the attorneys provided by your own policy would look out strictly for your best interests. The only question I would have about a policy purchased outside of AANA Insurance Services would be whether or not your own policy provides you with a true consent to settle provision.
Now, if you are referencing a policy provided to you by an employer or a facility even though you’re not an employee (you’re working as a self-employed, independent contractor at a facility of some sort), our Supplemental policy would be something you would want to consider. Most employers and facilities only provide claim-made coverage and there’s no guarantee that a “tail” will be purchased. Most likely you will be sharing the policy’s limits of liability with multiple providers. Those other providers could exhaust the policy’s limit of liability before you might need the coverage yourself. You would have no consent in how a claim is settled unless you have your own individual policy.
5. If I am involved in a claim involving several other individuals and the entity decides to settle, how does a Supplemental policy allow consent to settle if there are others involved in the same claim?
If a policy has a true consent to settle, the insurance company cannot settle a claim unless you consent to it. Many insurance companies say their polices have consent to settle, but it is often taken away in the fine print. We represent Medical Protective (MedPro) and I’m not aware of any insurance company that has a better consent to settle than they do.
If you’re involved in a claim with several other individuals and entities, and you haven’t purchased you own individual policy, you won’t have any legal representation that will look out for your best interests. You will have no say whatsoever in how the claim is handled or what’s reported to the National Practitioner Data Bank (NPDB). If you were to have our Supplemental policy, you would have your own attorney who would look out for your best interests. Your attorney would work in cooperation with the other attorneys involved in the claim. If you were also covered by any other policy (like your employer’s), the attorney provided by your Supplemental policy would hold the other attorney accountable and would not let them settle a claim against you if you neither caused nor contributed to the patient’s adverse outcome. While you would not have any say in how the policy provided by your employer would settle the claim, your employer’s attorney will be less likely to act in bad faith if you have your own attorney representing your interests in the claim settlement.
6. If someone has legal action filed against them, can the courts go after personal belongings? If so, how do you protect your assets?
A plaintiff’s attorney certainly could go after your personal assets. That being said, insurance money is the “easy money”. As long as you have an insurance limit that is usual and customary for your state (the usual and customary for most states is $1,000,000), that will normally be more than sufficient to protect you. It’s a lot more challenging for attorneys to turn personal assets like houses, boats and cars into money. So unless there’s little to no insurance, it’s very rare for attorneys to go after personal assets. In addition, as a CRNA, it would be very unlikely that you, and you alone, would be sued in the event of an adverse patient outcome. Even if you breached the standard of care, other parties such as the physician and the hospital/facility would undoubtedly be drawn into the claim and might end up contributing to a payout, so the amount of insurance money available to the plaintiff would be even greater than just your policy limits alone.
The key is being certain that you have insurance that will be both sufficient and available if you should ever need it. The further you are away from the actual purchase of the insurance that protects you, the less likely it will be there when you need it. If you purchase your own insurance, you want to buy an occurrence policy from an admitted insurance company with a Best rating of “A” or greater.
If you are relying on your employer for your malpractice coverage, you should consider purchasing your own policy to supplement what your employer provides. In most instances, employers provide claims-made coverage that is shared by multiple providers. If no “tail” is purchased on a claims-made policy, there is no coverage. If you are sharing limits of liability with multiple providers, the other providers could have claims that exhaust the policy’s limits before you are able to use it. The only time you wouldn’t need to purchase a supplemental policy would be when employer provides you with your own occurrence policy that you don’t have to share with other providers. In that situation, you don’t have to worry about a “tail” and only you can draw down on the policy’s limits.
7. I am a full time CRNA with malpractice coverage provided by my primary employer. The new supplemental policy looks appealing. I may start doing some very part time work in a plastic surgeon's office and I'm wondering if the supplemental policy would cover me for this work? Would I need to purchase the supplemental policy AND the moonlighting policy?
The supplemental policy is not intended to provide you with any primary malpractice coverage. It is designed to supplement the coverage that the plastic surgeon might provide on your behalf. If the plastic surgeon doesn't provide you with coverage under his or her malpractice policy then, yes you would need to purchase a moonlighting policy to cover the work you do at the plastic surgeon's office.
A supplemental policy is intended to supplement any coverage that is already provided by a hospital, group, or physician's office. It will not provide coverage for your moonlighting work.
Additional Supplemental Insurance Resources
Highlights of a Policy Designed Specifically for CRNAs Employed by Hospitals or Groups
Supplemental Malpractice Insurance for CRNAs Employed by Hospitals or Groups is a policy designed to protect you, your interests, and your professional reputation. The policy highlights below refer to this supplemental malpractice insurance policy.
- Occurrence coverage: No need to ever buy a tail
- An attorney to represent your interests if you have a claim
- Unlimited defense costs (investigation, attorney's fees, expert witness fees, etc.)
- No claim settlements without your consent (subject to policy terms)
- Administrative/disciplinary hearings coverage
- Deposition representation coverage
- Information privacy (HIPAA) coverage
- Defendant expense coverage
- Portability: You can take the policy from job to job
- Affordable premiums
Checklist for CRNAs Employed by Hospitals or Groups
Outlined below is a checklist that every CRNA, whose employer or facility provides their malpractice insurance, should complete.
Does the malpractice insurance provided by your employer:
- Supply you with written verification of the coverage you're being provided?
- Apply to you by name in the policy?
- Have a separate limit of liability for you so that coverage cannot be used up by claims against others covered by the same policy?
- Provide legal counsel representing your interests about who is at fault, even when that's in conflict with your employer's allegations?
- Respond to all types of work you are performing for your employer (that is, do you know if there are any exclusions of procedures or functions in the policy that might apply to you)?
- Include a written agreement from your employer that extended reporting or tail coverage must be maintained on your behalf at your employer's expense after you leave your job (and your rights to obtaining evidence each year that this coverage is maintained)?
- Advise you of settlement offers to those suing you before they are made?
- Advise you of the final disposition of any claims against you so you know what will be reported to the National Practitioner Data Bank (NPDB)?
- Reimburse you for loss of income when you are required to attend a trial or participate in pretrial meetings (remember you can be sued in the future and may no longer be working for your current employer)?
- Respond to volunteer or moonlighting activities outside of your principal workplace?
- Provide legal counsel for depositions you are required to attend even if you are not named in the lawsuit?
- Reimburse you for costs of legal representation for licensure and/or administrative reviews?
If you answered "no" to any of the above, you may have exposures not covered by your employer’s insurance.