Eniko1991 Posted August 18, 2020 Share Posted August 18, 2020 Wondering if anyone had advise -- I have a job offer that is great besides malpractice is claims made and APPs are responsible for acquiring their own tail coverage once they leave, this is "non-negotiable." I was wondering if anyone had any advice regarding what to do or experience with similar issues. I may be moving in 1-2 years as well so this might not be a "forever" position. Thanks! 1 Quote Link to comment Share on other sites More sharing options...
Cideous Posted August 18, 2020 Share Posted August 18, 2020 Tails can be hella expensive. Call the CM&F group and ask them what your options are. They are great. I have dealt with them for 20 years. Also, if it is a large group, corporation or hospital they prob have a group plan. Not much you can do with that. I would always buy CM&F's PA "asset guard" to supplement the main policy. You can read about it on their website and also get an insta quote. I think they are in NY so check their hours based on where you are. 2 Quote Link to comment Share on other sites More sharing options...
surgblumm Posted August 19, 2020 Share Posted August 19, 2020 It was so refreshing to see Cideous give you the best answer in the land. New PAs are bound to make errors even as some more experienced PAs. There is so much to learn and problems walk into your realm without much fan fare. Malpractice insurance is as important as your stethescope and if there is a policy provided to you, without a tail, the "Asset Guard" by CM&F is an absolute must. 1 Quote Link to comment Share on other sites More sharing options...
Eniko1991 Posted August 26, 2020 Author Share Posted August 26, 2020 Thank you for the responses! Is it better to purchase an occurrence policy (~3K/year) or tail once I leave? Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted August 26, 2020 Moderator Share Posted August 26, 2020 I am with Brexti (CM&F was 2-3 times more expensive) I would consider getting your own policy (after price shopping as there is HUGE price difference) 1m/3m is standard Quote Link to comment Share on other sites More sharing options...
iconic Posted August 27, 2020 Share Posted August 27, 2020 Isn't 100,000 liability too low with CMF Asset Protection policy? Quote Link to comment Share on other sites More sharing options...
Cideous Posted August 27, 2020 Share Posted August 27, 2020 1 hour ago, iconic said: Isn't 100,000 liability too low with CMF Asset Protection policy? So the asset protection is a rider on top of your regular group plan. It stacks on top, but it pays fully for you to have your own attorney defense, not your corporate overlords lawyer. 1 Quote Link to comment Share on other sites More sharing options...
Mayamom Posted August 27, 2020 Share Posted August 27, 2020 Occurrence for 3 k per year? It may start at this price but premium goes up yearly. I remember getting a bill for 6 k. Finally had to cancel the policy. Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted August 27, 2020 Moderator Share Posted August 27, 2020 10 minutes ago, Mayamom said: Occurrence for 3 k per year? It may start at this price but premium goes up yearly. I remember getting a bill for 6 k. Finally had to cancel the policy. been with for a number of years, still about 2-2500 per year search around for price - there is HUGE variability out there and CMF is one of the most expensive Quote Link to comment Share on other sites More sharing options...
surgblumm Posted August 28, 2020 Share Posted August 28, 2020 CM&F is slightly higher for a full Occurrence policy ( the best) but a key policy difference is they do not have a “Hammer Clause”. If CM&F had a hammer clause their pricing would probably be more closely aligned. The “Hammer Clause” removes the PAs ability to fight a claim to judgement. The “Hammer Clause” gives the insurance company the power to settle any claim without consent which saves the insurance company money on further defense costs. Why is this important to you as the purchaser of such an important insurance? If you allow a company to make your claims decision for you the outcome can be an NPI history judgement that can make you a poor risk and unemployable. I have seen this happen over the years . One of my friend's father was a co-owner and on the board of PRI , no longer available , I think, and this is what made them so popular to NYS physicians and at a detriment for PAs in their practice. We also have to remember that there are a number of different policy types which often creates confusion. The CM&F Occurrence policy would be many times more than the Claims Made policy from Berxi. However, the Tail purchased on the back end would be very costly. So it is hard to do an apples to apples comparison without specifically seeing what we are looking at. Of supreme importance is the fact that many malpractice companies stay in existence for a few years and then discontinue their insurance as they leave the business, usually because of bankruptcy whereas CM&F has been in this business for sevent-0ne years and has never discontinued its insurance. 1 Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted August 28, 2020 Moderator Share Posted August 28, 2020 I have an "occurance" policy with no hammer clause I was at $1581/yr for 1m/3m with Bexti I changed to Mercer/proliability and for same 1m/3m occurance I am at $2100 This is excellent insurance for 1/3 the price of most the competition ($6000) it pays to shop around..... Quote Link to comment Share on other sites More sharing options...
NeoTrion Posted August 31, 2020 Share Posted August 31, 2020 Ventana you were exactly right in my case. Mercer was about 1/3rd from that of CM&F for the coverage I was interested in. Anyone have any other places they like? Quote Link to comment Share on other sites More sharing options...
surgblumm Posted October 4, 2020 Share Posted October 4, 2020 I will have an article on this subject which has its genesis in your post. I will be posting it this coming week. Quote Link to comment Share on other sites More sharing options...
kittryn Posted October 29, 2020 Share Posted October 29, 2020 (edited) I've never had a PA job where the practice or hospital didn't provide full malpractice - with tail. I wouldn't take a job that didn't. Sometimes I had to chime in about getting the tail coverage, but I would get it. PAs do so much for practices/hospitals that we should never accept anything less than full coverage, benefits, good salary, etc. Edited October 29, 2020 by kittryn Quote Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted October 29, 2020 Share Posted October 29, 2020 Make sure that you get a copy of the policy declaration page for your own record. Don’t rely on the employer to keep all the information. I have had to explain to multiple employers the difference between occurrence and claims-made. Ugh... Quote Link to comment Share on other sites More sharing options...
