Asking for Nose Coverage & a few other malpractice questions

[PA-C]

Long story short, when I was a brand new grad with no bargaining power, I signed an employment contract that does not include tail coverage. I am in the process of signing on for a new job and thankfully, the new employer DOES include tail coverage. Is there a right way or "best way" to ask my new employer if I can also have nose coverage so that any potential incidents that occurred during my prior employment (but might not be reported until I am already working for my new employer) are covered?

Have any of you ever had to pay for your own nose or tail? If so, what specialty are you in and how much did it cost?

I think I have seen in previous threads that some of you carry your own private malpractice coverage, in addition to the coverage given to you by your employer. If I were to sign up for my own private malpractice coverage before I give notice to my current employer and I continue to carry this private coverage throughout my career, will it negate the need for nose/tail in the future in case there is ever another time where I cannot negotiate nose/tail?

I appreciate any input!

[GetMeOuttaThisMess]

No to current job, yes to future employment. Occurrence is not retroactive prior to policy initiation/underwriting.


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[Cideous]

Unreal that people still work without tail.  You have no idea just how expensive that tail is gong to be and if you don't pay it and you get sued....you are screwed.  Assistants....

[GetMeOuttaThisMess]

Since I'm not educated enough to teach a medical class being not only just a PA (former practitioner of allopathic medicine), but a B.S. PA at that, maybe I could volunteer some time to some of our local programs to review this most basic pieces of information such as the difference in malpractice policies.  They'd probably say that I'm not qualified for that either.

[Cideous]

4 hours ago, GetMeOuttaThisMess said:

Since I'm not educated enough to teach a medical class being not only just a PA (former practitioner of allopathic medicine), but a B.S. PA at that, maybe I could volunteer some time to some of our local programs to review this most basic pieces of information such as the difference in malpractice policies.  They'd probably say that I'm not qualified for that either.

LOL just don't apply to be a Covid contract tracer.  Evidently we are not qualified for that job......Assistants.

[SedRate]

On 7/30/2020 at 6:30 PM, GetMeOuttaThisMess said:

No to current job, yes to future employment. Occurrence is not retroactive prior to policy initiation/underwriting.


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If one needs tail, that is a claims made (CM) policy not occurrence. Occurrence doesn't require tail and is not retroactive. One must have an active CM policy to be covered whereas occurrence will cover acts that occurred during period of coverage. 

For example, if a patient has a condition in 2019 that results in an adverse event that is diagnosed and the patient sues in 2020, that means one would need an active 2020 claims made policy to cover the claim, tail coverage from 2019 CM policy, or a 2019 occurrence policy. I'm not too familiar with nose, but I'm guessing one could've also bought nose when they started their 2020 CM policy and that would suffice.

The job I left had a CM policy. I required tail to protect myself after I left since my coverage ended and I wouldn't have any malpractice coverage until I got a new policy. In theory, buying my own policy would cover me after leaving, which is similar to buying tail, except I would need to keep the policy active to continue having coverage, whereas buying tail is a one-time thing. If I cancel the policy, I would still need tail to extend the reporting period. That is essentially what one is doing in buying tail, which is buying an extension in one's reporting coverage.

 

On 7/30/2020 at 5:50 PM, PA-C said:

Long story short, when I was a brand new grad with no bargaining power, I signed an employment contract that does not include tail coverage. I am in the process of signing on for a new job and thankfully, the new employer DOES include tail coverage. Is there a right way or "best way" to ask my new employer if I can also have nose coverage so that any potential incidents that occurred during my prior employment (but might not be reported until I am already working for my new employer) are covered?

Have any of you ever had to pay for your own nose or tail? If so, what specialty are you in and how much did it cost?

I think I have seen in previous threads that some of you carry your own private malpractice coverage, in addition to the coverage given to you by your employer. If I were to sign up for my own private malpractice coverage before I give notice to my current employer and I continue to carry this private coverage throughout my career, will it negate the need for nose/tail in the future in case there is ever another time where I cannot negotiate nose/tail?

I appreciate any input!

