Pediatricians agree that protecting
their careers and professional and personal assets is essential, but many do not
take the time to assess the adequacy of
their medical liability insurance coverage.
A 2015 AAP Periodic Survey of Fellows showed that the proportion of pediatricians who reported knowing the
amount of basic professional medical liability coverage they have decreased from
66% in 2007 to 53% in 2015 (p<.001).
New legislative, regulatory, privacy and
electronic documentation requirements
have increased risk exposure for all pediatric practitioners, which may necessitate
expansion of medical malpractice insurance. While clinical malpractice claims in
pediatric medical care have decreased in
most states (due partly to medical malpractice reform legislation at the state
level), claims for failure to comply with
state and federal regulations, managed
care requirements, and privacy and safety
regulations are growing.
Following are three important questions
to ask your malpractice insurance carrier
(MIC) yearly and whenever your work
function, location or employer changes.
Am I covered for the
work I perform?
Employment and insur-
ance carrier changes are more common
today and should prompt you to inves-
tigate whether you are covered for the
work you perform:
• Investigate potential gaps in cover-
age. Most policies are “claims made,”
which means the coverage, which is
triggered by a report of an incident,
is in effect only while the policy is
current. If you change insurers, you
either need to purchase “tail cover-
age” from the previous insurer or en-
sure that “all prior acts” are covered
by the new insurer, to be certain that
insurance covers the date on which
the incident occurred.
• Verify that the policy covers you
if you work locum tenens, do volunteer or medical mission work,
assume any duties as a medical director outside your practice, add
or delete procedures within your
practice, take a leave of absence, or
change from full- to part-time status. If your practice varies from what
was described in the application to
the insurer, you may not be covered.
• Make sure you are within normal
limits of coverage, which are de-
termined by questioning others in
the community or state in which
you practice and checking recent
history of claims in your field and
location. Coverage limits (usually $1
million/$3 million) apply separately
to the named individual and to the
• Make sure all physician assistants
and nurse practitioners under your
supervision are covered for their ac-
tions and patient care.
• Ascertain that your MIC has an A.M.
Best Rating of at least “A,” which
measures financial stability. The
cheapest quote may be from a carrier
that will not be in business long term,
costing you in the long run.
Am I covered for a
breach of a practice
Most malpractice policies include
coverage (defense costs, fines, penalties)
for a breach of state and federal regulations. Purchasing additional regulatory