surgblumm Posted October 29, 2020 Share Posted October 29, 2020 Kaitlin - most PAs assume that full coverage extends to everything they do and moon lighting too. As has been mentioned, you need to see a copy and first check if it is an Occurrence or Claims made. Huge difference in their meaning. Secondly, if your hospital is in charge of your policy, who are they going to defend first? The hospital, all its entities and physicians. You are last on their list of concerns and would be thrown under the bus for either of the others I mentioned. This is the reality of malpractice insurance. Quote Link to comment Share on other sites More sharing options...
Cideous Posted May 18, 2021 Share Posted May 18, 2021 It's a thing now. Was reading my new job contract and there it was...I am responsible for paying the tail and they will take it out of my last paycheck. Non-negotiable. At this point I really didn't have a choice. So I am going to buy my own 1mil/3mil portable policy. Anything these companies can do to stick it to providers they will. They know they have the upper hand so they can force the "take it or leave it" ultimatum. Frustrating, but it's where we are. Quote Link to comment Share on other sites More sharing options...
CAAdmission Posted May 18, 2021 Share Posted May 18, 2021 Medicine has become a scummy business run by scummy people. The only hope is some kind of large scale revolt by both patients and providers. Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted May 19, 2021 Moderator Share Posted May 19, 2021 People. Read your contracts! refuse to sign any that put tail cost on you. company profits from your labor. Malpractice is required. They should pay. Period. 2 Quote Link to comment Share on other sites More sharing options...
surgblumm Posted May 19, 2021 Share Posted May 19, 2021 This remains the best advice but many of you are so eager to get employment that you throw this advice to the wind. do the math, it's simple and it demonstrates that it is costly. When you get a contract it is better to bring it to an attorney that specializes in this area and get an opinion that IS better than social media. Quote Link to comment Share on other sites More sharing options...
Cideous Posted May 19, 2021 Share Posted May 19, 2021 5 hours ago, surgblumm said: This remains the best advice but many of you are so eager to get employment that you throw this advice to the wind. do the math, it's simple and it demonstrates that it is costly. When you get a contract it is better to bring it to an attorney that specializes in this area and get an opinion that IS better than social media. Bob it took me 6 months to secure employment. I finally had a non-negotiable offer. 10 years ago I had the pick of the litter. Today? Up against a million NP's the contract was non-negotiable. I did request a higher salary (the only thing that was negotiable) in an effort to shore up and pay my tail when the time comes. Also, I am buying my own policy which is an occurrance policy and includes the tail. The job market is awful right now for PA's in many parts of the country and shows no signs of improving. It's easy to recommend getting the perfect contract from a vacuum, but spend 6 months being turned down for not being an NP and it's amazing what you will sacrifice to work. 2 1 Quote Link to comment Share on other sites More sharing options...
surgblumm Posted May 19, 2021 Share Posted May 19, 2021 Thanks for the input. Although I am on a dozen PA networks and manage to keep my finger on the pulse, I am however not in the job search realm. In times past an experienced PA in any specialty had the opportunity to pick and choose, yet today physicians and hospital employers do not seem to be interested in excellence but rather in filling slots and using a person that does not require supervision. I have also noticed a real downtrend in the capabilities and the examination by many providers such as physicians and PAs. I was so disillusioned last week after presenting with a cough of three weeks starting with slight hemoptysis and then changes of color in the sputum but a continuous nagging cough that may have given me a hernia and robbed me of sleep. The PA barely listened to me and then I had to repeat the entire scenario and her exam was ears, throat and anterior chest. What happened to the pulmonary exam? I had to almost demand a CXR because I had infiltrates on Covid five months ago and no x-rays since and after telling her I used all of the OTC cough medicines she offered me Tessalon Pereles which has never done anything for me. I asked for Phenagren with or without codeine and she was unable to prescribe this without asking the system's urgent care physician. I did get the medicine and was cured in five days. I hope that we remain vigilant on exams and do not cut corners so that we may be noticed as competent providers. The only NP I have ever used as an Endocrinology NP and she was better than the physician. We no longer own the turf and need to work at being the clinician at the top of the mountain. FYI, there is going to be a raise in malpractice insurance across the boards but affecting NPs and Nurses as the crop of post-covid litigation starts coming in. There will be a number of insurance companies that will be unable to sustain the losses and will go belly up. Thanks for the update and your posts in general. Regards, Bob 1 Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted May 22, 2021 Moderator Share Posted May 22, 2021 all this and more has driven me back into my own practice if you are in the PCP fields you might consider looking into to GERI field is pretty easy as Medicare is a huge player and rates are not bad for reimbursement and we can direct bill in 2022...... Quote Link to comment Share on other sites More sharing options...
ctPA0307 Posted November 29, 2022 Share Posted November 29, 2022 I'm leaving the PA field forever. I have to pay for my own tail insurance. Currently my employer pays for claim-based malpractice insurance through HPSO. I don't have my own policy. I've read that I should get tail coverage for at least the next 2 years after quitting. Is there anything else I should do or know? Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted December 6, 2022 Moderator Share Posted December 6, 2022 if your contract says that the employer is to provide med mal I would make them pay it even if it took court action Quote Link to comment Share on other sites More sharing options...
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