Professional Liability

Insurance coverage that protects healthcare providers against claims of negligence, errors, or omissions in the delivery of professional services.

Professional liability insurance is what most people in healthcare call malpractice insurance. It is the coverage that protects you if a patient sues you for harm caused by your professional services. Every payer and every hospital requires proof of current professional liability insurance before they will credential you. Coverage requirements vary by payer and by state, but the most common minimum is $1 million per occurrence and $3 million aggregate. Some high-risk specialties like obstetrics, neurosurgery, and orthopedics may require higher limits. Some states set their own minimum requirements that override payer requirements. Professional liability premiums vary enormously based on your specialty, your state, your claims history, and whether you have an occurrence or claims-made policy. An internist in Iowa might pay $8,000 per year. An OB/GYN in Florida might pay $150,000 per year. The disparity reflects the litigation environment and the risk profile of each specialty. Your professional liability policy is verified as part of primary source verification during credentialing. The payer contacts your insurance carrier directly to confirm your coverage limits, effective dates, and claims history. A gap in coverage, even for a single day, raises questions during credentialing. When you change jobs or retire, managing the transition of your professional liability coverage is critical. If you have a claims-made policy, you need tail coverage to protect against claims filed after your policy ends. If your new employer provides coverage, make sure there are no gaps between the old and new policies. And make sure your credentialing applications reflect your current coverage accurately. Some employers provide professional liability insurance as a benefit. Others require you to carry your own. Know which arrangement applies to you and make sure the coverage meets every payer's requirements. If any payer requires higher limits than what you carry, you will need to increase your coverage before that credentialing can proceed.