NYCPAC Posted July 13, 2016 Share Posted July 13, 2016 Hi all, I recently accepted a position and got word today while filling out an application for malpractice that the position does not include any type of tail insurance. I've only been in practice for 3yrs in another speciality but unsure if this should be a deal breaker or not. It's an ER position that has a $1M per occurrence claims-made coverage policy. I'm semi freaking out because I just turned down another position for this one unknowing that I wouldn't have any tail coverage. Any advice appreciated :/ Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted July 13, 2016 Share Posted July 13, 2016 Get your own occurrence based policy for minimal coverage (Mercer) and ask if they'll reimburse you while still adding you on their C-M policy. Find out what the tail cost is (they should be able to tell you) and decide if you want to cover it yourself. Go with the cheaper option. That's what I've done in my situation and I'm paying Mercer myself since employer didn't realize need for tail rider when they purchased the policy. Link to comment Share on other sites More sharing options...
Moderator ventana Posted July 13, 2016 Moderator Share Posted July 13, 2016 Tail is an issue for the following reason PA are commonly not listed as an insured, and the corporation is insured as long as the corporation is still in business and paying the insurance premium...... The doc's will likely NEVER fly with out insurance, so if they ever disbanded the corporation that would purchase a policy to cover themselves - and this in turn would cover you.... This is a really tough spot - ER tail is likely to be expensive, and ER coverage in general is likely to be $$$$ - might be cheap for the first few years as the policy matures, but I would expect it to be in the 5-10k range per year. I understand why they would not want to have to pay for tail coverage on top of the claims made policy, but it does expose the PA to additional liability as if you got sued personally and the SP was not sued, you would have no coverage..... Obviously this would not be advisable as you have far less assests then the corporation and the doc's..... This is the reason why after much research I decided to NOT purchase tail after both an IR and ER job that I was in..... I figure the Doc's ahve way more to loose them I did (at the time) and I did not want to fork out the $$ I have seen a few different ways to handle this 1) an indemnification clause that states they will make you whole if you are sued - with out a time limit on it, for any actions as a result of your employment 2) a clause that simply states that they must provide med mal coverage for all activities for you while you are at your job. Either one of these will likely protect you if you were ever to get sued.... I would suggest you review just about every case with your doc's initially and document that in the notes to make them aware/on the hook. As well you could make sure all notes are co-signed by a doc (common practice so they can bill under the Doc's pin for higher reimbursement. Best is to have your own policy, but that is also the most expensive and might not be needed???? Link to comment Share on other sites More sharing options...
NYCPAC Posted July 13, 2016 Author Share Posted July 13, 2016 From my research it's appears that a PA tail policy for ER would run be about $6k. I am in no way shape or form able to pay that out of pocket. I called the insurance co myself and was told even if I left the position I would be covered so long as the ER group was not dissolved. How does this exactly work? I don't have a contract so I am unsure of how to write in any type of clauses. I trust my skills given I've worked in icu and IM the last 3yrs and almost always make attendings aware of pts or issues that I am not 100% with or that appear complicated. I'm so unsure of what to do!!! Do I back out (not ideal) and try to see if other position is still available as I only said no yesterday to it or do I just move forward and sign the malpractice forms? Sent from my iPhone using Tapatalk Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted July 13, 2016 Share Posted July 13, 2016 One, your suit risk is not solely dependent on skills. Two, I question the statement that the policy is in effect as long as the group doesn't dissolve. The coverage is in effect as long as the PREMIUM is paid, regardless of the group status. The moment the group changes insurance providers, and it does happen, you're now exposed to prior events. Link to comment Share on other sites More sharing options...
Moderator ventana Posted July 13, 2016 Moderator Share Posted July 13, 2016 From my research it's appears that a PA tail policy for ER would run be about $6k. I am in no way shape or form able to pay that out of pocket. I called the insurance co myself and was told even if I left the position I would be covered so long as the ER group was not dissolved. How does this exactly work? I don't have a contract so I am unsure of how to write in any type of clauses. I trust my skills given I've worked in icu and IM the last 3yrs and almost always make attendings aware of pts or issues that I am not 100% with or that appear complicated. I'm so unsure of what to do!!! Do I back out (not ideal) and try to see if other position is still available as I only said no yesterday to it or do I just move forward and sign the malpractice forms? Sent from my iPhone using Tapatalk If in your employment contract it states that they are responsible for providing medical malpractice and that they will indemnify you for any claims made out your employment you are likely covered.... Yes it is true - the corp has to be in existence, and the policy needs to remain current for you to be covered. BUT if you are not covered neither are the doc's...... And it is highly unlikely that the doc's would expose themselves to no insurance risk...... And if you have the above clauses in your contract you likely would be able to sue them to cover you...... Very confusing, but I was in the same situation twice and choose to simply go on their policy and so be it.... Link to comment Share on other sites More sharing options...
NYCPAC Posted July 13, 2016 Author Share Posted July 13, 2016 Very true, I didn't consider if they switched insurance companies. However, if a claim is made after they've switched policies but the occurrence occurred 3years prior the previous insurance co would in no way cover any of that despite premiums being paid correct?? And I know it's not wise to assume I would only get sued based on skills. People are nuts and I know I need to protect myself here but I don't know what the best move is considering I've never been in a situation where I did not have tail coverage. Sent from my iPhone using Tapatalk Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted July 13, 2016 Share Posted July 13, 2016 This gets back to the recurring theme of variances between C-M and occurrence based policies. Occurrence based policies provide coverage regardless of timing as long as the policy was in effect at the time of the event, NOT when the litigation begins. C-M only covers you during the time the policy is in effect, thus the need for tail coverage. Link to comment Share on other sites More sharing options...
NYCPAC Posted July 14, 2016 Author Share Posted July 14, 2016 Has this ever been a deal breaker for anyone? I know ER groups are sued left and right and not so much the individual however I'm trying to be realistic with myself. On another note: was emailed by someone from the group today stating that "we do have tail coverage for all pts you see while working in the ED". ....meanwhile their broker told me there's no tail covered. Someone has to be misinformed here, but it's left me wanting to ask for proof of tail coverage Sent from my iPhone using Tapatalk Link to comment Share on other sites More sharing options...
Maverick87 Posted July 14, 2016 Share Posted July 14, 2016 I don't work in the ER, but I had it written into my contract. So if my practice goes back on this after I leave, I have legal grounds to sue them. Link to comment Share on other sites More sharing options...
NYCPAC Posted July 14, 2016 Author Share Posted July 14, 2016 I don't work in the ER, but I had it written into my contract. So if my practice goes back on this after I leave, I have legal grounds to sue them. What did you write into the contract specifically? Sent from my iPhone using Tapatalk Link to comment Share on other sites More sharing options...
Maverick87 Posted July 14, 2016 Share Posted July 14, 2016 What did you write into the contract specifically? Sent from my iPhone using Tapatalk Just that they would pay tail coverage. Link to comment Share on other sites More sharing options...
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