You can try to continue your coverage until your new policy. Call the malpractice company and ask if you can take over the policy. However, unlikely to do if you have an umbrella policy, since it is not your own individual policy. There are time limits to when a patient can sue. A quick search will tell you if you need to carry for 1, 2, or 7 years of extended reporting coverage (aka tail).

Alternatively, you can ask your new employer to provide nose coverage. 

Disclaimer: just a person on the web and not a legal expert nor malpractice expert. 

[PA-C]

36 minutes ago, SedRate said:

If one needs tail, that is a claims made (CM) policy not occurrence. Occurrence doesn't require tail and is not retroactive. One must have an active CM policy to be covered whereas occurrence will cover acts that occurred during period of coverage. 

For example, if a patient has a condition in 2019 that results in an adverse event that is diagnosed and the patient sues in 2020, that means one would need an active 2020 claims made policy to cover the claim, tail coverage from 2019 CM policy, or a 2019 occurrence policy. I'm not too familiar with nose, but I'm guessing one could've also bought nose when they started their 2020 CM policy and that would suffice.

The job I left had a CM policy. I required tail to protect myself after I left since my coverage ended and I wouldn't have any malpractice coverage until I got a new policy. In theory, buying my own policy would cover me after leaving, which is similar to buying tail, except I would need to keep the policy active to continue having coverage, whereas buying tail is a one-time thing. If I cancel the policy, I would still need tail to extend the reporting period. That is essentially what one is doing in buying tail, which is buying an extension in one's reporting coverage.

 

You can try to continue your coverage until your new policy. Call the malpractice company and ask if you can take over the policy. However, unlikely to do if you have an umbrella policy, since it is not your own individual policy. There are time limits to when a patient can sue. A quick search will tell you if you need to carry for 1, 2, or 7 years of extended reporting coverage (aka tail).

Alternatively, you can ask your new employer to provide nose coverage. 

Disclaimer: just a person on the web and not a legal expert nor malpractice expert. 

Thank you for sharing your understanding of it. The insurance industry is such a convoluted mess. Thankfully after discussion/contract negotiation my new employer is entertaining the idea of adding prior acts/nose for my policy with them; they are looking into cost and are going to let me know. I’m keeping my fingers crossed that this will all work out so I can avoid the personal expense and hassle.

The statute of limitations for malpractice in my state is 2 years from the date of discovery, but no more than 4 years from the date the treatment occurred, regardless of the discovery date.

Children under 18 have up to 8 years from the date of the treatment that caused injury, but must file no later than their 22nd birthday. 

Edited August 1, 2020 by PA-C

[GetMeOuttaThisMess]

You can try to continue your coverage until your new policy. Call the malpractice company and ask if you can take over the policy. However, unlikely to do if you have an umbrella policy, since it is not your own individual policy. There are time limits to when a patient can sue. A quick search will tell you if you need to carry for 1, 2, or 7 years of extended reporting coverage (aka tail).
Alternatively, you can ask your new employer to provide nose coverage. 
Disclaimer: just a person on the web and not a legal expert nor malpractice expert. 

This is what i was saying. CM policies, unless you buy tail, leave you exposed IF the policy is terminated, whether you’re made aware or not. Ask the employer what the cost is of tail coverage. This is why i always had a copy of the policy declaration page for any group CM umbrella coverage, on top of my own occurrence based policy. Remember that the clock starts running on the claim window once the patient is made aware of, or reasonably should be aware of, there being a potential concern; NOT when the event took place. This is where taking care of kids can come back to bite you, or leaving material behind during surgeries.


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[SedRate]

1 hour ago, GetMeOuttaThisMess said:

This is what i was saying. CM policies, unless you buy tail, leave you exposed IF the policy is terminated, whether you’re made aware or not. Ask the employer what the cost is of tail coverage. This is why i always had a copy of the policy declaration page for any group CM umbrella coverage, on top of my own occurrence based policy. Remember that the clock starts running on the claim window once the patient is made aware of, or reasonably should be aware of, there being a potential concern; NOT when the event took place. This is where taking care of kids can come back to bite you, or leaving material behind during surgeries.


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Ok, gotcha. I was helping to clarify in case you were somehow suggesting they had occurrence policy or were getting an occurrence policy at their next job (which, like you said, is not retroactive).

The clock for the statue of limitations clock starts ticking after the incident itself. To also clarify, what you're referring to is the discovery rule which is an exception to the statue of limitations, just like an incident with a minor which is another exception. The statue of limitations, discovery rules, and qualifications of minors vary by state. 

 

2 hours ago, PA-C said:

Thank you for sharing your understanding of it. The insurance industry is such a convoluted mess. Thankfully after discussion/contract negotiation my new employer is entertaining the idea of adding prior acts/nose for my policy with them; they are looking into cost and are going to let me know. I’m keeping my fingers crossed that this will all work out so I can avoid the personal expense and hassle.

The statute of limitations for malpractice in my state is 2 years from the date of discovery, but no more than 4 years from the date the treatment occurred, regardless of the discovery date.

Children under 18 have up to 8 years from the date of the treatment that caused injury, but must file no later than their 22nd birthday. 

Sure, no problem. Glad to hear they're entertaining the idea of additional coverage for you. 

 

Edited August 1, 2020 by SedRate

[SedRate]

This website discussed specific instances: https://www.nolo.com/legal-encyclopedia/state-state-medical-malpractice-statute-limitations

Interestingly, despite the statue of limitations started at age 18 for minors in New York, apparently the discovery rule exception for minors has more to it: claim cannot be made more than 10 years from date of incident or discovery, regardless of age.

North Carolina is confusing: statue is 3 years, discovery is 1 year, but no patient can sue after 4 years except in the event of a retained foreign body (e.g., surgical instrument) which can only be claimed if no later than 10 years from date of incident, in which case the patient has 1 year from discovery to claim. Lol

California has a 3-year statue and 1-year discovery, whichever comes first, with the exception of a retained foreign body (e.g., surgical instrument) which has no deadline. 

In Montana, they have a 3-year statue. No lawsuit can be filed after 5 years whatsoever except if the provider knew of the malpractice but didn't disclose it to the patient, then there is no statue. 

Edited August 1, 2020 by SedRate

[PA-C]

Figured I would post an update...

My new employer was not able to add tail/nose for me, “due to legal reasons.” However, they then offered me a sign on bonus to try to offset the cost of securing coverage on my own.

I spoke with a representative from the CM&F group endorsed by AAPA. Tail coverage alone would have been 8000-9000 a year. A full 1 million/3 million claims made (convertible to occurrence after 3 years) malpractice policy with prior acts is 4000/year. I am going to go with the full policy option and may continue to keep it active even after the funds from my sign on bonus run out. If I keep it active through my career I will never have to worry about whether or not an employer is covering my tail if I want to leave and look for a new opportunity. I will also have my own legal team working directly for me if (god forbid) a lawsuit ever happens. I believe I can also use that 4000 as a tax write off.

[ventana]

please shop around for policies

 

CMF is one of the most expensive out there - I was quoted 6500 from them and settled on a great company at around 2000 - and others have too

[PA-C]

2 minutes ago, ventana said:

please shop around for policies

 

CMF is one of the most expensive out there - I was quoted 6500 from them and settled on a great company at around 2000 - and others have too

Good to know! What company do you use if you don’t mind me asking?

[ventana]

On 9/4/2020 at 2:41 PM, PA-C said:

Good to know! What company do you use if you don’t mind me asking?

brexti, merceir, proliability 

[PA-C]

On 9/5/2020 at 2:02 PM, ventana said:

brexti, merceir, proliability 

Thanks!

I contacted Berxi; they won't insure me because in addition to medical dermatology I also perform cosmetic injectables (only maybe 10% of my appointments are cosmetic, but they don't care).

I also contacted Proliability by Mercer and they told me they only offer occurrence policies W/OUT prior acts for PAs, so that doesn't work for me. (Interestingly, their occurrence quote was a few hundred more than CM&F's occurrence quote that DOES include prior acts).

I have a couple other quotes pending and will hopefully be able to make a final decision soon. Getting these quotes has proven to be a major PIA.